Skip to main content

Advertisement

Log in

A Global Estimate of the Acceptability of Pre-exposure Prophylaxis for HIV Among Men Who have Sex with Men: A Systematic Review and Meta-analysis

AIDS and Behavior Aims and scope Submit manuscript

Abstract

Pre-exposure prophylaxis (PrEP) is a new biomedical intervention for HIV prevention. This study systematically reviews the acceptability of PrEP among men who have sex with men (MSM) worldwide. We searched major English databases to identify English-language articles published between July 2007 and July 2016, which reported the acceptability of PrEP and associated population characteristics. Meta-analysis was conducted to estimate a pooled acceptability, and meta-regression and subgroup analysis were used to analyse heterogeneities. The estimated acceptance from included sixty-eight articles was 57.8% (95% confidence internal 52.4–63.1%). MSM who were younger (4/5 studies, range of adjusted odds ratio (aOR) = 1.39–3.47), better educated (aOR = 1.49–7.70), wealthier (aOR = 1.31–13.03) and previously aware of PrEP (aOR = 1.33–3.30) showed significantly higher acceptance. Male sex workers (84.0% [26.3–98.7%] were more likely to accept PrEP than general MSM. Self-perceived low efficacy, concern about side effects, adherence, affordability, and stigma were main barriers. This review identifies a moderate acceptability of PrEP in MSM. Efficacy, perception of HIV risk and experienced stigma determine its acceptance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Joint United Nations Programme on HIV/AIDS. Global AIDS update, Geneva; 2016.

  2. Joint United Nations Programme on HIV/AIDS. The gap report, Geneva; 2014.

  3. Chris B, Andrea LW, Damian W, Benjamin J, Frangiscos S, Stefan DB. The global HIV epidemics in men who have sex with men. Washington, DC: The International Bank for Reconstruction and Development; 2011.

    Google Scholar 

  4. Ncaids N, China CDC. Update on the AIDS/STD epidemic in China and main response in control and prevention in December, 2015. China J AIDS STD. 2016;22(2):69.

    Google Scholar 

  5. CDC. HIV among gay and bisexual men. 2015. https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/cdc-msm-508.pdf.

  6. Charania MR, Crepaz N, Guenther-Gray C, Henny K, Liau A, Willis LA, et al. Efficacy of structural-level condom distribution interventions: a meta-analysis of U.S. and international studies, 1998-2007. AIDS Behav. 2011;15(7):1283–97.

    Article  PubMed  Google Scholar 

  7. Nugroho A, Erasmus V, Zomer TP, Wu Q, Richardus JH. Behavioral interventions to reduce HIV risk behavior for MSM and transwomen in Southeast Asia: a systematic review. AIDS Care. 2017;29(1):98–104.

    Article  PubMed  Google Scholar 

  8. Templeton DJ, Millett GA, Grulich AE. Male circumcision to reduce the risk of HIV and sexually transmitted infections among men who have sex with men. Curr Opin Infect Dis. 2010;23(1):45–52.

    Article  PubMed  Google Scholar 

  9. Joint United Nations Programme on HIV/AIDS. Prevention gap port, Geneva; 2016.

  10. Ford N, Irvine C, Shubber Z, Baggaley R, Beanland R, Vitoria M, et al. Adherence to HIV postexposure prophylaxis: a systematic review and meta-analysis. AIDS. 2014;28(18):2721–7.

    Article  PubMed  Google Scholar 

  11. World Health Organization. Guidance on pre-exposure oral prophylaxis (PrEP) for serodiscordant couples, men and transgender women who have sex with men at high risk of HIV: recommendations for use in the context of demonstration projects, Geneva; 2012.

  12. World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV, Geneva; 2015.

  13. Beyrer CBS, Collins C, Richardson ET, Sullivan PS, Sanchez J, Trapence G, et al. The global response to HIV in men who have sex with men. Lancet. 2016;388(10040):198–206.

    Article  PubMed  Google Scholar 

  14. Prevention GAfH. Media coverage of PrEP. 2016. http://www.prepwatch.org/about-prep/media-coverage-of-prep/.

  15. Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, et al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1 infection (PROUD): effectiveness results from the pilot phase of a pragmatic open-label randomised trial. Lancet. 2016;387(10013):53–60.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Liu A, Cohen S, Vittinghoff E. Adherence, sexual behavior and HIV/STI incidence among men who have sex with men (MSM) and transgender women (TGW) in the US PrEP demonstration (Demo) project. In: 8th International AIDS Society Conference on HIV Pathogenesis, Treatment, and Prevention; 2015.

  18. Ding Y, Yan H, Ning Z, Cai X, Yang Y, Pan R, et al. Low willingness and actual uptake of pre-exposure prophylaxis for HIV-1 prevention among men who have sex with men in Shanghai, China. Biosci Trends. 2016;10(2):113–9.

    Article  PubMed  Google Scholar 

  19. Zhou F, Gao L, Li S, Li D, Zhang L, Fan W, et al. Willingness to accept HIV pre-exposure prophylaxis among Chinese men who have sex with men. PLoS ONE. 2012;7(3):e32329.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Underhill K, Morrow KM, Colleran C, Holcomb R, Calabrese SK, Operario D, et al. A qualitative study of medical mistrust, perceived discrimination, and risk behavior disclosure to clinicians by U.S. male sex workers and other men who have sex with men: implications for biomedical HIV prevention. J Urban Health. 2015;92(4):667–86.

    Article  PubMed  PubMed Central  Google Scholar 

  21. The Organisation for Economic Co-operation and Development: Members and partners. October 1, 2016. http://www.oecd.org/about/membersandpartners/.

  22. Please Stop Using PrEP to Abandon Condoms. 2016. http://www.huffingtonpost.com/matthew-terrell/please-stop-using-prep-to_b_8715938.html.

  23. Adam BD, Husbands W, Murray J, Maxwell J. AIDS optimism, condom fatigue, or self-esteem? Explaining unsafe sex among gay and bisexual men. J Sex Res. 2005;42(3):238–48.

    Article  PubMed  Google Scholar 

  24. Belza MJ. Risk of HIV infection among male sex workers in Spain. Sex Transm Infect. 2005;81(1):85–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Tun W, de Mello M, Pinho A, Chinaglia M, Diaz J. Sexual risk behaviours and HIV seroprevalence among male sex workers who have sex with men and non-sex workers in Campinas, Brazil. Sex Transm Infect. 2008;84(6):455–7.

    Article  CAS  PubMed  Google Scholar 

  26. Stewart LJ, Closson EF, Holcomb R, Mimiaga MJ. HIV prevention needs among street-based male sex workers in Providence, Rhode Island. Am J Public Health. 2014;104(11):e100–2.

    Article  Google Scholar 

  27. Stefan D, Baral TP, Susanne S, Andrea LW, Thomas EG, Chris B, et al. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13:214–22.

    Article  Google Scholar 

  28. Joint United Nations Programme on HIV/AIDS. Global AIDS response progress reporting 2014, Geneva; 2014.

  29. National Summary Report—India: integrated behavioural and biological assessment, round 2 (2009–2010). 2011.

  30. Oldenburg CE, Le B, Toan T, Thien DD, Huyen HT, Friedman MR, et al. HIV pre-exposure prophylaxis indication and readiness among HIV-uninfected transgender women in Ho Chi Minh City, Vietnam. AIDS Behav. 2016;20:365–70.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Eaton LA, Kalichman S. Risk compensation in HIV prevention: implications for vaccines, microbicides, and other biomedical HIV prevention technologies. Curr HIV/AIDS Rep. 2007;4(4):165–72.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Marcus JL, Glidden DV, Mayer KH, Liu AY, Buchbinder SP, Amico KR, et al. No evidence of sexual risk compensation in the iPrEx trial of daily oral HIV preexposure prophylaxis. PLoS ONE. 2013;8(12):e81997.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Bil JP, Davidovich U, van der Veldt WM, Prins M, de Vries HJ, Sonder GJ, et al. What do Dutch MSM think of preexposure prophylaxis to prevent HIV-infection? A cross-sectional study. AIDS. 2015;29(8):955–64.

    Article  PubMed  Google Scholar 

  34. Young I, Flowers P, McDaid LM. Barriers to uptake and use of pre-exposure prophylaxis (PrEP) among communities most affected by HIV in the UK: findings from a qualitative study in Scotland. BMJ Open. 2014;4(11):e005717.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Nodin N, Carballo-Dieguez A, Ventuneac AM, Balan IC, Remien R. Knowledge and acceptability of alternative HIV prevention bio-medical products among MSM who bareback. AIDS Care. 2008;20(1):106–15.

    Article  CAS  PubMed  Google Scholar 

  36. Holt M, Lea T, Murphy D, Ellard J, Rosengarten M, Kippax S, et al. Willingness to use HIV pre-exposure prophylaxis has declined among australian gay and bisexual men: results from repeated national surveys, 2011-2013. J Acquir Immune Defic Syndr (1999). 2014;67(2):222–6.

    Article  Google Scholar 

  37. Holt M, Murphy DA, Callander D, Ellard J, Rosengarten M, Kippax SC, et al. Willingness to use HIV pre-exposure prophylaxis and the likelihood of decreased condom use are both associated with unprotected anal intercourse and the perceived likelihood of becoming HIV positive among Australian gay and bisexual men. Sex Transm Infect. 2012;88(4):258–63.

    Article  PubMed  Google Scholar 

  38. Hoff CC, Chakravarty D, Bircher AE, Campbell CK, Grisham K, Neilands TB, et al. Attitudes towards PrEP and anticipated condom use among concordant HIV-negative and HIV-discordant male couples. AIDS Patient Care STDs. 2015;29(7):408–17.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Kojima N, Davey DJ, Klausner JD. Pre-exposure prophylaxis for HIV infection and new sexually transmitted infections among men who have sex with men. AIDS. 2016;30(14):2251–2.

    Article  PubMed  Google Scholar 

  40. Cassell MM, Halperin DT, Shelton JD, Stanton D. Risk compensation: the Achilles’ heel of innovations in HIV prevention? BMJ. 2006;332(7541):605–7.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Mugwanya KK, Baeten JM. Safety of oral tenofovir disoproxil fumarate-based pre-exposure prophylaxis for HIV prevention. Expert Opin Drug Saf. 2016;15(2):265–73.

    Article  CAS  PubMed  Google Scholar 

  42. Sineath RC, Finneran C, Sullivan P, Sanchez T, Smith DK, Griensven F, et al. Knowledge of and interest in using preexposure prophylaxis for HIV prevention among men who have sex with men in Thailand. J Int Assoc Provid AIDS Care. 2013;12(4):227–31.

    Article  PubMed  Google Scholar 

  43. Krakower DS, Mimiaga MJ, Rosenberger JG, Novak DS, Mitty JA, White JM, et al. Limited awareness and low immediate uptake of pre-exposure prophylaxis among men who have sex with men using an internet social networking site. PLoS ONE. 2012;7(3):e33119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Wilton J, Kain T, Fowler S, Hart TA, Grennan T, Maxwell J, et al. Use of an HIV-risk screening tool to identify optimal candidates for PrEP scale-up among men who have sex with men in Toronto, Canada: disconnect between objective and subjective HIV risk. J Int AIDS Soc. 2016;19(1):20777.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Zhang Y, Peng B, She Y, Liang H, Peng HB, Qian HZ, et al. Attitudes toward HIV pre-exposure prophylaxis among men who have sex with men in western China. AIDS Patient Care STDs. 2013;27(3):137–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Yang D, Chariyalertsak C, Wongthanee A, Kawichai S, Yotruean K, Saokhieo P, et al. Acceptability of pre-exposure prophylaxis among men who have sex with men and transgender women in Northern Thailand. PLoS ONE. 2013;8(10):e76650.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Young I, Li J, McDaid L. Awareness and willingness to use HIV pre-exposure prophylaxis amongst gay and bisexual men in Scotland: implications for biomedical HIV prevention. PLoS ONE. 2013;8(5):e64038.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Ko NY, Chen BJ, Li CW, Ku WW, Hsu ST. Willingness to self-pay for pre-exposure prophylaxis in men who have sex with men: a National Online Survey in Taiwan. AIDS Educ Prevent. 2016;28(2):128–37.

    Article  Google Scholar 

  49. Jackson T, Huang A, Chen H, Gao X, Zhong X, Zhang Y. Cognitive, psychosocial, and sociodemographic predictors of willingness to use HIV pre-exposure prophylaxis among Chinese men who have sex with men. AIDS Behav. 2012;16(7):1853–61.

    Article  PubMed  Google Scholar 

  50. Mimiaga MJ, Case P, Johnson CV, Safren SA, Mayer KH. Preexposure antiretroviral prophylaxis attitudes in high-risk Boston area men who report having sex with men: limited knowledge and experience but potential for increased utilization after education. J Acquir Immune Defic Syndr. (1999). 2009;50(1):77–83.

    Article  Google Scholar 

  51. Goedel WC, Halkitis PN, Greene RE, Duncan DT. Correlates of awareness of and willingness to use pre-exposure prophylaxis (PrEP) in gay, bisexual, and other men who have sex with men who use geosocial-networking smartphone applications in New York City. AIDS Behav. 2016;20(7):1435–42.

    Article  PubMed  Google Scholar 

  52. Eaton LA, Driffin DD, Smith H, Conway-Washington C, White D, Cherry C. Psychosocial factors related to willingness to use pre-exposure prophylaxis for HIV prevention among Black men who have sex with men attending a community event. Sex Health. 2014;11(3):244–51.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Frankis J, Young I, Flowers P, McDaid L. Who will use pre-exposure prophylaxis (PrEP) and why? Understanding PrEP awareness and acceptability amongst men who have sex with men in the UK—a mixed methods study. PLoS ONE. 2016;11(4):e0151385.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Brooks RA, Landovitz RJ, Regan R, Lee SJ, Allen VC Jr. Perceptions of and intentions to adopt HIV pre-exposure prophylaxis among black men who have sex with men in Los Angeles. Int J STD AIDS. 2015;26(14):1040–8.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Meyers K, Rodriguez K, Moeller RW, Gratch I, Markowitz M, Halkitis PN. High interest in a long-acting injectable formulation of pre-exposure prophylaxis for HIV in young men who have sex with men in NYC: a P18 cohort substudy. PLoS ONE. 2014;9(12):e114700.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Oldenburg CE, Biello KB, Colby D, Closson EF, Nguyen T, Trang NN, et al. Engagement with peer health educators is associated with willingness to use pre-exposure prophylaxis among male sex workers in Ho Chi Minh City, Vietnam. AIDS Patient Care STDs. 2014;28(3):109–12.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Gamarel KE, Golub SA. Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships. Ann Behav Med. 2015;49(2):177–86.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Elsesser SA, Oldenburg CE, Biello KB, Mimiaga MJ, Safren SA, Egan JE, et al. Seasons of risk: anticipated behavior on vacation and interest in episodic antiretroviral pre-exposure prophylaxis (PrEP) among a large national sample of U.S. men who have sex with men (MSM). AIDS Behav. 2016;20(7):1400–7.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Frankis JS, Young I, Lorimer K, Davis M, Flowers P. Towards preparedness for PrEP: PrEP awareness and acceptability among MSM at high risk of HIV transmission who use sociosexual media in four Celtic nations: Scotland, Wales, Northern Ireland and The Republic of Ireland: an online survey. Sex Transm Infect. 2016;92(4):279–85.

    Article  PubMed  Google Scholar 

  60. Hoots BE, Finlayson T, Nerlander L, Paz-Bailey G. Willingness to take, use of, and indications for pre-exposure prophylaxis among men who have sex with men-20 US cities, 2014. Clin Infect Dis. 2016;63(5):672–7.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Lebouche B, Engler K, Machouf N, Lessard D, Thomas R. Predictors of interest in taking pre-exposure prophylaxis among men who have sex with men who used a rapid HIV-testing site in Montreal (Actuel sur Rue). HIV Med. 2016;17(2):152–8.

    Article  CAS  PubMed  Google Scholar 

  62. Leonardi M, Lee E, Tan DH. Awareness of, usage of and willingness to use HIV pre-exposure prophylaxis among men in downtown Toronto, Canada. Int J STD AIDS. 2011;22(12):738–41.

    Article  CAS  PubMed  Google Scholar 

  63. Perez-Figueroa RE, Kapadia F, Barton SC, Eddy JA, Halkitis PN. Acceptability of PrEP uptake among racially/ethnically diverse young men who have sex with men: the P18 study. AIDS Educ Prevent. 2015;27(2):112–25.

    Article  Google Scholar 

  64. Tripathi A, Whiteside YO, Duffus WA. Perceptions and attitudes about preexposure prophylaxis among seronegative partners and the potential of sexual disinhibition. South Med J. 2013;106(10):558–64.

    Article  PubMed  Google Scholar 

  65. Brooks RA, Kaplan RL, Lieber E, Landovitz RJ, Lee SJ, Leibowitz AA. Motivators, concerns, and barriers to adoption of preexposure prophylaxis for HIV prevention among gay and bisexual men in HIV-serodiscordant male relationships. AIDS Care. 2011;23(9):1136–45.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Gredig D, Uggowitzer F, Hassler B, Weber P, Niderost S. Acceptability and willingness to use HIV pre-exposure prophylaxis among HIV-negative men who have sex with men in Switzerland. AIDS Care. 2016;28(Suppl 1):44–7.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Crosby RA, Geter A, DiClemente RJ, Salazar LF. Acceptability of condoms, circumcision and PrEP among young black men who have sex with men: a descriptive study based on effectiveness and cost. Vaccines. 2014;2(1):129–37.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Chakrapani V, Newman PA, Shunmugam M, Mengle S, Varghese J, Nelson R, et al. Acceptability of HIV pre-exposure prophylaxis (PrEP) and implementation challenges among men who have sex with men in India: a qualitative investigation. AIDS Patient Care STDs. 2015;29(10):569–77.

    Article  PubMed  Google Scholar 

  69. Galea JT, Kinsler JJ, Salazar X, Lee SJ, Giron M, Sayles JN, et al. Acceptability of pre-exposure prophylaxis as an HIV prevention strategy: barriers and facilitators to pre-exposure prophylaxis uptake among at-risk Peruvian populations. Int J STD AIDS. 2011;22(5):256–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Galindo GR, Walker JJ, Hazelton P, Lane T, Steward WT, Morin SF, et al. Community member perspectives from transgender women and men who have sex with men on pre-exposure prophylaxis as an HIV prevention strategy: implications for implementation. Implement Sci. 2012;7:116.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Golub SA, Gamarel KE, Rendina HJ, Surace A, Lelutiu-Weinberger CL. From efficacy to effectiveness: facilitators and barriers to PrEP acceptability and motivations for adherence among MSM and transgender women in New York City. AIDS Patient Care STDs. 2013;27(4):248–54.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Smith DK, Toledo L, Smith DJ, Adams MA, Rothenberg R. Attitudes and program preferences of African-American urban young adults about pre-exposure prophylaxis (PrEP). AIDS Educ Prev. 2012;24(5):408–21.

    Article  PubMed  Google Scholar 

  73. Saberi P, Gamarel KE, Neilands TB, Comfort M, Sheon N, Darbes LA, et al. Ambiguity, ambivalence, and apprehensions of taking HIV-1 pre-exposure prophylaxis among male couples in San Francisco: a mixed methods study. PLoS ONE. 2012;7(11):e50061.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Karuga RN, Njenga SN, Mulwa R, Kilonzo N, Bahati P, O’Reilley K, et al. “How I wish this thing was initiated 100 years ago!” willingness to take daily oral pre-exposure prophylaxis among men who have sex with men in Kenya. PLoS ONE. 2016;11(4):e0151716.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Kesler MA, Kaul R, Myers T, Liu J, Loutfy M, Remis RS, et al. Perceived HIV risk, actual sexual HIV risk and willingness to take pre-exposure prophylaxis among men who have sex with men in Toronto, Canada. AIDS Care. 2016;28(11):1378–85.

    Article  PubMed  Google Scholar 

  76. Kubicek K, Arauz-Cuadra C, Kipke MD. Attitudes and perceptions of biomedical HIV prevention methods: voices from young men who have sex with men. Arch Sex Behav. 2015;44(2):487–97.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Van der Elst EM, Mbogua J, Operario D, Mutua G, Kuo C, Mugo P, et al. High acceptability of HIV pre-exposure prophylaxis but challenges in adherence and use: qualitative insights from a phase I trial of intermittent and daily PrEP in at-risk populations in Kenya. AIDS Behav. 2013;17(6):2162–72.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Sevelius JM, Keatley J, Calma N, Arnold E. ‘I am not a man’: trans-specific barriers and facilitators to PrEP acceptability among transgender women. Global Public Health. 2016;11(7–8):1060–75.

    Article  PubMed  Google Scholar 

  79. Marra E, Hankins CA. Perceptions among Dutch men who have sex with men and their willingness to use rectal microbicides and oral pre-exposure prophylaxis to reduce HIV risk—a preliminary study. AIDS Care. 2015;27(12):1493–500.

    Article  PubMed  Google Scholar 

  80. Gilmore HJ, Liu A, Koester KA, Amico KR, McMahan V, Goicochea P, et al. Participant experiences and facilitators and barriers to pill use among men who have sex with men in the iPrEx pre-exposure prophylaxis trial in San Francisco. AIDS Patient Care STDs. 2013;27(10):560–6.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Tangmunkongvorakul A, Chariyalertsak S, Amico KR, Saokhieo P, Wannalak V, Sangangamsakun T, et al. Facilitators and barriers to medication adherence in an HIV prevention study among men who have sex with men in the iPrEx study in Chiang Mai, Thailand. AIDS Care. 2013;25(8):961–7.

    Article  PubMed  Google Scholar 

  82. Garcia J, Parker C, Parker RG, Wilson PA, Philbin M, Hirsch JS. Psychosocial implications of homophobia and HIV stigma in social support networks: insights for high-impact HIV prevention among black men who have sex with men. Health Educ Behav. 2016;43(2):217–25.

    Article  PubMed  Google Scholar 

  83. Golub SA, Gamarel KE, Surace A. Demographic differences in PrEP-related stereotypes: implications for implementation. AIDS Behav. 2015. doi:10.1007/s10461-015-1129-4.

    Google Scholar 

Download references

Acknowledgements

This study was funded by The National Natural Science Foundation of China (81373060); The Six Major Human Resources Project of Jiangsu Province (WSN-015); Preventive Medicine Project of Jiangsu Province (Y2013071); The Science and Technology Program of Nantong City (MS12015125). The author would like to acknowledge the work of the research teams whose publications were included in this review.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Xun Zhuang or Lei Zhang.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplemental Figure S1

Meta-analyses flow chart depicting the number of reports screened and included in the systematic review. Supplementary material 1 (PPTX 43 kb)

Supplemental Figure S2

Funnel plot for publication bias test. Supplementary material 2 (PPTX 82 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Peng, P., Su, S., Fairley, C.K. et al. A Global Estimate of the Acceptability of Pre-exposure Prophylaxis for HIV Among Men Who have Sex with Men: A Systematic Review and Meta-analysis. AIDS Behav 22, 1063–1074 (2018). https://doi.org/10.1007/s10461-017-1675-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-017-1675-z

Keywords

Navigation