Barriers and facilitators to HIV pre-exposure prophylaxis for cisgender and transgender women in the UK.


Journal

The lancet. HIV
ISSN: 2352-3018
Titre abrégé: Lancet HIV
Pays: Netherlands
ID NLM: 101645355

Informations de publication

Date de publication:
Jul 2023
Historique:
received: 03 10 2022
revised: 24 01 2023
accepted: 05 04 2023
medline: 10 7 2023
pubmed: 5 6 2023
entrez: 4 6 2023
Statut: ppublish

Résumé

Uptake of oral HIV pre-exposure prophylaxis (PrEP) among cisgender and transgender women in the UK has been low. In this Review, we explore the barriers and facilitators to PrEP access for these groups, with a focus on health equity. We included 20 studies, including seven abstracts presented at conferences. The study samples were disparate, with minimal overlap between papers. We identified barriers at the individual, interpersonal, and structural levels, including poor awareness and acceptability; stigma, race, and ethnicity; restricted access to PrEP; and exclusion from clinical trials. We found hidden subpopulations of women who could potentially benefit from PrEP, of whom little is known about their PrEP knowledge, preferences, and access due to a lack of UK research. These subpopulations include non-Black African women, transgender women, sex workers, migrant women, women experiencing intimate partner violence, incarcerated women, and women who inject drugs. We highlight opportunities to address these obstacles. Research on the use of PrEP by women in the UK is scarce, and existing research has poor granularity. Without a better understanding of the needs and preferences of the full spectrum of women who could benefit from PrEP, the UK will not reach zero transmissions by 2030.

Identifiants

pubmed: 37271160
pii: S2352-3018(23)00080-2
doi: 10.1016/S2352-3018(23)00080-2
pii:
doi:

Substances chimiques

Anti-HIV Agents 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e472-e481

Informations de copyright

Copyright © 2023 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of interests CO has received honoraria for advisory boards, lectureships, and travel sponsorships from Janssen, Gilead, ViiV Healthcare, and MSD, and research grants from Janssen, Gilead, ViiV Healthcare, MSD, and AstraZeneca. VA has received grants or contracts from the National Institute for Health Research and Barts Charity, and payment or honoraria from Gilead, ViiV Healthcare, MSD, and Janssen. VA is on the board of NAZ and is chair of the National Audit Group of the British Association for Sexual Health and HIV. All other authors declare no competing interests.

Auteurs

Isabelle Whelan (I)

SHARE Collaborative, Queen Mary University of London, London, UK; Barts Health NHS Trust, London, UK. Electronic address: isabelle.whelan@nhs.net.

Sophie Strachan (S)

Sophia Forum, London, UK.

Vanessa Apea (V)

SHARE Collaborative, Queen Mary University of London, London, UK; Wolfson Institute of Population Health, Queen Mary University of London, London, UK; Barts Health NHS Trust, London, UK.

Chloe Orkin (C)

Department of Infection and Immunity, Blizard Institute, Queen Mary University of London, London, UK; SHARE Collaborative, Queen Mary University of London, London, UK; Barts Health NHS Trust, London, UK.

Sara Paparini (S)

SHARE Collaborative, Queen Mary University of London, London, UK; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.

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Classifications MeSH