OBJECTIVES : Men aged 23-35 are a key component of the HIV transmission cycle, but not much is known about them. This review identifies gaps in knowledge about men aged 23-35 living in Sub-Saharan Africa (SSA), including features relevant to viral transmission.

METHODS : Using the PICOS model, multiple databases were searched for papers published from 2014-July 2019 that addressed HIV among men aged 23-35 in SSA. Metanalyses were conducted including forest plots construction, calculation of pooled rates, and subgroup analysis when applicable.

RESULTS : 127 data sources met the inclusion criteria for review, including 98 full-text publications and 31 grey literature sources. Prevalence of HIV infection among men aged 23-35 in SSA is 8.5%, and varies by region (range: 2.3% in West Africa-12.7% in Southern Africa). HIV incidence using countrywide data is 0.9/100 person-years for men in SSA. Risk of HIV infection is higher among men whose work requires interpersonal contacts, travels and being away from families. Nearly half (43%) of HIV-infected men aged 23-35 are unemployed and 76% have a primary education only. 63% of men aged 25-29 and 46% of men aged 30-35 were unaware of their HIV status, and 39.3% have HIV-negative partners. A high percentage of HIV-infected men admitted to risky sexual behaviours such as multiple partnerships or lack of condom use. Only 26.4% of all HIV-positive men aged 23-35 (regardless of awareness) receive treatment. Limitations include overall limited data on HIV-infected men in this age group in SSA and diverse methodologies and definitions across studies.

CONCLUSIONS : Low awareness of HIV status and limited knowledge of the disease among men aged 23-35 in SSA increase risk of transmission and limit chances for positive health outcomes. Results emphasize the urgent need for popularization of testing and prophylactic practices among men in this age group in SSA.