Willingness to Use Prep Among Prep Naïve Men Who Have Sex with Men: A Meta-Analysis and Systematic Review

Author(s)

Goswami S1, Gannon T2, Nasruddin S1, Mancuso B2, Kang M3, Bentley J4, Bhattacharya K4, Barnard M5
1Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, MS, USA, 2University of Mississippi School of Pharmacy, University, MS, USA, 3Department of Health, Exercise Science, and Recreation Management, University of Mississippi, University, MS, USA, 4Department of Pharmacy Administration, University of Mississippi School of Pharmacy, Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, MS, USA, 5Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, University, MS, USA

OBJECTIVES: This study aimed to measure the pooled estimate of willingness to use HIV pre-exposure prophylaxis (PrEP) (WTUP) among PrEP-naïve US-based men who have sex with men (MSM). This study also reviewed and categorized factors reported in these studies to be associated with WTUP among PrEP-naïve MSM, according to individual, interpersonal, societal, and public policy factors from the social-ecological model.

METHODS: PubMed, Embase, Web of Science, CINAHL, and PsycINFO were searched. The search strategy contained MeSH terms for HIV, PrEP, willingness, and interest. Articles were included if they were published between January 2005–May 2022, reported quantitative data on WTUP among PrEP-naïve US-based MSM, and were available as full text and in English. Studies were excluded if they did not report original data (e.g., systematic reviews, meta-analyses, economic modeling). Meta-analysis was conducted to assess the pooled effect size of WTUP prevalence using a random effects model and heterogeneity in the pooled estimate was assessed. Factors affecting WTUP were systematically reviewed and categorized according to the social-ecological model.

RESULTS: Fifteen studies were included based on the inclusion and exclusion criteria, contributing effect sizes relating to WTUP and twelve studies reporting factors associated with WTUP. Meta-analysis revealed a moderate pooled prevalence proportion for WTUP of 0.58 (95% CI: 0.54-0.61) (or 58 out of 100) among PrEP-naïve MSM. High inter-study heterogeneity (Q=548.104, df=19, p<0.001, I2=96.53, t2=0.091) was observed. The prediction interval of the overall estimate was 0.42–0.72. The majority of the studies reported individual (n=12) and relatively fewer studies assessed interpersonal level factors (n=5), public policy (n=4) or societal (n=1) factors associated with WTUP.

CONCLUSIONS: Understanding the prevalence of WTUP in the US, as well as the factors affecting WTUP among PrEP-naïve MSM, will help in informing the design of targeted interventions and policies aimed at improving willingness and ultimately uptake of PrEP.

Conference/Value in Health Info

2023-05, ISPOR 2023, Boston, MA, USA

Value in Health, Volume 26, Issue 6, S2 (June 2023)

Code

EPH114

Topic

Patient-Centered Research, Study Approaches

Topic Subcategory

Literature Review & Synthesis, Meta-Analysis & Indirect Comparisons, Patient Behavior and Incentives

Disease

Drugs

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