Chido Mwaturura1, Michael Traeger2, Christopher Lemoh3, Mark Stoove2, Brian Price4, Alison Coelho5, Masha Mikola5, Kathleen E Ryan6, Edwina Wright7. 1. Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, Melbourne, Vic., Australia; and Melbourne Medical School, University of Melbourne, Melbourne, Vic., Australia; and Corresponding author. Email: chido.mwaturura@gmail.com. 2. School of Public Health and Preventative Medicine, Monash University, Melbourne, Vic., Australia; and Burnet Institute, Melbourne, Vic., Australia. 3. Monash Infectious Diseases, Monash Health, Melbourne, Vic., Australia. 4. Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, Melbourne, Vic., Australia. 5. Centre for Culture, Ethnicity & Health, Melbourne, Vic., Australia. 6. Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, Melbourne, Vic., Australia; and Burnet Institute, Melbourne, Vic., Australia. 7. Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, Melbourne, Vic., Australia; and Burnet Institute, Melbourne, Vic., Australia; and Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Vic., Australia.
Abstract
Background The aim of this review is to explore acceptability, barriers, and facilitators to PrEP use among African migrants in high-income countries. METHODS: A systematic review was conducted to explore reasons that contribute to low PrEP uptake in this population. Three online databases, abstracts from key conferences and reference lists of relevant studies articles published between the 2 July 2018 and 3 March 2019 were searched. Narrative synthesis was performed on quantitative data and thematic synthesis was performed on qualitative data. RESULTS: Of 1779 titles retrieved, two cross-sectional studies (United States (US) (n = 1), United Kingdom (UK) (n = 1)) and six qualitative studies (US (n = 2), UK (n = 3), Australia (n = 1)) met inclusion criteria. PrEP acceptability was reported in one cross-sectional article and two qualitative articles. Cross-sectional studies measured acceptability and willingness to use PrEP; in one study, 46% of African migrant men found PrEP use acceptable, and following PrEP education, another study categorised 60% of participants as willing to use PrEP if it were cost-free. Qualitative studies reported mixed acceptability, with higher acceptability reported for serodiscordant couples. Barriers and facilitators to PrEP use were coded into five themes: cultural aspects of stigma; knowledge gap in health literacy; risks unrelated to HIV transmission; practical considerations for PrEP use; and the impact of PrEP use on serodiscordant couples. CONCLUSIONS: Several common barriers to PrEP use, including stigma, health literacy and risk perception and cost, were identified. Findings were limited by there being no published data on uptake. Additional work is needed to understand PrEP acceptability and uptake among African migrants.
Background The aim of this review is to explore acceptability, barriers, and facilitators to PrEP use among African migrants in high-income countries. METHODS: A systematic review was conducted to explore reasons that contribute to low PrEP uptake in this population. Three online databases, abstracts from key conferences and reference lists of relevant studies articles published between the 2 July 2018 and 3 March 2019 were searched. Narrative synthesis was performed on quantitative data and thematic synthesis was performed on qualitative data. RESULTS: Of 1779 titles retrieved, two cross-sectional studies (United States (US) (n = 1), United Kingdom (UK) (n = 1)) and six qualitative studies (US (n = 2), UK (n = 3), Australia (n = 1)) met inclusion criteria. PrEP acceptability was reported in one cross-sectional article and two qualitative articles. Cross-sectional studies measured acceptability and willingness to use PrEP; in one study, 46% of African migrant men found PrEP use acceptable, and following PrEP education, another study categorised 60% of participants as willing to use PrEP if it were cost-free. Qualitative studies reported mixed acceptability, with higher acceptability reported for serodiscordant couples. Barriers and facilitators to PrEP use were coded into five themes: cultural aspects of stigma; knowledge gap in health literacy; risks unrelated to HIV transmission; practical considerations for PrEP use; and the impact of PrEP use on serodiscordant couples. CONCLUSIONS: Several common barriers to PrEP use, including stigma, health literacy and risk perception and cost, were identified. Findings were limited by there being no published data on uptake. Additional work is needed to understand PrEP acceptability and uptake among African migrants.
Authors: Gloria Aidoo-Frimpong; Heather Orom; Kafuli Agbemenu; R Lorraine Collins; Gene D Morse; LaRon E Nelson Journal: AIDS Patient Care STDS Date: 2021-12-15 Impact factor: 5.944
Authors: Susanne Hempel; Laura Ferguson; Maria Bolshakova; Sachi Yagyu; Ning Fu; Aneesa Motala; Sofia Gruskin Journal: BMJ Open Date: 2021-12-09 Impact factor: 3.006
Authors: Budiadi Sudarto; Eric P F Chow; Nicholas Medland; Christopher K Fairley; Edwina J Wright; Jude Armishaw; Brian Price; Tiffany R Phillips; Jason J Ong Journal: Front Public Health Date: 2022-08-19