Equity considerations in outcome measures of the HIV pre-exposure prophylaxis care continuum in high-income countries: a systematic review protocol
Open Access
- 4 February 2021
- Vol. 11 (2), e040701
- https://doi.org/10.1136/bmjopen-2020-040701
Abstract
Introduction HIV pre-exposure prophylaxis (PrEP) is an effective intervention to reduce acquisition of HIV. PrEP provision has increased in recent years, however, it is not known whether PrEP implementation has been equitably implemented across all risk groups, particularly groups experiencing high levels of health inequity. A PrEP care continuum (PCC) has been proposed to evaluate the success of PrEP implementation programmes, but the extent to which health equity characteristics are currently taken into account in the PCC has not been described. The objectives of this proposed systematic review are to (i) identify and collate outcome measure definitions for the main stages of the PCC (awareness, acceptability, uptake, adherence and retention), (ii) describe how equity characteristics are considered in outcome definitions of the PCC and (iii) describe data sources for capturing equity characteristics. Methods and analysis Quantitative studies published between 1 January 2012 and 3 March 2020 will be included. Five databases (MEDLINE, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts) will be searched to identify English language publications that include an outcome measure definition of at least one of the five main stages of the PCC. Risk of bias will be assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Data on outcome measure definitions and equity characteristics will be extracted. Results will be presented in a narrative synthesis and all findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Ethics and dissemination Ethical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete. The review findings will have relevance to healthcare professionals, policymakers and commissioners in informing how to best evaluate PrEP implementation programmes and inform new implementation strategies for vulnerable and less advantaged populations. PROSPERO registration number CRD42020169779.Funding Information
- Medical Research Council (MR/N013867/1)
- National Institute for Health Research (NIHR200911)
This publication has 24 references indexed in Scilit:
- Access to HIV/AIDS care: a systematic review of socio-cultural determinants in low and high income countriesBMC Health Services Research, 2013
- A pandemic of the poor: Social disadvantage and the U.S. HIV epidemic.American Psychologist, 2013
- PRISMA-Equity 2012 Extension: Reporting Guidelines for Systematic Reviews with a Focus on Health EquityPLoS Medicine, 2012
- Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and WomenThe New England Journal of Medicine, 2012
- Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with MenThe New England Journal of Medicine, 2010
- Closing the gap in a generation: health equity through action on the social determinants of healthThe Lancet, 2008
- Church ladies, good girls, and locas: Stigma and the intersection of gender, ethnicity, mental illness, and sexuality in relation to HIV riskSocial Science & Medicine (1982), 2008
- Safe Living: The Impact of Unstable Housing Conditions on HIV Risk Reduction Among Female Drug UsersAIDS and Behavior, 2007
- Road traffic crashes: operationalizing equity in the context of health sector reformInjury Control and Safety Promotion, 2003