The Pre-exposure Prophylaxis (PrEP) Care Cascade in People Who Inject Drugs: A Systematic Review
- 1 May 2021
- journal article
- review article
- Published by Springer Science and Business Media LLC in AIDS and Behavior
- Vol. 25 (5), 1490-1506
- https://doi.org/10.1007/s10461-020-02988-x
Abstract
Injection drug use is a key risk factor for the transmission of HIV. Prevention strategies, such as the use of pre-exposure prophylaxis (PrEP), are effective at reducing the risk of HIV transmission in people who inject drugs (PWID). Following PRISMA guidelines, a literature search was conducted to identify the current state of the PrEP care cascade in PWID. Twenty-three articles were evaluated in this systematic review. A decline in engagement throughout the stages of the PrEP care cascade was found. High awareness and willingness to use PrEP was found, yet PrEP uptake was relatively low (0–3%). There is a lack of research on interventions to increase engagement of PrEP across all levels of the care cascade in PWID. Implications from the interventions that have been published provide insight into practice and public policy on efficacious strategies to reduce HIV incidence in PWID. Our findings suggest that more efforts are needed to identify and screen PWID for PrEP eligibility and to link and maintain them with appropriate PrEP care.Keywords
Funding Information
- National Institute of Mental Health (5T32MH074387-14)
- National Institute on Drug Abuse (K24DA051344)
- National Institute on Drug Abuse (K01DA051346)
This publication has 47 references indexed in Scilit:
- Opioid Use Fueling HIV Transmission in an Urban Setting: An Outbreak of HIV Infection Among People Who Inject Drugs—Massachusetts, 2015–2018American Journal of Public Health, 2020
- Comparing Canadian and United States opioid agonist therapy policiesInternational Journal of Drug Policy, 2019
- Global, regional, and country-level coverage of interventions to prevent and manage HIV and hepatitis C among people who inject drugs: a systematic reviewThe Lancet. Global Health, 2017
- Exploring strategies for PrEP adherence and dosing preferences in the context of sexualized recreational drug use among MSM: a qualitative studyAIDS Care, 2017
- Risk Perception, Sexual Behaviors, and PrEP Adherence Among Substance-Using Men Who Have Sex with Men: a Qualitative StudyPrevention Science, 2017
- Differences in Attitudes About HIV Pre-Exposure Prophylaxis Use Among Stimulant Versus Alcohol Using Men Who Have Sex with MenAIDS and Behavior, 2015
- Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trialThe Lancet, 2013
- HIV infection and risk of overdoseAIDS, 2012
- The Urgency Of Providing Comprehensive And Integrated Treatment For Substance Abusers With HIVHealth Affairs, 2011
- HIV Prevalence and Risk Behaviors Among Men Who Have Sex with Men and Inject Drugs in San FranciscoJournal of Urban Health, 2005