AIDS and Behavior

, Volume 22, Issue 4, pp 1063–1074 | Cite as

A Global Estimate of the Acceptability of Pre-exposure Prophylaxis for HIV Among Men Who have Sex with Men: A Systematic Review and Meta-analysis

  • Peng Peng
  • Shu Su
  • Christopher K. Fairley
  • Minjie Chu
  • Shengyang Jiang
  • Xun Zhuang
  • Lei Zhang
Original Paper


Pre-exposure prophylaxis (PrEP) is a new biomedical intervention for HIV prevention. This study systematically reviews the acceptability of PrEP among men who have sex with men (MSM) worldwide. We searched major English databases to identify English-language articles published between July 2007 and July 2016, which reported the acceptability of PrEP and associated population characteristics. Meta-analysis was conducted to estimate a pooled acceptability, and meta-regression and subgroup analysis were used to analyse heterogeneities. The estimated acceptance from included sixty-eight articles was 57.8% (95% confidence internal 52.4–63.1%). MSM who were younger (4/5 studies, range of adjusted odds ratio (aOR) = 1.39–3.47), better educated (aOR = 1.49–7.70), wealthier (aOR = 1.31–13.03) and previously aware of PrEP (aOR = 1.33–3.30) showed significantly higher acceptance. Male sex workers (84.0% [26.3–98.7%] were more likely to accept PrEP than general MSM. Self-perceived low efficacy, concern about side effects, adherence, affordability, and stigma were main barriers. This review identifies a moderate acceptability of PrEP in MSM. Efficacy, perception of HIV risk and experienced stigma determine its acceptance.


Men who have sex with men MSM Pre-exposure prophylaxis PrEP Meta-analysis 



This study was funded by The National Natural Science Foundation of China (81373060); The Six Major Human Resources Project of Jiangsu Province (WSN-015); Preventive Medicine Project of Jiangsu Province (Y2013071); The Science and Technology Program of Nantong City (MS12015125). The author would like to acknowledge the work of the research teams whose publications were included in this review.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10461_2017_1675_MOESM1_ESM.pptx (44 kb)
Supplemental Figure S1 Meta-analyses flow chart depicting the number of reports screened and included in the systematic review. Supplementary material 1 (PPTX 43 kb)
10461_2017_1675_MOESM2_ESM.pptx (82 kb)
Supplemental Figure S2 Funnel plot for publication bias test. Supplementary material 2 (PPTX 82 kb)


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.School of Public HealthNantong UniversityNantongChina
  2. 2.School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneAustralia
  3. 3.Melbourne Sexual Health Centre, Alfred HealthMelbourneAustralia
  4. 4.Central Clinical School, Faculty of Medicine, Nursing and Health ScienceMonash UniversityMelbourneAustralia

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