{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:59:11Z","timestamp":1790740751117,"version":"4.1.0"},"reference-count":88,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>HIV pre\u2010exposure prophylaxis (PrEP) delivery in the UK is inequitable; over 95% of PrEP users were men who have sex with men (MSM) despite making up less than 50% of new HIV diagnoses. We conducted a systematic review to identify modifiable barriers and facilitators to PrEP delivery in the UK among underserved populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched bibliographic\/conference databases using the terms HIV, PrEP, barriers, facilitators, underserved populations, and UK. Modifiable factors were mapped along the PrEP Care Continuum (PCC) to identify targets for interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 44 studies were eligible: 29 quantitative, 12 qualitative and three mixed\u2010methods studies. Over half (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924 [54.5%]) exclusively recruited MSM, whereas 11 were in mixed populations (all included MSM as a sub\u2010population) and the other nine were in other underserved populations (gender and ethnicity minorities, women, and people who inject drugs). Of the 15 modifiable factors identified, two\u2010thirds were at the PrEP contemplation and PrEParation steps of the PCC. The most reported barriers were lack of PrEP awareness (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916), knowledge (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919), willingness (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916), and access to a PrEP provider (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916), whereas the more reported facilitators were prior HIV testing (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), agency and self\u2010care (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098). All but three identified factors were at the patient rather than provider or structural level.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This review highlights that the bulk of the scientific literature focuses on MSM and on patient\u2010level factors. Future research needs to ensure underserved populations are included and prioritized (e.g. ethnicity and gender minorities, people who inject drugs) and provider and structural factors are investigated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.13492","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T08:44:26Z","timestamp":1681980266000},"page":"893-913","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Barriers and facilitators to\n                    <scp>HIV Pre\u2010Exposure<\/scp>\n                    Prophylaxis (\n                    <scp>PrEP<\/scp>\n                    ) in Specialist Sexual Health Services in the United Kingdom: A systematic review using the\n                    <scp>PrEP<\/scp>\n                    Care Continuum"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2666-0125","authenticated-orcid":false,"given":"Flavien","family":"Coukan","sequence":"first","affiliation":[{"name":"National Institute for Health Research Applied Research Collaboration North West London Chelsea and Westminster Hospital  London UK"},{"name":"Patient Experience Research Centre, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3931-8142","authenticated-orcid":false,"given":"Keitumetse\u2010Kabelo","family":"Murray","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Applied Research Collaboration North West London Chelsea and Westminster Hospital  London UK"},{"name":"Patient Experience Research Centre, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2387-6780","authenticated-orcid":false,"given":"Vasiliki","family":"Papageorgiou","sequence":"additional","affiliation":[{"name":"Patient Experience Research Centre, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0241-7518","authenticated-orcid":false,"given":"Adam","family":"Lound","sequence":"additional","affiliation":[{"name":"Patient Experience Research Centre, School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3020-9916","authenticated-orcid":false,"given":"John","family":"Saunders","sequence":"additional","affiliation":[{"name":"UCL Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health University College London  London UK"},{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division UK Health Security Agency  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8304-7389","authenticated-orcid":false,"given":"Christina","family":"Atchison","sequence":"additional","affiliation":[{"name":"Patient Experience Research Centre, School of Public Health Imperial College London  London UK"},{"name":"National Institute for Health Research Imperial Biomedical Research Centre  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8238-5036","authenticated-orcid":false,"given":"Helen","family":"Ward","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Applied Research Collaboration North West London Chelsea and Westminster Hospital  London UK"},{"name":"Patient Experience Research Centre, School of Public Health Imperial College London  London UK"},{"name":"National Institute for Health Research Imperial Biomedical Research Centre  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,19]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Towards Zero\u2010An action plan towards ending HIV transmission.AIDS and HIV\u2010related deaths in England\u20102022 to 2025. 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