Acceptability and feasibility of HIV pre-exposure prophylaxis (PrEP) in Southeast Asia: A scoping review

The availability of HIV pre-exposure prophylaxis (PrEP) in Southeast Asia remains limited compared to regions like Western Europe or North America. Additionally, little is known about how key populations in Southeast Asia perceive the use of PrEP as a prevention tool for HIV. This scoping review aims to provide an overview of the literature on the acceptability and feasibility of HIV PrEP programs in Southeast Asia.

We conducted a systematic search using nine electronic databases, gray literature searches, and hand searches of references in included full-text articles. Following PRISMA guidelines for scoping reviews, we focused on original research articles published in English from July 2012 to December 2022. A narrative synthesis was used to summarize the findings.

We identified 8,871 articles through the database search, removed 1,094 duplicates, and excluded 7,745 articles after title and abstract screening. Over 28 articles met the inclusion criteria. The use of PrEP was found to be highly acceptable, with participants showing a willingness to use and pay for it, moderate usage rates, convenience, and preference over other prevention methods. It was also considered highly feasible due to its effectiveness and successful program implementation. However, barriers included risk compensation, concerns about side effects, the burden of daily pill administration, and, most commonly noted in studies, cost.

HIV PrEP has been shown to be both acceptable and feasible. The necessity for direct efforts to expand PrEP access in Southeast Asia and address barriers to its uptake and adherence underscores the importance of ongoing monitoring and implementation.