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Evaluating equity reporting within systematic reviews of pre-exposure prophylaxis (PrEP)
Bethany Paris1, Kelsi Batioja2, Vanessa Lin2
1Oklahoma State University College of Osteopathic Medicine, Tulsa, Oklahoma, USA bparis@okstate.edu.
Sexually Transmitted Infections
|January 8, 2025
Summary
Systematic reviews on HIV pre-exposure prophylaxis (PrEP) often overlook key health equity criteria. Improving reporting on factors like race and socioeconomic status can enhance PrEP access and HIV prevention strategies.
Area of Science:
- Public Health
- Epidemiology
- Health Equity Research
Background:
- HIV pre-exposure prophylaxis (PrEP) is crucial for reducing HIV transmission.
- Health equity is a significant concern due to HIV's disproportionate impact on minority communities.
- Assessing equity reporting in systematic reviews of PrEP is essential for understanding access barriers.
Purpose of the Study:
- To evaluate the reporting of health equity domains in systematic reviews and meta-analyses (SRMAs) of pre-exposure prophylaxis (PrEP).
- To utilize the PROGRESS Plus framework to assess the comprehensiveness of equity reporting in PrEP research.
- To identify gaps in reporting that may hinder PrEP utilization and inform improved HIV prevention strategies.
Main Methods:
- Conducted a systematic literature search across PubMed, Embase, and Cochrane databases for SRMAs on PrEP usage.
- Applied the PROGRESS Plus framework to extract data on equity domains: place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, social capital, age, and disability.
- Analyzed 36 selected SRMAs for the inclusion and reporting of these equity domains and subgroup analyses.
Main Results:
- Of 36 SRMAs, only 5.6% reported adherence to an equity framework; 66.7% were conducted in the USA.
- Place of residence and gender/sex were most frequently reported (34/36 studies), followed by age (83.3%) and race/ethnicity (66.7%).
- Religion (0%) and disability (2.8%) were least reported; 52.78% of SRMAs did not conduct subgroup analyses for equity domains.
Conclusions:
- SRMs on HIV PrEP commonly report on gender/sex and age but frequently overlook other critical equity criteria.
- Enhanced reporting of PROGRESS Plus items in PrEP SRMAs is necessary to address utilization barriers.
- Improving equity reporting can significantly enhance the effectiveness of HIV prevention strategies and reduce health disparities.
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