Assessing the Landscape for PrEP Provisions in Prisons: A Systematic Review

Area of Science:

• Public Health
• Infectious Disease Prevention
• Criminal Justice Health

Background:

• The incarcerated population faces a disproportionately high risk of HIV infection.
• Pre-exposure prophylaxis (PrEP) is a highly effective biomedical HIV prevention strategy.
• Understanding PrEP awareness and uptake barriers within correctional facilities is critical.

Purpose of the Study:

• To systematically review awareness and willingness for PrEP use among incarcerated individuals.
• To identify factors influencing PrEP uptake and adherence within the prison complex.

Main Methods:

• Systematic literature search of MEDLINE (OVID), EMBASE, and Scopus.
• Inclusion of qualitative or quantitative studies on incarcerated populations.
• Narrative synthesis of findings related to PrEP knowledge, willingness, and influencing factors.

Main Results:

• Incarcerated individuals exhibit very low knowledge of PrEP.
• Brief introductions to PrEP foster favorable attitudes and willingness to use it.
• Key barriers include low HIV risk perception, stigma, restrictive jail policies, health prioritization, logistical issues (appointments, transport), mental health challenges, substance misuse, and post-release financial constraints.

Conclusions:

• PrEP is a vital HIV prevention tool for the incarcerated population.
• Overcoming structural and social obstacles is imperative for sustained PrEP adherence and effectiveness.