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

This systematic review aims to review awareness and willingness for PrEP use in the prison complex and the factors influencing PrEP uptake among people incarcerated in state or federal prisons. We searched MEDLINE (OVID), EMBASE, and Scopus for relevant articles. Qualitative or quantitative studies focusing on incarcerated population, and outcome measures such as knowledge, willingness, or influencing factors for PrEP uptake were included. A narrative method was used to summarise the findings. Inmates' knowledge of PrEP was very low. Inmates who were briefly introduced to PrEP showed a favourable attitude and willingness toward it. However, low-risk perception of HIV, fear of stigma, jail policies, low priority to health overall, appointment issues, transportation problems, depression, substance misuse, and budgetary limitations after release were perceived as barriers to its uptake and continuation. PrEP is a much-needed HIV prevention strategy for the incarcerated population. However, removing the structural and social obstacles to sustained adherence is imperative.