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A Systematic Literature Review on Pre-exposure Prophylaxis as a Strategy for HIV Risk Reduction in the Middle East
Mas Chaponda1, Ahmed A AlHammadi2,3, Ali Alsaeed4
1Infectious Department, Communicable Diseases Center, Qatar University, Doha, QAT.
Cureus
|April 21, 2025
Summary
Pre-exposure prophylaxis (PrEP) shows promise for HIV prevention in the Middle East and North Africa (MENA) region. However, challenges like stigma and cost hinder its widespread use, requiring tailored strategies for effective implementation.
Area of Science:
- Public Health
- Infectious Disease Prevention
- Global Health
Background:
- Pre-exposure prophylaxis (PrEP) is a vital biomedical intervention for HIV prevention globally.
- Limited data exists on PrEP awareness, utilization, and effectiveness in the Middle East and North Africa (MENA) region.
- Cultural, social, and healthcare system factors present unique implementation challenges in MENA.
Purpose of the Study:
- To evaluate the value and effectiveness of PrEP in the MENA region.
- To identify barriers to PrEP implementation and utilization.
- To develop targeted recommendations for expanding PrEP programs in MENA.
Main Methods:
- Systematic literature review of PubMed, Scopus, and Web of Science databases up to October 2024.
- Inclusion of peer-reviewed clinical research on PrEP use in MENA high-risk populations.
- Screening by two independent reviewers using Rayyan software.
Main Results:
- Varying levels of PrEP awareness and willingness to use were observed across MENA, with higher interest among men who have sex with men (MSM).
- PrEP demonstrated effectiveness for HIV prevention when used correctly, but faced barriers including cost, stigma, and accessibility.
- Lack of comprehensive clinical studies in MENA limits definitive proof of efficacy, though pilot programs show promise.
Conclusions:
- Successful PrEP implementation in MENA necessitates addressing financial accessibility, awareness, stigma, and healthcare system integration.
- Tailored interventions are crucial for at-risk populations to enhance adherence and retention.
- Morocco's pilot program offers a model, but broader adoption requires improved accessibility and affordability.
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