Improving outpatient implementation of preexposure prophylaxis in men who have sex with men

J Am Assoc Nurse Pract. 2016 Aug;28(8):446-52. doi: 10.1002/2327-6924.12344. Epub 2016 Jan 27.


Background and purpose: Preexposure prophylaxis (PrEP) has been shown to decrease the transmission of human immunodeficiency virus (HIV) when used in high-risk populations including men who have sex with men. However, despite effectiveness, there is underutilization in the outpatient setting. This review aims to assess the facilitators and barriers to improve outpatient utilization.

Methods: A systematic search of four databases, CINAHL, Ovid, Scopus, and PsychINFO, during March-May of 2015. A total of 22 articles were included for review.

Conclusions: Barriers to utilization were either patient or provider centered. Patient barriers included a significant lack of knowledge, stigma, risk-taking, and adherence. Provider barriers also included lack of knowledge of treatment and protocols as well as fears of resistance and behavior change. Facilitators included adherence regimens, education, and comprehensive care.

Implications for practice: Men who have sex with men are a high-risk population for HIV transmission. PrEP is successful in this subgroup at reducing transmission. Through education, nonjudgmental and comprehensive care providers can utilize PrEP to decrease transmission.

Keywords: HIV/AIDS; adults; men who have sex with men; prevention.

Publication types

  • Review

MeSH terms

  • Adult
  • Ambulatory Care / standards*
  • HIV Infections / prevention & control*
  • Health Services Accessibility / standards
  • Homosexuality, Male*
  • Humans
  • Male
  • Pre-Exposure Prophylaxis / methods*
  • Quality of Health Care / trends*