Duke University, School of Nursing, 307 Trent Drive, Durham, NC, 27710, USA.
Duke University, Medical Center Library, Durham, NC, USA.
AIDS Behav. 2024 Nov;28(11):3666-3709. doi: 10.1007/s10461-024-04434-8. Epub 2024 Jul 31.
Latinx cisgender sexually minoritized men (SMM) and transgender women (TW) in the U.S. are disproportionately affected by HIV. Although pre-exposure prophylaxis (PrEP) is a highly effective strategy for HIV prevention, rates of PrEP use among Latinx SMM and TW remain suboptimal. The main purpose of this systematic review was to (1) describe engagement in the various stages of the PrEP care continuum among Latinx SMM and TW, and (2) identify multilevel determinants that function as barriers or facilitators to engagement in the PrEP continuum of care for Latinx SMM and TW. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement (PRISMA). Five databases (MEDLINE, CINAHL, PsycINFO, Embase, Scopus) were searched to examine the available qualitative, quantitative, and mixed method studies relevant to the research question. A total of 56 studies were included, with the majority focusing on SMM and being cross-sectional in design. Barriers included PrEP knowledge, risk perception, intersecting stigma, and structural conditions. Community resources, social support, and PrEP navigation services facilitated engagement in the PrEP continuum of care. This review highlights the complex factors that influence PrEP care engagement among Latinx SMM and TW. These findings call for comprehensive, multilevel approaches to address inequities disparities in PrEP care engagement among these groups.
美国的拉丁裔跨性别少数群体男性（SMM）和跨性别女性（TW）感染艾滋病毒的比例过高。虽然暴露前预防（PrEP）是预防艾滋病毒的一种非常有效的策略，但拉丁裔 SMM 和 TW 中 PrEP 的使用率仍然不理想。本系统评价的主要目的是：（1）描述拉丁裔 SMM 和 TW 参与 PrEP 护理连续体的各个阶段；（2）确定作为拉丁裔 SMM 和 TW 参与 PrEP 护理连续体的障碍或促进因素的多层次决定因素。本评价根据系统评价和荟萃分析报告的首选报告项目（PRISMA）进行。共检索了 5 个数据库（MEDLINE、CINAHL、PsycINFO、Embase 和 Scopus），以研究与研究问题相关的现有定性、定量和混合方法研究。共纳入 56 项研究，其中大多数研究集中在 SMM 上，且设计均为横断面研究。障碍包括 PrEP 知识、风险认知、交叉污名和结构条件。社区资源、社会支持和 PrEP 导航服务促进了参与 PrEP 护理连续体。本评价强调了影响拉丁裔 SMM 和 TW 参与 PrEP 护理的复杂因素。这些发现呼吁采取综合的多层次方法来解决这些群体中 PrEP 护理参与的不平等差距。
