Ma Junye, Paltin Dafna, Buch Keegan D, Miller-Perusse Michael, Jaramillo Jahn, Horvath Keith J
Doctoral Program in Clinical Psychology, San Diego State University, University of California San Diego Joint, San Diego, CA, USA.
San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, University of California, San Diego, CA, USA.
AIDS Behav. 2025 Jun 4. doi: 10.1007/s10461-025-04791-y.
The COVID-19 pandemic substantially impacted the pre-exposure prophylaxis (PrEP) care continuum among men who have sex with men (MSM). While PrEP use during the pandemic has been studied, regional differences in PrEP regulations highlight the need for U.S.-specific reviews. This scoping review evaluates empirical literature on COVID-19's impact on PrEP engagement among U.S. MSM. A systematic search on August 29, 2024, identified articles from PubMed, PsycINFO, and Embase. Eligible studies (a) collected empirical data from U.S. MSM, (b) assessed COVID-19's impact on PrEP engagement, and (c) were peer-reviewed, English-language, full-text articles. Standardized forms were used to extract study information. Study quality was appraised using validated tools for qualitative and quantitative research. Findings were synthesized using descriptive statistics and narrative summaries, categorized by distinct pandemic phases. Of 438 records, 21 studies were included (15 quantitative, five qualitative, one mixed-method), mostly conducted during the lockdown phase. Results showed reduced PrEP use (5.9-35.6%), increased missed doses (8.3-14.2%), and higher discontinuation rates (9.0-33.3%) during COVID-19. Barriers included refill issues (9.0-20.0%), limited access to care (2.5-17.0%), disrupted lab testing (~ 25.5%), and changes in clinic procedures. College-aged youth reported confidentiality concerns after returning home. Qualitative evidence highlighted telehealth and injectable PrEP as promising alternatives. This review reveals significant disruptions to PrEP care for U.S. MSM during COVID-19, a lack of post-lockdown research, underrepresentation of MSM from Northeastern and Pacific regions, and limited use of objective PrEP adherence measures. These findings underscore the need for emergency-prepared PrEP services and expanded telehealth and home-delivery options for future crises.
新冠疫情对男男性行为者（MSM）的暴露前预防（PrEP）护理连续过程产生了重大影响。虽然疫情期间的PrEP使用情况已得到研究，但PrEP法规的地区差异凸显了针对美国进行具体审查的必要性。本范围审查评估了关于新冠疫情对美国男男性行为者PrEP参与度影响的实证文献。2024年8月29日进行的系统检索从PubMed、PsycINFO和Embase数据库中识别出相关文章。符合条件的研究需满足：（a）从美国男男性行为者中收集实证数据；（b）评估新冠疫情对PrEP参与度的影响；（c）为经过同行评审的英文全文文章。使用标准化表格提取研究信息。采用经过验证的定性和定量研究工具评估研究质量。研究结果通过描述性统计和叙述性总结进行综合，按不同的疫情阶段进行分类。在438条记录中，纳入了21项研究（15项定量研究、5项定性研究、1项混合方法研究），大部分研究是在封锁阶段进行的。结果显示，在新冠疫情期间，PrEP的使用减少（5.9% - 35.6%），漏服剂量增加（8.3% - 14.2%），停药率更高（9.0% - 33.3%）。障碍包括药品 refill 问题（9.0% - 20.0%）、获得护理的机会有限（2.5% - 17.0%）、实验室检测中断（约25.5%）以及诊所程序的变化。大学年龄的年轻人在回家后报告了对保密性的担忧。定性证据强调远程医疗和注射用PrEP是有前景的替代方案。本审查揭示了新冠疫情期间美国男男性行为者的PrEP护理受到重大干扰，缺乏封锁后研究，东北部和太平洋地区的男男性行为者代表性不足，以及客观PrEP依从性测量方法的使用有限。这些发现强调了为未来危机做好准备的PrEP服务以及扩大远程医疗和送货上门选项的必要性。
