Barriers and facilitators to engagement with the PrEP care continuum among sexual minority men in China: a systematic review

作者：Chenglin Hong, Liying Wang, Yilin Wang, Yuqing Wang, Lingxiao Chen, Frank Y. Wong, Jane M. Simoni, Ian W. Holloway, Steven A. John · 发表于：Sexual Health · 年份：2025 · DOI：10.1071/sh25021 · 被引用次数：2 · 研究领域：HIV/AIDS Research and Interventions、HIV, Drug Use, Sexual Risk、LGBTQ Health, Identity, and Policy

Sexual minority men (SMM) in China are disproportionately affected by the HIV epidemic, yet utilization of HIV prevention services, such as pre-exposure prophylaxis (PrEP), remains low. This systematic review summarizes the barriers and facilitators to the PrEP care continuum among Chinese SMM using thematic analysis. Following PRISMA guidelines, a comprehensive literature search was conducted in English and Chinese databases, including PubMed, EMBASE, Web of Science, PsycINFO, CINAHL, CNKI and WanFang. From 820 records, 50 studies met inclusion criteria, revealing five key themes: (1) sexual behaviors and perceived HIV risk; (2) PrEP-related stigma and homophobia; (3) history of HIV and other STI care engagement; (4) perceptions of PrEP efficacy, side-effects and adherence, and (5) structural and access barriers, including cost, health insurance and residential status. Improving PrEP uptake among Chinese SMM requires addressing sexual risk behaviors, societal stigma and structural barriers. Comprehensive education around PrEP, stigma reduction and financial support are crucial. Targeted public health initiatives and policy changes are necessary to enhance PrEP awareness, accessibility and adherence among Chinese SMM. Additionally, integrating PrEP education into existing HIV/STI care frameworks, and fostering supportive environments within healthcare settings can further mitigate barriers. There is a need to explore and promote alternative PrEP modalities, including on-deman...