Behavioural and social factors in the use of HIV pre-exposure prophylaxis among gay, bisexual and other men who have sex with men

Gay, bisexual and other men who have sex with men (GBMSM) remain disproportionately affected by human immunodeficiency virus (HIV) and are at higher risk of acquiring the virus. Pre-exposure prophylaxis (PrEP) with antiretroviral drugs is a significant advance in HIV prevention. PrEP uptake and adherence among GBMSM is likely to be influenced by multifaceted social and behavioural factors. This article reports on a qualitative systematic review exploring the interrelationships between behavioural and social factors and the use of HIV PrEP among GBMSM. Seven qualitative studies involving a total of 315 participants were analysed, revealing significant variations in risk perceptions, sexual behaviours and social dynamics. The use of PrEP appears to have both positive and negative implications. Reducing stigma, promoting inclusivity and facilitating equitable PrEP provision is crucial. GBMSM accessing PrEP care need culturally competent care, integrated risk reduction strategies and mental health support and counselling. PrEP provision should be extended from specialist sexual health services to primary care and community services.