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Research article
Jef Vanhamel
Institute of Tropical Medicine Antwerp
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0020-1876
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Strengthening HIV combination prevention is imperative given the continued high HIV incidence worldwide. The introduction of oral PrEP as a new biomedical HIV prevention tool can be a potential gamechanger because of its high clinical efficacy and the feasibility of making it available for different key populations.Experiences with different PrEP delivery models in a variety of settings and HIV epidemics will inform howits uptake and usage can be maximised.
Methods: We conducted a scoping review using the five-step framework for conducting scoping studies provided by Arksey and O’Malley. We systematically searched the existing peer-reviewed international and grey literature describing four components of a PrEP service delivery model in real-world: the target population of PrEP services, the setting where PrEP was delivered, PrEP providers’ professionalisation and PrEP delivery channels. We restricted our search to English language articles. No geographical or time restrictions were set.
Results: Following exclusion of ineligible records and removal of duplicates, 33 articles were retained for charting and analysing of the results. The target population of PrEP services was often described in terms of PrEP eligibility without targeting specific subgroups. If a specific target group was mentioned, PrEP was mainly offered to men who have sex with men (MSM). PrEP was often delivered centralisedin specialist clinics providing HIV, sexual health or STI care. Yet examples of de-centralised and community-based PrEP delivery have been reported. Health care providers delivering PrEP were mainly medical professionals, with task-shifting to non-traditional health professionals and lay providers identified in a minority of the studies. PrEP was mainly delivered through classic in-person visits. More innovative options using mHealth and telemedicine approaches to deliver specific parts of PrEP services are currently being applied.
Conclusions: Within our scope for PrEP service delivery models, a range of possibilities was found for all components of such models. This reflects differentiation of care according to different contextual settings. More research is needed on how integration of services in these contexts could respond to the needs of different profiles of PrEPuserswithin a combination prevention approach.
Keywords
HIV prevention , PrEP , health care providers, delivery of health care, sexual health, MSM
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This is a list of supplementary files associated with this preprint. Click to download.
- BMCHealthServResVanhamelReviewAdditionalFile2.pdf
- BMCHealthServResVanhamelReviewAdditionalFile6PRISMA.pdf
- BMCHealthServResVanhamelReviewAdditionalFile3.pdf
- BMCHealthServResVanhamelReviewAdditionalFile5.pdf
- BMCHealthServResVanhamelReviewAdditionalFile4.pdf
- BMCHealthServResVanhamelReviewAdditionalFile1.pdf
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CURRENT STATUS: Published
View the published article at BMC Health Services Research.
No community comments so far
Editorial decision: Accept
On 17 Jul, 2020
Editor assigned
On 16 Jul, 2020
Submission checks complete
On 15 Jul, 2020
Editor invited
On 15 Jul, 2020
Version 1
Posted 20 May, 2020
No comments provided
Editorial decision: Major revision
On 16 Jun, 2020
Review #4 received
Received 10 Jun, 2020
Reviewer #5 agreed
On 25 May, 2020
Reviewer #4 agreed
On 23 May, 2020
Review #3 received
Received 22 May, 2020
Reviewer #3 agreed
On 22 May, 2020
Reviewer #2 agreed
On 20 May, 2020
Review #1 received
Received 20 May, 2020
Review #2 received
Received 20 May, 2020
Editor assigned
On 20 May, 2020
Reviewers invited
Invitations sent on 20 May, 2020
Reviewer #1 agreed
On 20 May, 2020
Submission checks complete
On 19 May, 2020
Editor invited
On 17 May, 2020
First submitted
On 06 May, 2020
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Health Services Research.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Jef Vanhamel
Institute of Tropical Medicine Antwerp
Corresponding Author
ORCiD: https://orcid.org/0000-0003-0020-1876
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Health Services Research.
No community comments so far
Editorial decision: Accept
On 17 Jul, 2020
Editor assigned
On 16 Jul, 2020
Submission checks complete
On 15 Jul, 2020
Editor invited
On 15 Jul, 2020
Version 1
Posted 20 May, 2020
No comments provided
Editorial decision: Major revision
On 16 Jun, 2020
Review #4 received
Received 10 Jun, 2020
Reviewer #5 agreed
On 25 May, 2020
Reviewer #4 agreed
On 23 May, 2020
Review #3 received
Received 22 May, 2020
Reviewer #3 agreed
On 22 May, 2020
Reviewer #2 agreed
On 20 May, 2020
Review #1 received
Received 20 May, 2020
Review #2 received
Received 20 May, 2020
Editor assigned
On 20 May, 2020
Reviewers invited
Invitations sent on 20 May, 2020
Reviewer #1 agreed
On 20 May, 2020
Submission checks complete
On 19 May, 2020
Editor invited
On 17 May, 2020
First submitted
On 06 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Background: Strengthening HIV combination prevention is imperative given the continued high HIV incidence worldwide. The introduction of oral PrEP as a new biomedical HIV prevention tool can be a potential gamechanger because of its high clinical efficacy and the feasibility of making it available for different key populations.Experiences with different PrEP delivery models in a variety of settings and HIV epidemics will inform howits uptake and usage can be maximised.
Methods: We conducted a scoping review using the five-step framework for conducting scoping studies provided by Arksey and O’Malley. We systematically searched the existing peer-reviewed international and grey literature describing four components of a PrEP service delivery model in real-world: the target population of PrEP services, the setting where PrEP was delivered, PrEP providers’ professionalisation and PrEP delivery channels. We restricted our search to English language articles. No geographical or time restrictions were set.
Results: Following exclusion of ineligible records and removal of duplicates, 33 articles were retained for charting and analysing of the results. The target population of PrEP services was often described in terms of PrEP eligibility without targeting specific subgroups. If a specific target group was mentioned, PrEP was mainly offered to men who have sex with men (MSM). PrEP was often delivered centralisedin specialist clinics providing HIV, sexual health or STI care. Yet examples of de-centralised and community-based PrEP delivery have been reported. Health care providers delivering PrEP were mainly medical professionals, with task-shifting to non-traditional health professionals and lay providers identified in a minority of the studies. PrEP was mainly delivered through classic in-person visits. More innovative options using mHealth and telemedicine approaches to deliver specific parts of PrEP services are currently being applied.
Conclusions: Within our scope for PrEP service delivery models, a range of possibilities was found for all components of such models. This reflects differentiation of care according to different contextual settings. More research is needed on how integration of services in these contexts could respond to the needs of different profiles of PrEPuserswithin a combination prevention approach.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
- BMCHealthServResVanhamelReviewAdditionalFile2.pdf
- BMCHealthServResVanhamelReviewAdditionalFile6PRISMA.pdf
- BMCHealthServResVanhamelReviewAdditionalFile3.pdf
- BMCHealthServResVanhamelReviewAdditionalFile5.pdf
- BMCHealthServResVanhamelReviewAdditionalFile4.pdf
- BMCHealthServResVanhamelReviewAdditionalFile1.pdf
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