SynthesisBMJ open2022
Oral pre-exposure prophylaxis (PrEP) to prevent HIV: a systematic review and meta-analysis of clinical effectiveness, safety, adherence and risk compensation in all populations.
Synthesis in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 147 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
147 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Indirect Treatment Comparison of the Efficacy of Long-Acting Injectable Cabotegravir Compared With Lenacapavir for HIV Pre-exposure Prophylaxis.Advances in therapy · 2026Pooled it
- Strategies to Improve PrEP Adherence in People Who Use Drugs: A Systematic Review.AIDS and behavior · 2026Pooled it
- Assessing Structural Racism and Discrimination Along the Pre-exposure Prophylaxis Continuum: A Systematic Review.AIDS and behavior · 2024Pooled it
- Low clinical impact of HIV drug resistance mutations in oral pre-exposure prophylaxis: a systematic review and meta-analysis.AIDS research and therapy · 2024Pooled it
- Prevention of Viral Hepatitis and HIV Infection among People Who Inject Drugs: A Systematic Review and Meta-Analysis.Viruses · 2024Pooled it
- Adverse effects of daily oral pre-exposure prophylaxis in men who have sex with men and transgender women: a systematic review and meta-analysis.Cadernos de saude publica · 2023Pooled it
- "It Reduces Stigma Now That the Service Is Under One Roof" Women and Provider Experiences on Factors Influencing Effective Integration of Oral PrEP Delivery in Family Planning Clinics in Kenya: A Qualitative Study.Journal of the International AIDS Society · 2026Trial
- Trial
- Bone Changes With Long-Acting Cabotegravir or Tenofovir Disoproxil Fumarate/Emtricitabine for HIV Prevention in Cisgender Men and Transgender Women: HPTN 083.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Trial
- Randomized Controlled Trial Testing an HIV/STI Prevention Intervention Among People Leaving Incarceration Who Were Assigned Male at Birth, Have Sex with Men and A Substance Use Disorder.AIDS and behavior · 2025Trial
- "I have the vaccine in my body": perceptions of female sex workers after enrolling in a phase IIb HIV vaccine and pre-exposure prophylaxis trial in urban Tanzania.BMC public health · 2025Trial
- Effect of pre-exposure prophylaxis on risky sexual behaviour of female sex workers in Dakar, Senegal: A randomised controlled trial.PLoS medicine · 2025Trial
- Exploring and Predicting HIV Preexposure Prophylaxis Adherence Patterns Among Men Who Have Sex With Men: Randomized Controlled Longitudinal Study of an mHealth Intervention in Western China.JMIR mHealth and uHealth · 2024Trial
- Acceptability and Effectiveness of a One-Hour Healthcare Provider Intervention Integrating HIV Pre-Exposure Prophylaxis and Cultural Competence Training.AIDS and behavior · 2023Trial
- Long-acting HIV pre-exposure prophylaxis adherence and discontinuation: a global systematic review and meta-analysis.EClinicalMedicine · 2026Article
- The Role of Healthcare-Related Experiences in Willingness and Preference for Long-Acting Injectable PrEP (LAI-PrEP) Among Transfeminine People in the United States.AIDS and behavior · 2026Article
- Intimate Partner Violence Victimization and HIV PrEP Adherence Among Gay, Bisexual Men, and Other Men Who Have Sex with Men in Ukraine.AIDS and behavior · 2026Article
- High Burden of Sexually Transmitted Infections Among Pre-exposure Prophylaxis (PrEP) Users: Testing and Prevention Needs.AIDS and behavior · 2026Article
- HIV Transmission and Immunology of the Male Reproductive Tract.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026Review
- Vaccination Coverage and Prevention Counselling for Vaccine-Preventable STIs Among HIV PrEP Users in São Paulo, Brazil: A Retrospective Cohort Study.Journal of the International AIDS Society · 2026Article
87 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo conduct a systematic review and meta-analysis of randomised controlled trials (RCTs) of the effectiveness and safety of oral pre-exposure prophylaxis (PrEP) to prevent HIV.
methodsDatabases (PubMed, Embase and the Cochrane Register of Controlled Trials) were searched up to 5 July 2020. Search terms for 'HIV' were combined with terms for 'PrEP' or 'tenofovir/emtricitabine'. RCTs were included that compared oral tenofovir-containing PrEP to placebo, no treatment or alternative medication/dosing schedule. The primary outcome was the rate ratio (RR) of HIV infection using a modified intention-to-treat analysis. Secondary outcomes included safety, adherence and risk compensation. All analyses were stratified a priori by population: men who have sex with men (MSM), serodiscordant couples, heterosexuals and people who inject drugs (PWIDs). The quality of individual studies was assessed using the Cochrane risk-of-bias tool, and the certainty of evidence was assessed using GRADE.
resultsOf 2803 unique records, 15 RCTs met our inclusion criteria. Over 25 000 participants were included, encompassing 38 289 person-years of follow-up data. PrEP was found to be effective in MSM (RR 0.25, 95% CI 0.1 to 0.61; absolute rate difference (RD) -0.03, 95% CI -0.01 to -0.05), serodiscordant couples (RR 0.25, 95% CI 0.14 to 0.46; RD -0.01, 95% CI -0.01 to -0.02) and PWID (RR 0.51, 95% CI 0.29 to 0.92; RD -0.00, 95% CI -0.00 to -0.01), but not in heterosexuals (RR 0.77, 95% CI 0.46 to 1.29). Efficacy was strongly associated with adherence (p<0.01). PrEP was found to be safe, but unrecognised HIV at enrolment increased the risk of viral drug resistance mutations. Evidence for behaviour change or an increase in sexually transmitted infections was not found.
conclusionsPrEP is safe and effective in MSM, serodiscordant couples and PWIDs. Additional research is needed prior to recommending PrEP in heterosexuals. No RCTs reported effectiveness or safety data for other high-risk groups, such as transgender women and sex workers. PROSPERO REGISTRATION NUMBER: CRD42017065937.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.