ArticleEClinicalMedicine2024
Restarting pre-exposure prophylaxis (PrEP) for HIV: a systematic review and meta-analysis.
Article in EClinicalMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of community-based PrEP delivery for men who have sex with men: a global systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- PrEP reinitiation, uptake, and persistence as targets for reducing HIV incidence and racial and ethnic inequities among men who have sex with men in Boston, USA: a network modeling study.Lancet regional health. Americas · 2026Article
- Development of a Self-administered Sexual Behavior Assessment Tool to Facilitate Self-reflection by Young Women in South Africa About HIV/STI Risk.AIDS and behavior · 2026Article
- "O for KP": an evidence review on recentering HIV prevention and PrEP delivery for key populations and the underserved.Current opinion in infectious diseases · 2026Review
- Attrition from Care and Barriers to PrEP Use Among Key Populations in Kinshasa, DRC: A Multiple Methods Study.AIDS and behavior · 2025Article
- Engaging the private sector as part of HIV pre-exposure prophylaxis service delivery in Vietnam: a comparative analysis of uptake, persistence and HIV seroconversion from 2018 to 2023.Frontiers in reproductive health · 2024Article
- Disparities in PrEP use and unmet need across PEPFAR-supported programs: doubling down on prevention to put people first and end AIDS as a public health threat by 2030.Frontiers in reproductive health · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: High coverage of pre-exposure prophylaxis (PrEP) will reduce HIV transmission and help end the HIV/AIDS pandemic. However, PrEP users face challenges, including long-term adherence. The study aimed to document the proportions of individuals who restart HIV PrEP after they stop and the reasons for restarting PrEP. Methods: This study is a systematic review and meta-analysis. We systematically searched CINAHL, Embase, Emcare, Global Health, Medline, Scopus, and PsychINFO for peer-reviewed with no date restrictions. A grey literature search was conducted through Google search, a search of abstract books of AIDS conferences and the websites of WHO and UNAIDS. The data search was conducted in April 2023 and updated in February 2024. Two authors extracted data on the proportion of people who stopped and then restarted PrEP, reasons for restarting, and strategies to support people restarting PrEP. Two authors appraised the data using the Joanna Briggs Institute Appraisal Tools. We used a random-effects meta-analysis to pool estimates of restarting. We conducted meta-regression to determine potential sources of heterogeneity. This study is registered with PROSPERO, CRD42023416777. However, we deviated from our original plan as we did not identify enough studies for strategies to support restarting PrEP (primary objective). Subsequently, we revised our plan to strengthen our secondary objective to quantify the proportion of people who stopped and restarted PrEP, and explore possible reasons for its heterogeneity. Findings: Of 988 studies, 30 unique studieswere included: 27 reported the proportion restarting PrEP, and of these, 7 also reported reasons for restarting PrEP, and 3 studies reported only on the reasons for restarting PrEP. No study evaluated interventions for restarting PrEP. For the meta-analysis, we included 27 studies. Most studies were from high-income countries (17/27, 63%) or the USA (15/27, 56%). Overall, 23.8% (95% CI: 15.9-32.7, Interpretation: About a quarter of people who stopped PrEP would restart, with substantial variation across countries and populations. It is important to understand the motivations and contextual factors influencing restarting PrEP and the support systems to enable restarting PrEP for those at ongoing risk. Funding: Australian National Health and Medical Research Council.
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