The Association between Social Support and Pre-Exposure Prophylaxis use among Sexual Minority Men in the United States: A Scoping Literature Review

Sexual minority men (SMM) are disproportionately affected by HIV. Although pre-exposure prophylaxis (PrEP) is an effective way of reducing HIV incidence, PrEP use has remained relatively low. Social support may be one effective factor in increasing PrEP use among SMM, but the association between social support and PrEP use/adherence is not well understood. The objective of this paper was to summarize the current literature on the association of social support and PrEP use among SMM in the United States. A systematic search was conducted using six different databases MEDLINE / PubMed, PsycINFO, Cochrane CENTRAL, Google Scholar, Embase, and Web of Science using terms established from keywords and medical subject headings (MeSH) terms before being adapted to each database. Data were extracted for key study factors (e.g., study population, geographic location, study design) and main findings. This search produced eleven articles: ten manuscripts and one conference abstract. Of these, two were randomized control trials, two were interventions, three were qualitative, and four were cross-sectional. The studies were widespread across the country, but most were in major metropolitan areas. From the articles included in this review, findings were inconsistent in the association between social support; some studies showed null findings, others that only certain sources of social support were significant, and others that there was a significant association between social support and PrEP use. This review highlights the complexity of the relationship between social support and PrEP use among SMM, indicating the need for further research to identify specific types and sources of support that effectively enhance PrEP uptake and adherence. Targeted interventions based on these insights could significantly reduce HIV incidence in the population. Los hombres pertenecientes a minor & iacute;as sexuales (HSH) se ven afectados de forma desproporcionada por el VIH. Aunque la profilaxis preexposici & oacute;n (PrEP) es una forma eficaz de reducir la incidencia del VIH, el uso de la PrEP se ha mantenido relativamente bajo. El apoyo social puede ser un factor eficaz para aumentar el uso de la PrEP entre los SMM, pero la asociaci & oacute;n entre el apoyo social y el uso/adherencia a la PrEP no se conoce bien. El objetivo de este documento fue resumir la literatura actual sobre la asociaci & oacute;n entre el apoyo social y el uso de la PrEP entre los HSH en los Estados Unidos. Se realiz & oacute; una b & uacute;squeda sistem & aacute;tica en seis bases de datos diferentes MEDLINE / PubMed, PsycINFO, Cochrane CENTRAL, Google Scholar, Embase y Web of Science utilizando t & eacute;rminos basados en palabras clave y t & eacute;rminos de encabezamientos de materias m & eacute;dicas (MeSH) antes de adaptarlos a cada base de datos. Se extrajeron datos para los factores clave del estudio (p. ej., poblaci & oacute;n del estudio, ubicaci & oacute;n geogr & aacute;fica, dise & ntilde;o del estudio) y los hallazgos principales. Esta b & uacute;squeda produjo once art & iacute;culos: diez manuscritos y un resumen de conferencia. De ellos, dos eran estudios controlados aleatorizados, dos eran intervenciones, tres eran estudios cualitativos y cuatro eran estudios transversales. Los estudios estaban repartidos por todo el pa & iacute;s, pero la mayor & iacute;a se realizaban en las principales & aacute;reas metropolitanas. De los art & iacute;culos incluidos en esta revisi & oacute;n, los hallazgos fueron inconsistentes en la asociaci & oacute;n entre el apoyo social; algunos estudios mostraron hallazgos nulos, otros que s & oacute;lo ciertas fuentes de apoyo social eran significativas y otros que exist & iacute;a una asociaci & oacute;n significativa entre el apoyo social y el uso de la PrEP. Esta revisi & oacute;n pone de manifiesto la complejidad de la relaci & oacute;n entre el apoyo social y el uso de la PrEP entre los HSH, lo que indica la necesidad de realizar m & aacute;s investigaciones para identificar los tipos y las fuentes de apoyo espec & iacute;ficos que mejoran de forma efectiva la aceptaci & oacute;n y el cumplimiento de la PrEP. Las intervenciones espec & iacute;ficas basadas en estos conocimientos podr & iacute;an reducir significativamente la incidencia del VIH en la poblaci & oacute;n.