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PrEP policy implementation gaps and opportunities in Latin America and the Caribbean: a scoping review.

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dc.contributor.author Murphy, Luke
dc.contributor.author Bowra, Andrea
dc.contributor.author Adams, Ellithia
dc.contributor.author Cabello, Robinson
dc.contributor.author Clark, Jesse L.
dc.contributor.author Konda, Kelika Anne
dc.contributor.author Perez-Brumer, Amaya
dc.coverage.spatial Argentina
dc.coverage.spatial Bolivia
dc.coverage.spatial Brasil
dc.coverage.spatial Chile
dc.coverage.spatial Colombia
dc.coverage.spatial Ecuador
dc.coverage.spatial Guyana
dc.coverage.spatial Paraguay
dc.coverage.spatial Perú
dc.coverage.spatial Surinam
dc.coverage.spatial Uruguay
dc.coverage.spatial Venezuela
dc.coverage.spatial México
dc.coverage.spatial Belice
dc.coverage.spatial Costa Rica
dc.coverage.spatial El Salvador
dc.coverage.spatial Guatemala
dc.coverage.spatial Honduras
dc.coverage.spatial Nicaragua
dc.coverage.spatial Panamá
dc.coverage.spatial Antigua y Barbuda
dc.coverage.spatial Bahamas
dc.coverage.spatial Barbados
dc.coverage.spatial Cuba
dc.coverage.spatial Dominica
dc.coverage.spatial República Dominicana
dc.coverage.spatial Granada
dc.coverage.spatial Haití
dc.coverage.spatial Jamaica
dc.coverage.spatial San Cristóbal y Nieves
dc.coverage.spatial Santa Lucía
dc.coverage.spatial San Vicente y las Granadinas
dc.coverage.spatial Trinidad y Tobago
dc.date.accessioned 2023-05-19T14:08:34Z
dc.date.available 2023-05-19T14:08:34Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13537
dc.description.abstract BACKGROUND: Pre-exposure prophylaxis (PrEP) is an important tool for HIV prevention in Latin America and the Caribbean (LAC). Yet, little is known about the PrEP policies landscape in the region. Addressing this gap, this scoping review assessed current PrEP policies throughout LAC to better understand existing PrEP implementation gaps and identify opportunities to improve access. METHODS: We conducted a scoping review, using a modified PRISMA extension, through 28 July 2022, to identify country-level PrEP policies. Data were collected in English, Spanish, French, and Portuguese utilizing online platforms for screening and data extraction (Google Forms, Zotero, and Excel). Extracted data were divided by data source, including country-level government policies, gray literature, and peer-reviewed literature, with at least one full-text reviewer and data extractor per publication. An iterative summative content analysis was performed to compare and interpret themes across phases and data sources. RESULTS: Of the 33 countries in LAC, 22 (67%) had policies approving daily oral PrEP for HIV prevention, which outlined specific key populations, including men who have sex with men, transgender women, sex workers, and serodiscordant couples. Generic tenofovir disoproxil fumarate/emtricitabine has been approved in 15 of the 33 countries, and 13 of the 33 countries have incorporated PrEP into their public health system. No countries were found to have approved cabotegravir. Costing data were reported by only one country, Ecuador, in its national health ministry guidelines. Findings also document a lag between the media/gray-literature announcement of PrEP and implementation of policies. CONCLUSION: Findings underscore significant advances in PrEP policies in the region and signal opportunities for greater PrEP implementation. Since 2017, an increasing number of countries have begun to provide PrEP to communities at heightened need, although significant gaps remain. Policy approval is a key step to further increasing access to PrEP in LAC, necessary to reduce the burden of HIV in LAC, specifically among marginalized populations. en_US
dc.language.iso eng
dc.publisher SAGE Publications
dc.relation.ispartofseries Therapeutic Advances in Infectious Disease
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject HIV prevention en_US
dc.subject implementation en_US
dc.subject Latin America en_US
dc.subject policy en_US
dc.subject PrEP en_US
dc.subject.mesh VIH
dc.subject.mesh América Latina
dc.subject.mesh Políticas
dc.subject.mesh Profilaxis Pre-Exposición
dc.title PrEP policy implementation gaps and opportunities in Latin America and the Caribbean: a scoping review. en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.1177/20499361231164030
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 2049-937X


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