HIV Pre-Exposure Prophylaxis Awareness and Acceptability

Pre-exposure prophylaxis (PrEP) has emerged as a transformative biomedical intervention capable of reducing HIV transmission risk by up to 99% when adherence is optimal. Initially piloted in high-income settings among men who have sex with men (MSM), PrEP adoption has rapidly extended to diverse at-risk populations globally, including young students, female sex workers and serodiscordant couples. Awareness of PrEP varies widely, often reflecting disparities in education, health literacy and access to sexual health services. Regions with targeted community engagement and peer-led outreach report the highest levels of knowledge.

Acceptability of PrEP is shaped by individual, social and structural determinants. Higher education and prior HIV testing consistently predict greater interest, while concerns about side effects, stigma and cost deter uptake. Event-driven regimens have gained traction among those with intermittent risk, whereas daily dosing remains preferred when routine use is feasible. Sociocultural factors—including anticipated discrimination based on sexual orientation or HIV status—continue to undermine confidence in PrEP programmes, necessitating integrated stigma-reduction initiatives.

Practical deployment of PrEP requires integration within comprehensive prevention frameworks that combine condom promotion, regular testing and behavioural counselling. Long-acting injectable formulations and community-based delivery models offer promising avenues to overcome adherence barriers and sustain engagement. Policy measures such as subsidised pricing, free provision in public clinics and the inclusion of PrEP in national guidelines have been critical to scaling services. Collaboration between health authorities, civil society and affected communities remains central to ensuring equitable access and realising the full preventive potential of PrEP.

Research from Nature Portfolio

Recent studies have examined factors influencing PrEP awareness and use among urban MSM in East Asia. A cross-sectional survey conducted in Beijing in 2021 revealed that fewer than one third of respondents had heard of PrEP, and only a small fraction had ever taken it. Higher levels of education, comprehensive HIV knowledge and prior testing were associated with increased awareness. Conversely, stigma related to sexual orientation and concern about side effects correlated with lower odds of PrEP knowledge. Interest in future use exceeded current uptake, underscoring the need for targeted educational campaigns and peer educator training to bridge the gap between awareness and utilisation.

HIV Pre-Exposure Prophylaxis Awareness and Acceptability publication trend

The graph below shows the total number of articles in hiv pre-exposure prophylaxis awareness and acceptability across all publications each year (not limited to Nature Index journals).

Technical terms

Pre-exposure prophylaxis (PrEP): The use of antiretroviral medications by HIV-negative individuals prior to potential exposure to prevent infection.

Adherence: The extent to which a person correctly follows a prescribed PrEP regimen, critical for efficacy.

Event-driven PrEP: A dosing strategy in which pills are taken around the time of sexual activity rather than daily.

Stigma: Negative attitudes or beliefs about individuals based on HIV status or associated behaviours, which can deter PrEP uptake.

References

1. Awareness and use of HIV pre-exposure prophylaxis and factors associated with awareness among MSM in Beijing, China. Scientific Reports (2023).
2. Significant insights from a National survey in China: PrEP awareness, willingness, uptake, and adherence among YMSM students. BMC Public Health (2024).
3. Pre‐exposure prophylaxis in real life: experience from a prospective, observational and demonstration project among men who have sex with men in Benin, West Africa. Journal of the International AIDS Society (2023).
4. Strategies to improve PrEP uptake among West African men who have sex with men: a multi-country qualitative study. Frontiers in Public Health (2023).