Lila Wulandari L.P.Salita Negara S.N.Mashuri Y.A.Wahyuningtias S.D.Cahyadi Surya Distira Putra I.W.Subronto Y.W.Ahmad R.A.Thabrany H.Guy R.Law M.Hammoud M.Bavinton B.B.Kaldor J.Medland N.Liverani M.Probandari A.Boettiger D.Wiseman V.Mahidol University2024-07-222024-07-222024-01-01Journal of Acquired Immune Deficiency Syndromes (2024)15254135https://repository.li.mahidol.ac.th/handle/20.500.14594/99777Background:The WHO is committed to strengthening access to pre-exposure prophylaxis (PrEP) for HIV prevention and its integration into primary care services. Unfortunately, the COVID-19 pandemic has disrupted the delivery of primary care, including HIV-related services. To determine the extent of this disruption, we conducted a systematic review and meta-analysis of the changes in access to PrEP services during the pandemic and the reasons for these changes.Methods:A search was conducted using Pubmed, Scopus, Embase, PsycINFO, and Cinahl for studies published between January 2020 and January 2023. Selected articles described self-reported disruptions to PrEP service access associated with the COVID-19 pandemic or its responses. Pooled effect sizes were computed using a random-effects model.Results:Thirteen studies involving 12,652 PrEP users were included in our analysis. The proportion of participants reporting a disruption in access to PrEP services during the COVID-19 pandemic ranged from 3% to 56%, with a pooled proportion of 21% (95%CI: 8 - 38%). Social restrictions, financial constraints, and limited health insurance coverage were key factors impacting access to PrEP services during the pandemic.Conclusions:To our knowledge, this is the first meta-analysis to quantify the extent of disruptions to accessing PrEP services due to the COVID-19 pandemic. To increase the ability of primary care services to maintain PrEP services during public health crises, a mixture of strategies is worth considering. These include multi-month PrEP prescriptions, telehealth services, deployment of peer support groups to provide a community-based service or home delivery, and provision of financial support interventions.MedicineArticleSCOPUS10.1097/QAI.00000000000034882-s2.0-8519871784319447884