Willingness to Use PrEP among MSM


Kamitani, E., Wichser, M. E., Mizuno, Y., DeLuca, J. B., & Higa, D. H. (2023).What factors are associated with willingness to use HIV pre-exposure prophylaxis (PrEP) among U.S. men who have sex with men not on PrEP? A systematic review and meta-analysis. Journal of the Association of Nurses in AIDS Care, 34(2), 135-145. doi: 10.1097/JNC.0000000000000384

Visual Abstract

Visual Abstract
Plain Language Summary


Pre-exposure prophylaxis (PrEP) is a medicine used to prevent HIV. PrEP use among men who have sex with men (MSM) is still limited. Many MSM indicate that they are willing to use PrEP but are not on PrEP. This gap might point to challenges of getting PrEP.

Questions addressed in the review

  • What are the factors related to the willingness to use PrEP among MSM who are not on PrEP?

Search date

The search was conducted in 2021 and repeated in 2022. The search covered the years 2000-2020.

Study characteristics

Twenty-three studies were included in the review. Most of the studies looked at a single point in time.

Key results

The results showed 12 characteristics were related to a person’s willingness to use PrEP*:

  • Being Hispanic/Latino
  • Being Black/African American
  • Being younger
  • Having an income of $20,000 or less per year
  • Having less than a college degree
  • Having recent anal sex without a condom
  • Having six or more sex partners in the past 12 months
  • Being diagnosed with a sexually transmitted infection in past 12 months
  • Receiving an HIV behavioral program in past 12 months
  • Having fewer concerns about long-term reactions to PrEP
  • Believing in more PrEP benefits
  • Having a greater belief of a high chance of HIV infection

*Among MSM who were not on PrEP

Quality of the evidence

The majority of studies had low risk of bias.

Study funding source

This study was funded by the Centers for Disease Control and Prevention

Related resources

Prep Basics

Paying for PrEP

Clinical Guidelines for PrEP

Downloadable PrEP Resources

PRS Compendium Pre-Exposure Prophylaxis (PrEP) Chapters