Person-centred HIV prevention services in sub-Saharan Africa: a scoping review

TL;DR

This review explores how person-centred HIV prevention services can improve engagement in sub-Saharan Africa, highlighting successes and remaining challenges.

Contribution

The study provides a comprehensive map of person-centred HIV prevention models and their outcomes in sub-Saharan Africa.

Findings

Community-based and peer-supported models improved accessibility and adherence to HIV prevention services.

Interventions offering prevention method choices showed better uptake and clinical outcomes.

Implementation varied regionally, with gaps in West and Central Africa and among certain populations.

Abstract

In spite of numerous advancements in HIV prevention, there are still gaps that impede reaching key populations throughout sub-Saharan Africa. Traditional approaches usually overlook personal preferences, social context and structural obstacles, often leading to subpar service uptake. Person-centred care (PCC) has emerged in recent times as an approach that shows promise; however, its implementation is still not widespread in sub-Saharan Africa.

This scoping review aimed to systematically map the landscape of Person- Centred HIV prevention services in Sub-Saharan Africa, identifying intervention models, outcomes, and implementation barriers and facilitators.

A comprehensive search of PubMed, ScienceDirect, Google Scholar, and AJOL identified studies published between 2010 and 2025. Following PRISMA-ScR guidance, 174 records were identified, 33 duplicates removed, and 141 records screened. A total of 128 records were excluded, 13 full texts were sought, and 12 studies from six countries met the inclusion criteria. Data were charted and synthesised narratively.

Services included PrEP programmes, choice based models, peer-led outreach initiatives, and differentiated ART delivery systems. Essential elements of PCC included shared decision-making, decentralisation, social support, and counselling that takes into account stigma. Models that are community-based and peer-supported improved accessibility, trust, and adherence to treatment. Interventions that provided options for prevention methods and service locations consistently demonstrated improved uptake, satisfaction, and clinical outcomes. Nonetheless, implementation varied by region, with no representation from West and Central Africa and notable disparities in reach among adolescent boys, older adults, and sexual minorities.

Evidence from the included studies indicates that person-centred strategies can enhance engagement with HIV prevention services in several settings across sub-Saharan Africa. However, the benefits were not uniform, and gaps in geographical representation, equity, and integration of broader psychosocial needs persist. Future programmes should address structural barriers, strengthen psychological safety and community trust, and ensure more inclusive design to improve the reach and consistency of person-centred HIV prevention.

The online version contains supplementary material available at 10.1186/s12981-025-00839-0.

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