A scoping review of Indigenous Peoples’ conceptualization of HIV pre-exposure prophylaxis in Australia, Canada, New Zealand and the United States and its applications to Canada
Bibliographic record
Abstract
Despite increasing PrEP use in Canada, uptake remains low among Indigenous Peoples, who experience disproportionately higher rates of HIV. A scoping review following Arksey and O’Malley’s framework and PRISMA-ScR was conducted using literature from 2012 to 2024 to explore how Indigenous Peoples conceptualize PrEP regarding awareness, motivation, access, and effectiveness. We included qualitative, quantitative, and mixed-method studies and reports from Canada, Australia, New Zealand, and the United States. Out of 181 identified articles, 11 met our inclusion criteria. The studies highlighted a lack of Indigenous People identifying with mainstream gay communities where PrEP promotion usually occurs. Individuals were motivated to use PrEP to prevent getting HIV and if PrEP was funded. Healthcare provider barriers such as overburdened Indigenous-specific services and a focus on chronic diseases, along with HIV-related stigma and homophobia, limit access to PrEP. This review also revealed a lack of effective use of PrEP by Indigenous populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.039 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.016 | 0.019 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".