Impact of Pre-exposure prophylaxis (PrEP) use on risk perception and behaviour among at risk young people: a narrative review

Theodora Omenoba C; Ogbonna Chigozie A; James Esther; Ogbonna Brian O

doi:10.15406/mojph.2026.15.00513

MOJ

eISSN: 2379-6383

Public Health

Review Article Volume 15 Issue 1

Impact of Pre-exposure prophylaxis (PrEP) use on risk perception and behaviour among at risk young people: a narrative review

Theodora Omenoba C, Ogbonna Chigozie A, James Esther, Ogbonna Brian O

Received: November 21, 2025 | Published: March 11, 2026

Citation: Omenoba TC, Chigozie OA, Esther J, et al. Impact of Pre-exposure prophylaxis (PrEP) use on risk perception and behaviour among at risk young people: a narrative review. MOJ Public Health. 2026;15(1):47-53. DOI: 10.15406/mojph.2026.15.00513

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Abstract

Background: Pre-exposure prophylaxis (PrEP) is a proven strategy for preventing HIV , especially among at- risk young people. However, concerns persist about potential risk compensation behaviors, such as reduced condom use and increased sexually transmitted infections (STIs), which could undermine its benefits. This narrative review explored the impact of PrEP use on risk perception and risk compensation behavior among at-risk young individuals, synthesizing evidence from global studies and highlighting implications for PrEP programs. Methods: A comprehensive literature search was conducted in PubMed and Google Scholar for studies published between 2012 and 2024. Studies included focused on young people (aged 18–35) and assessed behavioral outcomes post-PrEP initiation. Data were extracted and synthesized into an evidence-based table and analyzed thematically. Results: Seventeen studies were included, encompassing diverse populations including men who have sex with men (MSM), young women, sex workers, and heterosexual serodiscordant couples. While randomized controlled trials showed minimal risk compensation, observational and cross-sectional studies indicated a trend toward increased condomless sex and STI diagnoses among PrEP users, particularly among MSM in highincome settings. Adherence played a critical role, with risk behaviors more pronounced among non-adherent users. Contextual factors such as gender, age, and socioeconomic conditions influenced PrEP uptake and behavioral outcomes. Conclusion: Risk compensation following PrEP use is not universal but may occur in specific populations. PrEP remains highly effective in preventing HIV , but its rollout should include behavioral counseling, STI screening, and efforts to address structural and perceptual barriers. Further research is needed in low- and middle-income countries (LMICs) and among adolescent girls and young women (AGYW) to inform inclusive and context-sensitive prevention strategies.

Keywords: Pre-exposure prophylaxis (PrEP), risk compensation, HIV prevention, young people, sexual behavior, condom use, sexually transmitted infections (STIs), adherence, men who have sex with men (MSM), narrative review