Publication
Portugal remains one of the countries in the EU with the highest annual number of reported HIV cases and the highest proportion of AIDS diagnosis, despite its commitment to achieve UNAIDS 2030 targets. This scoping review aims to map how knowledge and usage of primary and secondary prevention strategies are being assessed in Portugal across key populations, such as sex workers (SW), men who have sex with men (MSM), people who inject drugs (PWID), migrants and transgender. Following PRISMA-ScR guidelines, we searched PubMed, Web of Science, and Scopus for peer-reviewed articles in English or Portuguese, between 2008 and 2025, that reported knowledge and/or use assessment of condoms, HIV testing, pre-exposure prophylaxis (PrEP), or post-exposure prophylaxis (PEP) in key populations. From 655 studies identified, 54 met the eligibility criteria. Most studies assessed condom use (n=44) and HIV testing (n=42), with fewer examining PrEP (n=16) and PEP (n=12). No studies assessed condom knowledge. Condom use was characterized by partnership type, gender, sexual intercourse type, and sexual role across key populations. Knowledge about HIV testing was characterized as knowing where to get tested and/or that HIV testing is confidential and free. PrEP and PEP were often assessed coupled with condom usage. Assessment methods across prevention strategies showed inconsistent recall periods and reported frequencies. This heterogeneity makes comparison across studies challenging, within and across key populations, and limits the development of mathematical modelling studies that can inform public health policies. Standardized assessment metrics are urgently needed to strengthen evidence-based HIV prevention programs in Portugal.
