Characteristics and HIV-related Engagement of Male Sexual Partners of Female Sex Workers in Sub-Saharan Africa (SSA): a Scoping Review Protocol

Introduction
There is considerable research literature exploring HIV epidemiology among FSWs but there is little research on their male sexual partners. Sexual partners of FSWs are key to the transmission dynamics of the HIV epidemic. There exist key gaps in the available information on the characteristics, HIV prevalence, and engagement with HIV services of these partners. Addressing these gaps could help improve understanding of the HIV epidemic and inform targeted prevention strategies.

Methods
This scoping review will follow the framework of Arksey and O'Malley. The study selection occurs in three stages: retrieval, screening, and data extraction. A literature search will be conducted in Medline Complete, Global Health, and CINAHL, with duplicates removed using Zotero. A combination of keywords and Medical Subject Headings (MeSH) terms about the characteristics, HIV prevalence, proportion of men who pay for sex, uptake of HIV preventive and care services, and SSA will be used in the search strategy. Titles and abstracts will be screened, followed by full-text reviews based on inclusion criteria. Two independent reviewers will resolve conflicts, with a third reviewer assisting as needed. Data will be extracted into a piloted spreadsheet and studies appraised using the Appraisal Tool for Cross-Sectional Studies (AXIS). We will include peer-reviewed studies conducted between January 2010 and November 2024 from SSA, including meta-analyses. Results will be presented using tables and narrative summaries.

Results
The study selection process will be summarized in a PRISMA flow diagram. We will present some information gathered during the extraction and analysis stage using tables, including the Population, Concept, and Context components, and ensure that the study objectives and research questions are answered. A narrative description will also be provided alongside any visual representations.

Conclusions
Conducting this scoping review can help to identify gaps in knowledge and gain an in-depth understanding of the characteristics, population sizes, HIV prevalence, and HIV services uptake among men who have sex with FSWs. This information is important for informing future research directions specific to these populations in SSA. We plan to disseminate our findings via a peer-reviewed journal.