Predictive Modelling's role in improving pre-exposure prophylaxis (PrEP) Uptake in High-Risk HIV Groups in Africa: An Integrative Scoping Review

This scoping review explores how predictive modelling can strengthen preexposure prophylaxis (PrEP) uptake among high-risk populations in Africa, where HIV prevalence remains disproportionately high. Although PrEP is highly effective (40 to 90 percent), its uptake and adherence remain suboptimal in LMICs. Predictive modelling provides a promising solution by identifying individuals at elevated risk, enabling targeted, evidence-based interventions. Using Arksey and O Malley's framework and PRISMA-ScR strategy, PubMed, Cochrane Library, ProQuest, and Google Scholar were searched for Africa-based studies from 2015 to 2025. Eligible studies focused on high-risk groups, including men who have sex with men, sex workers, persons who inject drugs, adolescents, and serodiscordant couples, and applied machine learning, regression models, deep learning, and neural networks. Out of 209 records screened, 10 studies met inclusion criteria. Conducted between 2019 to 2025, they demonstrated how predictive tools can stratify HIV risk, enhance adherence monitoring, and improve resource allocation. Sixty percent relied on demographic and behavioural data and achieved strong predictive performance, particularly for HIV status prediction (70 percent). However, stigma, weak health systems, poor integration, and limited data quality still hinder implementation. The review underscores predictive modelling's transformative potential to scale PrEP services across Africa. Integrating machine learning, behavioural modelling, and community-based approaches can improve programmatic efficiency, equity, and targeting. Yet substantial gaps persist in translating predictive outputs into actionable interventions, addressing ethical issues, and validating models in diverse, resource-limited settings. Strengthening collaborations between data scientists, healthcare workers, and policymakers are essential to deliver cost-effective, context-specific PrEP services and accelerate HIV prevention efforts across the continent