Mapping antimicrobial stewardship principles in HIV positive patients in sub-Saharan Africa: a systematic scoping review protocol

Bacterial infections are one of the main causes of hospitalization and death in people living with HIV (PLHIV), equating to around a third of hospital admissions and 25% of deaths. Patients who are non-adherent with their prescribed regimen are at increased risk for infection with opportunistic and multidrug-resistant organisms. Antimicrobial resistance in PLHIV has become more complex and exacerbated through antimicrobial use for prophylaxis and treatment of opportunistic infections. This systematic scoping review aims to map and synthesize existing evidence on antimicrobial use practices and antimicrobial stewardship adherence among people living with HIV (PLHIV) in sub-Saharan Africa (SSA). A systematic scoping review guided by Arksey and O’Malley’s framework, with enhancements and recommendations of other guidelines, will be conducted. The PCC framework will include HIV-seropositive patients in SSA, treated with antibiotics, and research articles with qualitative and quantitative designs, published in English. A web-based application will be used to facilitate the screening, selection and organization of relevant studies from various databases. Grey literature will be sourced from conference abstracts and reports, governmental reports and unpublished dissertations and theses. Literature published between 2010 and 2025, meeting the inclusion criteria will be included in this systematic scoping review. All the retrieved literature will be deduplicated and exported to an online library. Once mapped literature is analyzed and summarized, the data will be useful in guiding AMS interventions in PLHIV, adapting existing AMS guidelines and setting research priorities for PLHIV. PROSPERO CRD420251168135.