From community engagement to lived experience leadership: a systematic review of HIV services among men who have sex with men

Abstract

Community responses are essential to achieving the global goal of Ending AIDS by 2030, yet men who have sex with men (MSM) remain underrepresented and often tokenized within HIV initiatives. While community engagement is widely emphasized, far less attention has been given to leadership rooted in lived experience. Meaningful community engagement requires recognizing MSM not merely as a target population, but as leaders shaping HIV responses. This systematic review examines how MSM perceive the use of their lived experiences in HIV responses and how institutions incorporate these experiences into service delivery. Following PRISMA guidelines, we analyzed 40 peer-reviewed studies. Results show that across diverse contexts, MSM navigate systemic barriers—including intersecting systems of oppression—that hinder equitable access to HIV care. Despite these challenges, MSM assume (in)formal roles of leadership, negotiating power, and agency within institutions that have historically marginalized them. Using lived experience leadership as a framework in HIV services characterizes meaningful community engagement among MSM and their communities, including pathways for strengthening community-engaged HIV health promotion. This synthesis underscores the need to move beyond narrow notions of community engagement and toward recognizing MSM as leaders whose experiential expertise can enhance equity, relevance, and effectiveness in HIV health promotion programs and provides actionable insights for community-engaged service design and policy.