Too few teens getting PrEP to prevent HIV

Preexposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) has been an important tool in preventing the further spread of HIV. Although adolescents and young adults are particularly affected by HIV, the uptake of PrEP has remained low among teenagers. A new review in JAMA Pediatrics looks at the current status of PrEP uptake among adolescents aged 13 to 19 years who are at risk.¹

Among the 37,377 diagnoses of HIV made in 2018, 7734 cases were diagnosed in adolescents and young adults aged 12 to 24 years and 1707 diagnoses occurred in adolescents aged 13 to 19 years. Two-thirds of all HIV infections in adolescents and young adults occurred in young African American men who have sex with men. Investigators found that PrEP awareness and engagement was lowest among teenagers who were at the greatest risk of HIV.

Despite recommendations from the Centers for Disease Control and Prevention, many clinicians who treat adolescents do not routinely offer HIV testing or do a sexual history taking to assess sexual risk exposures. Prescribing PrEP was found to be often guided by clinicians’ perceptions of the patient’s HIV risk as well as the clinician’s knowledge and acceptance of PrEP guidelines. State laws governing the rights of the patient’s confidentiality and consent that allow adolescents to get PrEP without parental influence are varied across the country and can often limit PrEP use.

The use of PrEP is a key way to prevent HIV in a population that is already disproportionately impacted by the disease. Improving uptake involves a number of strategies including enhancing sexual history taking and risk assessment, using social media to spread the word on PrEP, urge family support, and continue research to find formulations that can reduce HIV transmission.

References:

1.    Yusuf H, Fields E, Arrington-Sanders R, Griffith D, Agwu AL. HIV preexposure prophylaxis among adolescents in the US: a review. JAMA Pediatr. May 11, 2020. Epub ahead of print. doi: 10.1001/jamapediatrics.2020.0824