Pre-exposure prophylaxis to prevent HIV acquisition has been approved in the U.S. for adolescents since 2018. However, there are special considerations when issuing prescriptions to minors, researchers noted in Morbidity and Mortality Weekly Report.
While PrEP is generally safe in adolescents, more research is needed about the effects of tenofovir disoproxil fumarate on bone density in young people, they wrote. There are also non-medical issues to consider, they noted: While all U.S. states allow youth to be treated for sexually transmitted infections without a parent’s consent, confidentiality issues may still arise—e.g., from health insurance billing statements. Adherence to PrEP may also be a greater challenge for adolescents, as may transportation and other access issues.
Authors stressed the importance for health care providers to take a comprehensive history of their adolescent patients, and continue to screen teens for their ongoing need of PrEP. Young people also need developmentally appropriate, comprehensive sexual health education to make informed decisions.
Parents should be involved in the process “when it is safe and reasonable to do so,” but an adolescent’s autonomy over their body should be recognized as much as possible, the report emphasized.
In sum, the report recommended considering the following issues when deciding on PrEP for young people:
- Medical management.
- PrEP safety.
- Legal issues.
- Therapeutic partnership.
- Clinical visits for preventive services.
- Medication initiation, adherence, and persistence.