To improve PrEP uptake in adolescents, it is imperative to improve clinician knowledge about biomedical HIV prevention, leverage social media to increase teen awareness, ensure access without parental knowledge, and find “lifestyle-congruent” formulations for young people, according to a team of clinician-researchers from Johns Hopkins University reporting in JAMA Pediatrics.
While routine HIV testing is recommended starting at age 13, many primary care physicians do not offer it—and do not feel equipped to prescribe PrEP, the authors note. Patient-provider confidentiality laws do apply to teens, but insurance companies’ explanation of benefits statements may expose young people’s sexual health visits and prescriptions to parents, if they are covered by their parent’s health insurance.
PrEP access may also be impaired by coverage restrictions: Not all insurance plans cover PrEP for people under 18 years old, and Gilead Science’s patient assistance program is only available to adults, the authors noted.
In addition, the present requirement that PrEP be taken as a daily pill may also pose a problem, the study authors wrote; on-demand formulations that align with teenager’s lifestyles are needed.
“Adolescent-tailored research trials are indispensable to determining the efficacy, feasibility, acceptability, and pharmacokinetics of biomedical interventions and are, therefore, a necessity,” they concluded.