Normalization of Preexposure Prophylaxis for Adolescents

Saleska, Jessica Londeree; Lee, Sung–Jae

doi:10.1001/jamapediatrics.2020.2545

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Although this study occurred before the release of the updated CDC guidelines, implementing these strategies for improved sexual health discussions is even more crucial now that guidelines recommend providers discuss PrEP with all sexually active adolescents, as PrEP may provide the impetus for normalizing AGYW sexual health discussions. 3,21 In addition, provider-focused strategies may include the following: improving providers' comfort discussing sexual health using a normative, sex-positive lens, enhanced sexual history taking skills, and increasing understanding of HIV epidemiology and knowledge about adolescent relationships (e.g., sexual concurrency, serial monogamy, and sexual networks, especially among Black AGYW) to accurately evaluate AGYW behaviors. 8 Our team is currently working on PrEP implementation among Alabama family medicine residency training programs.…”

Section: Discussionmentioning

confidence: 99%

“…One AGYW states "when I was growing up, my mom was very transparent about sexual health." (AGYW age 21) Finally, public policy needs to be addressed to improve these discussions. Variation exists among providers, adolescents, and their parents regarding knowledge and understanding of consent and confidentiality legislation.…”

Section: Sexual Health and Hiv Prevention Strategiesmentioning

confidence: 99%

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“Nobody wants to have conversation about HIV.” A thematic analysis of in-depth interviews with Black adolescent women and providers about strategies for discussing sexual health and HIV prevention

Hill,

Pratt,

Elopre

et al. 2024

Sexual Trans Dis

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Background Black adolescent girls and young women (AGYW) in the U.S. Southeast are disproportionately burdened by HIV. Infrequent assessment of sexual health in clinical encounters may contribute to low PrEP uptake for this population. This study explores Black AGYW and providers’ perspectives on engaging in discussions about sexual health, including PrEP. Methods In-depth interviews (IDIs) were conducted with Black AGYW ages 14-24 and healthcare providers (MD, DO, NP, PA) who self-reported caring for Black AGYWs in Alabama. IDIs were grounded in Andersen’s Behavioral Model of Health Service Utilization to explore barriers and facilitators to sexual health discussions. After separate analyses, AGYW and provider IDIs were aggregated and reanalyzed using thematic analysis to identify themes related to their views on ways to improve Black AGYW engagement in sexual health discussions while in clinical settings. Results Twelve Black AGYW and 11 providers completed IDIs. Client median age was 21, representing nine Alabama counties. Providers were predominately non-Hispanic White (82%), female (73%), and physicians (64%). Themes about ways to improve sexual health discussions included: 1) Improve sexual health education for providers and adolescents; 2) Normalize conversations in clinical settings; 3) Engage communities to continue these conversations outside of clinical settings. Conclusions Sexual health and HIV prevention discussions with Black AGYW are not occurring. This study is one of the first to to identify and highlight Black AGYW and provider-identified shared strategies for improving these discussions. Operationalizing these strategies is crucial to facilitating these discussions.

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Section: Discussionmentioning

confidence: 99%

Section: Sexual Health and Hiv Prevention Strategiesmentioning

confidence: 99%

“Nobody wants to have conversation about HIV.” A thematic analysis of in-depth interviews with Black adolescent women and providers about strategies for discussing sexual health and HIV prevention

Hill,

Pratt,

Elopre

et al. 2024

Sexual Trans Dis

View full text Add to dashboard Cite

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‘How come they don’t talk about it in school?’ Identifying adolescent barriers to PrEP use

Gailloud

Gonzalez-Argoti

Philip

et al. 2021

Health Education Research

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Although 21% of new human immunodeficiency virus (HIV) diagnoses in the United States are in youth aged 13–24 years, adolescent awareness and uptake of the HIV prevention medication pre-exposure prophylaxis (PrEP) are low. This study explores the attitudes and challenges that adolescents face while taking PrEP. Thirty interviews were conducted with Black and Latine (we use the gender-inclusive term Latine rather than Latinx for more appropriate Spanish pronunciation) students aged 15–17 who received care at school-based health centers (SBHCs) in the Bronx, NY. Transcripts were coded inductively and deductively using thematic analysis. Most participants were unaware of PrEP, but nearly all were enthusiastic when informed about it; a majority denied that they would feel any stigma when taking PrEP. Despite this high receptivity, multiple barriers were identified, particularly confidentiality from parents, low perceived need of PrEP and concerns about daily adherence and side effects. Adolescents overall were enthusiastic about the availability of PrEP and felt it empowered them to have control over their health. SBHCs were considered trusted sources of confidential, accessible care, and we believe that they can be uniquely positioned to mitigate barriers to PrEP distribution in the future.

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Adolescents and Young Adults: The Pediatrician’s Role in HIV Testing and Pre- and Postexposure HIV Prophylaxis

Hsu

Rakhmanina

2021

Pediatrics

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Most sexually active youth in the United States do not believe that they are at risk for contracting HIV and have never been tested. Creating safe environments that promote confidentiality and respect, obtaining an accurate sexual and reproductive health assessment, and providing nonstigmatizing risk counseling are key components of any youth encounters. Pediatricians can play a key role in preventing and controlling HIV infection by promoting risk-reduction counseling and offering routine HIV testing and prophylaxis to adolescent and young adult (youth) patients. In light of persistently high numbers of people living with HIV in the United States and documented missed opportunities for HIV testing, the Centers for Disease Control and Prevention and the US Preventive Services Task Force recommend universal and routine HIV screening among US populations, including youth. Recent advances in HIV diagnostics, treatment, and prevention help support this recommendation. This clinical report reviews epidemiological data and recommends that routine HIV screening be offered to all youth 15 years or older, at least once, in health care settings. After initial screening, youth at increased risk, including those who are sexually active, should be rescreened at least annually, and potentially as frequently as every 3 to 6 months if at high risk (male youth reporting male sexual contact, active injection drug users, transgender youth; youth having sexual partners who are HIV-infected, of both genders, or injection drug users; youth exchanging sex for drugs or money; or youth who have had a diagnosis of or have requested testing for other sexually transmitted infections). Youth at substantial risk for HIV acquisition should be routinely offered HIV preexposure prophylaxis, and HIV postexposure prophylaxis is also indicated after high-risk exposures. This clinical report also addresses consent, confidentiality, and coverage issues that pediatricians face in promoting routine HIV testing and HIV prophylaxis for their patients.

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Normalization of Preexposure Prophylaxis for Adolescents

Cited by 3 publications

References 6 publications

“Nobody wants to have conversation about HIV.” A thematic analysis of in-depth interviews with Black adolescent women and providers about strategies for discussing sexual health and HIV prevention

“Nobody wants to have conversation about HIV.” A thematic analysis of in-depth interviews with Black adolescent women and providers about strategies for discussing sexual health and HIV prevention

‘How come they don’t talk about it in school?’ Identifying adolescent barriers to PrEP use

Adolescents and Young Adults: The Pediatrician’s Role in HIV Testing and Pre- and Postexposure HIV Prophylaxis

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