Preexposure Prophylaxis for Prevention of HIV Acquisition Among Adolescents: Clinical Considerations, 2020

Tanner, Mary R.; Miele, Peter; Carter, Wendy; Valentine, Sheila Salvant; Dunville, Richard; Kapogiannis, Bill G.; Smith, Dawn K.

doi:10.15585/mmwr.rr6903a1

Cited by 67 publications

(50 citation statements)

References 66 publications

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“…Numerous HIV prevention tools, such as consistent condom use and pre-exposure prophylaxis for HIV (PrEP), could address these disproportionate rates but remain underutilized by AYAs [3]. Despite the expanded indication in 2018 for PrEP (tenofovir emtricitabine or TDF/FTC) for anyone weighing at least 35kg (~77lbs), there remain numerous barriers to increasing AYA PrEP use including low PrEP knowledge, challenges adhering to a daily medication, medication costs, HIV-and sex-related stigma, parent and provider concerns, and confidentiality [3][4][5][6]. For instance, demonstration studies among AYAs highlight adherence challenges as only 22% of 15 to 17 year olds were adherent to PrEP over a 48-week period, with adherence declining after visit spacing was increased from monthly to quarterly [7].…”

Section: Introductionmentioning

confidence: 99%

“…In Alabama, AYAs account for 31% of new cases [ 2 ]. Numerous HIV prevention tools, such as consistent condom use and pre-exposure prophylaxis for HIV (PrEP), could address these disproportionate rates but remain underutilized by AYAs [ 3 ]. Despite the expanded indication in 2018 for PrEP (tenofovir emtricitabine or TDF/FTC) for anyone weighing at least 35kg (~77lbs), there remain numerous barriers to increasing AYA PrEP use including low PrEP knowledge, challenges adhering to a daily medication, medication costs, HIV- and sex-related stigma, parent and provider concerns, and confidentiality [ 3 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Exploring adults as support persons for improved pre-exposure prophylaxis for HIV use among select adolescents and young adults in the Deep South

et al. 2021

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Purpose Pre-exposure prophylaxis for HIV (PrEP) is an effective yet underutilized biomedical tool for adolescents and young adults’ (AYA) HIV prevention due to barriers such as PrEP adherence. We assessed HIV prevention knowledge, attitudes and beliefs from adults who self-identified as a primary support person to an AYA. Methods We surveyed AYA primary support persons at an academic hospital. Univariate and multivariate regression analyses were completed to identify factors associated with the belief AYAs engaging in HIV-associated behaviors should use PrEP and willingness to support AYAs on PrEP. Results 200 primary support persons completed the survey. Participants were predominately female (77%) and black (56%). Nearly all primary support persons believed AYAs engaging in HIV-associated behaviors should take PrEP (94%) and 98% would support an AYA taking PrEP via transportation to appointments, assistance with refilling prescriptions, medication reminders, or encouragement. Conclusions Primary support persons are willing to support AYAs using PrEP.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploring adults as support persons for improved pre-exposure prophylaxis for HIV use among select adolescents and young adults in the Deep South

et al. 2021

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“…This evidence has resulted in the firm conclusion that treatment is prevention, and that those who maintain an undetectable HIV viral load do not transmit HIV to their sexual partners (i.e., undetectable = untransmittable [U=U]) [ 6 ]. Pre-exposure prophylaxis (PrEP) has also demonstrated impressive results in reducing HIV transmission, with daily oral pill regimens tenofovir disoproxil/emtricitabine (TDF/FTC) and tenofovir alafenamide/emtricitabine (TAF/FTC) reducing the risk of HIV acquisition up to 99% with daily adherence, leading to a grade A recommendation from the U.S. Prevention Services Task Force (USPSTF) [ 7 – 11 ]. Emerging technologies, including long-acting injectable PrEP (cabotegravir) awaiting FDA approval, will further augment and diversify prevention modalities and strategies [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Mind the Gap: HIV Prevention Among Young Black Men Who Have Sex with Men

2020

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Purpose of Review Young Black men who have sex with men (YBMSM) suffer profound health inequities in new HIV diagnoses and clinical outcomes. While the evolution of HIV prevention options has become increasingly biomedical, inequities in access and uptake of these modalities persist. Recent Findings Studies suggest that while YBMSM display interest and acceptability of varied HIV prevention options, uptake lags due to the lingering effects of intersectional oppression from racism and sexual prejudice, HIV stigma, institutional and provider bias, and unresolved health policy barriers. Promising avenues to address these barriers have yet to be fully explored. Summary We have the tools to effectively prevent HIV transmission and acquisition among YBMSM, but we have not yet effectively implemented these tools for this priority population. To end the epidemic, we must tailor and adapt HIV prevention strategies to meet the unique intersecting needs, identities, and social contexts of YBMSM. Keywords Young Black MSM. Sexual minority youth. HIV prevention. Adolescent and young adult. Sexual minority men. LGBTQ health This article is part of the Topical Collection on The Science of Prevention

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“…PrEP is an effective and safe intervention to prevent HIV [ 6 , 7 ], approved by the Food and Drug Administration (FDA) in 2018 for use by adolescents weighing at least 77 pounds. PrEP could significantly contribute to reducing the HIV burden among ASMM [ 8 ], but little is known about how effective a PrEP program is likely to be for this population [ 9 ]. Previous modeling studies have demonstrated that PrEP use by ASMM can be highly impactful in reducing new infections [ 10 , 11 ] and potentially cost-effective in some subpopulations in high-incidence settings [ 12 ].…”

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confidence: 99%

Modeling the Impact of PrEP Programs for Adolescent Sexual Minority Males Based on Empirical Estimates for the PrEP Continuum of Care

Hamilton

Rosenberg

Sullivan

et al. 2021

Journal of Adolescent Health

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Purpose: Pre-exposure prophylaxis (PrEP)—an effective and safe intervention to prevent HIV transmission—was recently approved by the Food and Drug Administration for use by adolescents. Informed by studies of sexual behavior and PrEP adherence, retention, and promotion, we model the potential impact of PrEP use among at-risk adolescent sexual minority males. Methods: We simulate an HIV epidemic among men who have sex with men (MSM) aged 13–39. We assume adult MSM ages 19–39 have had PrEP available for 3 years with 20% coverage among eligible MSM based on the Centers for Disease Control and Prevention guidelines. PrEP interventions for ages 16–18 are then simulated using adherence and retention profiles drawn from the ATN113 and Enhancing Preexposure Prophylaxis in Community studies across a range of uptake parameters (10%–100%). Partnerships across age groups were modeled using parameterizations from the RADAR study. We compare the percent of incident infections averted (impact), person-years on PrEP per infection averted (efficiency), and changes in prevalence over 10 years. Results: As compared to no PrEP use, baseline PrEP adherence and retention among adolescent sexual minority males drawn from the ATN113 and Enhancing Preexposure Prophylaxis in Community studies averted from 2.8% to 41.0% of HIV infections depending on the fraction of eligible adolescent sexual minority males that initiated PrEP at their annual health-care visit. Improved adherence and retention achieved with an array of focused interventions from real-world settings increased the percent of infections averted by as much as 26%–70%. Conclusions: Empirically demonstrated improvements in the PrEP continuum of care in response to existing interventions can substantially reduce incident HIV infections among adolescent sexual minority males.

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Preexposure Prophylaxis for Prevention of HIV Acquisition Among Adolescents: Clinical Considerations, 2020

Cited by 67 publications

References 66 publications

Exploring adults as support persons for improved pre-exposure prophylaxis for HIV use among select adolescents and young adults in the Deep South

Exploring adults as support persons for improved pre-exposure prophylaxis for HIV use among select adolescents and young adults in the Deep South

Mind the Gap: HIV Prevention Among Young Black Men Who Have Sex with Men

Modeling the Impact of PrEP Programs for Adolescent Sexual Minority Males Based on Empirical Estimates for the PrEP Continuum of Care

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