In 2015, young people aged 13 to 24 years—disproportionately young men and boys—accounted for 23% of new HIV infections. Pre-exposure prophylaxis (PrEP) can prevent HIV, and has been found safe and effective for young people, but are health care providers who treat adolescents willing to prescribe it?
Researchers from University of California, San Francisco say internal medicine and infectious disease providers have expressed concerns about adherence, development of resistant HIV strains, higher risk sexual behavior, cost, toxicity, and lack of evidence. Data are lacking, though, among youth providers. To find out how aware those clinicians are about PrEP, and how willing they are to prescribe it, the researchers conducted an online survey of members of the Society of Adolescent Health and Medicine.
Almost all of the 162 respondents had heard of PrEP, and agreed that it prevents HIV. Of the respondents, 57 (35%) had prescribed PrEP. Although 73% said they had treated few to no young patients with HIV, 65% were willing to prescribe PrEP to adolescents (aged 13-17 years) and young adults. Only 30 providers said they would refer adolescents and 25 would refer young adults.
Among the providers who would refer or were not willing to prescribe to adolescents, 35 (67%) would prescribe PrEP if it were FDA-approved for adolescents.
Willingness to prescribe was associated with the provider having enough knowledge to safely provide PrEP to adolescents and a belief that adolescents would adhere to a daily medication regimen. Some also said they would prefer to know that they could ensure confidentiality.
The researchers say their findings highlight potential opportunities to reduce HIV incidence among young people by shaping educational and implementation tools to improve provider self-efficacy and youth adherence.