Adolescent Human Immunodeficiency Virus Care Providers' Attitudes Toward the Use of Oral Pre-Exposure Prophylaxis in Youth.

TitleAdolescent Human Immunodeficiency Virus Care Providers' Attitudes Toward the Use of Oral Pre-Exposure Prophylaxis in Youth.
Publication TypePublication
Year of Publication2016
AuthorsMullins TLKowalczy, Zimet G, Lally M, Kahn JA
JournalAIDS Patient Care STDS
Volume30
Issue7
Pagination339-48
Date Published2016 07
ISSN1557-7449
KeywordsAdolescent, Adult, Anti-HIV Agents, Attitude of Health Personnel, Female, Health Education, Health Knowledge, Attitudes, Practice, Health Personnel, HIV Infections, Humans, Interviews as Topic, Male, Perception, Pre-Exposure Prophylaxis, Qualitative Research, Safe Sex, United States
Abstract

<p>Oral pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) prevention is currently indicated for use in adults in the United States and may soon be indicated for minor adolescents. However, implementation of PrEP use among minors may present unique barriers. We conducted 15 individual, semi-structured interviews among US clinicians caring for HIV-infected and at-risk youth. The theory-driven interview guide assessed demographics, perceived role of oral PrEP in HIV prevention among adolescents, perceived barriers to and facilitating factors for use of PrEP in adolescents, and clinician-reported likelihood of prescribing PrEP. Transcripts were analyzed using framework analysis. Overall, clinicians viewed PrEP as a time-limited intervention that is one part of a comprehensive approach to HIV prevention among adolescents. Perceived barriers to prescribing to minors included concerns about: confidentiality, legality of minors consenting to PrEP without parental involvement, ability of minors to understand the risks/benefits of PrEP, the possible impact of PrEP on bone accrual, off-label use of PrEP medication in minors, and the high costs associated with PrEP use. Clinician-reported facilitating factors for prescribing PrEP to youth included educating communities and other clinicians about PrEP, ensuring adequate financial resources and infrastructure for delivering PrEP, developing formal guidance on effective behavioral interventions that should be delivered with PrEP, and gaining personal experience with prescribing PrEP. Clinicians indicated greater comfort with prescribing PrEP to adults versus minors. For PrEP to become more widely available to youth at risk for HIV infection, barriers that are unique to PrEP use in minors must be addressed.</p>

DOI10.1089/apc.2016.0048
Alternate JournalAIDS Patient Care STDS
PubMed ID27410497
PubMed Central IDPMC4948218
Grant ListK23 HD072807 / HD / NICHD NIH HHS / United States
P30 AI042853 / AI / NIAID NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States
UL1 TR001425 / TR / NCATS NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States