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Cited by 138HIV/AIDS Research and InterventionsAdolescent Sexual and Reproductive HealthHIV/AIDS drug development and treatment

The DOI matches its Crossref record; 31 of the 32 references it cites were found in a registry or an index.

Preventing HIV among adolescents with oral PrEP: observations and challenges in the United States and South Africa

Open access
Hosek, Sybil, Celum, Connie, Wilson, Craig M, Kapogiannis, Bill, Delany‐Moretlwe, Sinead, Bekker, Linda‐Gail·2016·Journal of the International AIDS Society
DOI 10.7448/ias.19.7.21107PMC PMC5071778
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Abstract

Introduction: Adolescents and young adults aged <25 are a key population in the HIV epidemic, with very high HIV incidence rates in many geographic settings and a large number who have limited access to prevention services. Thus, any biomedical HIV prevention approach should prepare licensure and implementation strategies for young populations. Oral pre‐exposure prophylaxis (PrEP) is the first antiretroviral‐based prevention intervention with proven efficacy across many settings and populations, and regulatory and policy approvals at global and national levels are occurring rapidly. We discuss available data from studies in the United States and South Africa on the use of oral PrEP for HIV prevention in adolescent minors, along with some of the implementation challenges. Discussion: Ongoing studies in the United States and South Africa among youth under the age of 18 should provide the safety data needed by the end of 2016 to contribute to licensure of Truvada as daily PrEP in adolescents. The challenges of completing these studies as well as foreseeable broader challenges highlighted by this work are presented. Adherence to daily PrEP is a greater challenge for younger populations, and poor adherence was associated with decreased efficacy in all PrEP trials. Individual‐level barriers include limited familiarity with antiretroviral‐based prevention, stigma, product storage, and social support. Structural challenges include healthcare financing for PrEP, clinician acceptability and comfort with PrEP delivery, and the limited youth‐friendly health services available. These challenges are discussed in the context of the work done to date in the United States and South Africa, but will likely be magnified in the setting of limited resources in many other countries that are heavily impacted by HIV. Conclusions: Adolescent populations are particularly vulnerable to HIV, and oral PrEP in these populations is likely to have an impact on population‐level HIV incidence. The challenges of disseminating an HIV biomedical prevention tool requiring daily usage in adolescents are formidable, but addressing these issues and starting dialogues will lay the groundwork for the many other HIV prevention tools now being developed and tested.

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Research works printed but not linked: 6

  1. HosekS RudyB LandovitzR KapogiannisB SiberryG LiuN et al.An HIV pre‐exposure prophylaxis demonstration project and safety study for young men who have sex with men in the United States (ATN 110).J Int AIDS Soc.2015;18:20479. Available from:http://www.jiasociety.org/index.php/jias/article/view/20479
  2. GillK MarcusR DietrichJ BennieT HosekS GrayG et al.An analysis of baseline and early data from the Plus Pills study: an open‐label trial of preexposure prophylaxis for South African adolescents. In International AIDS Conference; 2016 July 19; Durban.
  3. Centers for Disease Control and Prevention., 2014, Clinical guidelines for the use of pre‐exposure prophylaxis to prevent HIV.
  4. 2015, UNICEF consultation on clinical, ethical and operational onsiderations for the implementation of oral pre‐exposure prophylaxis (PrEP) in sexually active older adolescents (15–19) at high risk of HIV infection: meeting report
  5. KnopfA OttM LiuN KapogiannisB ZimetG FortenberryD et al.Unexpected benefits and heightened disclosure risks: adolescents’ experiences in a PrEP trial. International AIDS Conference Durban; 2016 July 19.
  6. BekkerLG HughesJ AmicoR RouxS HendrixC AndersonPL et al.HPTN 067/ADAPT CapeTown:a comparison of daily and nondaily PrEP dosing in African women.Conference on Retroviruses and Opportunistic Infections (CROI) San Francisco CA USA: International AIDS Society;2015Feb 23. p. 23–6.

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Metadata

Authors
Hosek, S., Celum, C., Wilson, C. M., Kapogiannis, B., Delany‐Moretlwe, S., & Bekker, L.
Affiliations
  • John H. Stroger, Jr. Hospital of Cook County (US)
  • University of Washington (US)
  • University of Alabama at Birmingham (US)
  • National Institutes of Health (US)
  • University of Cape Town (ZA)
Corresponding author
Hosek, Sybil
ORCID
Venue
Journal of the International AIDS Society
Publisher
Wiley
Published
2016-10
Volume
19
Issue
7S6
Pages
21107-21107
ISSN
1758-2652 (ISSN-L)
DOI
10.7448/ias.19.7.21107
PMC
PMC5071778
OpenAlex
W2536440088
Cited by
138
References
32
Citations by year
2026: 5 · 2025: 6 · 2024: 7 · 2023: 9 · 2022: 19 · 2021: 28 · 2020: 14 · 2019: 19 · 2018: 17 · 2017: 12 · 2016: 2
FWCI
15.38
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the International AIDS Society (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Adolescent Sexual and Reproductive Health
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
Keywords
HIV prevention, oral pre-exposure prophylaxis, adolescents, Truvada, PrEP adherence, youth-friendly health services, HIV stigma, health care financing, clinician acceptability, HIV incidence, United States, South Africa
MeSH terms
Adolescent, Adult, Delivery of Health Care, Female, Humans, Male, South Africa, United States, HIV Infections, Anti-HIV Agents, Young Adult, Social Stigma, Pre-Exposure Prophylaxis

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