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Adolescent pre-exposure prophylaxis for HIV prevention: current perspectives.

Daisy Maria Machado1, Alexandre Machado de Sant'Anna Carvalho2, Rachel Riera3

  • 1Disciplina de Infectologia Pediátrica, Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo.

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Summary

Pre-exposure prophylaxis (PrEP) shows promise for preventing HIV in adolescents, but more research is needed on its safety and feasibility in this group. This review summarizes current evidence on PrEP for young people aged 10-24.

Keywords:
HIV preventionadolescentspre-exposure prophylaxis (PrEP)youth

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Adolescent Medicine

Background:

  • Adolescents, particularly girls and other vulnerable subgroups, are disproportionately affected by the HIV epidemic.
  • Over 2 million adolescents aged 10-19 live with HIV, with millions more at risk.
  • Pre-exposure prophylaxis (PrEP) is an effective HIV prevention tool for high-risk adults, but its use in adolescents is under investigation.

Purpose of the Study:

  • To review and summarize existing evidence on the safety, feasibility, adherence, self-perception, and legal aspects of PrEP for adolescents aged 10-24.
  • To identify knowledge gaps and inform future research and policy regarding adolescent PrEP implementation.

Main Methods:

  • Systematic review of published studies on PrEP for adolescents.
  • Compilation and analysis of data focusing on safety, adherence, feasibility, self-perception, and legal considerations.
  • Inclusion of studies involving individuals aged 10 to 24 years.

Main Results:

  • PrEP has demonstrated efficacy in adult trials, with effectiveness dependent on adherence.
  • Concerns regarding real-world PrEP implementation in adolescents include stigma, cost, and clinician experience.
  • Limited studies currently exist on PrEP efficacy and feasibility specifically within adolescent populations.

Conclusions:

  • Further research is crucial to address the gaps in knowledge regarding PrEP for adolescents.
  • No country has yet approved PrEP for adolescent use, highlighting the need for more evidence.
  • Understanding the unique challenges and benefits of PrEP for adolescents is essential for effective HIV prevention strategies.