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Adolescent Health Providers’ Willingness to Prescribe Pre-Exposure Prophylaxis (PrEP) to Youth at Risk of HIV Infection in the United States

  • Author Footnotes
    1 Present address: Stanford Children's Health, 50 S San Mateo Dr, #180, San Mateo, CA 94401.
    Geoffrey D. Hart-Cooper
    Correspondence
    Address correspondence to: Geoffrey D. Hart-Cooper, M.D., University of California San Francisco, UCSF-Benioff Children's Hospital, Department of Pediatrics, 550 16th Street, 4th floor, San Francisco, CA 94143-0110.
    Footnotes
    1 Present address: Stanford Children's Health, 50 S San Mateo Dr, #180, San Mateo, CA 94401.
    Affiliations
    Department of Pediatrics, UCSF-Benioff Children's Hospital, University of California, San Francisco, California
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  • Isabel Allen
    Affiliations
    Department of Epidemiology and Biostatistics, University of California, San Francisco, California
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  • Charles E. Irwin Jr.
    Affiliations
    Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UCSF-Benioff Children's Hospital, University of California, San Francisco, California
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  • Hyman Scott
    Affiliations
    Bridge HIV, San Francisco Department of Public Health, San Francisco, California
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  • Author Footnotes
    1 Present address: Stanford Children's Health, 50 S San Mateo Dr, #180, San Mateo, CA 94401.

      Abstract

      Purpose

      HIV disproportionately affects young men who have sex with men. Pre-exposure prophylaxis (PrEP) can prevent HIV acquisition; however, youth access to PrEP is limited by provider willingness to prescribe PrEP.

      Methods

      We conducted an online survey of clinicians working with adolescents (aged 13–17 years) and young adults (aged 18–26 years) in the United States through the Society of Adolescent Health and Medicine. We used multivariate logistic regression to assess provider beliefs associated with willingness to provide PrEP.

      Results

      Nearly all (93.2%) providers had heard of PrEP, and 57 (35.2%) had prescribed PrEP. While almost all providers (95%) agreed that PrEP prevents HIV, fewer were willing to prescribe to young adults (77.8%) or adolescents (64.8%). Willingness to prescribe PrEP was strongly associated with the belief that providers had enough knowledge to safely provide PrEP to adolescents (OR 2.11, confidence interval [CI]: 1.18–3.76, p = .01) and young adults (odds ratio 5.19, CI: 2.15–12.50, p ≤ .001), and that adolescents would be adherent (odds ratio 3, CI: 1.30–6.90, p = .01). Response rate was 17%.

      Conclusions

      Almost all providers had heard of PrEP and most providers were willing to prescribe PrEP. Provider education and tools to promote provider self-efficacy and adolescent adherence might improve provider willingness to provide PrEP.

      Keywords

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