Abstract
Purpose
One third of people newly living with HIV/AIDS are adolescents. Research on adolescent
HIV prevention is critical owing to differences between adolescents and adults. Parental
permission requirements are often considered a barrier to adolescent enrollment in
research, but whether adolescents view this barrier as the most important one is unclear.
Methods
Adolescents were approached in schools in KwaZulu-Natal, South Africa, and at a sexually
transmitted infection clinic at the Children’s Hospital of Aurora, Colorado. Surveys
with a hypothetical vignette about participation in a pre-exposure prophylaxis trial
were conducted on smartphones or tablets with 75 adolescents at each site. We calculated
descriptive statistics for all variables, using 2-sample tests for equality of proportions
with continuity correction. Statistical significance was calculated at p < 0.05. Multivariate analyses were also conducted.
Results
Most adolescents thought side effects (77%) and parental consent requirements (69%)
were very important barriers to research participation. When asked to rank barriers,
adolescents did not agree on a single barrier as most important, but the largest group
of adolescents ranked parental consent requirements as most important (29.5%). Parental
consent was seen as more of a barrier for adolescents in South Africa than in the
United States. Concerns about being experimented on or researchers’ mandatory reporting
to authorities were ranked much lower. Finally, most (71%, n = 106) adolescents said
they would want to extra support from another adult if parental permission was not
required.
Conclusion
Adolescents consider both parental permission requirements and side effects important
barriers to their enrollment in HIV prevention research. Legal reform and better communication
strategies may help address these barriers.
Keywords
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Article info
Publication history
Published online: July 05, 2020
Accepted:
April 17,
2020
Received:
November 22,
2019
Footnotes
Conflicts of interest: The authors had no conflicts of interest to report.
Disclaimer: The opinions expressed herein are the authors' and not the views of the National Institutes of Health, the Department of Health and Human Services, or the U.S. federal government.
Identification
Copyright
© 2020 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- HIV Prevention in Adolescents: Removing Obstacles and Protecting Human RightsJournal of Adolescent HealthVol. 67Issue 4
- PreviewA disturbingly high proportion of new HIV infections occur in adolescents and young adults, and far too many young people are dying of AIDS-related illnesses. As noted by Shah et al. [1] in their important study of obstacles to HIV prevention research in adolescents, globally one-third of new HIV infections are in the 15- to 24-year age group. HIV prevention for young people is therefore an essential public health imperative. Successful HIV prevention efforts must include research, outreach and education, HIV testing and counseling, and access to preexposure prophylaxis (PrEP) as well as HIV treatment.
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