What Works in Youth HIV
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PrEP for HIV Prevention [1]

Pre-Exposure Prophylaxis

There are varied prevention methods to help young adults remain HIV-negative. Most of these methods involve changing behavior to prevent HIV. Pre-Exposure [2] Prophylaxis [2], referred to as PrEP, is a biomedical prevention method for people who are not HIV-positive but are at high risk of getting HIV. It requires taking a pill (Truvada) every day to prevent HIV infection. Combined with other behavioral strategies, PrEP offers an effective way to prevent young adults from contracting HIV and becoming HIV-positive.

How PrEP Works for HIV Prevention

PrEP involves taking an antiretroviral medication, Truvada, once a day before exposure to HIV. Truvada is a combination of two medications (tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC). Like the birth control pill, the medication is taken continuously and not just when engaging in sex or sharing needles. When taken as directed, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by more than 90%. This effectiveness decreases when PrEP is taken inconsistently. The higher the concentration of PrEP medication in a person’s system, the more effective it is at preventing HIV. PrEP does not protect against other sexually transmitted infections (STIs) or pregnancy, making other prevention methods necessary to address other sexual health needs.

Who Can Take PrEP

Since 2004, Truvada, the antiretroviral medication used for PrEP, has been approved as an HIV treatment medication for HIV-positive people ages 12 and older. In 2012, the Food and Drug Administration (FDA) approved Truvada for use as PrEP for HIV prevention in people ages 18 and over. In 2018, the FDA expanded this approval to include adolescents at risk for HIV who weigh at least 77 pounds. There are no clinical guidelines [3] or published protocols for providing PrEP to youth under the age of 18. 

Youth HIV Facts

Studies have shown that PrEP reduces the risk of getting HIV from sex by more than 90% when used consistently.
Source: 
Centers for Disease Control and Prevention
Tweet this [4]

Linking Young Adults to PrEP

PrEP can only be prescribed by a health care provider. Therefore, young adults must be connected to health care providers who can screen them in order to prescribe PrEP. Youth-serving professionals can also help young adults learn about PrEP by adding information to their organizations' websites and printed materials, and by including PrEP in educational sessions.

Supporting Young Adults Taking PrEP

Young adults on PrEP need support to ensure that they are taking the medication daily and seeing their health care providers for follow-up appointments. These appointments include regular screening for HIV, STIs, and other adverse effects such as renal toxicity. As young adults may have other concerns in their lives that create barriers to doing this, it is essential to engage them in timely and appropriate conversations about medication adherence, STI prevention, or pregnancy prevention.

The cost of PrEP can pose a financial challenge for some young adults. They will likely need help to get health insurance, navigate their existing insurance, or leverage patient assistance programs to reduce the cost of the medication.

event [5]
Image of two men talking to a health care professional [6]

A Conversation about Youth Access to PrEP [6]

May 31, 2018

View this webinar to hear a conversation about increasing youth access to PrEP, challenges youth face in accessing and adhering to PrEP, and common misconceptions about PrEP.

Implementation Resources: 
Article/Report [7]
Article Resource

FDA Approves Truvada as PrEP for Adolescents at Risk for HIV [8]

This POZ article describes the new Food & Drug Administration approval of Truvada as PrEP for adolescents at risk of HIV.

Fact Sheet [9]
Fact Sheet Resource

PrEP 101 [10]

A fact sheet about PrEP: pre-exposure prophylaxis, a daily medicine that can reduce a person's chance of getting HIV.

Toolkit [11]
Toolkit Resource

PrEP Education for Youth-Serving Primary Care Providers Toolkit [12]

The PrEP Education for Youth-Serving Primary Care Providers Toolkit focuses on supporting primary care providers (PCPs) to provide PrEP to youth.

Blog [13]
Blog Resource

5 Barriers Teens Face to Accessing PrEP [14]

This Mount Sinai Adolescent Health Center blog post outlines five barriers that young people face when they try to access PrEP.

Webpage [15]
Webpage Resource

PleasePrEPMe.org: Resources [16]

PleasePrEPMe.org: Resources provides individual webpages with PrEP resources for all 50 U.S. states.

Article/Report [7]
Article Resource

Drug combination reduces risk of HIV infection among teen males [17]

The National Institutes of Health conducted a study of PrEP in adolescent males and concluded that Truvada is safe for youth.

Audio [18]
Audio Resource

Be PrEPared [19]

This episode of NPR's 1A podcast discusses pre-exposure prophylaxis, or PrEP, an HIV prevention medication.

What Works in Youth HIV is operated by JSI, a public health management consulting and research organization dedicated to improving the health of individuals and communities around the world. From July 1, 2015 through June 30, 2018, the Adolescent HIV/AIDS Prevention National Resource Center was provided financial support through a cooperative agreement awarded by the Department of Health and Human Services (HHS) Office of Adolescent Health (OAH) under grant number MAIAH000001-01-00, with funding from the HHS Secretary’s Minority AIDS Initiative Fund. The content and conclusions on this website are those of the author/s and do not necessarily represent the official positions or policies of OAH, HHS, or the U.S. Government.

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Source URL: https://whatworksinyouthhiv.org/strategies/prep-hiv-prevention

Links
[1] https://whatworksinyouthhiv.org/strategies/prep-hiv-prevention
[2] http://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/pre-exposure-prophylaxis/
[3] https://www.cdc.gov/hiv/pdf/PrEPguidelines2014.pdf
[4] https://twitter.com/intent/tweet?url=https://tinyurl.com/y4lc8xfd&text=Studies+have+shown+that+PrEP+reduces+the+risk+of+getting+HIV+from+sex+by+more+than+90%25+when+used+consistently.
[5] https://whatworksinyouthhiv.org/search/?field_event_type_tid%5B0%5D=65&field_event_type_tid%5B1%5D=66&field_event_type_tid%5B2%5D=67&field_event_type_tid%5B3%5D=18&field_event_type_tid%5B4%5D=19&field_event_type_tid%5B5%5D=17
[6] https://whatworksinyouthhiv.org/event/conversation-about-youth-access-prep
[7] https://whatworksinyouthhiv.org/search/?field_resource_type_tid%5B%5D=15
[8] https://whatworksinyouthhiv.org/resource/fda-approves-truvada-prep-adolescents-risk-hiv
[9] https://whatworksinyouthhiv.org/search/?field_resource_type_tid%5B%5D=12
[10] https://whatworksinyouthhiv.org/resource/prep-101
[11] https://whatworksinyouthhiv.org/search/?field_resource_type_tid%5B%5D=81
[12] https://whatworksinyouthhiv.org/resource/prep-education-youth-serving-primary-care-providers-toolkit
[13] https://whatworksinyouthhiv.org/search/?field_resource_type_tid%5B%5D=78
[14] https://whatworksinyouthhiv.org/resource/5-barriers-teens-face-accessing-prep
[15] https://whatworksinyouthhiv.org/search/?field_resource_type_tid%5B%5D=83
[16] https://whatworksinyouthhiv.org/resource/pleaseprepmeorg-resources
[17] https://whatworksinyouthhiv.org/resource/drug-combination-reduces-risk-hiv-infection-among-teen-males
[18] https://whatworksinyouthhiv.org/search/?field_resource_type_tid%5B%5D=77
[19] https://whatworksinyouthhiv.org/resource/be-prepared