Competence to Consent to Oral and Injectable PrEP Trials Among Adolescent Males Who Have Sex with Males

Celia B. Fisher*, Leah Ibrahim Puri, Kathryn Macapagal, Leah Feuerstahler, Jungwon Rachael Ahn, Brian Mustanski

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Adherence to oral pre-exposure prophylaxis (PrEP) is challenging for adolescent males who have sex with males (AMSM). Once adult trials comparing oral to longer lasting injectable PrEP are completed, there will be a need for adolescent studies. However, lack of data on adolescent consent capacity may sustain guardian permission requirements identified as a barrier to AMSM participation in prior PrEP trials. This online study assessed AMSM’s (14–17 years) consent capacity for these trials, comparing performance to MSM (18–19 years) for whom guardian permission is not required. Applying the MacCAT-CR, participants (N = 214) viewed a video and mock consent form followed by open-ended and yes/no items. Cognitive diagnostic models and means testing analyses supported AMSM capacity to consent to these trials: 16–17 and most 14–15 year-olds, demonstrated consent understanding, appreciation and reasoning at 18–19 year-old levels. Data also identified vulnerabilities requiring attention during informed consent.

Original languageEnglish (US)
Pages (from-to)1606-1618
Number of pages13
JournalAIDS and behavior
Issue number5
StatePublished - May 2021


  • Adolescent sexual minority males
  • HIV prevention
  • Informed consent
  • MacCAT-CR
  • Pre-exposure prophylaxis (PrEP)
  • Randomized clinical trials

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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