Perspectives on and Preferences for On-Demand and Long-Acting PrEP Among Sexual and Gender Minority Adolescents Assigned Male at Birth

Kathryn Macapagal*, Mara Nery-Hurwit, Margaret Matson, Shariell Crosby, George J. Greene

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Introduction: Sexual and gender minority (SGM) adolescents assigned male at birth who have sex with male partners are at increased risk for HIV. Daily oral pre-exposure prophylaxis (PrEP) is available for minor adolescents in the United States, who may have difficulty with adherence. Adolescents’ perspectives toward emerging PrEP delivery methods that would not require daily pill-taking have not been well-explored. Methods: We conducted online surveys and focus groups in November 2018–February 2019 with 59 SGM adolescents assigned male at birth who reported sex with or attraction to male partners. Questions assessed their perspectives on and preferences for biomedical (on-demand, injection, implant) and non-biomedical HIV prevention options (condoms). Data were analyzed thematically. Results: Of all prevention options, the implant and condoms were rated highest, and participants preferred the implant over other biomedical options. Convenience, duration, and ease of access played important roles in adolescents’ preferences. Parents were viewed as a barrier to taking PrEP regardless of delivery method due to their role in adolescents’ ability to access healthcare. Conclusions: SGM adolescents are interested in long-acting PrEP, yet also perceive substantial obstacles to using biomedical prevention that reflect adolescents’ developmental contexts. Policy Implications: State laws expanding adolescents’ access to HIV preventive services, sex education inclusive of PrEP information, and parent- and provider-initiated PrEP conversations can reduce barriers regardless of PrEP delivery method. Research to accelerate the availability of long-acting implants for adolescents is needed.

Original languageEnglish (US)
Pages (from-to)39-53
Number of pages15
JournalSexuality Research and Social Policy
Issue number1
StatePublished - Mar 2021


  • Adolescent behavior
  • HIV
  • Pre-exposure prophylaxis
  • Sexual and gender minorities
  • Sexual behavior

ASJC Scopus subject areas

  • Gender Studies
  • Health(social science)
  • Sociology and Political Science


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