TY - JOUR
T1 - Perspectives on and Preferences for On-Demand and Long-Acting PrEP Among Sexual and Gender Minority Adolescents Assigned Male at Birth
AU - Macapagal, Kathryn
AU - Nery-Hurwit, Mara
AU - Matson, Margaret
AU - Crosby, Shariell
AU - Greene, George J.
N1 - Funding Information:
This research was supported by an administrative supplement to Kathryn Macapagal from the National Institute of Allergy and Infectious Diseases to the Third Coast Center for AIDS Research (P30 AI117943; PI: Richard D’Aquila).
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Adolescent behavior
KW - HIV
KW - Pre-exposure prophylaxis
KW - Sexual and gender minorities
KW - Sexual behavior
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U2 - 10.1007/s13178-020-00441-1
DO - 10.1007/s13178-020-00441-1
M3 - Article
AN - SCOPUS:85080960202
VL - 18
SP - 39
EP - 53
JO - Sexuality Research and Social Policy: Journal of NSRC
JF - Sexuality Research and Social Policy: Journal of NSRC
SN - 1868-9884
IS - 1
ER -