CDC Publishes Clinical Considerations on PrEP for HIV Prevention in Adolescents
The Centers for Disease Control and Prevention (CDC) has released clinical considerations for the evaluation of adolescents for pre-exposure prophylaxis (PrEP) for the prevention of HIV.
Important, unique considerations for the adolescent population outlined by the CDC include:
- Safety data for PrEP. Overall, data indicate that PrEP is safe for use among adolescents.
- Legal issues about consent for clinical care and confidentiality. Providers should be aware of legal issues related to providing health care to minors in their respective states.
- The therapeutic partnership between providers and adolescents and their parents or guardians. Providers should partner with adolescent patients when it comes to PrEP-related decisions, with recognition of the adolescent’s autonomy to the extent permitted by laws, and inclusion of parents when discussing PrEP when doing so is reasonable and safe.
- The approach to the adolescent patient’s clinical visit. During clinical visits, a comprehensive approach to adolescent health is recommended. This often includes consideration of PrEP as one potential facet of health care for adolescents who inject drugs or engage in sexual behaviors that increase their risk for acquiring HIV.
- Medication initiation, adherence, and persistence during adolescence. Data indicate that medication adherence tends to decline over time among adolescents. More frequent follow-up visits may be needed to ensure adherence.
The authors of the considerations note that recommendations for PrEP medical management are available in the 2017 US Public Health Service clinical practice guideline for PrEP in the prevention of HIV in the United States, along with the 2017 supplement to this guideline.
—Christina Vogt
Reference:
Tanner MR, Miele P, Carter W, et al. Preexposure prophylaxis for prevention of HIV acquisition among adolescents: clinical considerations, 2020. MMWR Recomm Rep. 2020;69(No. RR-3):1-12. doi:10.15585/mmwr.rr6903a1