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Review
. 2017 Nov 29:8:137-148.
doi: 10.2147/AHMT.S112757. eCollection 2017.

Adolescent pre-exposure prophylaxis for HIV prevention: current perspectives

Daisy Maria Machado  1 , Alexandre Machado de Sant'Anna Carvalho  2 , Rachel Riera  3
Affiliations
Review

Adolescent pre-exposure prophylaxis for HIV prevention: current perspectives

Daisy Maria Machado et al. Adolesc Health Med Ther. .

Abstract

Adolescents are a critical population that is disproportionately impacted by the HIV epidemic. More than 2 million adolescents between the age group of 10 and 19 years are living with HIV, and millions are at risk of infection. HIV risks are considerably higher among girls, especially in high-prevalence settings such as eastern and southern Africa. In addition to girls, there are other vulnerable adolescent subgroups, such as teenagers, who use intravenous (IV) drugs, gay and bisexual boys, transgender youth, male sex workers, and people who fall into more than one of these categories. Pre-exposure prophylaxis (PrEP) is a new intervention for people at high risk for acquiring HIV, with an estimated HIV incidence of >3%. Recent data from trials show evidence of the efficacy of PrEP as a powerful HIV prevention tool in high-risk populations, including men who have sex with men, HIV-1-serodiscordant heterosexual couples, and IV drug users. The reported efficacy in those trials of the daily use of oral tenofovir, alone or in combination with emtricitabine, to prevent HIV infection ranged from 44% to 75% and was heavily dependent on adherence. Despite the proven efficacy of PrEP in adult trials, concerns remain about its feasibility in real-life scenarios due to stigma, cost, and limited clinician experience with PrEP delivery. Recent studies are attempting to expand the inquiry into the efficacy of such HIV prophylaxis approaches in adolescent populations, but there are still many gaps in knowledge, and no country has yet approved it for use with adolescents. The aim of this review was to identify and summarize the evidence from studies on PrEP for adolescents. We have compiled and reviewed published studies focusing on safety, feasibility, adherence to therapeutics, self-perception, and legal issues related to PrEP in people aged between 10 and 24 years.

Keywords: HIV prevention; adolescents; pre-exposure prophylaxis (PrEP); youth.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Factors that influence acceptability and implementation of PrEP in adolescents. Note: Arguments in favor and the issues that should be better addressed. Abbreviation: PrEP, pre-exposure prophylaxis.
See this image and copyright information in PMC

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