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Sexuality Research and Social Policy

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21-02-2020

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

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

Published in: Sexuality Research and Social Policy | Issue 1/2021

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Abstract

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.

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Title: Perspectives on and Preferences for On-Demand and Long-Acting PrEP Among Sexual and Gender Minority Adolescents Assigned Male at Birth
Authors: Kathryn Macapagal
Mara Nery-Hurwit
Margaret Matson
Shariell Crosby
George J. Greene
Publication date: 21-02-2020
Publisher: Springer US
Published in: Sexuality Research and Social Policy / Issue 1/2021
Print ISSN: 1868-9884
Electronic ISSN: 1553-6610
DOI: https://doi.org/10.1007/s13178-020-00441-1

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Abstract

Introduction

Methods

Results

Conclusions

Policy Implications

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