Identifying Missed Opportunities for Human Immunodeficiency Virus Pre-exposure Prophylaxis During Preventive Care and Reproductive Visits in Adolescents in the Deep South.

Academic Article


  • BACKGROUND: Pre-exposure prophylaxis (PrEP) for individuals at significant risk for Human Immunodeficiency Virus acquisition is approved for individuals weighing at least 35 kg by the Food and Drug Administration. This cross-sectional study analyzed indications for PrEP in a clinical setting. METHODS: There were 429 charts reviewed from adolescents between 15 and 21 years old seen for preventive care visits at an adolescent primary care center in the Deep South during a 1-year timeframe. Univariate and multivariable regression analyses were completed to identify factors associated with indications for PrEP. RESULTS: Forty-four percent of 429 adolescents (between 15 and 21 years) had a PrEP indication; 77% were women and 95% heterosexual. Significant factors associated with an indication for PrEP included living with a nonparent or nonrelative and polysubstance use. No adolescents with an indication for PrEP were prescribed PrEP. A sensitivity analysis comparing indications for PrEP between the 2014 and 2017 The Centers for Disease Control and Prevention Guidelines revealed no significant differences in percent with an indication (44.5% vs. 42.8%) or factors associated with indications. CONCLUSIONS: Pre-exposure prophylaxis as a biomedical tool for adolescents and young adults (AYAs) may remain underutilized. A key factor in improving utilization involves providers being able to recognize AYAs who may have an indication for PrEP with a specific focus on those AYAs who do not live in households with parents or a surrogate family member and those who are polysubstance users.
  • Published In


  • Adolescent, Adolescent Medicine, Alabama, Ambulatory Care, Anti-HIV Agents, Cross-Sectional Studies, Drug Users, Female, HIV, HIV Infections, Heterosexuality, Humans, Male, Pre-Exposure Prophylaxis, Primary Health Care, Surveys and Questionnaires, Young Adult
  • Digital Object Identifier (doi)

    Author List

  • Hill SV; Westfall AO; Coyne-Beasley T; Simpson T; Elopre L
  • Start Page

  • 88
  • End Page

  • 95
  • Volume

  • 47
  • Issue

  • 2