Adolescent Health Providers’ Willingness to Prescribe Pre-Exposure Prophylaxis (PrEP) to Youth at Risk of HIV Infection in the United States

Abstract

PurposeHIV disproportionately affects young men who have sex with men. Pre-exposure prophylaxis (PrEP) can prevent HIV acquisition; however, youth access to PrEP is limited by provider willingness to prescribe PrEP. MethodsWe conducted an online survey of clinicians working with adolescents (aged 13–17 years) and young adults (aged 18–26 years) in the United States through the Society of Adolescent Health and Medicine. We used multivariate logistic regression to assess provider beliefs associated with willingness to provide PrEP. ResultsNearly all (93.2%) providers had heard of PrEP, and 57 (35.2%) had prescribed PrEP. While almost all providers (95%) agreed that PrEP prevents HIV, fewer were willing to prescribe to young adults (77.8%) or adolescents (64.8%). Willingness to prescribe PrEP was strongly associated with the belief that providers had enough knowledge to safely provide PrEP to adolescents (OR 2.11, confidence interval [CI]: 1.18–3.76, p = .01) and young adults (odds ratio 5.19, CI: 2.15–12.50, p ≤ .001), and that adolescents would be adherent (odds ratio 3, CI: 1.30–6.90, p = .01). Response rate was 17%. ConclusionsAlmost all providers had heard of PrEP and most providers were willing to prescribe PrEP. Provider education and tools to promote provider self-efficacy and adolescent adherence might improve provider willingness to provide PrEP.