HIV PrEP

The MCG Pediatric Podcast

Adolescents represent a portion of the fastest growing demographic for development of sexually transmitted infection. Studies have found that STIs have some of the highest rates in individuals aged 15-24, and 20% of new HIV diagnoses occur in people aged 13-24. Pre-exposure prophylaxis (PrEP) is medicine people at risk for HIV take to prevent getting HIV from sex or injection drug use and is an effective tool to dramatically decrease the risk of HIV acquisition in at-risk youth. Dr. Cheryl Newman, a board certified infectious disease specialist joins medical students Patrice Collins and Elise Liu to discuss PrEP for HIV prevention in the adolescent population. After listening to this podcast, learners should be able to:

• Learn the approach to sexual health screening in adolescents.
• Understand the risks of HIV exposure in adolescents.
• Define PrEP and how it works.
• Understand the requirements for starting PrEP, including demographics and preliminary testing.
• Explain the federal and/or state laws that govern the prescription of HIV prevention medicine for adolescents.

FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=11407

References:

1. Agwu A. Sexuality, Sexual Health, and Sexually Transmitted Infections in Adolescents and Young Adults. Top Antivir Med. 2020;28(2):459-462.
2. Centers for Disease Control and Prevention. Prep for HIV Prevention in the U.S. Accessed Apr 15, 2022. https://www.cdc.gov/nchhstp/newsroom/fact-sheets/hiv/PrEP-for-hiv-prevention-in-the-US-factsheet.html
3. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV. National Institute of Health. Updated Jun 03, 2021. Accessed Apr 15, 2022. https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/adolescents-and-young-adults-hiv#:~:text=Preventive%20Measures%20and%20Supporting%20Long,%2C%20osteoporosis%2C%20and%20neurocognitive%20impairment.
4. Hsu K, Rakhmanina N. Adolescents and Young Adults: The Pediatrician’s Role in HIV Testing and Pre- and Postexposure HIV Prophylaxis. Pediatrics. 2022; 149(1):e2021055207
5. Hosek S, Henry-Reid L. PrEP and Adolescents: The Role of Providers in Ending the AIDS Epidemic. January 2020; 145 (1): e20191743. 10.1542/peds.2019-1743
6. Truvada Website. https://www.truvada.com/truvada-safety/clinical-studies. Accessed Apr 15, 2022.
7. Descovy Website. https://www.descovy.com/#isi. Accessed Apr 15, 2022.
8. FDA Approves First Injectable Treatment for HIV Pre-Exposure Prevention. Dec 20, 2021. Accessed Apr 15, 2022. https://www.fda.gov/news-events/press-announcements/fda-approves-first-injectable-treatment-hiv-pre-exposure-prevention
9. Landovitz RJ, Donnell D, Clement ME, et al. Cabotegravir for HIV Preention in Cisgender Men and Transgender Women. N Engl J Med. August 2021; 385:595-608. https://www.nejm.org/doi/full/10.1056/NEJMoa2101016

• Highleyman L. US approves injectable cabotegravir for PrEP. Accessed Apr 15, 2022. https://www.aidsmap.com/news/dec-2021/us-approves-injectable-cabotegravir-prep
• Trial results reveal that long-acting injectable cabotegravir as PrEP is highly effective in preventing HIV acquisition in women. Nov 9, 2020. Accessed Apr 15, 2022. https://www.who.int/news/item/09-11-2020-trial-results-reveal-that-long-acting-injectable-cabotegravir-as-prep-is-highly-effective-in-preventing-hiv-acquisition-in-women
• FDA approves second drug to prevent HIV infection as part of ongoing efforts to end the HIV epidemic. Oct 3, 2019. Accessed Apr 15, 2022. https://www.fda.gov/news-events/press-announcements/fda-approves-second-drug-prevent-hiv-infection-part-ongoing-efforts-end-hiv-epidemic#:~:text=The%20U.S.%20Food%20and%20Drug,who%20have%20receptive%20vaginal%20sex
• Centers for Disease Control and Prevention. Pre-exposure Prophylaxis (PrEP). Accessed Apr 15, 2022. https://www.cdc.gov/hiv/clinicians/prevention/prep.html#:~:text=For%20oral%20PrEP&text=Assess%20creatinine%20clearance%20once%20every,creatinine%20clearance%20every%206%20months
• Tanner M, Miele P, et al. Preexposure Prophylaxis for Prevention of HIV Acquisition Among Adolescents: Clinical Considerations, 2020. CDC Recommendations and Reports. 2020; 69(3):1-12
• Cowan EA, McGowan JP, Fine SM, et al. Diagnosis and Management of Acute HIV [Internet]. Baltimore (MD): Johns Hopkins University; 2021 Jul. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563020/
• Sax PE. Screening and diagnostic testing for HIV infection. In: Post TW, ed. UpToDate; 2022. Accessed May 15, 2022. https://www.uptodate.com/contents/screening-and-diagnostic-testing-for-hiv-infection?search=hiv%20screening&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
• Jaspard M, Le Moal G, Saberan-Roncato M, Plainchamp D, Langlois A, Camps P, Guigon A, Hocqueloux L, Prazuck T. Finger-stick whole blood HIV-1/-2 home-use tests are more sensitive than oral fluid-based in-home HIV tests. PLoS One. 2014 Jun 27;9(6):e101148. doi: 10.1371/journal.pone.0101148. PMID: 24971842; PMCID: PMC4074152.
• NBC News. 2022. PrEP, the HIV prevention pill, must now be totally free under almost all insurance plans. [online] Available at: [Accessed 19 May 2022].