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JAMA Pediatrics Patient Page
October 25, 2021

Pre-exposure Prophylaxis—Preventing HIV in Adolescents

Author Affiliations
  • 1Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
  • 2Department of Pediatrics, University of Florida, Gainesville
JAMA Pediatr. 2021;175(12):1300. doi:10.1001/jamapediatrics.2021.3274

According to the US Centers for Disease Control and Prevention (CDC), approximately 25% of new HIV infections annually occur in people younger than 24 years.

What Is HIV?

Anyone who is having sex or is thinking about having sex must know how to protect themselves against HIV infection. HIV is a virus that is primarily transmitted via blood and sexual contact, and it infects and damages the body’s immune system. Over time, if untreated, it can lead to a disease called AIDS. Untreated persons infected with HIV can get severe infections and cancers, which may lead to death. Unfortunately, there is no cure or vaccine for HIV, so prevention of infection is critical.

Is My Teen at Risk for HIV Infection?

You, your teen, and your pediatrician must have conversations about preventing sexually transmitted infections like HIV. Preventing HIV can be accomplished through various strategies, such as abstinence, consistent and correct condom use, and pre-exposure prophylaxis (PrEP) for HIV.

Historically, HIV infections have been attributed solely to men who have sex with men. However, according to data from the CDC, 30% of new HIV infections in 2017 were due to heterosexual sexual contact or intravenous drug use. Additionally, as many as 20% of people living with HIV are not aware that they have HIV; this places their sexual partners at high risk for developing HIV.

What Is PrEP for HIV?

PrEP is a very effective means to prevent HIV infection from sexual contact when taken as prescribed. Most current forms of PrEP are prescribed as a once-daily pill, but newer medication forms may become available in the coming years, so talk to your pediatrician about what is best for your adolescent. When combined with safer sex practices such as correct and consistent condom use, the chance of getting HIV from sexual contact is nearly zero. It is currently recommended that PrEP be offered to adolescents who are at high risk of contracting HIV. Generally, your teen could be considered at high risk if they have had a sexually transmitted infection, such as chlamydia, gonorrhea, or syphilis, in the past or if they are sexually active in an area where there are a lot of people living with HIV; you can visit https://aidsvu.org to find the prevalence of HIV in your community. Other high-risk activities include using intravenous drugs, having any sex without the use of condoms or other barrier protections such as dental dams, or having sexual partners with unknown or positive HIV status. The CDC has an online tool to estimate the risk of HIV at http://hivrisk.cdc.gov.

How Can My Teen Get PrEP?

PrEP can be prescribed by your pediatrician and is also available through many local health departments. PrEP medications are usually covered by most major insurance companies. If you do not have insurance or have trouble paying, you can visit the CDC’s PrEP Basics website (https://www.cdc.gov/hiv/basics/prep.html) or talk to your pediatrician about how to find free or affordable PrEP coverage.

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Article Information

Published Online: October 25, 2021. doi:10.1001/jamapediatrics.2021.3274

Conflict of Interest Disclosures: None reported.