Macapagal Kathryn, Nery-Hurwit Mara, Matson Margaret, Crosby Shariell, Greene George J
Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University; 625 N. Michigan Avenue, Chicago, IL 60611, USA.
Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University; 625 N. Michigan Avenue, Chicago, IL 60611, USA.
Sex Res Social Policy. 2021 Mar;18(1):39-53. doi: 10.1007/s13178-020-00441-1. Epub 2020 Feb 21.
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.
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.
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.
SGM adolescents are interested in long-acting PrEP, yet also perceive substantial obstacles to using biomedical prevention that reflect adolescents' developmental contexts.
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.
出生时被指定为男性且与男性伴侣发生性行为的性少数和性别少数（SGM）青少年感染艾滋病毒的风险增加。在美国，青少年可以获得每日口服暴露前预防（PrEP）药物，但他们可能在坚持服药方面存在困难。对于那些无需每日服药的新型PrEP给药方式，青少年的看法尚未得到充分探讨。
我们在2018年11月至2019年2月期间对59名出生时被指定为男性且报告与男性伴侣发生性行为或对男性伴侣有吸引力的SGM青少年进行了在线调查和焦点小组访谈。问题评估了他们对生物医学（按需、注射、植入）和非生物医学艾滋病毒预防选项（避孕套）的看法和偏好。对数据进行了主题分析。
在所有预防选项中，植入式预防和避孕套的评分最高，参与者更喜欢植入式预防而非其他生物医学选项。便利性、持续时间和获取的难易程度在青少年的偏好中起着重要作用。无论采用何种给药方式，父母都被视为服用PrEP的障碍，因为他们在青少年获得医疗保健的能力方面发挥着作用。
SGM青少年对长效PrEP感兴趣，但也意识到使用生物医学预防措施存在重大障碍，这反映了青少年的发展背景。
扩大青少年获得艾滋病毒预防服务的州法律、包括PrEP信息的性教育以及由父母和提供者发起的PrEP对话，无论采用何种PrEP给药方式，都可以减少障碍。需要开展研究以加速青少年长效植入式预防措施的可用性。
