Leonard Sean, Sotindjo Tatiana, Brophy Jason, Tan Darrell H S, Nashid Nancy
Department of Paediatrics, Western University, London, Ontario, Canada.
Division of Adolescent Medicine and Division of Paediatric Infectious Diseases, University of British Columbia, Vancouver, British Columbia, Canada.
Paediatr Child Health. 2023 Mar 22;28(6):338-343. doi: 10.1093/pch/pxac115. eCollection 2023 Oct.
Youth (aged 15 to 29 years) account for one quarter of new HIV cases in Canada. Of those, men-who-have-sex-with-men make up one third to one half of new cases in that age range. Moreover, Indigenous youth are over-represented in the proportion of new cases. The use of emtricitabine/tenofovir disoproxil fumarate as pre-exposure prophylaxis (PrEP) significantly reduces the risk of HIV acquisition in adults. Its use was expanded to include youth over 35 kg by the U.S. Food and Drug Administration in 2018. However, PrEP uptake remains low among adolescents. Prescriber-identified barriers include lack of experience, concerns about safety, unfamiliarity with follow-up guidelines, and costs. This article provides an overview of PrEP for youth in Canada, and its associated safety and side effect profiles. Hypothetical case vignettes highlight some of the many demographics of youth who could benefit from PrEP. We present a novel flow diagram that explains the baseline workup, prescribing guidelines, and follow-up recommendations in the Canadian context. Additional counselling points highlight some of the key discussions that should be elicited when prescribing PrEP.
在加拿大，青年（15至29岁）占新增艾滋病毒病例的四分之一。其中，男男性行为者占该年龄组新增病例的三分之一至二分之一。此外，原住民青年在新增病例比例中占比过高。使用恩曲他滨/替诺福韦酯富马酸替诺福韦二吡呋酯作为暴露前预防（PrEP）可显著降低成年人感染艾滋病毒的风险。2018年，美国食品药品监督管理局将其使用范围扩大至体重超过35公斤的青年。然而，青少年对PrEP的接受度仍然很低。处方医生指出的障碍包括缺乏经验、对安全性的担忧、不熟悉随访指南以及费用问题。本文概述了加拿大针对青年的PrEP及其相关的安全性和副作用情况。假设病例 vignettes 突出了一些可能从PrEP中受益的青年的众多人口统计学特征。我们展示了一个新颖的流程图，解释了加拿大背景下的基线检查、处方指南和随访建议。其他咨询要点突出了在开具PrEP处方时应引发的一些关键讨论。
原文中“vignettes”未找到合适的中文释义，保留英文未译。
