Young cisgender females (at or under age 26) were 63% less likely to be prescribed HIV pre-exposure prophylaxis (PrEP). And this is even if they are also at risk for HIV infection.
This is according to a study, “Differences in Sexual Health Clinic Services by Age and Gender in Metropolitan Boston”, that was published in the journal Sexually Transmitted Diseases. This was authored by Anne M. Neilan, Yiqi Qian, Grace Chamberlin, et al.
According to the researchers, adolescents and young adults comprise only one quarter of the sexually active population, but approximately half of new sexually transmitted infections (STIs) are diagnosed in people of these ages. Sadly, “compared to older adults, little is known about how teens and young adults access and use services like STI screening and treatment, sexual health vaccinations and HIV PrEP, (the) preventive medicine for people who do not have HIV but are at increased risk of exposure.”
The researchers analyzed data from 7,949 visits to a sexual health clinic, made by 4,004 individuals, between January 2019 to June 2021. They grouped data on visits, STI diagnoses, PrEP use and health insurance by age and gender, and then used statistical analysis to examine how outcomes — such as being prescribed preventive PrEP — were associated with factors like age and gender.
The researchers found:
- among patients at increased risk for HIV exposure, PrEP prescribing differed by age and gender. For example, cisgender males who were 26 years old or under with PrEP indications were prescribed the medicine at slightly higher rates (86%) than their counterparts over age 26 (83%).
- among cisgender females at increased risk, only 20% of those at or under age 26 were prescribed PrEP compared to 72% of those over age 26.
- young cisgender females (at or under age 26) were 63% less likely to be prescribed PrEP during their visits than young cisgender males.
- only 17% of visits attended by even younger cisgender females (under age 22) who were candidates for PrEP received it.
“Addressing disparities by age, gender and race/ethnicity in HIV prevention — via PrEP prescriptions — is critical. Significant gaps for young cisgender females with PrEP indications reflect opportunities for improved programming tailored to this population, with the potential to avert new HIV diagnoses,” co-author Neilan stated.
Neilan added that gaps between PrEP need and prescription may also reflect patient preferences or other barriers such as the need for quarterly visits for oral PrEP or anticipated costs. “They could also reflect provider-related barriers, such as limited knowledge of the drug or failure to consider PrEP for individuals other than men who have sex with men.” As such, “policy efforts focused on alleviating these barriers may help reduce HIV incidence by improving how well PrEP reaches those who would benefit from it.”
