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Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States

INTRODUCTION: Youth under the age of 25 are at high risk for HIV infection. While pre‐exposure prophylaxis (PrEP) has the potential to curb new infections within this population, it is unclear how country‐specific laws and policies that govern youth access to sexual and reproductive health (SRH) ser...

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Autores principales: Taggart, Tamara, Bond, Keosha T, Ritchwood, Tiarney D, Smith, Justin C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6672744/
https://www.ncbi.nlm.nih.gov/pubmed/31369211
http://dx.doi.org/10.1002/jia2.25363
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author Taggart, Tamara
Bond, Keosha T
Ritchwood, Tiarney D
Smith, Justin C
author_facet Taggart, Tamara
Bond, Keosha T
Ritchwood, Tiarney D
Smith, Justin C
author_sort Taggart, Tamara
collection PubMed
description INTRODUCTION: Youth under the age of 25 are at high risk for HIV infection. While pre‐exposure prophylaxis (PrEP) has the potential to curb new infections within this population, it is unclear how country‐specific laws and policies that govern youth access to sexual and reproductive health (SRH) services impact access to PrEP. The purpose of this review was to analyse laws and policies concerning PrEP implementation and SRH services available to youth in countries with a high HIV incidence. To the best of our knowledge this is the first systematic assessment of country‐level policies that impact the availability of PrEP to adolescent populations. METHODS: We conducted a review of national policies published on or before 12 June 2018 that could impact adolescents’ access to PrEP, SRH services and ability to consent to medical intervention. Countries were included if: (1) there was a high incidence of HIV; (2) they had active PrEP trials or PrEP was available for distribution; (3) information regarding PrEP guidelines were publicly available. We also included a selected number of countries with lower adolescent HIV incidence. Internet and legal database searches were used to identify policies relevant to adolescent PrEP (e.g. age of consent to HIV testing). RESULTS AND DISCUSSION: Fifteen countries were selected for inclusion in this review. Countries varied considerably in their respective laws and policies governing adolescents’ access to PrEP, HIV testing and SRH services. Six countries had specific polices around the provision of PrEP to youth under the age of 18. Five countries required people to be 18 years or older to access HIV testing, and six countries had specific laws addressing adolescent consent for‐ and access to‐ contraceptives. CONCLUSIONS: Adolescents’ access to PrEP without parental consent remains limited or uncertain in many countries where this biomedical intervention is needed. Observational and qualitative studies are needed to determine if and how adolescent consent laws are followed in relation to adolescent PrEP provisions. Intensified efforts to amend laws that limit adolescent access to PrEP and restrict the establishment of national guidelines supporting adolescent PrEP are also needed to address the epidemic in this group.
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spelling pubmed-66727442019-08-06 Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States Taggart, Tamara Bond, Keosha T Ritchwood, Tiarney D Smith, Justin C J Int AIDS Soc Reviews INTRODUCTION: Youth under the age of 25 are at high risk for HIV infection. While pre‐exposure prophylaxis (PrEP) has the potential to curb new infections within this population, it is unclear how country‐specific laws and policies that govern youth access to sexual and reproductive health (SRH) services impact access to PrEP. The purpose of this review was to analyse laws and policies concerning PrEP implementation and SRH services available to youth in countries with a high HIV incidence. To the best of our knowledge this is the first systematic assessment of country‐level policies that impact the availability of PrEP to adolescent populations. METHODS: We conducted a review of national policies published on or before 12 June 2018 that could impact adolescents’ access to PrEP, SRH services and ability to consent to medical intervention. Countries were included if: (1) there was a high incidence of HIV; (2) they had active PrEP trials or PrEP was available for distribution; (3) information regarding PrEP guidelines were publicly available. We also included a selected number of countries with lower adolescent HIV incidence. Internet and legal database searches were used to identify policies relevant to adolescent PrEP (e.g. age of consent to HIV testing). RESULTS AND DISCUSSION: Fifteen countries were selected for inclusion in this review. Countries varied considerably in their respective laws and policies governing adolescents’ access to PrEP, HIV testing and SRH services. Six countries had specific polices around the provision of PrEP to youth under the age of 18. Five countries required people to be 18 years or older to access HIV testing, and six countries had specific laws addressing adolescent consent for‐ and access to‐ contraceptives. CONCLUSIONS: Adolescents’ access to PrEP without parental consent remains limited or uncertain in many countries where this biomedical intervention is needed. Observational and qualitative studies are needed to determine if and how adolescent consent laws are followed in relation to adolescent PrEP provisions. Intensified efforts to amend laws that limit adolescent access to PrEP and restrict the establishment of national guidelines supporting adolescent PrEP are also needed to address the epidemic in this group. John Wiley and Sons Inc. 2019-08-01 /pmc/articles/PMC6672744/ /pubmed/31369211 http://dx.doi.org/10.1002/jia2.25363 Text en © 2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Reviews
Taggart, Tamara
Bond, Keosha T
Ritchwood, Tiarney D
Smith, Justin C
Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States
title Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States
title_full Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States
title_fullStr Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States
title_full_unstemmed Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States
title_short Getting youth PrEPared: adolescent consent laws and implications for the availability of PrEP among youth in countries outside of the United States
title_sort getting youth prepared: adolescent consent laws and implications for the availability of prep among youth in countries outside of the united states
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6672744/
https://www.ncbi.nlm.nih.gov/pubmed/31369211
http://dx.doi.org/10.1002/jia2.25363
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