RETROSPECTIVE REVIEW OF HIGH-RISK ADOLESCENTS ELIGIBLE FOR PRE-EXPOSURE PROPHYLAXIS (PREP) THERAPY FOR HIV

Purpose: In 2014 in the US, adolescents aged 13-24 made up 22% of all new HIV infections. In July 2012, the FDA approved Truvada as preexposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV in high-risk patients. The Adolescent Trials Network has completed 2 pilot studies to assess feasibility of PrEP to adolescents, the most recent resulting in the expanded indication of Truvada for individuals aged 15-17. The primary goal of this study was to identify the percentage of adolescent patients at the Le Bonheur Children's Hospital General Pediatrics Clinic that would meet clinical criteria for PrEP therapy. Secondary objectives were to identify high-risk patients that may benefit from PrEP that did not meet CDC clinical criteria. Methods: A retrospective chart review included all patients ages 1119 that presented to the Le Bonheur General Pediatrics Clinic from March 2018-March 2019. The CDC 2017 Clinical Practice Guidelines were used to identify patients based who qualified for HIV prophylaxis based on reported sexual activity, contraceptive use, and confirmed history of bacterial sexually transmitted infection. Results: We reviewed the charts of 1038 adolescent patients seen in the General Pediatrics clinic between March 2018 - March 2019. 27 patients met clinical criteria for PrEP therapy (0.026%). Of those, 19 were female and 8 were male. 3 patients were under the age of 15. 2 additional patients were identified as high-risk patients that may benefit from PrEP without meeting criteria, one patient who engaged in isolated oral MSM and another with a high number of sexual partners. Conclusions: Using the CDC criteria, a small percentage of adolescent patients in our clinic would be candidates for PrEP therapy, potentially preventing new HIV infections in this patient population. Resident and provider educations would be beneficial in increasing recognition and referrals for treatment.