FM providers were 32 times more likely to prescribe PrEP than pediatric providers, highlighting the crucial need for educational interventions for pediatric providers around PrEP provision and adolescent sexual health care more widely.
Family medicine providers were significantly more familiar with PrEP than pediatric providers.
Family medicine providers were more experienced with prescribing PrEP compared to pediatric providers.
Logistic regression analysis found that FM providers were 32 times more likely to prescribe PrEP than pediatric providers.
Pediatric providers were more likely than FM providers to identify barriers to PrEP prescription.
Non-prescribers were more likely than prior prescribers to identify specific barriers to PrEP prescription.
The study assessed provider comfort across multiple domains of adolescent sexual health care beyond PrEP alone.
Over 7000 youth ages 13-24 are diagnosed annually with HIV-1 in the United States despite oral PrEP approval for adolescents in 2018.
This research suggests that there is a significant gap between family medicine doctors and pediatricians when it comes to prescribing HIV prevention medication (PrEP) to teenagers. In a survey of 158 healthcare providers, family medicine doctors were 32 times more likely to have prescribed PrEP to adolescents than pediatricians. Family medicine providers also reported being much more familiar with PrEP and more comfortable prescribing it, while pediatricians were far more likely to say they faced barriers such as not having enough time, not enough knowledge, and not feeling comfortable discussing sexual health topics with teenage patients. This matters because over 7,000 young people between ages 13 and 24 are diagnosed with HIV every year in the United States, even though a medication to prevent HIV infection has been approved for use in teenagers since 2018. The fact that pediatricians — who are often the primary doctors for this age group — are much less likely to prescribe PrEP or feel comfortable discussing sexual health suggests a major missed opportunity for HIV prevention in young people. This research suggests that targeted educational programs for pediatric providers are needed, not just about PrEP specifically, but about adolescent sexual health more broadly, including how to discuss sexual activity, gender identity, sexual orientation, and sexually transmitted infections with teenage patients. Bridging this knowledge and comfort gap among pediatricians could be an important step toward reducing new HIV diagnoses in young people.
Rosencrance A, Rosebush J, Mannheim J. (2025). Barriers to Adolescent Pre-exposure prophylaxis and Sexual Health Care in Pediatric Versus Family Medicine Providers.. AIDS patient care and STDs. https://doi.org/10.1177/10872914251394786