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In western Kenya, a study of adolescent girls and young women attending family planning clinics found that 76% met Pr EP eligibility criteria, but only 4% initiated Pr EP [16], and the proportion of adolescent girls and young women persisting with Pr EP for 3 months postinitiation ranged from 5% to 37% across studies [7,10,11,15,17]. In samples of Pr EP users at an average of 6 months postinitiation, only 4% to 8% had tenofovir diphosphate (TFVdp) levels suggesting high adherence [4-6].
JMIR Res Protoc 2025;14:e55931
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Lastly, the feasibility measure will indicate how well vlogs can be used to motivate access to Pr EP.
JMIR Public Health Surveill 2025;11:e67367
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Clinical trials of sexual event-driven Pr EP regimens or 2-1-1 Pr EP using F/TDF have demonstrated it to be highly effective for HIV prevention among MSM [3,4]. These options provide MSM with choices about their preferred Pr EP regimen; however, little is known about the Pr EP choices men make, their switching between Pr EP options, and the reasons for these decisions.
Pr EP coverage continues to increase markedly among men [5].
JMIR Res Protoc 2025;14:e64186
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The Pr EP-to-need ratio, defined as the number of Pr EP users divided by new HIV diagnoses [14], is lower in the South than in any other region, particularly among racial and ethnic minorities, further highlighting inequitable access [15].
To decrease HIV incidence, there is a need to improve Pr EP use in populations most heavily impacted by HIV.
JMIR Res Protoc 2025;14:e64813
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In addition, in 2021, Alabama had a Pr EP-to-Need ratio of 5.55, with the highest unmet need for Pr EP occurring among the Black community (Pr EP-to-need ratio among Black vs White individuals: 2.94:11.30) [9].
When focusing on cisgender women, who account for approximately one-fifth of new HIV diagnoses in the United States, only 8% of the 227,010 women with a Pr EP indication are currently receiving Pr EP prescriptions [10-13].
JMIR Res Protoc 2025;14:e58976
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Preexposure prophylaxis (Pr EP) is a highly effective biomedical prevention strategy to reduce HIV incidence and curb the HIV epidemic [3-10]. When taken as prescribed (daily or at least 4 times per week), Pr EP reduces HIV transmission by up to 99% among MSM [7-9,11-13].
JMIR Hum Factors 2025;12:e59780
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In 2019, pre-exposure prophylaxis (Pr EP) was established as safe and effective in preventing HIV among adolescent-aged men who have sex with men (MSM), and the US Food and Drug Administration approved Pr EP for individuals weighing at least 77 pounds (~34.9 kg), thereby making it available to adolescents [10,11]. Nevertheless, prescribing Pr EP to adolescents remains under ideal levels [12].
JMIR Res Protoc 2025;14:e63114
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Despite the US Food and Drug Administration’s approval of oral Pr EP for individuals aged under 18 years in 2018 and long-acting injectable Pr EP in 2021 [7], Pr EP uptake remains subpar in this age group [8,9]. One study that used US pharmacy claims data to estimate adolescent Pr EP use [10] found that of the 6444 youths aged 13 to 19 years who were prescribed Pr EP in 2021, just 12% were aged under 18 years, and most were adolescent girls.
JMIR Form Res 2025;9:e60398
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MSM who were aware of HIV Pr EP and PEP were more likely to obtain their sexual partners’ HIV status. A previous study showed that awareness of and access to Pr EP might reduce the need and motivation to discuss HIV status with partners because they may assume that it is the partner’s responsibility to use Pr EP to protect themselves from HIV infection [13].
JMIR Public Health Surveill 2025;11:e66139
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active Pr EP prescription (prescription confirmed by study staff) or those who were currently on Pr EP who had an active Pr EP prescription (prescription confirmed by study staff).
J Med Internet Res 2025;27:e57619
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