HIV Prevention Drug Severely Underprescribed to Young Women at Risk
A comprehensive study examining sexual health services in metropolitan Boston has uncovered significant disparities in the prescription of HIV prevention medication, with young women at increased risk receiving the drug at dramatically lower rates than their male counterparts.The research, published in Sexually Transmitted Diseases and conducted by Mass General Brigham physicians, analyzed 7,949 visits across six hospital and community-based sites between January 2019 and June 2021. The findings reveal troubling gaps in access to pre-exposure prophylaxis (PrEP), a preventive medication for individuals at increased HIV risk.Among the most striking discoveries: young cisgender women aged 26 and under were 63% less likely to be prescribed PrEP during clinic visits compared to young men of the same age group. Only 20% of at-risk women under 26 received the medication, compared to 86% of similarly aged men.The disparity becomes even more pronounced among younger demographics. Among women under 22 who were candidates for PrEP, only 17% received prescriptions during their visits."These 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," said Dr. Anne Neilan, lead author and researcher at the Medical Practice Evaluation Center.The study's timing is particularly relevant given that adolescents and young adults, while comprising only one quarter of the sexually active U.S. population, account for approximately half of all new sexually transmitted infections diagnosed annually.Researchers identified multiple potential barriers contributing to these disparities, including patient preferences, logistical challenges such as quarterly visit requirements, anticipated costs, and provider-related factors including limited knowledge of the medication or failure to consider PrEP for populations beyond men who have sex with men.The findings highlight broader systemic challenges in sexual health service delivery and suggest the need for targeted interventions to improve access for indicated young women. The research was supported by multiple federal grants and represents part of ongoing efforts to address health disparities in HIV prevention.Mass General Brigham researchers emphasize that addressing these gaps through policy reforms and improved programming could significantly impact HIV prevention efforts, particularly among vulnerable young populations who face the highest rates of new infections.
