Youth-specific considerations in the development of preexposure prophylaxis, microbicide, and vaccine research trials.
Preventing HIV infection in adolescents and young adults will require a multimodal targeted approach, including individual-directed behavioral risk reduction, community-level structural change, and biomedical interventions to prevent sexual transmission. Trials testing biomedical interventions to prevent HIV transmission will require special attention in this population due to the unique psychosocial and physiologic characteristics that differentiate them from older populations. For example, microbicide research will need to consider acceptability, dosing requirements, and coinfection rates that are unique to this population. Preexposure prophylaxis studies also will need to consider potential unique psychosocial issues such as sexual disinhibition and acceptability as well as unique pharmacokinetic parameters of antiretroviral agents. Vaccine trials also face unique issues with this population, including attitudes toward vaccines, risks related to false-positive HIV tests related to vaccine, and different immune responses based on more robust immunity. In this article, we will discuss issues around implementing each of these biomedical prevention modalities in trials among adolescents and young adults to help to guide future successful research targeting this population.
Rudy
Bret J
BJ
Department of Pediatrics, New York University School of Medicine, New York, NY, USA.
Kapogiannis
Bill G
BG
Lally
Michelle A
MA
Gray
Glenda E
GE
Bekker
Linda-Gail
LG
Krogstad
Paul
P
McGowan
Ian
I
D016915:AIDS Vaccines / Q000627:therapeutic use; D000282:Administration, Intravaginal; D000285:Administration, Rectal; D000293:Adolescent; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local; D002986:Clinical Trials as Topic / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006679:HIV Seropositivity; D006801:Humans; D008297:Male
D016915:AIDS Vaccines; D019380:Anti-HIV Agents; D000891:Anti-Infective Agents, Local