Adolescent Prep Administration: An Education Curriculum For Providers

<p>Background: On May 15, 2018, the Federal Drug Administration (FDA) approved once daily tenofovir/emtricitabine (TDF/FTC) for use as preexposure prophylaxis (PrEP) for adolescents (weighing greater than 35kgs) engaging in high-risk sexual behavior (Gilead, 2018). This decision was largely based on the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) 113 which demonstrated that PrEP was well tolerated among the adolescents, age 15-17, enrolled in the study (Hosek, 2017). The use of TDF/FTC for PrEP in adults (18 and older) was approved by the FDA in 2012 after its safety and efficacy had been demonstrated in multiple international clinical trials (FDA, 2016).</p> <p>Purpose: Adolescent providers are now in need of access to a comprehensive education curriculum on the administration of PrEP to adolescents. This paper outlines such a curriculum with the goals of reaching adolescent providers not familiar with the intricacies of PrEP assessment, administration and monitoring.</p> <p>Methods: An extensive adolescent PrEP curriculum was designed using a comprehensive literature review. An expert panel of seven reviewed the curriculum for content validity. A pilot implementation of the curriculum was conducted with 54 staff members from eight school based health clinics located in Upper Manhattan and the Bronx. A Provider Manual was also designed, based on the content of the extended curriculum, for the purposes of having an easily accessible handbook for providers</p> <p>Results: A comprehensive curriculum on the provision of HIV prevention modalities to adolescents has been successfully developed, piloted, and validated by a panel of experts. While the provision of PrEP can be as simple as writing a prescription, more is needed to engage and assess an adolescent in order to administer a multicomponent HIV prevention intervention. This curriculum contains content validated components that should be included when training clinicians how to administer PrEP to adolescents.</p> <p>Conclusions: We have learned a great deal in the first 6 years of PrEP implementation in the United States, and this can be applied to the roll out of PrEP for adolescents. However, adolescents have a unique set of needs when it comes to a biomedical intervention for HIV prevention. The healthcare community, for the first time, has an intervention that can prevent the transmission of HIV among at-risk individuals if taken correctly. Given the high rates of HIV in the younger age groups, we have a considerable responsibility to determine how to efficiently and safely provide this intervention to youth. PrEP Implementation in a younger population requires a new set of youth focused guidelines, teaching points, and educational methodologies. Implications for Practice and Research: The validated curriculum developed through the stakeholder driven process may be an important contribution. Preventing HIV transmission in adolescents is a national and international priority and is undoubtedly an essential step necessary to end the HIV epidemic.</p>

Name thesis:degree_name

Doctor of Nursing Practice (DNP)

Level thesis:degree_level

Open Access Thesis

Discipline thesis:degree_discipline

Yale University School of Nursing

Year

2018

Author dc:creator

• Carnevale, Caroline

Contributors dc:contributor

• Julie Womack

• Adolescents
• Curriculum
• HIV Prevention
• PreExposure Prophylaxis (PrEP)
• Providers
• Sexual Health

Repository record dc:identifier

https://elischolar.library.yale.edu/ysndt/1088

OAI identifier oai:identifier

oai:elischolar.library.yale.edu:ysndt-1087