BACKGROUND: Enrolling adolescents under 18 years of age in pre-exposure prophylaxis (PrEP) is challenging because of the low-risk perception of this population. The psychosocial approach of multidisciplinary health teams can improve adolescents’ persistence in PrEP. We aimed to describe the experience of a psychosocial team in enrolling adolescent men who have sex with men (aMSM), and transgender women (aTGW) in a PrEP service in Brazil.
DESCRIPTION: PrEP1519 is a prospective, multicenter, open-label PrEP demonstration cohort study conducted with aMSM and aTGW aged 15-19 in Brazil from April 2019 to May 2022. In this project, the multidisciplinary health team adopted a psychosocial approach in the work of the psychologist and social worker in the Salvador site of PrEP1519. The team assessed the population by analyzing situations of violence, broken families, and other vulnerabilities and, when possible, promoted dialogue with the adolescent’s family to explain the use of the prophylaxis.
LESSONS LEARNED: 45 adolescents aged 15 to 17 were included in this analysis. Of these, 27 were enrolled in PrEP without their parents’ or guardians’ awareness of the team’s conclusion of a possible risk of violence against adolescents. We communicated this procedure to the Public Prosecutor’s Office and the Juvenile Court of the State of Bahia. Conversely, we enrolled 18 adolescents based on dialogue with their legal guardians.
CONCLUSIONS: The psychosocial approach to adolescents aged 15 to 17 years was significant for enrolling this population in a PrEP service. In Brazil, the PrEP policy of the National Health System was expanded to include adolescents 15 years or older. Therefore, this experience may inspire programs to facilitate the inclusion of young adolescents in PrEP without parental or guardian consent.

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