Engaging young people in conversations about HIV prevention is essential when helping to make informed, empowered decisions about their health. Pre-exposure prophylaxis (PrEP) offers a safe and effective way to reduce the risk of HIV transmission, but young people may have questions, misconceptions, or concerns that need to be addressed with care and clarity.
When talking to young people about PrEP, providing clear information is essential. You should also try to address any concerns that they may have.
You may want to start the conversation by explaining that PrEP is a medication that HIV-negative individuals can take to prevent HIV infection.
Go on to explain the different PrEP options that are available. Highlight that it is most commonly taken as a daily pill, though the vaginal ring and injectable PrEP are available in some regions.
It’s important to explain that PrEP is not a lifetime commitment—it is only needed during periods of high HIV risk. Additionally, be clear that while PrEP is highly effective against HIV, it does not protect against other STIs. So using condoms is still important.
Our PrEP page has lots of advice and resources for you to use and share.
A good place to start is understanding an individual’s needs—everyone has different reasons for being interested in PrEP, so listen to their stories and tailor your advice to suit each person.
When talking about PrEP you should:
- Be clear: clearly explain what PrEP is, how it works, and the different options available, ensuring young people understand it’s a proactive step in HIV prevention.
- Personalise the conversation: plan your advice to suit each individual’s needs and situation. Listen to their concerns and provide relevant and factual information that speaks to their experiences.
- Make it routine: include PrEP conversations in routine healthcare discussions. Regularly revisit the topic to ensure young people are comfortable and prepared to take PrEP when needed.
- Talk about self-care: frame PrEP as a form of self-care, empowering young people to take control of their sexual health without stigma or judgment.
- Empower decision-making: offer non-judgmental guidance. Help them make informed decisions about whether PrEP is right for them, while respecting their autonomy.
- Offer information without pressure: no-one should feel pressured to take PrEP. Focus on empowering people with the information they need to make a decision the right decision for them.
PrEP might not be the right choice for everyone. If someone is not at risk of HIV exposure, such as those who always practice safer sex, PrEP may not be necessary.
If someone cannot commit to taking PrEP as prescribed or if they have major concerns about potential side effects, it may be better to explore other HIV prevention options. Always ensure that the young person fully understands the options available to them and that they feel confident in the process of making decisions about their health.
PrEP stigma can often arise from mistaken beliefs and judgments about those who choose to use it. These assumptions can include the idea that PrEP users are promiscuous or that they engage in risky sexual behavior. Normalising PrEP by talking about it as a responsible health choice is one way to start addressing this stigma
It’s helpful to explain that PrEP is about protecting our health and is not an indication of behavior. Always use non-judgmental language, provide accurate information, and create a supportive environment where people feel comfortable discussing their choices without any fear of shame or judgment.
An empowering and non-judgmental approach is essential when supporting young people as they take PrEP. They should also be supported to take regular HIV tests to prevent HIV drug resistance from developing.
Depending on the PrEP option available, adherence may be a challenge. Ensuring that anyone taking PrEP understands that PrEP will only be effective with good adherence and that they understand how to take it is important is an important first step in supporting adherence.
Other ways to support young people to take PrEP are:
- Create a routine: encourage young people to incorporate PrEP into their daily routine, such as taking it at the same time as another daily activity (for example brushing teeth or eating breakfast). This can help build a habit and reduce the chances of missing doses.
- Use reminders and tools: suggest using reminder tools like alarms, smartphone apps, or pill organizers to help them stay on track with their PrEP dose if taking PrEP as a pill. Reminders can also be set for injection appointments or changing the vaginal ring.
- Address side effects: side effects can be a big concern. It’s important to address this issue before anyone starts on PrEP and offer support if side-affects do crop up.
- Ongoing support: offer continuous support by scheduling regular check-ins if possible. These can be used to discuss any challenges they face and provide encouragement.
- Peer support: encourage connecting with peers who are also on PrEP. Peer support groups or online communities can offer a sense of belonging and shared experiences, making it easier to stay committed to taking PrEP.
Yes, PrEP is safe for transgender women on hormone replacement therapy (HRT). Research shows that PrEP does not interfere with the effectiveness of gender-affirming hormones.
Although concerns about potential drug interactions exist within the transgender community, you can reassure transgender women that PrEP is compatible with HRT.
For transgender women on HRT, it is advisable to consult a health practitioner before starting PrEP. To look up interactions between PrEP and other medications, you can refer to the Liverpool University website.
For more information on working with transgender women visit our page on inclusive sexual health care for LGBT+ people.
Yes, it is okay for people who inject drugs to use injectable PrEP (like CAB-LA) to protect themselves against HIV that may be transmitted during sex. However, we do not yet know if it also protects against HIV from sharing needles or injecting drugs.
While research continues, healthcare providers should offer PrEP together with other support services for people who inject drugs. This way, they can still benefit from the protection of PrEP against sexual HIV transmission while staying informed about its limitations for needle use.
A key message is that PrEP is safe and effective during conception, pregnancy, and breastfeeding. It does not interfere with the ability to get pregnant. PrEP gives protection against HIV for those at risk of exposure to HIV and their unborn babies.
When advising people who are pregnant or trying to conceive about PrEP, it is also important to highlight that pregnancy, and the postpartum period can increase the risk of HIV. HIV infection during pregnancy or breastfeeding also raises the risk of the virus being passed on to the baby.
PrEP services should be offered within antenatal and postnatal care, especially for women at significant risk of HIV infection.
If someone asks for PrEP but it is not available you should respond with empathy and offer practical advice.
Start by acknowledging and celebrating their effort to seek HIV prevention options then explain the current limitations in the access of PrEP. Offer alternative HIV prevention methods, such as condoms. Ensure they understand the importance of any method that reduces their risk of HIV and help them explore the options open to them.
You can also encourage them to stay connected to healthcare services, as PrEP availability might change, especially with the ongoing efforts to expand PrEP options. You can also help them identify other healthcare facilities that might offer PrEP.
