ATN: Focus on Youth in HIV Prevention and Treatment

We know that PrEP, PEP, and ART work really well to prevent and treat HIV. How do we get them to the people who need them? The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) is an exciting project to address the HIV epidemic by getting PrEP and ART to young people.^1,2

What is the Adolescent Medicine Trials Network?

The ATN is a team investigating ways to effectively increase awareness, prevention, testing and treatment of HIV in youth.³

But this isn’t just a bunch of scientists in white lab coats - the team includes a diverse 12-member youth advisory board that provides direction for the ATN projects and priorities. The project focuses on learning how to support those at high risk: gay, bisexual, and transgender youth, and young people who are homeless, incarcerated, or from communities of color.^2,4

Key areas of research

This team has identified key areas for future research:^2,5-6

• What works to increase youth HIV prevention, screening and treatment

• How to improve the health care system to make screening and treatment more accessible. For example, only a quarter of primary health care providers prescribe PrEP; ATN is looking at ways to educate clinicians to provide better care to youth.

• Research on vaccines and medications, like new, simpler forms of PrEP

• Increasing youth engagement by using cell phone technology

• Policy work to reduce disparities and increase services and support for youth living with HIV and for prevention (2). ATN’s research on PrEP use in teens was a key factor in getting FDA approval for teen PrEP.

ATN research groups and studies

There are 3 main groups within ATN that are doing research:^2,7-9

• CARES is trying out a program to support youth living with or at increased risk for HIV by providing testing, education, support, and linkages to healthcare or other social services as needed. The approach includes peer-support chat rooms in addition to text messaging.

• iTech is a team that studies ways to use technology to improve HIV prevention and care for young people. They are testing innovative apps, games, text messages, and even specialized counseling to help young people access testing and to begin and continue treatment.

• Scale It Up looks for ways to increase the reach of programs that have been shown to be successful in small studies. For example, they are expanding a text message and phone support system to help youth living with HIV take ART more consistently. They also have a study on communication skills counseling, focusing on how to help young couples communicate more clearly about HIV testing and risk reduction.

ATN is not the only team working to empower young people. For example, a team based at Emory University is trying out a home-based PrEP system for rural youth that includes an app with text messaging, video consults with clinicians, and home test kits for monitoring. The study is scheduled to finish in 2022.¹⁰

Improving care and access for adolescents

In the US, 21 percent of HIV cases diagnosed in 2019 were in young people ages 13 to 24. In 2018, only 55 percent of youth knew their HIV status. Youth are less likely to receive ongoing care, and only 60 percent have a suppressed viral load.^11-13

Identifying and removing barriers to care for the diverse population of youth in the US will be key to helping them stay healthy. Groups like ATN that center the perspectives of young people will help us give better support to our youth.

Dr. Audrey Sheridan is a board-certified obstetrician-gynecologist (OB-GYN) and also a caretaker for her dad. Dr. Sheridan is inspired by people finding their way through life-changing medical situations with resilience and is interested in how we can increase our mental durability in the face of the unpredictable.