iPrEPyouQ study

Study background

Pre-exposure prophylaxis (PrEP), referring to the use of antiretroviral medications prior to possible HIV risk exposure, is an effective biomedical HIV prevention strategy. PrEP has been available in Australia since 2018, through the Pharmaceutical Benefits Scheme (PBS) at a subsidised cost for people over the age of 18 years. In January 2021 the PBS expanded eligibility to include people under 18 years of age for subsidised access to PrEP. HIV notifications have remained low among young people over previous decades in Australia, however, when young people reach their 20s there is a substantial increase in HIV notification rates. This, coupled with the sustained low rates of uptake of PBS-subsidised PrEP in young people under the age of 24, suggests young people may be facing unique individual, sociocultural and structural barriers to PrEP access and use despite policy supporting access.

The iPrEPyouQ study aimed to build an understanding of the barriers and facilitators that influence access, uptake and use of PrEP in young people aged 16-24 years living in Queensland to inform the development of appropriate and acceptable models of PrEP support, education and provision for young people. This was be done through exploring the knowledge, attitudes, and practices of young people (16-24 years) in Queensland in relation to their knowledge, access, and usage of PrEP. It also explored the attitudes and experience of healthcare and service providers who provide and recommend PrEP to young people.

Data collection

This multi-phase mixed-methods study included 5 phases of data collection:

1. A Systematic Review of PrEP access, uptake and use in young people with the aim of providing an understanding of the factors that impact PrEP access uptake and use in young people globally
2. Data analysis of Tertiary Students Sexual and Reproductive Health (TSSRH) Survey: Southeast Queensland Pilot – an anonymous online survey developed in 2019 through a consortium of researchers and stakeholders across Queensland University institutions – this allowed for insight into overall HIV-related knowledge and awareness of PrEP as well as insight into various demographic groups of interest in this research, including young gay, bisexual and other men who have sex with men and overseas born populations. Providing some of the first evidence about PrEP use among young people in Queensland and the broader Australian context.
3. Interviews with young people aged 16-24 living in Queensland to explore and elicit a contextualised understanding of young people’s knowledge, attitudes and practices relating to sexual health, HIV prevention, PrEP, impacts of PBS-subsidy, experienced and/or perceived barriers and facilitators to access and potential preference for alternative PrEP modalities
4. A cross-sectional survey of Healthcare and service providers across Australia to explore the attitudes, experiences, and concerns about initiating PrEP for young people among healthcare professionals that were eligible to prescribe PrEP, as well as non-prescribing healthcare professionals and service providers working with young people (16-24 years) or providing sexual health information and care.
5. Survey with young people (16-24 years) exploring the knowledge attitudes and practices with regard to HIV prevention and PrEP of young people from across Australia