Willingness to Prescribe PrEP to Bisexual Men Depends on Genders of Their Past Partners: A Study of Medical Students in the USA.

Bisexual men are at increased risk for HIV compared to heterosexual men but unlikely to use pre-exposure prophylaxis (PrEP). Given that biases may influence whether bisexual men are prescribed PrEP, we examined whether medical students' decision-making was influenced by the genders of a bisexual male patient's partners. Medical students (N = 718) were randomized to one of nine conditions where they answered questions about a bisexual male patient after reviewing his electronic medical record. We manipulated the gender of his current partner (none, male, female) and the genders of his past partners (male, female, both). Current partners were described as living with HIV and not yet virally suppressed, past partners were described as being of unknown HIV-status, and condom use was described as intermittent with all partners. When the patient was not in a current relationship, perceived HIV risk and likelihood of prescribing PrEP were lowest if he only had female partners in the past. When he was in a current relationship, perceived HIV risk and likelihood of prescribing PrEP did not differ based on current or past partners' genders. In addition, identification as a PrEP candidate, perceived likelihood of adherence, and perceived likelihood of engaging in condomless sex if prescribed were lower when the patient was not in a current relationship. Medical students appropriately prioritized the status of the partner living with HIV, but their decision-making was influenced by past partner genders when the patient was not in a current relationship. Medical students may require additional education to ensure they understand PrEP eligibility criteria and make decisions based on patients' individual presentations.

An Overview of Adolescent Psychostimulant Use.

Adolescence marks a period of significant neural maturation and development of lifelong habits, including the potential use of recreational psychostimulant drugs. Increased prevalence of drug adulteration and fatalities related to drug overdose pose new challenges for individuals who use drugs recreationally. As the prevalence of recreational psychostimulant use drastically increases during young adulthood, pediatric and adolescent health care providers can play a crucial role in the lifelong well-being of their patients by identifying those with risk factors for consequences associated with substance use at an early age. This article discusses the epidemiology, pharmacology, clinical manifestations, complications, and common methods of use for three types of psychostimulant drugs-amphetamines, methamphetamine, and 3,4-Methylenedioxymethamphetamine. This article aims to provide pediatric and adolescent health care providers with practical knowledge to effectively perform substance use screening, brief intervention, and referral to treatment with the goal of reducing drug-related morbidity and mortality among the adolescent age group. [Pediatr Ann. 2023;52(5):170-e177.].