Over the last four years, a growing body of research has shown that pre-exposure prophylaxis (PrEP), the HIV prevention method requiring a daily dose of the drug Truvada, is effective in reducing viral risk.

PrEP is an especially vital tool for youth, who are one of the most vulnerable populations at high-risk for HIV transmission. This past July, a group of investigators revealed the results of a ground-breaking trial — funded by the National Institutes of Health — that found PrEP to be safe and effective in adolescents, including young girls.

Yet PrEP is still underutilized among youth ages 13 to 24, which account for more than one in fivenew HIV diagnoses, according to a 2015 report from the U.S. Centers for Disease Control and Prevention. Advocates say those low usage rates are driven by a confluence of barriers that keep PrEP from the very people who could use PrEP the most.

“When we talk about HIV prevention, we talk about sex. Parents and most doctors don’t want to think about youth having sex,” says Dr. Uri Belkind, MD, clinical director of health outreach to teens at Callen-Lorde Community Health Center in New York City. “But not talking about it doesn’t make it go away.”

Many doctors shy away from discussing sex or HIV prevention, due to either feeling uncomfortable addressing the topic to minors or a lack of appropriate training, according to Belkind. In fact, there are no established guidelines or protocols available on how to provide PrEP to people under 18 years old.

Doctors who refuse to address sexual health and prevention do a disservice to young people. And their silence, advocates say, is most harmful to youth of color, transgender youth, and young women — populations that already face significant barriers in reproductive healthcare. Read more via TeenVogue