The Adolescent Medicine Trials Network

The Adolescent Medicine Trials Network

ATN Era #4

2016-2022

In our fourth funding cycle, the ATN restructured into multi-project hubs (iTech, Scale It Up, & CARES) that created and tested digital health interventions, youth-centered design, and systems-level approaches to HIV prevention and care.

ATN CARES, iTech, and Scale It Up logos

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2016
2017
2018
2019
2020
2021
2022

2016

ATN Funding Cycle 4 Begins

2016-2022

The National Institutes of Health (NIH) funds the ATN in cycles that last for about 5-7 years. In each cycle, NIH determines the structure of the network and areas of focus for research studies that will occur in the cycle.

Innovation

For the fourth funding cycle, the ATN restructured its research into coordinated multi-project hubs: iTech, Scale it Up, and CARES.

Why It Matters

Restructuring emphasized technology-enabled interventions, youth-centered design, and systems-level approaches to HIV prevention and care.

2017

ATN 138: YouTHrive

2017-2022

Innovation

The YouTHrive study designed and tested a webapp to support medication adherence among youth living with HIV. The webapp included peer interactions, daily youth-centered content on living with HIV and HIV medications, a feature to track medications and adherence, and goal-setting.

YouTHrive mood tracker screenshot
YouTHrive "My Tracker" screenshot
YouTHrive profile screenshot
YouTHrive screenshot
YouTHrive "My Journey" screenshot
YouTHrive "Thrive Tips" screenshot

Why It Matters

Youth living with HIV face a number of challenges to having an undetectable viral load (a substantially low number of the virus in the body so that tests cannot detect it and the virus cannot be transmitted). Barriers include access to youth-centered HIV healthcare, insurance costs, transportation to and from clinic appointments, as well as stigma and mental health challenges that make it harder to take HIV medications every day.

Though programs exist to encourage people living with HIV to take HIV medication as prescribed, they are typically tailored to adults and few show that they are effective. Similarly, YouTHrive did not appear to increase how often youth living with HIV take HIV medication. However, it may be helpful to combine the intervention may with more intensive interventions in the future to support HIV medication adherence among youth.

ATN 139: Get Connected

2017-2022

Innovation

The Get Connected study designed and tested a webapp that aimed to motivated young men to get tested for HIV and STIs, as well as to use PrEP. The study involved youth participants “mystery shopping” at over 60 testing locations in Atlanta, Houston, and Philadelphia. The feedback was shared with the testing locations, and the Get Connected webapp used the data to match users to HIV testing services.

Get Connected webapp: the facts
Get Connected webapp: What do you want in a testing site?
Get Connected webapp: Testing Sites
Get Connected webapp: Know Your Values
Get Connected webapp: Types of Tests

ATN 140: LYNX

2017-2019

Innovation

The LYNX study developed and tested an app to support young gay and bisexual men in HIV and STI testing as well as getting linked to PrEP services. The app allowed users to track their sexual partners and motivated them to get tested for HIV.

LYNX app
LYNX app - your partners
LYNX app - insights
LYNX app - badge
LYNX app - badge collection
LYNX app - new encounter
LYNX app - badge

Why It Matters

Young gay and bisexual men in the U.S. have amongst the highest rates of HIV and STIs but the lowest rates of HIV/STI testing and use of PrEP, the medication that prevents HIV. The LYNX app proved to be a promising approach to increasing HIV and STI testing in young people. Young gay and bisexual men will likely need additional support in getting linked to PrEP services.

ATN 141: MyChoices

2017-2019

Innovation

The MyChoices study developed and tested an app to help young gay and bisexual men find HIV/STI testing locations in their area, track their testing timeline and history, and easily access HIV/STI prevention information.

MyChoices app - home
MyChoices app test kit order
MyChoices app - PrEP
MyChoices app testing locator
MyChoices app - ordering
MyChoices app - testing plan

Why It Matters

Young gay and bisexual men in the U.S. have amongst the highest rates of HIV and STIs but the lowest rates of HIV/STI testing and use of PrEP, the medication that prevents HIV. The MyChoices study showed that mobile app interventions like MyChoices can play a vital role in reaching communities affected by HIV, including younger people, and encourage more HIV/STI testing as well as usage of PrEP.

ATN 145: Young Men’s Health Project (YMHP)

2017-2022

The YMHP study explored different ways to deliver support that helps young people reduce substance use and the likelihood of acquiring HIV. It compared clinic visits and phone-based sessions to learn which approach worked best and was easiest to access, with the goal of identifying scalable approaches for real-world healthcare settings.

The study found that remote counseling based in motivational interviewing was a viable alternative to in-person delivery, supporting the implementation for real-world adolescent health settings using trained clinic staff.

ATN 146

2017-2021

Study Title
Tailored Motivational Interviewing Implementation Intervention (TMI) Effectiveness Trial in Multidisciplinary Adolescent HIV Care Settings

ATN 146 focused on improving providers’ communication skills so that they could better support young people in HIV prevention, treatment, and long-term care. The study worked with doctors, nurses, case managers, and other clinic staff to test whether tailored training and coaching could help providers use motivational interviewing more effectively to support healthy behavior change.

The study found that tailored motivational interviewing significantly improved providers’ competence compared to baseline performance. This provided a structured implementation strategy that can help increase provider competence across HIV clinics.

ATN 150: Minor Consent & Confidential Care

2017-2022

ATN 153: EPIS

2017-2018

Study Title
Implementation Science Research Examining the Integration of Evidence-Based Practices Into HIV Prevention and Clinical Care Using the Exploration, Preparation, Implementation, and Sustainment (EPIS) Model

The EPIS study was an implementation science study that looked at what helps healthcare programs succeed in the real world. Researchers worked with HIV clinics across the country to understand how proven programs can be adopted and sustained so more young people can benefit from effective care and prevention services.

The study found that successful implementation depends on factors at multiple levels, including clinic leadership, staff engagement, organizational readiness, resources, training, and ongoing support. The study helped identify practical strategies used throughout the Scale It Up program.

2018

Biktarvy Approved by FDA for People Living with HIV

In early 2018, the FDA approved Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) as a once-daily, single-pill treatment for adults living with HIV. In June 2019, approval was granted for children weighing at least 55 pounds.

Why It Matters

In clinical trials, the virus showed zero cases of resistance to Biktarvy. It’s strong enough to consistently lock the virus down without letting it figure out a workaround.

5-year data proved that a whopping 99% of participants maintained an undetectable viral load. Biktarvy put highly reliable treatment into one tiny daily pill, making staying healthy easier and more foolproof than ever before.

ATN 152: TERA

2018-2020
ATN 152 TERA Infographic

PrEP as HIV Prevention for Teens Approved by FDA

The FDA officially approved a daily HIV prevention pill called Truvada (emtricitabine/tenofovir) for adolescents aged 13 and older.

The ATN’s Impact

This major approval happened because our study called ATN 113: PrEPare showed that the medication worked for younger people, too.

Why It Matters

Before this approval, teens didn’t have access to HIV prevention medication. Having oral PrEP available to youth, who account for 1 out of every 5 new HIV diagnoses in the U.S., was a massive win for keeping youth healthy.

ATN 142:
PrEPared, Protected, emPowered (P3)

2018-2021

Innovation

P3 aimed to build upon previous mobile app research to design an app that met the complex and unique needs of young people starting or taking PrEP.

P3 app - add your meds
P3 app - med strategies
P3 app - homescreen
P3 app - PrEP check in
P3 app
P3 app - brain builder
P3 app - knowledge center
P3 app - adherence

Why It Matters

P3 showed that a smartphone app could help young people stay on PrEP and reduce their likelihood of acquiring HIV. P3 provided a fun, supportive, and effective way to build healthy habits and take control of sexual health.

ATN 144: SMART

2018-2021

Innovation

The SMART study tested adaptive treatment strategies that respond dynamically when medication adherence declines. It explored whether text messages, phone calls, and incentives could help young people living with HIV stay on track with their medication, and adjusted support over time to give participants more help if they were struggling or less intensive support if they were doing well.

Why It Matters

The SMART study helped identify the most effective sequence of adherence supports for youth living with HIV. Results showed that adaptive interventions can help improve medication adherence and viral suppression by delivering the right level of support at the right time.

ATN 151: Work2Prevent

2018-2019

The Work2Prevent study was one of the first studies to address employment as a social and structural factor often linked to HIV prevention outcomes. The study evaluated whether helping young people build job-readiness skills and increase economic stability could reduce the likelihood of acquiring HIV.

The study developed and tested a four-session employment program that used youth empowerment, career planning, job readiness training, and asset-building strategies.

Participants reported positive experiences and improvements in employment-related skills and confidence. Researchers concluded that addressing economic stability and employment may help reduce HIV vulnerability by tackling upstream social determinants of health.

ATN 154: Cascade Monitoring

2018-2020

The Cascade Monitoring study tracked how young people moved through different steps of HIV care—from getting connected to a clinic to staying in treatment and reaching an undetectable viral load.

By identifying where youth were doing well and where they were more likely to fall out of care, this study’s findings can help clinics and researchers develop better ways to support the long-term health of youth living with HIV.

ATN 157: We Prevent

2018-2022

Innovation

The We Prevent study tested relationship-based HIV prevention strategies among couples (a dyadic strategy).

Why It Matters

The We Prevent study highlighted that sexual health decisions often occur within relationships, not isolation. Participants who received We Prevent counseling reported less condomless sex with people who were not their boyfriend/partner. We Prevent may be an important inclusion into existing service delivery for young gay and bisexual men.

ATN 158: LifeSteps PrEP for Youth

2018-2022

Innovation

LifeSteps PrEP for Youth (LSPY) adapted and tested a nurse-led, multi-session program designed to help adults take PrEP as prescribed into a program tailored for youth.

Why It Matters

Medication adherence can be challenging, particularly for youth. LifeSteps PrEP for Youth showed that a PrEP adherence program may be acceptable and helpful for young people.

2019

Undetectable = Untransmittable Endorsed by CDC

Research by the HIV Prevention Trials Network (HPTN) 052 study in 2011 and the PARTNER studies from 2014-2016 provided data from over 2,000 serodifferent couples, meaning one partner is living with HIV and one partner does not have HIV. The final score? There were literally zero cases of HIV transmission when the partner living with HIV took their medication as prescribed and achieved an “undetectable” viral load.

This led to the Prevention Access Campaign’s launch of Undetectable=Untransmittable (U=U), aiming to turn the science into a simple, actionable message.

Why It Matters

U=U crushes outdated, fear-based stigma and misconceptions about HIV transmission. It proves that people living with HIV can date, hook up, love, live full sexual lives, and have children with absolutely zero fear of passing HIV on to someone else.

Descovy Approved by FDA for HIV Prevention

In October 2019, the FDA approved another daily pill, Descovy (emtricitabine/tenofovir alafenamide) as PrEP for both adults and teens aged 12 and older.

Why It Matters

Similar to previously approved Truvada, this medication delivers the medicine to your body more efficiently, allowing for a lower dose that is gentler on bones and kidneys.

Because the formula is more efficient, the actual pill is physically smaller and easier to swallow, while still being over 99% effective at preventing HIV when taken as prescribed.

ATN 143: COMPARE

2019-2021

Innovation

The COMPARE study expanded on the LYNX and MyChoices studies through a larger study testing and comparing the two HIV/STI testing apps.

Why It Matters

Participants who used the LYNX or MyChoices app had higher rates of HIV and STI testing over the first six months of the study compared to participants who received usual care. Participants who used LYNX or MyChoices also had higher rates of starting PrEP for HIV prevention in the first six months. The results of MyChoices’ impact on HIV testing rates remained significant after statistical testing to account for other factors that might affect testing rates, but no other results remained significant. This shows that young gay and bisexual men may need additional support over the longer term to support HIV/STI testing and getting linked to PrEP services.

ATN 159: ePrEP

2019-2022

Innovation

Before telehealth was widely used, the ePrEP study tested whether young people in rural communities could use telehealth visits and a smartphone app to receive HIV and STI testing, get PrEP, and complete blood work at home instead of traveling to clinics and laboratories.

Why It Matters

The ePrEP study showed that a virtual PrEP program could be delivered to young men to help overcome access barriers like transportation, limited local healthcare providers, and privacy concerns. It helped lay the groundwork for the expanded use of virtual healthcare approaches that became much more common during and after the COVID-19 pandemic.

ATN 160: TechStep

2019-2021

Innovation

The ATN 160: TechStep study tested different digital tools, including supportive text messages, an interactive web app, and online coaching, to help participants learn about sexual health, and connect with helpful resources.

Why It Matters

The TechStep study demonstrated that digital health support outside the clinic setting, including text messaging, web-based tools, and virtual coaching, can be an effective way to provide sexual health education, support health-related decision-making, and connect young people with HIV prevention resources.

2020

ATN 141A: NextChoices

2020-2021

The NextChoices explored how young people learned about and felt about new HIV prevention options beyond a daily pill. The study conducted interviews with youth to test how new options were described and understood, including long-acting injections, implants, and other technologies under development.

The study found that youth wanted clear, straightforward explanations of emerging options. Participants emphasized the importance of minimizing medical jargon, providing relatable examples, including visual aids, protecting confidentiality, and improving access to affordable care.

ATN 155: Planning4PrEP

2020-2022

The Planning44PrEP study developed and tested ways to offer PrEP through family planning and reproductive health clinics. The goal was to bring HIV prevention into healthcare settings that many young women already visit, helping more adolescent and young women access PrEP.

The study demonstrated that family planning clinics are promising settings for delivering PrEP to young women who may not otherwise access HIV prevention services. The Planning4PrEP study identified important clinic-level, provider-level, and patient-level factors that affect successful PrEP implementation and helped establish practical approaches for integrating HIV prevention into routine reproductive healthcare, like clinic-wide training, workflow development, and ongoing support.

CDC Releases Guidance Highlighting Importance of PrEP Support for Adolescents

In 2020, the CDC released guidance encouraging healthcare providers to help teens and young adults stay on PrEP by offering ongoing support, check-ins, and conversations about any challenges they might face taking it regularly.

The guidance recognized that sticking with a daily medication can be tough, especially for young people, and emphasized working together to find strategies that fit each person’s life so PrEP can provide the best protection against HIV.

The ATN’s Impact

ATN 110 and ATN 113: PrEPare identified adherence as a major challenge for youth. The findings emphasized the need for ongoing adherence support like reminders, counseling, and more frequent engagement with providers. This helped shape CDC guidance and youth-focused PrEP programs.

ATN 156: We Test

2020-2022

The ATN 156: We Test study tested whether adding communication skills training videos and counseling sessions before couples compelted HIV testing together could reduce the likelihood of acquiring HIV and STIs.

The study worked with adolescents and young adults ages 14-24 to understand how HIV testing could be better designed to meet their needs, reduce fear, and increase engagement.

Instead of treating testing as just a medical procedure, the study explored how messaging, communication skills, environment, and provider interactions influence a young person’s willingness to get tested.

Why was it innovative?
It adapted an evidence-based intervention design for adults (Couples HIV Testing and Counseling) for adolescents and young adults. Researchers worked with youth to understand what changes were needed to make the intervention more relevant and useful for younger couples, tested potential intervention components, and compared approaches to determine which was most feasible and acceptable.

2021

ATN 163: DREAM

2020-2022

Innovation

The DREAM study tested a new HIV prevention product: a medicated rectal douche. Rather than requiring a daily pill, the medicated douche was designed as a potential on-demand option.

Why It Matters

The study found that the product was safe, well tolerated, and delivered promising levels of HIV prevention medication to rectal tissues, supporting further research on this strategy.

WHO Approved Vaginal Ring for HIV Prevention

In January 2021, the World Health Organization (WHO) recommended the dapivirine vaginal ring (DPV-VR) as HIV prevention for women.

Why It Matters

The vaginal ring for HIV prevention offers a discrete, long-term option without having to remember to take a pill. While not approved in the U.S., the vaginal ring is approved for use in at least 12 countries in Africa.

The ATN’s Impact

An ATN study (ATN 062) previously interviewed young women who tested a lubricant as HIV prevention. Findings showed that women had issues with the consistency of the gel and experienced vaginal leakage. The ATN’s findings contributed to other researchers pivoting to develop the vaginal ring for HIV prevention.

Long-Acting Injectable Approved as HIV Treatment for Adults

In January 2021, the FDA approved Cabenuva (cabotegravir/rilpivirine), making it the first long-acting injectable treatment for adults living with HIV, taken just once a month.

Why It Matters

90% of participants in clinical trials for Cabenuva preferred it over their previous daily pills. Let’s be honest—pill fatigue is real. Remembering to take a medication at the same time every single day can be hard to maintain. Monthly injections remove that barrier, making it easier for people to stay consistent and keep their viral load down.

However, teens were left out of initial approval because more testing was needed to find out how the injections worked on younger bodies.

ATN Era #1
ATN Era #2
ATN Era #3
ATN Era #5
ATN Era #1
ATN Era #2
ATN Era #3
ATN Era #5