Adolescents most at risk for HIV infection are least likely to use PrEP. Adolescents and young adults ages 12 to 24 made up 21% of the 37,832 new HIV diagnoses in 2018, with a disproportionately high percentage (77% to 82%) in black and Latinx youth. Yet, according to a review published online May 11 in JAMA Pediatrics, only 0.6% of all prescriptions for preexposure prophylaxis (PrEP) provided in 2018 were for adolescents. The authors note that most clinicians caring for adolescents do not routinely offer HIV testing, a necessary first step in starting PrEP. Another barrier to its use is the differing state laws regarding adolescents' right to consent to sexual and reproductive health care or, if they do have the right, whether it covers initiation of PrEP. Other barriers to use include the prohibitive cost of the drugs and concerns about confidentiality, particularly related to sexual identity or engagement in risk behaviors.