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Aims and Method A retrospective service evaluation of the first 500 referrals to a new community forensic service (FCAMHS) describing profiles of young people accessing the service. The evaluation aims to understand the impact of changes in health service care models and diversion from youth justice services over the last two decades in England. Accessibility to enhance opportunity for prevention of high-risk behaviours for all ages up to 18 is evaluated. Results The majority of referrals were living with their families, had no social care status, attended mainstream school and had an average age of 14 (range 7–18). Most referrals were for aggression, followed by harmful sexual behaviour and fire setting. Half the referrals had no formal mental health diagnosis or criminal status. Neurodevelopmental disorders were present in a quarter of referrals. Despite lower numbers of female referrals, the reasons for referral were similar to males. Clinical Implications The service evaluation highlights the changing face of forensic services and the move towards early intervention by pioneering an accessible and flexible model of care. [ABSTRACT FROM AUTHOR]

Health care providers have an important role to play in expanding PrEP uptake to populations disproportionately burdened by HIV. In this study, in-depth, semi-structured qualitative interviews were conducted with 20 PrEP providers in Los Angeles, California to explore their experiences and perspectives prescribing PrEP. Overall, the findings indicate that providers generally adhered to US CDC clinical guidelines in determining PrEP eligibility. However, they also identified special considerations with respect to adults with "low" or "no" HIV risk. Three themes were developed from the data related to the delivery of PrEP to such individuals: 1) patients may not disclose sexual behaviours; 2) patient autonomy and agency; and 3) the importance of PrEP in gay male monogamous relationships. Two additional themes were identified related to prescribing PrEP to young people under the age of consent: 4) the need for more PrEP and sexual health education with youth and 5) challenges in providing PrEP to youth without parental consent. Findings highlight the importance of providing PrEP to patients who could potentially benefit from adoption, whether or not they present with clear behavioural indicators for PrEP. Providers should also consider the potential barriers to delivering PrEP to youth to ensure successful adoption among members of this population. [ABSTRACT FROM AUTHOR]