A new systematic review highlights why HIV prevention pills are still failing to reach many adolescents and young people. Published in BMC Health, the analysis points to stigma, restrictive consent rules in some settings, and “pill fatigue” as major barriers that shrink real-world uptake. The review reframes prevention as not just a biomedical question but a delivery and social-acceptability challenge—particularly where young people face judgment, confidentiality concerns, and uneven access to prescribing and refills. For biotech and pharma, the findings add urgency to adherence-oriented trial design, demand-generation strategies, and policy engagement around consent frameworks and youth-friendly dispensing models.