hesitant parents were more likely to report being “very confident” at addressing parents’ religious/personal beliefs compared to providers with a lower percentage of HPV vaccine-hesitant parents (p ¼ 0.03). Most providers (86%) report parents who accept other recommended adolescent vaccines yet refused HPV in the past 12 months. Finally, 26% of providers reported they somewhat/strongly agree with policies that dismiss hesitant parents. More providers reported a dismissal policy for childhood (19%) than for adolescent immunizations (9.6%). Conclusions: Almost a third (29.5%) of North Texas providers encounter a sizeable proportion of HPV vaccine-hesitant parents. Providers report lower confidence in addressing vaccine-hesitant parents’ religious/per- sonal beliefs and parents’ misinformation obtained from the internet/so- cial media. Use of dismissal policies to manage vaccine-hesitant parents remains lower for adolescent than childhood immunizations despite the high prevalence of HPV vaccine-refusal parents. (NCI P30, Lyda Hill Phi- lanthropies, NIH K23). 81. Recurrent Labial Hair Thread Tourniquet Syndrome in an Adolescent Girl: A Systematic Review and Case Report Naomi Adjei, Anna Lynn, Alyssa Grimshaw, Marie Brault, Alla Vash-Margita Yale University School of Medicine Background: Hair Thread Tourniquet Syndrome (HTTS) occurs when a hair-like fiber strangulates an area of tissue. HTTS occurs commonly on fingers, toes, and male genitalia. We present the successful identification and treatment of recurrent labial HTTS in an adolescent girl. Case: A healthy 11 year old premenarchal girl presented to the Pediatric Adolescent Gynecology clinic as an urgent referral from her pediatrician for vulvar lesion, pain and itching present for few days. Patient and parents denied trauma or sexual abuse. General physical exam was unremarkable. External genitalia demonstrated Tanner 4 pubic hair, structurally normal labia majora, asymmetric labia minora, normal external meatus and clitoris, and annular hymen. Right labium minus was asymmetrically enlarged with strands of pubic hair wrapped around outer edge of the swollen and necrotic labium (Fig 1). HTTS was diagnosed. The hair was removed in the office under topical anesthetic. Acetaminophen and sitz baths were recommended for pain relief. Vulvar culture was positive for Gardnerella vaginalis. Course of metronidazole was completed. After one week patient reported complete resolution of symptoms (Fig 2). Nine months later, now 12 year old postmenarchal patient returned with intermittent severe vulvar pain and pruritus. A recurrent hair tourniquet was found in the same area of right labium minus and was removed in the office under topical anesthetic. After shared decision making, surgical excision of the redundant asymmetric right labium minus was scheduled to prevent recurrence. Comments: We conducted a systematic literature review on adolescent male and female genitalia HTTS. The Cochrane Library, Embase, Google Scholar, Medline, Pubmed, Scopus, and Web of Science databases were searched resulting in 64 relevant articles. Excel and SPSS were used for data analysis. There were 35 female cases from 30 articles (1980 to 2019) and 118 male cases from 34 articles (1971 to 2017), majority being case reports. Average age among females was 9.3 years and 5.9 years among males. 92% of the females were premenarchal. 89% of males were circumcised. Clitoris (50%) and labia minora (41%) were most commonly involved in females, and penis (92%) and urethra (32%) in males. Pain and edema were most common symptoms in both sexes. Urologists and Emergency Physicians mostly managed male and female genitalia HTTS, respectively. 6 of 55 providers were gynecologists, and only one was pe- diatric adolescent gynecologist. General anesthesia was used for excision of tourniquet in most cases. As delayed treatment can lead to necrosis and auto-amputation of involved body part, clinicians need to recognize signs of HTTS and make timely and accurate diagnosis. 82. PrEP Eligibility Among Adolescent Women of Color Nathalie Duroseau, Gylynthia Trotman, Li Niu, Anthony Salandy, Angela Diaz Mount Sinai Adolescent Health Center Background: Pre-Exposure prophylaxis (PrEP) is an effective HIV pre- vention strategy that is underutilized among women of color, a group at high risk of HIV acquisition. One of the barriers to use among women of color is a poor perception of risk. Current PrEP criteria also does not include additional factors that increase rates of HIV acquisition among women of color such as depression, intimate partner violence, and a his- tory of trauma. The aim of this study is to characterize PrEP eligibility and report on its utilization among a cohort of adolescent women of color. Methods: The sample was derived from a parent longitudinal prospective study on the effect of HPV vaccination. Sexually active females were recruited from an adolescent health center in New York City from 2012 to 2019. Participants completed a questionnaire at the initial visit regarding their sexual practices including number of partners, partner’s HIV status, barrier method use, and history of STI/ HIV diagnosis. Additional data was collected on drug/alcohol use, depression, and childhood trauma. The survey was re-administered every 6 months. Descriptive statistics were performed to describe the population sample. This study was approved by the institutional review board. Results: A total of 1411 participants were included. Approximately 50% identified as black and 44% identified as Hispanic. About 71% were be- tween the ages of 18 to 25 years old. Using the current PrEP criteria, a considerable number of the sample were considered high risk for HIV infection. For example, 41% reported two or more partners in the past 6 months, and 54% reported infrequent to no condom use over the past 6 months. A total of 21% reported having two or more sexual partners and infrequent condom use within a 6 month period. An estimated 4% of participants reported that they had a partner who was HIV+ and 13% re- ported testing positive for either Syphilis or Gonorrhea at either the initial baseline visit or follow up. When looking at additional risk factors for HIV acquisition, 12% reported a history of intimate partner violence, 34% had a history of childhood trauma, and15% reported depressive symptoms in the initial baseline visit. Among this sample of patients PrEP was prescribed to only 2.8% of participants. web 4C=FPO web 4C=FPO Poster Presentation Abstracts 2 / J Pediatr Adolesc Gynecol 33 (2020) 212e237 214