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Family Characteristics in Sex Communication and Social Support: Implications for Emerging Adult Men Who Have Sex with Men’s PrEP Engagement

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Abstract

While emerging adulthood (ages 18–25) is marked by increased independence from parents, parental support remains a strong correlate of positive sexual health outcomes for heterosexual youth. With the emergence of pre-exposure prophylaxis (PrEP), few studies have examined the potential for parent–child sex communication and PrEP adoption among emerging adult men who have sex with men (MSM). We aimed to describe the extent to which parents/family characteristics play supportive roles in emerging adult MSM’s current PrEP use. PrEP-indicated participants (N = 222) were recruited via social media to complete an online survey. Multivariable logistic regression assessed associations between emerging adult MSM’s current PrEP use and comfort with parent–child sex communication, family social support, family outness, and family prioritization, adjusted for sociodemographic variables. Thirty percent of participants reported current PrEP use. Only 20% reported moderate/high comfort with parent sex communication, 80% reported any family sexual identity disclosure, 70% reported moderate/high family social support, and 70% ranked family as a high/very high priority. Our multivariable model demonstrated an association between comfort with parent–child sex communication with current PrEP use only (AOR= 1.55, 95% CI 1.04–2.32). Our findings support that parents of emerging adult MSM possess a critical potential to reduce their sons’ risk of HIV and promote PrEP uptake. Interventions that facilitate parents’ efficacy to foster affirming, non-judgmental environments and discussions about their child’s sexual behaviors, attractions/relationships, and health (e.g., PrEP) may be impactful in reducing the high HIV incidence rate that burdens emerging adult MSM.

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Funding

This publication resulted (in part) from research supported by the Mid-Atlantic CFAR Consortium Scholars Program, an inter-CFAR collaboration between the District of Columbia Center for AIDS Research (P30 AI 117970), the University of Pennsylvania Center for AIDS Research (P30 AI 045008), and the Johns Hopkins University Center for AIDS Research (P30 AI 094189). This collaboration is supported by the following NIH Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHLBI, NIDA, NIMH, NIA, FIC, NIGMS, NIDDK, and OAR. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Correspondence to Dalmacio D. Flores.

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Flores, D.D., Meanley, S.P., Wood, S.M. et al. Family Characteristics in Sex Communication and Social Support: Implications for Emerging Adult Men Who Have Sex with Men’s PrEP Engagement. Arch Sex Behav 49, 2145–2153 (2020). https://doi.org/10.1007/s10508-020-01648-4

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