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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References
Bauermeister, J. A., Pingel, E., Zimmerman, M., et al. (2012). Data quality in HIV/AIDS web-based surveys: Handling invalid and suspicious data. Field Methods,24, 272–291.
Bouris, A., & Hill, B. J. (2017). Exploring the mother–adolescent relationship as a promotive resource for sexual and gender minority youth. Journal of Social Issues,73(3), 618–636.
Bouris, A., Hill, B. J., Fisher, K., Erickson, G., & Schneider, J. A. (2015). Mother–son communication about sex and routine human immunodeficiency virus testing among younger men of color who have sex with men. Journal of Adolescent Health,57(5), 515–522.
Calzo, J. P., Antonucci, T. C., Mays, V. M., & Cochran, S. D. (2011). Retrospective recall of sexual orientation identity development among gay, lesbian, and bisexual adults. Developmental Psychology,47(6), 1658–1673. https://doi.org/10.1037/a0025508.
Centers for Disease Control and Prevention. (2018). US Public Health Service: Preexposure prophylaxis for the prevention of HIV infection in the United States: 2017 Update—A clinical practice guideline. https://www.cdc.gov/hiv/pdf/risk/prep/cdc-hiv-prep-guidelines-2017.pdf.
Córdova, D., Heinze, J., Hsieh, H., Mistry, M., Salas-Wright, C., Cook, S., & Zimmerman, M. (2018). Are trajectories of a syndemic index in adolescence linked to HIV vulnerability in emerging and young adulthood? AIDS,32, 495–503. https://doi.org/10.1097/QAD.0000000000001717.
D’Augelli, A. R., Grossman, A. H., & Starks, M. T. (2008). Families of gay, lesbian, and bisexual youth: What do parents and siblings know and how do they react? Journal of GLBT Family Studies,4(1), 95–115. https://doi.org/10.1080/15504280802084506.
Feinstein, B. A., Thomann, M., Coventry, R., Macapagal, K., Mustanski, B., & Newcomb, M. E. (2018). Gay and bisexual adolescent boys’ perspectives on parent-adolescent relationships and parenting practices related to teen sex and dating. Archives of Sexual Behavior,47(6), 1825–1837.
Flores, D. D., Abboud, S., & Barroso, J. (2019). Hegemonic masculinity during parent–child sex communication with sexual minority male adolescents. American Journal of Sexuality Education, 14, 417–439. https://doi.org/10.1080/15546128.2019.1626312.
Flores, D., & Barroso, J. (2017). 21st century parent–child sex communication in the United States: A process review. Journal of Sex Research,54(4–5), 532–548.
Flores, D., Docherty, S. L., Relf, M. V., McKinney, R. E., & Barroso, J. V. (2019). “It’s almost like gay sex doesn’t exist”: Parent-child sex communication according to gay, bisexual, and queer male adolescents. Journal of Adolescent Research, 34(5), 528–562. https://doi.org/10.1177/0743558418757464
Glick, S. N., & Golden, M. R. (2014). Early male partnership patterns, social support, and sexual risk behavior among young men who have sex with men. AIDS and Behavior,18(8), 1466–1475.
Goldfarb, E., Lieberman, L., Kwiatkowski, S., & Santos, P. (2018). Silence and censure: A qualitative analysis of young adults’ reflections on communication with parents prior to first sex. Journal of Family Issues,39(1), 28–54.
Grossman, J., Jenkins, L., & Richer, A. (2018). Parents’ perspectives on family sexuality communication from middle school to high school. International Journal of Environmental Research and Public Health,15(1), 107. https://doi.org/10.3390/ijerph15010107.
Guzmán, B. L., Schlehofer-Sutton, M. M., Villanueva, C. M., Stritto, M. E. D., Casad, B. J., & Feria, A. (2003). Let’s talk about sex: How comfortable discussions about sex impact teen sexual behavior. Journal of Health Communication,8(6), 583–598.
Hickey, A. M., Bury, G., O’Boyle, C. A., Bradley, F., O’Kelly, F. D., & Shannon, W. (1996). A new Short Form Individual Quality of Life measure (SEIQoL-DW): Application in a cohort of individuals with HIV/AIDS. British Medical Journal,313, 29–33.
Hosek, S., Rudy, B., Landovitz, R., Kapogiannis, B., Siberry, G., Rutledge, B., & Lally, M. (2017). An HIV pre-exposure prophylaxis (PrEP) demonstration project and safety study for young MSM. Journal of Acquired Immune Deficiency Syndromes,74(1), 21.
Jadwin-Cakmak, L. A., Pingel, E. S., Harper, G. W., & Bauermeister, J. A. (2015). Coming out to dad: Young gay and bisexual men’s experiences disclosing same-sex attraction to their fathers. American Journal of Men’s Health,9(4), 274–288.
Johnston, L., Steinhaus, M., Sass, J., Benjarattanaporn, P., Sirinirund, P., Siraprapasiri, T., & Gass, R. (2018). The associations of perceived social support with key HIV risk and protective factors among young males who have sex with males in Bangkok and Chiang Mai, Thailand. AIDS and Behavior,22(6), 1899–1907.
Kubicek, K., Beyer, W. J., Weiss, G., Iverson, E., & Kipke, M. D. (2010). In the dark: Young men’s stories of sexual initiation in the absence of relevant sexual health information. Health Education & Behavior,37(2), 243–263.
LaSala, M. C. (2007). Parental influence, gay youths, and safer sex. Health and Social Work,32(1), 49–55. https://doi.org/10.1093/hsw/32.1.49.
LaSala, M. C. (2015). Condoms and connection: Parents, gay and bisexual youth, and HIV risk. Journal of Marital and Family Therapy,41(4), 451–464.
LaSala, M. C., Siebert, Carl F., Fedor, James P., & Revere, Elyse J. (2016). The role of family interactions in HIV risk for gay and bisexual male youth: A pilot study. Journal of Family Social Work,19(2), 113–131.
Mehrotra, M. L., Amico, K. R., McMahan, V., Glidden, D. V., Defechereux, P., Guanira, J. V., & Grant, R. M. (2018). The role of social relationships in PrEP uptake and use among transgender women and men who have sex with men. AIDS and Behavior,22(11), 3673–3680.
Mera, R., Magnuson, D., Hawkins, T., Bush, S., Rawlings, K., & McCallister, S. (2017). Changes in Truvada for HIV pre-exposure prophylaxis utilization in the USA: 2012–2016 [Abstract WEPEC0919]. Presented at the 9th International AIDS Society Conference on HIV Science, Paris, France.
Morgan, E. M., Thorne, A., & Zurbriggen, E. L. (2010). A longitudinal study of conversations with parents about sex and dating during college. Developmental Psychology,46(1), 139–150. https://doi.org/10.1037/a0016931.
Mustanski, B., Macapagal, K., Thomann, M., Feinstein, B. A., Newcomb, M. E., Motley, D., & Fisher, C. B. (2018). Parents’ perspectives about adolescent boys’ involvement in biomedical HIV prevention research. Archives of Sexual Behavior,47(7), 1923–1935.
Needham, B. L., & Austin, E. L. (2010). Sexual orientation, parental support, and health during the transition to young adulthood. Journal of Youth and Adolescence,39(10), 1189–1198. https://doi.org/10.1007/s10964-010-9533-6.
Newcomb, M. E., Feinstein, B. A., Matson, M., Macapagal, K., & Mustanski, B. (2018). “I have no idea what’s going on out there:” Parents’ perspectives on promoting sexual health in lesbian, gay, bisexual, and transgender adolescents. Sexuality Research and Social Policy,15(2), 111–122.
Newcomb, M. E., LaSala, M. C., Bouris, A., Mustanski, B., Prado, G., Schrager, S. M., & Huebner, D. M. (2019). The influence of families on LGBTQ youth health: A call to action for innovation in research and intervention development. LGBT Health, 6(4), 139–145.
Padilla-Walker, L. M. (2018). Longitudinal change in parent-adolescent communication about sexuality. Journal of Adolescent Health,63(6), 753–758.
Pierce, J. D., Ylitalo, K. R., Lanning, B. A., & Limbers, C. C. (2018). Sex education and HIV testing among young men who have sex with men: Findings from the 2006–2010 and 2011–2015 national survey of family growth. Journal of Acquired Immune Deficiency Syndromes,79(2), 179–185.
Pingel, E. S., Bauermeister, J. A., Elkington, K. S., Fergus, S., Caldwell, C. H., & Zimmerman, M. A. (2012). Condom use trajectories in adolescence and the transition to adulthood: The role of mother and father support. Journal of Research on Adolescence,22(2), 350–366.
Roe, S. (2017). “Family support would have been like amazing”: LGBTQ youth experiences with parental and family support. The Family Journal,25(1), 55–62.
Rose, I. D., & Friedman, D. B. (2012). We need health information too: A systematic review of studies examining the health information seeking and communication practices of sexual minority youth. Health Education Journal, 72(4), 417–430. https://doi.org/10.1177/0017896912446739.
Rose, I. D., Friedman, D. B., Annang, L., Spencer, S. M., & Lindley, L. L. (2014). Health communication practices among parents and sexual minority youth. Journal of LGBT Youth, 11(3), 316–335. https://doi.org/10.1080/19361653.2013.864964.
Ryan, C., Russell, S. T., Huebner, D., Diaz, R., & Sanchez, J. (2010). Family acceptance in adolescence and the health of LGBT young adults. Journal of Child and Adolescent Psychiatric Nursing,23(4), 205–213.
Simons, L. G., Sutton, T. E., Simons, R. L., Gibbons, F. X., & Murry, V. M. (2016). Mechanisms that link parenting practices to adolescents’ risky sexual behavior: A test of six competing theories. Journal of Youth and Adolescence,45(2), 255–270.
Snapp, S. D., Watson, R. J., Russell, S. T., Diaz, R. M., & Ryan, C. (2015). Social support networks for LGBT young adults: Low cost strategies for positive adjustment. Family Relations,64(3), 420–430.
Soler, J. H., Caldwell, C. H., Córdova, D., Harper, G., & Bauermeister, J. A. (2018). Who counts as family? Family typologies, family support, and family undermining among young adult gay and bisexual men. Sexuality Research and Social Policy,15(2), 123–138.
Sowicz, T. J., Teitelman, A. M., Coleman, C. L., & Brawner, B. M. (2014). Considerations for implementing oral preexposure prophylaxis: A literature review. Journal of the Association of Nurses in AIDS Care,25(6), 496–507.
Thoma, B. C., & Huebner, D. M. (2018). Brief report: HIV Pre-exposure prophylaxis engagement among adolescent men who have sex with men the role of parent-adolescent communication about sex. Journal of Acquired Immune Deficiency Syndromes,79(4), 453–457.
Widman, L., Choukas-Bradley, S., Helms, S. W., Golin, C. E., & Prinstein, M. J. (2014). Sexual communication between early adolescents and their dating partners, parents, and best friends. Journal of Sex Research,51(7), 731–741.
Wood, S., Gross, R., Shea, J. A., Bauermeister, J. A., Franklin, J., Petsis, D., & Dowshen, N. (2019). Barriers and facilitators of PrEP Adherence for young men and transgender women of color. AIDS and Behavior,23, 2719–2729.
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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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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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DOI: https://doi.org/10.1007/s10508-020-01648-4