What If My Dad Finds Out!? Assessing Adolescent Men Who Have Sex with Men’s Perceptions About Parents as Barriers to PrEP Uptake

David A. Moskowitz, Kathryn Macapagal, Melissa Mongrella, Leishla Pérez-Cardona, Michael E. Newcomb, Brian Mustanski*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy for high-risk adults and recently was given US FDA approval for use among adolescents. Yet, the barriers to medication uptake for this population are unique when compared to adult populations, as parents may be just as likely as prescribers to be gatekeepers to access. To better understand the role of parents in adolescents’ attitudes towards PrEP, we surveyed 491 adolescent men who have sex with men (AMSM) ages 13–18, using forced choice and open-ended response questions. We measured perceived parent-PrEP supportiveness, hypothetical parent reactions to a request to initiate PrEP, and perceived positive and negative aspects of taking PrEP without parents knowing. A mixed-methods approach was employed. Results indicated a majority of AMSM had heard of PrEP and most reported their parents would be unsupportive of their taking PrEP. Teens perceived their parents would likely be angry, accusatory, and punitive if PrEP use was discovered, and that accessing PrEP independent of parents might increase their health autonomy, agency, and prevent awkward conversations about sex. Furthermore, a path model revealed that fears of parental reaction and poor self-efficacy to communicate with parents about PrEP significantly contributed to participants feeling PrEP was not “right” for them, and as a corollary, less interest in starting PrEP. The study suggests that improving parental knowledge of PrEP and encouraging parents to begin the conversation about PrEP could help increase uptake in AMSM.

Original languageEnglish (US)
Pages (from-to)2703-2719
Number of pages17
JournalAIDS and behavior
Volume24
Issue number9
DOIs
StatePublished - Sep 1 2020

Keywords

  • Adolescents
  • Family communication
  • HIV prevention
  • Parents
  • PrEP

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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