Background: Large-scale surveys reveal alarming rates of high-risk sexual behavior and HIV infection among gay male youth (Centers for Disease Control and Prevention, 2002; Valleroy et al., 2000). Investigators have identified important variables associated with incidents of unprotected anal intercourse in this population such as drug and alcohol use, (Diaz, Stall, Hoff, Daigle, & Coates, 1997; Koblin, et al., 2000; Meyer & Dean, 1995), mental illness (Meyer & Dean, 1995), internalized homophobia, (Diaz, Ayala, & Bein, 2004) and being misinformed about safer sex (Hays, Kegeles, & Coates, 1997). However, what is remarkably lacking from these studies is the consideration of the family as a factor in HIV risk or prevention for this population. This omission is particularly striking considering the growing literature demonstrating how family factors play a role in HIV prevention for heterosexual youth (Jaccard, Dittus, & Gordon, 1996; Luster & Small, 1994; Rogers, 1999, Voisin, 2002).

Purpose and Methods: To begin to understand how family relationships and interactions play a role in young gay males' decisions to avoid unsafe sexual practices, a multicultural sample of parents and sons (ages 16-25) in 30 families were qualitatively interviewed. All youth were out to their parents and reportedly HIV-negative at the time of the study. A combination of grounded theory and narrative methods were used to collect and analyze the data. Parents and sons were asked whether and if so, how they discussed HIV risk. Sons were asked what if anything their parents did to convince them to adhere to safer sex practices. Interviewers used probes to elicit the perceived impacts of parental relationships on the gay youth's safer sex behaviors. All interviews were audio taped, transcribed, and coded. The principal investigator used peer debriefing and member checking to check codes.

Results: Youth with histories of strong, close family relationships reported feeling obliged to their parents to stay HIV-negative, and this emerged as a major factor in their decisions to avoid unsafe sex. Some youth reported no parental influence, and many of them had parents with a history of problems such as marital difficulties, addictions, and mental illness. However, some of the youth from these historically troubled families had parents who regularly discussed safer sex practices with them and frequently gave them condoms. This active, hands-on approach led these youth to feel obligated to their parents to consistently avoid unsafe sexual behavior.

Practice Implications: Based on these exploratory findings, AIDS prevention specialists working with "out" gay youth would be advised to recruit parents, assess family relationships, and facilitate parent-child communication and parental monitoring. Furthermore, the functional role of family obligation in influencing youth to avoid high-risk sexual behavior might have import for parents of young adults concerned with other types of risky youth behavior, such as driving, alcohol and drug use, etc. Though more research is needed, practitioners might want to consider these findings and help parents explicitly discuss their concerns about risky behavior in ways that engender feelings of obligation in their children to stay healthy and safe.