Family Matters: How Gay and Bisexual Youth and Their Parents Discuss HIV
Gay and bisexual men are estimated to comprise 2% of the U.S. population, yet account for an estimated 61% of recent new HIV infections. Despite ongoing prevention efforts, gay and bisexual youth continue to engage in sexual behaviors that place them at disproportionately high risk. Family influence is a relatively unexplored but promising resource for gay and lesbian youth, as close and accepting family relationships are related to lower rates of high-risk sexual behavior among this population. Considering the unique challenges these families face, more information is needed to specifically identify parental influences so that they can be targeted for HIV-prevention interventions. To that aim, the research question for this study was: What are the types of parent-child interactions that may relate to lower incidents of unsafe sexual behavior among gay and bisexual youth?
Methods:
As part of a larger study that examined the role of family influence on safer sex behaviors, 38 Black, Latino, and White, gay and bisexual males, aged 14-21 (M = 18.8, SD = 2.04 ), and at least one of their parents were instructed to discuss HIV-related topics in the presence of an investigator. Topics included, “What helps young gay men avoid unsafe sex?” and “What is the role of parents in keeping their gay sons stay safe from AIDS; what is the child’s?” Discussions were video recorded
The PI and two assistants independently rated the quality of parent-child interactions using a typology (mutuality, directedness, support, disagreement, and withdrawal) developed by Wilson and Donenberg (2004). Using means of rater values and information from respondents, a Latent Class Analysis (LCA) was conducted using Mplus 7.11. The analysis focused on exploring models that identify respondent groups showing differences in unsafe sexual behavior.
Results:
After removing variables that did not support behavior variations, a well-fit LCA model was identified (i.e., entropy = .989), and theoretical support represented three groups (n= 4, 29, and 2, respectively). Group 1 indicated the lowest level and Group 3 the highest unsafe sexual behavior mean estimate (0.492 and 2.5, respectively). Other variable combinations provided less insight into unsafe sexual behavior. Therefore, the final model used to identify group membership included only mutuality and disagreement, because directedness, support, withdrawal, along with demographic variables, did not effectively identify the varying levels of unsafe sexual behavior for the respondents. A plot of the mean estimates for mutuality and disagreement by group shows graphically which groups were similar and which were different for these two constructs.
Conclusions and Implications:
Although this study was exploratory in nature, knowing how respondents were classified begins to suggest that family interactions typified by high mutuality and low disagreement might be the most related to lower incidents of unsafe sex. Based on these findings, clinical social workers and HIV prevention workers might be advised to coach families to discuss HIV-related issues in ways that highlight non-hierarchal dialogue that is low in conflict. Videotaped examples of parent-child discussions typified by high mutuality and low disagreement will be presented.