Parents' and Their Gay/Bisexual Sons' Opinions and Suggestions for HIV Prevention

Background/Purpose

Despite ongoing prevention efforts, young gay and bisexual men (YGBM) account for more than three fourths of all recent HIV infections and continue to engage in high-risk sexual behaviors (CDC, 2014). Previous investigators have focused on either the prevalence and correlates of HIV-risk behavior among YGBM (e.g. Biedas, Birkett, Newcomb, & Mustanski, 2012: Newcomb, Clerken, & Mustanski, 2010), or family influences (Garafalo, Mustanski, & Donenberg, 2008; Ryan, Russell, Huebner, Diaz, & Sanchez, 2010). With few exceptions (Seal et al., 2000; Vanable et al., 2012), investigators have not directly and systematically solicited the opinions of YGBM concerning HIV prevention, despite longstanding calls to do so (Altman, 1995; De La Cancela, 1989), and no studies were found that described the perceptions and suggestions of parents of YGBM. Thus, the research questions for this study were: 1) what do YGBM and their parents believe are the reasons for unsafe sex among YGBM and, 2) what would they propose as potential interventions to reduce sexual risk behaviors among this population?

Methods

We completed in-person, semi-structured, qualitative interviews with 37 Black, White, and Latino YGBM (aged 14-21) and at least one of their parents/guardians. Respondents were recruited predominantly via Craigslist advertisements. We asked a series of questions and probes about what they believed leads to unsafe sex among YGBM and what could be done to prevent it.  To capture shared family meanings, conjointly interviewed parent-child dyads were the unit of data collection and analysis (Chesla, 1995; Eggenberger & Nelms, 2007).  All interviews were recorded, transcribed, entered into Dedoose (2013) software and underwent a thematic analysis (Braun & Clarke, 2006).

Results

Regarding the first research question, respondents believed that YGBM engaged in unsafe sex because they felt invulnerable, suffered stigma-related low self-esteem and that their judgment was often clouded by sexual arousal and/or substance use. Respondents reported intrapersonal factors such as parental disapproval as both a function of and contributor to gay stigma, and structural/societal barriers that kept youth closeted and thus inaccessible to prevention efforts.  Suggestions for interventions were predominantly in the structural/institutional domain and included providing gay-specific sex education in schools, wide-reaching community programs featuring celebrities popular among YGBM, and greater overall societal acceptance. 

Implications and Conclusions

This research with its focus on the healthcare needs of a marginalized at-risk population of youth, fits squarely into the conference theme. The findings begin to suggest that YGBM and their parents, primary stakeholders in the fight against HIV/AIDS, have a valuable perspective that could enrich current prevention efforts. It is noteworthy that the suggested interventions (i.e. gay-specific, school-based sex education) would require a reduction of institutional homophobia as well as a greater societal understanding of YGBM and their sexual desires and behaviors. Social workers, with their understanding of contextual factors and ability to assess and intervene at macro levels and engage client groups in program development (Netting, Kettner, McMurty, & Thomas, 2011) are ideally suited to engage and collaborate with YGBM and their parents to enact these stigma-reducing HIV prevention interventions.