Family of Origin or Chosen: Pathways to PrEP Uptake Among Young Black MSM

Purpose: Despite the availability of HIV prevention medication, known as pre-exposure prophylaxis (PrEP), the uptake of PrEP has remained suboptimal among young Black men who have sex with men (MSM) since 2012. Prior research has demonstrated that parent-adolescent communication has increased HIV testing, lowered PrEP stigma and condom use among vulnerable populations. The current study sought to further investigate the influence of families of origin and chosen families on internalized homophobia, HIV testing, and PrEP use among young Black MSM ages 18 to 24.

Methods: A cross-sectional survey was administered to young Black MSM ages 18 to 24 (N=225). The survey was programmed for different sampling sites with Qualtrics software. An anonymous link was generated and embedded on a recruitment flyer. The flyer was then distributed via social media sites (e.g., Facebook, Twitter), as well as provided to community-based organizations and Amazon Mechanical Turk (MTurk) sites. The mean of the sample is 22 (standard deviation =1.92). Recruitment of participants was between December 1, 2021, and January 31, 2022. A path analysis was conducted to examine associations between stigma and positive attitudes toward PrEP among external assets (families of origin or chosen, internalized homophobia, HIV testing, and PrEP use).

Results: Our results indicated that family bonding was negatively associated with internalized homophobia (b = −0.43, p < .001). Communication with parents about drugs and sex was positively associated with internalized homophobia (b = 0.37, p < .001).

Conclusion: Overall, findings highlight the complexities of the family relationships of Black MSM and how some of these relationships can contribute to reducing risk factors and others may not. There must ways to include families, both chosen and of origin, involved in HIV prevention and intervention program to help increase uptake in young Black MSM.