Parents are a Significant Barrier to Adolescent Male PrEP Use

David Moskowitz, Ph.D., an Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH) faculty  
member and director of the SMART Project, recently co-authored the paper “What If My Dad Finds Out!?: Assessing Adolescent Men Who Have Sex with Men’s Perceptions About Parents as Barriers to PrEP Uptake.”  The paper explores adolescents’ perceptions of PrEP, their barriers to accessing the HIV prevention medication, and their challenges talking about PrEP with parents.

To better understand the role of parents in adolescents’ attitudes towards PrEP, the SMART Project surveyed 491 adolescent men who have sex with men (AMSM) ages 13–18 using forced-choice and open-ended response questions. Researchers measured perceived parent supportiveness of PrEP, hypothetical parent reactions to a request to initiate PrEP, and perceived positive and negative aspects of taking PrEP without parents knowing.

“Although PrEP has become widely available for teens over the past two years, teens still must rely on parents for their health needs. We know that certain barriers like cost, insurance, and healthcare providers can prevent adults from obtaining PrEP, but adults have more agency than teens, so we wanted to find out what specific barriers prevent teens from accessing PrEP,” says Moskowitz.

The number one concern adolescents expressed in regards to taking PrEP was fear that their parents might find out, with 32% of study participants citing this concern. Some participants noted that this was due to fear of awkwardness, fear of punishment, or fear of being labeled a derogatory term by their parents. In contrast, another 10% of participants expressed that they didn’t believe their parents to be barriers at all and would be comfortable talking to them about PrEP.

“The biggest move parents can make is to address this fear by speaking openly and honestly with their kids about HIV,” says Moskowitz. “It’s important for parents to know and understand the options for HIV preventive care and be able to talk about those options with their teens. If a parent is equipped with this knowledge and prepared to bring it up, that could resolve many of the barriers we uncovered with our study.”

Co-authors on this paper include Kathryn Macapagal, Ph.D.; Melissa Mongrella, M.H.S.; Leishla Pérez-Cardona, M.P.H.E.; Michael Newcomb, Ph.D.; and Brian Mustanski, Ph.D.