1
|
Owens C. Attitudes Toward Using and Willingness to Use a Hypothetical Online Sex Communication Intervention for Parents of Sexual and Gender Minority Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:3119-3127. [PMID: 39107530 DOI: 10.1007/s10508-024-02946-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 08/22/2024]
Abstract
Although parents of sexual and gender minority (SGM) adolescents play a critical role in communicating about sexual health to their children, most parents have reported that they are unknowledgeable and uncomfortable talking about sexual health to their SGM adolescent. Because of the limited availability of sex education programs for parents of SGM adolescents, the study aimed to (1) describe the attitudes toward using and willingness to use a hypothetical online sex communication intervention for parents of SGM adolescents and (2) examine factors associated with willingness to use such an intervention. Parents of SGM adolescents from across the United States (N = 385) completed an online survey from March 10-16, 2023. Most participants were open to participating in a hypothetical online sex communication program and had positive attitudes toward it. Logistic regression results showed that participants who overall agreed a hypothetical online parent-based sex education intervention would be helpful and of interest had higher odds of being overall willing to participate in such a hypothetical intervention. Additionally, participants with higher income levels were also more likely to be willing to participate in a hypothetical program. Results from this exploratory study suggest that most parents of SGM adolescents have positive attitudes toward a hypothetical online parent-based sex education program and are willing to participate in it, highlighting a need to develop sex education programs tailored to the needs and preferences of parents of SGM adolescents. Additionally, equitable access to such programs is necessary especially regarding income level.
Collapse
Affiliation(s)
- Christopher Owens
- Department of Health Behavior, Texas A&M University School of Public Health SPHA, Room 317, 212 Adriance Lab Rd., College Station, TX, 77843, USA.
| |
Collapse
|
2
|
Barnett AP, Huebner DM. Parent Facilitation of Condom Access and HIV Testing Associated with Improved Sexual Health Outcomes for Sexual Minority Young Men. AIDS Behav 2024:10.1007/s10461-024-04428-6. [PMID: 38963570 DOI: 10.1007/s10461-024-04428-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2024] [Indexed: 07/05/2024]
Abstract
Sexual minority young men experience a high HIV incidence. Parent-based interventions are promising for prevention efforts, but further research is needed to identify specific, replicable parental behaviors associated with improved sexual health outcomes for sexual minority young men. We assessed parental behaviors in the domains of facilitating access to condoms, providing instruction in condom use, and supporting HIV testing, and tested whether parental behaviors were associated with sons' condom use self-efficacy and intentions to get tested for HIV. Data came from the baseline assessment of a pilot trial of a parent-based HIV prevention program, and participants were dyads (n = 61) of sexual minority young men (M. age: 16.87; 46% racial/ethnic minority) and their parents (M. age: 44.31; 26% racial/ethnic minority). Parents and sons reported on parental behaviors in each domain. Results indicated that parents' facilitation of access to condoms was associated with sons' condom use self-efficacy, and parents' facilitation of HIV testing was associated with sons' HIV testing intentions. Findings were robust across both parent and son reports of parental behaviors. Parental condom use instruction was unrelated to sons' condom use self-efficacy. Findings suggest that parent-based HIV prevention programs for sexual minority young men should encourage parents to provide instrumental assistance to their sons in accessing condoms and HIV testing. There is a need for further research to identify underlying mechanisms.
Collapse
Affiliation(s)
- Andrew P Barnett
- Department of Psychiatry, Rhode Island Hospital, 1 Hoppin Street, Suite 204, Providence, RI, RI 02903, USA.
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - David M Huebner
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| |
Collapse
|
3
|
Dawson K, Gabhainn SN, Friday R, MacNeela P. Barriers and recommendations for parent-child conversations about pornography. FRONTIERS IN SOCIOLOGY 2024; 9:1349549. [PMID: 38726390 PMCID: PMC11080982 DOI: 10.3389/fsoc.2024.1349549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/29/2024] [Indexed: 05/12/2024]
Abstract
Introduction Parents consistently report being worried about the impact of online pornography on their adolescent and pre-adolescent children's development. Yet, most parents do not discuss pornography as part of parent-child conversations about sexuality. The current study sought to identify the barriers to parent-child conversations about pornography. Methods We present two studies. The first study employed one-to-one interviews to explore parents' (n = 14) beliefs about their role in their child's pornography education. The second study involved the quantitative assessment of Study 1 findings in a sample of parents of pre-adolescent and adolescent children (n = 408). Results Findings indicate that three overarching themes prevent parents from addressing pornography with their adolescent children, parents' practical ability to discuss pornography, their attitudes toward discussing pornography, and the perceived positive impact of addressing pornography with their adolescent children. Practical ability was most often reported as the greatest barrier to parents engaging in parent-child conversations about pornography. Most notably, parents reported hesitancy in discussing pornography because they did not know how to define pornography or how to address pornography in an age-appropriate way. Fathers were also significantly less likely to believe that talking about pornography was socially acceptable. Discussion We discuss the implications of these findings and present recommendations for developing a parents' pornography education resource.
Collapse
Affiliation(s)
- Kate Dawson
- School of Psychology, University of Galway, Galway, Ireland
| | | | - Ross Friday
- Psychology and Counselling, University of Greenwich, London, United Kingdom
| | | |
Collapse
|
4
|
Astle SM, Jankovich MO, Vennum A, Rogers AA. Parent-Child Sexual Communication Frequency and Adolescent Disclosure to Mothers About Sexuality: The Moderating Role of Open Communication in a Common Fate Structural Equation Model. JOURNAL OF SEX RESEARCH 2023; 60:1045-1054. [PMID: 35302912 DOI: 10.1080/00224499.2022.2045888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Although frequent and open parent-child sexual communication (PCSC) has been shown to yield positive effects on adolescent sexual health outcomes, most PCSC is one-sided and parent dominated rather than ideal communication characterized by openness. Adolescent children's disclosure of sexual feelings and behaviors to parents can prompt parent-child sexual communication (PCSC) and help parents tailor PCSC to children's needs, increasing the effectiveness of PCSC in promoting positive sexual outcomes. However, very little work has been done exploring correlates of adolescent disclosure about sexuality. Thus, the current study explored the associations between frequent PCSC and child disclosure and secret keeping, and whether open PCSC moderated the relationships. The sample included 603 mother-child dyads from the United States. Adolescent children were 12-17 years old (M = 14.55, SD = 1.68), White (55.6%) and cisgender female (49.8%). A common-fate SEM model revealed that PCSC frequency was positively associated with adolescent disclosure and adolescent secret keeping. However, when PCSC was open, PCSC frequency was associated with a decrease in adolescent secret keeping and an increase in adolescent disclosure. We discuss the importance of encouraging both open and frequent PCSC, as their interaction is related to increased adolescent disclosure and less adolescent secret keeping.
Collapse
|
5
|
Flores D, Kornides M, Meanley S. Inclusive and Age-Appropriate Timing of Sexual Health Discussions at Home According to Gay, Bisexual, and Queer Adolescent Males. J Adolesc Health 2023; 72:754-762. [PMID: 37062572 PMCID: PMC10111203 DOI: 10.1016/j.jadohealth.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE The exclusion of gay, bisexual, and queer (GBQ) adolescent males' specific sexuality concerns in standard classroom education heightens the need for parents to be primary sources of trusted sexual health information. The aim of this study was to collect GBQ adolescent males' suggestions for a comprehensive list and age-appropriateness of topics that parents may use for inclusive discussions at home throughout the elementary, middle school, and high school years. METHODS Semistructured interviews and card sorts of 48 topics were conducted with a sample of 30 racial and ethnic diverse GBQ adolescents in central North Carolina. Thematic analysis of the interview transcripts and a calculation of card sort responses followed. RESULTS Topics chosen for elementary-age GBQ youth were focused on core issues about human anatomy, safety, and the continuum of sexual orientations and gender identities. Participants designated the majority of topics for home-based discussions in middle school and emphasized considerations for engaging in sex, relating with others socially, options for HIV/STI risk reduction, issues around interpersonal safety, and pleasure. They reserved topics for high school focused on complex sociorelational issues and technology-based concerns. DISCUSSION Participants' varied rationale for timing of topics centered on the age-appropriateness and level of details that they deemed acceptable for discussions with parents. To address disproportionate negative sexual and mental health outcomes noted in this youth subgroup, parents should focus on being supportive by providing factual and sequential information crucial for their GBQ childrens' anticipated developmental needs and sexual identity milestones.
Collapse
Affiliation(s)
- Dalmacio Flores
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Melanie Kornides
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Steven Meanley
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
6
|
Haupt KR, Stout CD, Simmons J, Nelson KM. Differences in the sexual health information parents/guardians give their adolescent sexual minority sons by outness. JOURNAL OF LGBT YOUTH 2023; 21:132-149. [PMID: 38434757 PMCID: PMC10906741 DOI: 10.1080/19361653.2023.2176399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 01/30/2023] [Indexed: 03/05/2024]
Abstract
Introduction Parents and guardians are a potentially valuable source of sexual health information for adolescent sexual minority males (ASMM). The current study examines what sexual health topics ASMM report discussing with a parent/guardian and whether topics differ by outness about sexual attraction to other males. Methods ASMM (N=154; ages 14-17) in the United States completed the baseline of an online sexual health intervention pilot in 2020. They reported which of twelve sexual health topics they discussed with a parent/guardian and if they had disclosed their sexual attraction to other males. Associations between topics discussed and outness to a parent/guardian were examined with Firth logistic regression. Results Eighty-eight (57%) participants reported being out to a parent/guardian. Six sexual health topics were significantly more likely to be discussed if participants were out. The three categories with the largest differences by outness were how to: discuss with a partner what they would not like to do sexually (aOR = 7.0, 95% CI: 2.0-24.6), use condoms (aOR = 5.9, 95% CI: 2.3-15.1), and prevent HIV/AIDS (aOR = 3.5, 95% CI = 1.4-8.7). Conclusions Interventions on parental/guardian provision of sexual health information are needed to ensure ASMM receive relevant sexual health knowledge.
Collapse
Affiliation(s)
- Kaitlin R Haupt
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Claire D Stout
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Journey Simmons
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Kimberly M Nelson
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| |
Collapse
|
7
|
Bond KT, Mansour M, Kershaw T, Flores DD. "Whenever you're ready to talk about it": Prompts and barriers to inclusive family sex communication with gay, bisexual, and queer sons. AMERICAN JOURNAL OF SEXUALITY EDUCATION 2022; 18:569-593. [PMID: 38213905 PMCID: PMC10783024 DOI: 10.1080/15546128.2022.2141935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Despite growing evidence that parent-child sex communication (PCSC) is a positive strategy for adolescent sexual health outcomes, there is little research about what prompts and impedes these conversations among parents of gay, bisexual, and queer (GBQ) adolescent sons. Using interview data from a multi-method qualitative study, we analyzed parental perspectives (N=15) on non-heteronormative sex communication with GBQ adolescent sons. Our results revealed that parents are most likely to engage in sex communication if they established open communication with their child, accepted their child's sexual orientation, encouraged safe sex practices, and were knowledgeable about LGBTQ issues. Conversely, parents who experience communication discomfort were unable to engage in inclusive and comprehensive sex conversations, thus creating a barrier to effective sex-positive communication. These findings have implications for future research and interventions that promote parents' ability to successfully facilitate conversations about sexual health with their sexuality diverse children.
Collapse
Affiliation(s)
- Keosha T Bond
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY
- Department of Public Health, New York Medical College, Valhalla, NY
| | - Maikel Mansour
- Department of Public Health, New York Medical College, Valhalla, NY
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale University School of Public Health, Hartford CT
| | - Dalmacio D Flores
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia PA
| |
Collapse
|
8
|
Barnett AP, Brown LK, Crosby R, Craker L, Washington R, Burns PA, Mena LA. Family-Related Factors and HIV-Related Outcomes Among Black Young Men Who Have Sex with Men in Mississippi. AIDS Behav 2022; 27:1548-1563. [PMID: 36318432 PMCID: PMC9628553 DOI: 10.1007/s10461-022-03889-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 11/05/2022]
Abstract
Given their disproportionate HIV incidence, there is a critical need to identify factors related to HIV risk among Black young men who have sex with men (YMSM) in the southeastern United States. This study investigated the association of family factors and HIV-related outcomes among Black YMSM in Mississippi ages 14-20 (n = 72). Multivariable regression models evaluated associations of family factors and outcomes. Greater parent/child communication about sex was associated with fewer lifetime male sex partners and lower odds of lifetime anal sex. Greater parental monitoring was associated with greater likelihood of future condom use. Sexual orientation disclosure was associated with more lifetime male sex partners. Parental monitoring and parent/child communication about sex were protective, suggesting that family-based interventions are promising for HIV prevention among Black YMSM in Mississippi. Results also indicated that YMSM who are "out" to family are important to reach, and families could be useful in encouraging healthy behaviors.
Collapse
Affiliation(s)
- Andrew P. Barnett
- Bradley/Hasbro Children’s Research Center, Rhode Island Hospital, 1 Hoppin Street, Suite 204, Providence, RI 02903 USA ,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI USA
| | - Larry K. Brown
- Bradley/Hasbro Children’s Research Center, Rhode Island Hospital, 1 Hoppin Street, Suite 204, Providence, RI 02903 USA ,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI USA
| | - Richard Crosby
- Department of Health, Behavior, and Society, University of Kentucky, Lexington, KY USA
| | - Lacey Craker
- Bradley/Hasbro Children’s Research Center, Rhode Island Hospital, 1 Hoppin Street, Suite 204, Providence, RI 02903 USA ,Present Address: Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL USA
| | - Rodney Washington
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, USA
| | - Paul A. Burns
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, USA
| | - Leandro A. Mena
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, USA ,Present Address: Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA USA
| |
Collapse
|
9
|
Flores DD, Allen JL, Bannon JA. Do Say Gay: Inclusive Sexuality Discussions for Out, Closeted, Questioning, and Straight Youth. J Pediatr Health Care 2022; 36:e7-e12. [PMID: 36088221 PMCID: PMC9978038 DOI: 10.1016/j.pedhc.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Debates questioning the soundness of inclusive elementary school discussions that acknowledge sexual and gender diverse people are harmful to gay, bisexual, or queer (GBQ) males. With parents as sexual socialization agents, examining sex communication at home is critical for promoting inclusive health information for all youth. METHOD We examined how GBQ youth (n = 30), aged 15-20 years, conceptualized inclusive sex communication with parents and the value of open sexuality discussions. RESULTS Most of the sample identified as gay (76.7%) and diverse (13.3% Asian, 13.3% Black/African American, 33.3% Latino). Participants discussed sexual health with their parents and perceived its significance for GBQ, questioning, and heterosexual children. DISCUSSION Findings can inform interventions that promote inclusive sex communication between parents and children to promote acceptance of sexual and gender diversity and sexual health for all youth.
Collapse
|
10
|
Dittman CK, Sprajcer M, Turley EL. Revisiting gendered parenting of adolescents: understanding its effects on psychosocial development. CURRENT PSYCHOLOGY 2022; 42:1-13. [PMID: 35967502 PMCID: PMC9364298 DOI: 10.1007/s12144-022-03536-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/03/2022]
Abstract
Introduction: Today's adolescents are growing up in a unique sociocultural climate in which gender issues are highly prominent. Alongside new ways of understanding gender identity, there are persistent gender disparities in social, health and mental health outcomes despite increasingly egalitarian views and a significant public focus on sexual assault and gender-based violence. Given gender-differentiated outcomes emerge during adolescence, it is critical to revisit factors influencing adolescent gender development. It has been argued that gendered parenting, reflected in differences in parenting attitudes and behaviors directed towards boys and girls, influences gender development. While numerous studies have examined gendered parenting with children, there has been no previous synthesis of gendered parenting of adolescents. Method: The current narrative review presents an overview of research into gendered parenting of adolescents, including parental modelling, gendered environments, and specific parenting practices, and draws together the available research on how it impacts adolescents. Gendered parenting is also examined in the context of LGBTQI + and gender non-conforming adolescents. Results: There is limited research investigating the presence of gendered parenting of adolescents, and even less assessing its impact on adolescent psychosocial outcomes. The available literature suggests that there may be effects of gendered parenting on adolescents, particularly on their gender role attitudes and gender-typed behaviors. Conclusions: Future work is needed to better understand how gendered parenting of adolescents manifests in the family home. In addition, research is needed to examine the longitudinal impact of gendered parenting, particularly within non-traditional families, and across a range of sociocultural contexts.
Collapse
Affiliation(s)
- Cassandra K. Dittman
- Central Queensland University, Locked Bag 3333, 4670 Bundaberg, DC, QLD Australia
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, St Lucia, QLD Australia
| | - Madeline Sprajcer
- Appleton Institute, Central Queensland University, Norman Gardens, QLD Australia
| | - Emma L. Turley
- Central Queensland University, Locked Bag 3333, 4670 Bundaberg, DC, QLD Australia
| |
Collapse
|
11
|
Chan ASW, Wu D, Lo IPY, Ho JMC, Yan E. Diversity and Inclusion: Impacts on Psychological Wellbeing Among Lesbian, Gay, Bisexual, Transgender, and Queer Communities. Front Psychol 2022; 13:726343. [PMID: 35572280 PMCID: PMC9105225 DOI: 10.3389/fpsyg.2022.726343] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
For scholars, practitioners, and legislators concerned about sexual minority adolescents, one of the main goals is to create more positive and inclusive learning environments for this minority group. Numerous factors, such as repeated patterns of homophobic bullying by classmates and others in school, have been a significant barrier to achieving this goal. In addition, lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents encounter substantial inequality across a broad spectrum of wellbeing and education consequences. Compared with their heterosexual counterparts, LGBTQ adolescents experience more anxiety, depression, suicidal thoughts, antisocial behavior, poorer academic performance, less school attachment and protection, and a weaker desire to finish their studies. Such discrepancies based on gender and sexuality were linked to more maltreatment encountered by LGBTQ adolescents. It is crucial to recognize the backgrounds and expectations of LGBTQ adolescents to offer them the best resources. To overcome the inequality and obstacles faced by these LGBTQ adolescents, it is essential to examine tools and techniques that can be utilized. This study examined the literature that explains why society fails to provide enough support to LGBTQ students. Specifically, mechanisms explaining how LGBTQ adolescents interact with others in the learning environment and how such discrepancies arise will be examined. Following that, violence and prejudice, which are fundamental causes of psychological problems among LGBTQ adolescents, will be explored. This review paper thus provides supportive strategies for schools to develop more inclusive learning environments for LGBTQ adolescents.
Collapse
Affiliation(s)
- Alex Siu Wing Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Dan Wu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Iris Po Yee Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Jacqueline Mei Chi Ho
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Elsie Yan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| |
Collapse
|
12
|
Flores DD, Hennessy K, Rosario A, Chung J, Wood S, Kershaw T, Villarruel A, Bauermeister J. Parents ASSIST: Acceptability and Feasibility of a Video-Based Educational Series for Sexuality-Inclusive Communication between Parents and Gay, Bisexual, and Queer Sons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:379. [PMID: 35010638 PMCID: PMC8744946 DOI: 10.3390/ijerph19010379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/21/2021] [Accepted: 12/26/2021] [Indexed: 06/14/2023]
Abstract
Young men who have sex with men (YMSM) between the ages of 13 and 24 are a key population for HIV prevention. The parents of gay, bisexual, and queer (GBQ) adolescent males and the sex communication they have with their sons has yet to be explored as an HIV prevention intervention. We developed an online video series called Parents ASSIST (Advancing Supportive and Sexuality-Inclusive Sex Talks) to educate parents about sexual health topics pertinent to GBQ males. We pilot tested the series with a sample of 54 parents of GBQ males using a single-group post-test design. Participants viewed the videos and completed a survey measuring the acceptability and feasibility of an online video series to educate parents. Most of the parents (70.4%) believed that the videos would make parents more likely to initiate talking about sex with their sons. The results suggest that online videos are an acceptable way for parents to learn about GBQ sexual health topics.
Collapse
Affiliation(s)
- Dalmacio D. Flores
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; (K.H.); (A.R.); (J.C.); (A.V.); (J.B.)
| | - Kate Hennessy
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; (K.H.); (A.R.); (J.C.); (A.V.); (J.B.)
| | - Andre Rosario
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; (K.H.); (A.R.); (J.C.); (A.V.); (J.B.)
| | - Jamie Chung
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; (K.H.); (A.R.); (J.C.); (A.V.); (J.B.)
| | - Sarah Wood
- Craig A. Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA;
| | - Antonia Villarruel
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; (K.H.); (A.R.); (J.C.); (A.V.); (J.B.)
| | - Jose Bauermeister
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA; (K.H.); (A.R.); (J.C.); (A.V.); (J.B.)
| |
Collapse
|
13
|
Grossman JM, DeSouza LM, Richer AM, Lynch AD. Father-Teen Talks about Sex and Teens' Sexual Health: The Role of Direct and Indirect Communication. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9760. [PMID: 34574683 PMCID: PMC8471207 DOI: 10.3390/ijerph18189760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 12/28/2022]
Abstract
Family talks about sex can protect against teens' risky sexual behavior, but most research has focused on the role of mothers. The current study included cross-sectional survey data from 728 adolescents in the 11th and 12th grades (Mage = 17.00, SD = 0.90) in the United States. Structural equation modeling (SEM) was used to assess associations between teens' direct and indirect talk, defined as less straightforward ways to communicate one's sexual values, with fathers about sex, and teens' sexual behaviors. There were no significant direct associations between father-teen talk about sex and teens' sexual behavior. However, teen gender moderated associations between indirect father-teen communication and teens' sexual behavior. The results suggest the need to assess indirect talk about sex in studies of family sexuality communication and to further investigate the role of teens' identities in determining the influence of father-teen talk about sex on teens' sexual behavior.
Collapse
Affiliation(s)
- Jennifer M. Grossman
- Wellesley Centers for Women, Wellesley College, Wellesley, MA 02481, USA; (L.M.D.); (A.M.R.)
| | - Lisette M. DeSouza
- Wellesley Centers for Women, Wellesley College, Wellesley, MA 02481, USA; (L.M.D.); (A.M.R.)
| | - Amanda M. Richer
- Wellesley Centers for Women, Wellesley College, Wellesley, MA 02481, USA; (L.M.D.); (A.M.R.)
| | - Alicia D. Lynch
- Lynch Research Associates, 41 Oakland Street Ext, Natick, MA 01760, USA;
| |
Collapse
|
14
|
Kaestle CE, Allen KR, Wesche R, Grafsky EL. Adolescent Sexual Development: A Family Perspective. JOURNAL OF SEX RESEARCH 2021; 58:874-890. [PMID: 34003063 DOI: 10.1080/00224499.2021.1924605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Adolescent sexual development is informed by individual, relational, generational, institutional, and cultural perspectives. Families matter: they are the social institution at the intersection of adolescent development and broader social systems, charged with the responsibility for rearing children and adolescents to adulthood. This narrative review maps insights from family theory and research onto adolescent sexual development research. Our purpose is to inform sexuality researchers from diverse fields about how family perspectives can enrich understanding of adolescent sexual development. We present the critical, intersectional theoretical framework guiding this review as consisting of three meta-themes for understanding families through an examination of family structure, process, and context. Then, we apply those meta-themes to current research on adolescent sexual development by selectively organizing our review around the contexts of family structural diversity and family relational complexity, demonstrating that both the structure and the process components are embedded within the intersectional and cultural contexts that shape and are shaped by families. Our review demonstrates that diverse, intersectional family structures and transitions may affect adolescent sexual development by influencing family processes, particularly around sexual communication. We conclude with implications of using family perspectives for future inquiry related to adolescent sexual development.
Collapse
Affiliation(s)
| | | | - Rose Wesche
- Department of Human Development and Family Science, Virginia Tech
| | - Erika L Grafsky
- Department of Human Development and Family Science, Virginia Tech
| |
Collapse
|
15
|
The Family System of Sexuality Communication: Extended Family Perceptions of Adolescent-Family Talk about Sex, with Sibling and Non-Sibling Comparison. SEXES 2021; 2:1-16. [PMID: 34423149 PMCID: PMC8376207 DOI: 10.3390/sexes2010001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Talk with parents and extended family about sex and relationships can support adolescents’ sexual health. However, few studies explore how parent and extended family communication with adolescents intersect. This study used thematic analysis to assess family roles in talk with teens about sex and relationships among a sample of 39 adult extended family members (such as aunts and uncles, and older siblings and cousins) in the United States. Analyses identified four themes in sexuality communication that address: why adolescents talk to extended family about sex and relationships, family engagement in these conversations, consistency of family messages, and family communication about adolescents. Findings identify variation in how family members interact with adolescents and one another regarding talk about sex and relationships. For example, some participants described family coordination of sexual messages to the teen, while others reported no family communication about this topic. Results also showed similarities and differences in how sibling and non-sibling extended family describe these processes. These findings identify the need to examine family talk about sex and relationships in the context of a larger family system, rather than only within dyadic relationships, and suggests possibilities for family-based interventions to support adolescents’ sexual health.
Collapse
|
16
|
Doucette H, Collibee C, Rizzo CJ. A Review of Parent- and Family-based Prevention Efforts for Adolescent Dating Violence. AGGRESSION AND VIOLENT BEHAVIOR 2021; 58:101548. [PMID: 33613079 PMCID: PMC7888980 DOI: 10.1016/j.avb.2021.101548] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Prevention efforts for adolescent dating violence (ADV) have largely focused on adolescent-based interventions with little emphasis on parent- and family-based interventions, despite the integral role parents serve in adolescent relationship development. This literature review provides an overview of the existing parent- and family-based intervention efforts for ADV. This review highlights that some programs are geared toward a universal audience, whereas others are more targeted towards populations believed to be at greater risk for ADV. Some programs primarily target parents, whereas others integrate parent-based components into primarily adolescent-focused or comprehensive programs. Aspects to consider when selecting a program are discussed, as well as future directions. Suggested future directions involve broadening existing parent- and family-based programming for ADV to include a focus on secondary and tertiary prevention, gender differences, and gender and sexual minorities. This review also highlights the need for existing programs to expand their evaluation of behavioral outcomes and comparison of programs to one another.
Collapse
Affiliation(s)
| | - Charlene Collibee
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
- Bradley Hasbro Children’s Research Center, Providence, RI, USA
| | | |
Collapse
|
17
|
Grossman JM, Lynch AD, DeSouza LM, Richer AM. Resources for teens' health: Talk with parents and extended family about sex. JOURNAL OF CHILD AND FAMILY STUDIES 2021; 30:338-349. [PMID: 33776392 PMCID: PMC7996344 DOI: 10.1007/s10826-020-01896-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/24/2020] [Indexed: 06/12/2023]
Abstract
Communication with family members about sex can protect teens from risky sexual behavior, but most research focuses on teens' communication with parents. Extended family members may also be a source of sexual socialization to support teens' health, but teens' perspectives on communication with extended family about sex have been little explored. The current study aims were to examine similarities and differences in the frequency and content of teens' communication with extended family and parents about sex and to assess whether the content of this communication differs based on teens' gender. This cross-sectional study used structural equation models (SEM) to analyze survey data from 952 11th and 12th graders (55% Female, 52% Latinx) in the United States. The study assessed three types of family talk about sex: Communication about Risks of Sex addresses negative consequences of sex, communication about Protection involves ways teens can guard against pregnancy and sexually transmitted infections and Relational Sex communication addresses sex within the context of a close relationship. We found that teens were as likely to report talk with extended family members as parents about sex. Teens' conversations with parents were more focused on sexual risk and protection while conversations with extended family focused on relational sex topics. Girls were more likely to engage in protection and relational sex communication with extended family, while boys talked more often with parents about these topics. These findings highlight the potential of extended family to support teens' healthy development.
Collapse
|
18
|
Flores DD, Meanley SP, Bond KT, Agenor M, Relf MV, Barroso JV. Topics for Inclusive Parent-Child Sex Communication by Gay, Bisexual, Queer Youth. Behav Med 2021; 47:175-184. [PMID: 32027581 PMCID: PMC7416429 DOI: 10.1080/08964289.2019.1700481] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purposes of this study were to identify the sexuality-related topics parents and gay, bisexual, or queer (GBQ) adolescent males discussed at home and to describe the topics GBQ adolescent males recommend for parents to discuss with future cohorts of GBQ youth. Minimal research on parent-child sex communication with sexual minority adolescents prevents the development of interventions that would benefit adolescent males with same-sex attractions, behaviors and identities. As part of a multimethod qualitative study, we interviewed 30 GBQ adolescent males ages 15-20 and asked them to perform card sorts. From a list of 48 topics, we explored sexuality-related issues GBQ males were familiar with, the topics they discussed with a parent, and topics they suggested parents address with GBQ males at home. Most participants reported that parents assumed them heterosexual during sex talks prior to GBQ adolescent males' coming out. Participants challenged the heteronormative scripts used by parents when discussing sex and health. Participants identified sexuality topics that parents did not routinely cover during sex talks, but that GBQ youth felt would have been useful for them growing up with emergent identities. A non-heteronormative approach to parent-child sex communication is recommended to provide appropriate guidance about sex and HIV/STI prevention to this youth population. Our findings highlight a need to reconfigure parental sexuality scripts to be more inclusive when assisting GBQ males navigate adolescence.
Collapse
Affiliation(s)
| | - Steven P. Meanley
- School of Nursing, University of Pennsylvania (Philadelphia, PA, 19104)
| | - Keosha T. Bond
- School of Public Health, New York Medical College (Valhalla, NY, 10595)
| | | | | | - Julie V. Barroso
- College of Nursing, Medical University of South Carolina (Charleston, SC, 29425)
| |
Collapse
|
19
|
Lee-Foon NK, Logie CH, Siddiqi A, Grace D. “I just trust what Google says, it’s the Bible”: Exploring young, Black gay and other men who have sex with men’s evaluation of sexual health information sources in Toronto, Canada. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2020. [DOI: 10.3138/cjhs.2020-0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
While sexual health literature identifies youths’ sexual health information sources and its impact on their sexual practices, little is known about the way youth evaluate the credibility of this information. This knowledge gap is significant among young, Black gay and other men who have sex with men (YBGM) who belong to intersectional populations disproportionately impacted by HIV and other STIs. We conducted a qualitative study using constructivist grounded theory to explore YBGM’s approaches to evaluating sexual health information sources’ credibility. Intersectionality and the socioecological model informed our analysis. We explored connections between social locations (e.g., race, sexual orientation) and socio-ecological environments and how their impact shaped YBGM’s evaluation of sexual health information. Findings revealed evaluation strategies varied by source: friends, the internet and healthcare providers. Friends’ information was deemed credible if they were older, shared social locations and provided embodied testimonials. Testimonials mirrored oral-traditions specific to Black populations where oral narratives help disseminate sensitive information in a culturally relevant way. Website selection was informed by YBGM’s social locations and ranged from being implicitly trusted to assessed by its association with established healthcare organizations. Many participants’ acceptance of healthcare providers’ information revealed patient-client power imbalances and a perception that providers’ actions reflected their institutions’ sexual health policies. Findings highlight a need for sexual health services to create culturally effective ways to disseminate information that accounts for the histories, contexts, and approaches YBGM use to identify credible sources of sexual health information.
Collapse
Affiliation(s)
- Nakia K. Lee-Foon
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Carmen H. Logie
- Factor-Inwentash School of Social Work, University of Toronto, Toronto, ON
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| |
Collapse
|
20
|
Charmaraman L, Grossman JM, Richer AM. Same-Sex Attraction Disclosure and Sexual Communication Topics within Families. JOURNAL OF GLBT FAMILY STUDIES 2020; 17:118-134. [PMID: 34737682 PMCID: PMC8562695 DOI: 10.1080/1550428x.2020.1820414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Few studies compare family communication about sex and relationships for sexual minority youth versus hetero-sexual teenagers. Further, existing studies often focus on mothers, overlooking fathers and extended family. Our survey of 952 adolescents aged 14-21 included 115 adolescents disclosing non-heterosexual attraction. Mothers offered more sexual protection methods messages to their non-SM teens, whereas fathers talked less with SM teens about risks of sex and relational sex. Most participants identified mothers, sisters, and female cousins, with male SMs having the highest number of disclosures to family members, whereas female and non-binary SMs confided in fewer family members or no one.
Collapse
Affiliation(s)
- Linda Charmaraman
- Wellesley Centers for Women, Wellesley College, Wellesley, Massachusetts, USA
| | - Jennifer M Grossman
- Wellesley Centers for Women, Wellesley College, Wellesley, Massachusetts, USA
| | - Amanda M Richer
- Wellesley Centers for Women, Wellesley College, Wellesley, Massachusetts, USA
| |
Collapse
|
21
|
Morris E, Balaji AB, Trujillo L, Rasberry CN, Mustanski B, Newcomb ME, Brady KA, Prachand NG. Family Factors and HIV-Related Risk Behaviors Among Adolescent Sexual Minority Males in Three United States Cities, 2015. LGBT Health 2020; 7:367-374. [PMID: 33048009 PMCID: PMC11346381 DOI: 10.1089/lgbt.2019.0317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose: We examined the relationship between family factors and HIV-related sexual risk behaviors among adolescent sexual minority males (ASMM) who are affected disproportionately by HIV. Methods: We analyzed results from the National HIV Behavioral Surveillance among Young Men Who Have Sex with Men. Adolescent males ages 13-18 who identified as gay or bisexual, or who reported attraction to or sex with males were interviewed in 2015 in Chicago, New York City, and Philadelphia. Separate log-linked Poisson regression models were used to estimate associations between family factors and sexual risk behaviors. Results: Of the 569 ASMM, 41% had condomless anal intercourse in the past 12 months, 38% had ≥4 male sex partners in the past 12 months, and 23% had vaginal or anal sex before age 13. ASMM who had ever been kicked out of their house or run away, those who were out to their mother, and those who were out to their father, were more likely to engage in sexual risk behaviors. ASMM who were currently living with parents or guardians and those who received a positive reaction to their outness by their mother were less likely to engage in sexual risk behaviors. Conclusion: Our findings highlight the important role of family factors in HIV risk reduction among ASMM. A better understanding of the complex dynamics of these families will help in developing family-based interventions.
Collapse
Affiliation(s)
- Elana Morris
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alexandra B. Balaji
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lindsay Trujillo
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Catherine N. Rasberry
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Mustanski
- Department of Medical Social Sciences and Institute for Sexual and Gender Minority Health and Wellbeing, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Michael E. Newcomb
- Department of Medical Social Sciences and Institute for Sexual and Gender Minority Health and Wellbeing, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kathleen A. Brady
- Philadelphia Department of Public Health, Philadelphia, Pennsylvania
| | | |
Collapse
|
22
|
Grieb SM, Donovan E, White JJ, Miller D, Dangerfield DT. Increasing Opportunities for Spiritual and Religious Supports to Improve HIV-Related Outcomes for Black Sexual Minority Men. J Urban Health 2020; 97:704-714. [PMID: 32728845 PMCID: PMC7560667 DOI: 10.1007/s11524-020-00461-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Given the importance of spirituality and religion in the lives of many Black gay, bisexual, and other Black sexual minority men (SMM) and the need for additional resources to improve HIV outcomes within this population, research on how spiritual and religious support can promote HIV prevention and treatment among Black SMM is greatly needed. We conducted nine focus groups with 52 spiritual and religious Black SMM in Baltimore, Maryland, to explore opportunities for HIV-related programming that incorporates spiritual and/or religious supports. Thematic analysis of the focus group transcripts was conducted using an iterative constant comparison coding process. Participants expressed a desire for more spiritual/religious support in non-church-based settings and identified the use of peer supports, inclusion of prayer and gospel music, and messaging related to the ideas that God is love, the Bible says to treat yourself preciously, and taking care of your health can strengthen your relationship with God as ways in which this could be incorporated into HIV-related programming. Participants living with HIV identified the message of "keeping the faith" as important for maintaining their HIV treatment plans. Participants also expressed a need for parental supports to improve HIV-related outcomes for Black SMM and potentially expand opportunities for spiritual and religious support to Black SMM within the church. Spirituality and religion can influence HIV outcomes for Black SMM, and the strategies identified by Black SMM in this study could aid in designing culturally congruent HIV prevention and treatment programs situated in the community.
Collapse
Affiliation(s)
- Suzanne M Grieb
- Center for Child and Community Health Research, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| | | | - Jordan J White
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | |
Collapse
|
23
|
McKay EA, Fontenot HB. Parent-Adolescent Sex Communication with Sexual and Gender Minority Youth: An Integrated Review. J Pediatr Health Care 2020; 34:e37-e48. [PMID: 32861429 DOI: 10.1016/j.pedhc.2020.04.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/03/2020] [Accepted: 04/13/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Sexual and gender minority (SGM) youth experience adverse sexual health outcomes at higher rates than their heterosexual and cisgender peers. Although parent-adolescent sex communication (PASC) is associated with improved sexual health outcomes among heterosexual youth, less is known about PASC with SGM youth. METHODS Studies describing experiences of SGM youth and parents during PASC and/or health outcomes of PASC were reviewed. RESULTS Eleven studies met inclusion criteria, and six themes emerged. These included: (1) limited communication and barriers to communication, (2) impact of SGM disclosure on communication, (3) HIV and/or sexually transmitted disease-focused communication, (4) heteronormative communication, (5) outcomes of communication, and (6) youth preferences for PASC. DISCUSSION Parent-adolescent sex communication was complicated by barriers to communication and was limited, heteronormative, and influenced by SGM disclosure. Parent-adolescent sex communication may improve sexual health outcomes, but adequate parental education and guidance is lacking. This review identifies ways that health providers can foster positive and inclusive PASC.
Collapse
|
24
|
Mustanski B, Moskowitz DA, Moran KO, Newcomb ME, Macapagal K, Rodriguez-Díaz C, Rendina HJ, Laber EB, Li DH, Matson M, Talan AJ, Cabral C. Evaluation of a Stepped-Care eHealth HIV Prevention Program for Diverse Adolescent Men Who Have Sex With Men: Protocol for a Hybrid Type 1 Effectiveness Implementation Trial of SMART. JMIR Res Protoc 2020; 9:e19701. [PMID: 32779573 PMCID: PMC7448177 DOI: 10.2196/19701] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/07/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Adolescent men who have sex with men (AMSM), aged 13 to 18 years, account for more than 80% of teen HIV occurrences. Despite this disproportionate burden, there is a conspicuous lack of evidence-based HIV prevention programs. Implementation issues are critical as traditional HIV prevention delivery channels (eg, community-based organizations, schools) have significant access limitations for AMSM. As such, eHealth interventions, such as our proposed SMART program, represent an excellent modality for delivering AMSM-specific intervention material where youth are. OBJECTIVE This randomized trial aimed to test the effectiveness of the SMART program in reducing condom-less anal sex and increasing condom self-efficacy, condom use intentions, and HIV testing for AMSM. We also plan to test whether SMART has differential effectiveness across important subgroups of AMSM based on race and ethnicity, urban versus rural residence, age, socioeconomic status, and participation in an English versus a Spanish version of SMART. METHODS Using a sequential multiple assignment randomized trial design, we will evaluate the impact of a stepped-care package of increasingly intensive eHealth interventions (ie, the universal, information-based SMART Sex Ed; the more intensive, selective SMART Squad; and a higher cost, indicated SMART Sessions). All intervention content is available in English and Spanish. Participants are recruited primarily from social media sources using paid and unpaid advertisements. RESULTS The trial has enrolled 1285 AMSM aged 13 to 18 years, with a target enrollment of 1878. Recruitment concluded in June 2020. Participants were recruited from 49 US states as well as Puerto Rico and the District of Columbia. Assessments of intervention outcomes at 3, 6, 9, and 12 months are ongoing. CONCLUSIONS SMART is the first web-based program for AMSM to take a stepped-care approach to sexual education and HIV prevention. This design indicates that SMART delivers resources to all adolescents, but more costly treatments (eg, video chat counseling in SMART Sessions) are conserved for individuals who need them the most. SMART has the potential to reach AMSM to provide them with a sex-positive curriculum that empowers them with the information, motivation, and skills to make better health choices. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03511131; https://clinicaltrials.gov/ct2/show/NCT03511131. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19701.
Collapse
Affiliation(s)
- Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - David A Moskowitz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kevin O Moran
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Carlos Rodriguez-Díaz
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States
| | - Eric B Laber
- Department of Statistics, North Carolina State University, Raleigh, NC, United States
| | - Dennis H Li
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Margaret Matson
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
| | - Ali J Talan
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States
| | - Cynthia Cabral
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States
| |
Collapse
|
25
|
Flores DD, Meanley SP, Wood SM, Bauermeister JA. Family Characteristics in Sex Communication and Social Support: Implications for Emerging Adult Men Who Have Sex with Men's PrEP Engagement. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2145-2153. [PMID: 32222853 PMCID: PMC7781437 DOI: 10.1007/s10508-020-01648-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 01/20/2020] [Accepted: 01/27/2020] [Indexed: 05/29/2023]
Abstract
While emerging adulthood (ages 18-25) is marked by increased independence from parents, parental support remains a strong correlate of positive sexual health outcomes for heterosexual youth. With the emergence of pre-exposure prophylaxis (PrEP), few studies have examined the potential for parent-child sex communication and PrEP adoption among emerging adult men who have sex with men (MSM). We aimed to describe the extent to which parents/family characteristics play supportive roles in emerging adult MSM's current PrEP use. PrEP-indicated participants (N = 222) were recruited via social media to complete an online survey. Multivariable logistic regression assessed associations between emerging adult MSM's current PrEP use and comfort with parent-child sex communication, family social support, family outness, and family prioritization, adjusted for sociodemographic variables. Thirty percent of participants reported current PrEP use. Only 20% reported moderate/high comfort with parent sex communication, 80% reported any family sexual identity disclosure, 70% reported moderate/high family social support, and 70% ranked family as a high/very high priority. Our multivariable model demonstrated an association between comfort with parent-child sex communication with current PrEP use only (AOR= 1.55, 95% CI 1.04-2.32). Our findings support that parents of emerging adult MSM possess a critical potential to reduce their sons' risk of HIV and promote PrEP uptake. Interventions that facilitate parents' efficacy to foster affirming, non-judgmental environments and discussions about their child's sexual behaviors, attractions/relationships, and health (e.g., PrEP) may be impactful in reducing the high HIV incidence rate that burdens emerging adult MSM.
Collapse
Affiliation(s)
- Dalmacio D Flores
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Suite 223L, Philadelphia, PA, 19104, USA.
| | - Steven P Meanley
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Suite 223L, Philadelphia, PA, 19104, USA
| | - Sarah M Wood
- Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jose A Bauermeister
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Suite 223L, Philadelphia, PA, 19104, USA
| |
Collapse
|
26
|
Russell S, Mallory A, Bishop M, Dorri A. Innovation and Integration of Sexuality in Family Life Education. FAMILY RELATIONS 2020; 69:595-613. [PMID: 34588714 PMCID: PMC8478349 DOI: 10.1111/fare.12462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 05/09/2020] [Indexed: 05/25/2023]
Abstract
As a fundamental aspect of the human experience, sexuality is experienced at every stage in the lifespan. Sexual values, behaviors, and health are important components of individual and family well-being. Educating about such a fundamental aspect of life is both obvious and crucial. In this article, we consider the potential of sexuality education in the field and profession of family life education (FLE). We critique sexuality education in the United States, and we critique the marginal place of human sexuality in the FLE field. We then offer recommendations for incorporating lifespan, socio-ecological, family systems and intersectionality into sexuality education, and recommendations for FLE and sexuality education research and practice. We argue that educating about sexuality in the context of FLE-and activating the profession of FLE for sexuality education-will strategically advance sexuality education, sexual health, and the field of FLE.
Collapse
|
27
|
Flores D, Docherty SL, Relf MV, McKinney RE, Barroso JV. "It's Almost Like Gay Sex Doesn't Exist:" Parent-Child Sex Communication According to Gay, Bisexual, and Queer Adolescent Sons. JOURNAL OF ADOLESCENT RESEARCH 2019; 34:528-562. [PMID: 34054207 PMCID: PMC8159159 DOI: 10.1177/0743558418757464] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sex communication interventions facilitate positive sexual health outcomes with heterosexual adolescents. The same has yet to be established for male youth with same-sex attractions, behaviors, and identities. Our study describes the experiences of gay, bisexual and queer-identifying adolescent males with parent-child sex communication. We conducted 30 in-depth semi-structured interviews with a diverse group of 15 to 20 year-old gay, bisexual, and queer (GBQ) males. Interview transcripts were coded and themes were identified using thematic and content analysis. Narratives revealed that sex communication with parents occurs rarely, is heteronormative in content prior to adolescent males' disclosure as GBQ, and after disclosure is reactionary and based on stereotypes that associate this population with negative health outcomes. Parents were rated poorly as sex educators by adolescent males and the findings are mixed regarding perception of parents' knowledge about GBQ-specific information. Parents and healthcare providers were identified as preferred sources of sex information by GBQ adolescent males. Sex communication with parents throughout adolescence that excludes GBQ males' same-sex concerns is a missed opportunity for targeted sexual risk reduction. There are multiple ways healthcare providers can assist parents to plan age-appropriate, sexuality-inclusive, home-based discussions about sex for this group.
Collapse
Affiliation(s)
- Dalmacio Flores
- University of Pennsylvania School of Nursing, Philadelphia PA
| | | | | | | | | |
Collapse
|
28
|
Schrager SM, Steiner RJ, Bouris AM, Macapagal K, Brown CH. Methodological Considerations for Advancing Research on the Health and Wellbeing of Sexual and Gender Minority Youth. LGBT Health 2019; 6:156-165. [PMID: 31145662 PMCID: PMC6551986 DOI: 10.1089/lgbt.2018.0141] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Continued research with sexual and gender minority (SGM) youth is essential both to understand health disparities and to develop interventions targeting those disparities, but conducting rigorous, ethical research with these populations remains a substantial challenge. In addition to considerations for research with adolescents in general, such as utilizing developmentally appropriate measures and obtaining parental permission, factors unique to SGM youth must be addressed at every step of the research process. Defining the study population is complex, as is recruiting a sample once it is defined. Measurement is another challenge, given the paucity of measures developed for or validated with SGM samples. Key constructs, such as sexual orientation, gender identity, and family acceptance, are not amenable to randomization and involving minor participants' parents poses ethical concerns given the precarious home and safety situations that can arise from employing typical study procedures with youth who have a stigmatized identity. In this article, we examine some of these unique methodological challenges. Informed by theoretical and empirical literature, practical experience, and an ongoing dialogue with SGM youth themselves, we present a guide to best practices for ethical, productive research with SGM youth. By discussing existing approaches to studying SGM youth and suggesting innovative ways to approach the questions that remain, we hope to assist the research community in addressing methodological gaps to advance research on SGM youth in relation to families and schools.
Collapse
Affiliation(s)
- Sheree M Schrager
- 1 Department of Research and Sponsored Programs, California State University, Northridge, Northridge, California
- 2 Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Riley J Steiner
- 3 Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alida M Bouris
- 4 School of Social Service Administration, University of Chicago, Chicago, Illinois
- 5 Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois
| | - Kathryn Macapagal
- 6 Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- 7 Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - C Hendricks Brown
- 6 Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- 7 Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| |
Collapse
|
29
|
Newcomb ME, LaSala MC, Bouris A, Mustanski B, Prado G, Schrager SM, Huebner DM. The Influence of Families on LGBTQ Youth Health: A Call to Action for Innovation in Research and Intervention Development. LGBT Health 2019; 6:139-145. [PMID: 30844341 DOI: 10.1089/lgbt.2018.0157] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Lesbian, gay, bisexual, transgender, queer, questioning, and other sexual and gender minority youth (LGBTQ) experience myriad health inequities relative to their cisgender heterosexual peers. Families have a profound impact on adolescent health, but little is known about this influence on LGBTQ youth specifically. We draw on work presented at a public symposium that aimed to characterize existing scientific evidence, identify gaps in knowledge, and set priority areas for future research on the influence of family factors on LGBTQ youth health. We review the evidence in each identified priority area and propose promising avenues for future research and opportunities for innovation.
Collapse
Affiliation(s)
- Michael E Newcomb
- 1 Department of Medical Social Sciences and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Michael C LaSala
- 2 School of Social Work, Rutgers, the State University of New Jersey, New Brunswick, New Jersey
| | - Alida Bouris
- 3 School of Social Service Administration, University of Chicago, Chicago, Illinois
| | - Brian Mustanski
- 1 Department of Medical Social Sciences and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Guillermo Prado
- 4 Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Sheree M Schrager
- 5 Office of Research and Sponsored Programs, California State University, Northridge, Northridge, California
| | - David M Huebner
- 6 Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia
| |
Collapse
|
30
|
Padilla-Walker LM. Longitudinal Change in Parent-Adolescent Communication About Sexuality. J Adolesc Health 2018; 63:753-758. [PMID: 30279105 DOI: 10.1016/j.jadohealth.2018.06.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/26/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Research suggests that parents can be important sources of sex education for their children, but we know little about how this type of communication changes developmentally. Thus, the current study explored longitudinal change in child-, mother-, and father-reports of parent-child communication about sexuality, and how change might be associated with behaviors indicative of sexual risk. METHODS The sample included 468 adolescents (52% female, 67% white) who participated every year from age 14 to 18, and their mother and father. RESULTS Growth-curve analyses revealed relatively low and stable levels of parent-child communication from all three reporters, with some differences as a function of reporter and child gender. Results also suggested that initial levels and change in parent-child communication over time were associated with child-reports of safer sex at the final time point (age 21). CONCLUSIONS The discussion focuses on developmental approaches to parent-child sex communication and the need for future research.
Collapse
|
31
|
Feinstein BA, Thomann M, Coventry R, Macapagal K, Mustanski B, Newcomb ME. Gay and Bisexual Adolescent Boys' Perspectives on Parent-Adolescent Relationships and Parenting Practices Related to Teen Sex and Dating. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1825-1837. [PMID: 29280027 PMCID: PMC6019640 DOI: 10.1007/s10508-017-1057-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 07/19/2017] [Accepted: 08/09/2017] [Indexed: 05/25/2023]
Abstract
Close parent-adolescent relationships and specific parenting practices (e.g., communication about sex, monitoring) are associated with reduced sexual risk behavior among heterosexual youth. Despite gay/bisexual male youth being at increased risk of HIV, little is known about parental influences on their sexual behavior. As such, the goal of the current study was to examine parent-adolescent relationships and parenting practices related to teen sex and dating from the perspective of gay/bisexual adolescent boys. Online focus groups were conducted with 52 gay/bisexual male youth ages 14-17 years. Most gay/bisexual adolescent boys felt that their sexual orientation had an influence on their relationships with their parents and discussions about sex/dating. Although some felt that their relationships improved after coming out, a larger percentage reported that it put strain on their relationships. Discussions about sex/dating generally decreased after coming out, but some youth described positive conversations with their parents. Many reported that their parents struggled with whether or not to adapt parenting practices (e.g., rules about dating) after they came out. Youth consistently noted that parent-adolescent relationships and parenting practices depended on the adolescent's level of outness. Findings have important implications for refining HIV prevention programs for gay/bisexual adolescent boys, especially interventions that include parents.
Collapse
Affiliation(s)
- Brian A Feinstein
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA.
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA.
| | - Matthew Thomann
- Department of Anthropology and Sociology, Kalamazoo College, Kalamazoo, MI, USA
| | - Ryan Coventry
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Kathryn Macapagal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| |
Collapse
|
32
|
Newcomb ME, Feinstein BA, Matson M, Macapagal K, Mustanski B. "I Have No Idea What's Going On Out There:" Parents' Perspectives on Promoting Sexual Health in Lesbian, Gay, Bisexual, and Transgender Adolescents. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2018; 15:111-122. [PMID: 30245747 PMCID: PMC6145819 DOI: 10.1007/s13178-018-0326-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Lesbian, gay, bisexual, transgender, and other sexual and gender minority (LGBTQ) adolescents experience higher rates of negative sexual health outcomes relative to their heterosexual and cisgender peers. Healthy parent-adolescent relationships and effective parenting are robust predictors of sexual health in heterosexual adolescents, but very little is known about barriers to and facilitators of effective parenting from the perspective of parents of LGBTQ adolescents. This study conducted online focus groups with 44 parents of LGBTQ adolescents in order to describe the factors influencing effective sexual health communication and parental monitoring in this population. Parents described generally positive relationships with teens, but many noted they went through a transition process in which they struggled with their child's identity and were less supportive of their LGBTQ teen. Lack of understanding about LGBTQ-specific sexuality was a commonly endorsed barrier to effective communication, and this was most commonly endorsed by parents of cisgender girls. Parents of cisgender boys and transgender/gender-nonconforming teens described fears about long-term sexual health (i.e., sexual predators, consent) as a barrier to parental monitoring. Parents of LGBTQ adolescents need information and skills to optimize their teen's sexual health. Parent-based programs for LGBTQ adolescents are long overdue for addressing these issues.
Collapse
Affiliation(s)
- Michael E. Newcomb
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., 14-059, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian A. Feinstein
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., 14-059, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Margaret Matson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., 14-059, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Kathryn Macapagal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., 14-059, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., 14-059, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| |
Collapse
|
33
|
Flores D, McKinney R, Arscott J, Barroso J. Obtaining waivers of parental consent: A strategy endorsed by gay, bisexual, and queer adolescent males for health prevention research. Nurs Outlook 2018; 66:138-148. [PMID: 28993074 PMCID: PMC5857413 DOI: 10.1016/j.outlook.2017.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 09/05/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Requiring parental consent in studies with sexual minority youth (SMY) can sometimes be problematic as participants may have yet to disclose their sexual orientation, may not feel comfortable asking parents' permission, and may promote a self-selection bias. PURPOSE We discuss rationale for waiving parental consent, strategies to secure waivers from review boards, and present participants' feedback on research without parents' permission. METHODS We share our institutional review board proposal in which we made a case that excluding SMY from research violates ethical research principles, does not recognize their autonomy, and limits collection of sexuality data. DISCUSSION Standard consent policies may inadvertently exclude youth who are at high risk for negative health outcomes or may potentially put them at risk because of forced disclosure of sexual orientation. Securing a waiver addresses these concerns and allows for rich data, which is critical for providers to have a deeper understanding of their unique sexual health needs. CONCLUSION To properly safeguard and encourage research informed by SMY, parental consent waivers may be necessary.
Collapse
Affiliation(s)
| | - Ross McKinney
- Association of American Medical Colleges, Washington, DC
| | | | - Julie Barroso
- Medical University of South Carolina School of Nursing, Charleston, SC
| |
Collapse
|
34
|
LaSala MC, Fedor JP, Revere EJ, Carney R. What Parents and Their Gay and Bisexual Sons Say About HIV Prevention. QUALITATIVE HEALTH RESEARCH 2016; 26:1519-1530. [PMID: 26443796 DOI: 10.1177/1049732315604588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Despite ongoing prevention efforts, young gay and bisexual men (YGBM) accounted for more than three fourths of all recent HIV infections. Furthermore, they continue to engage in high-risk sexual behaviors at alarming rates. Nowadays, families are beginning to emerge as important resources for these youth. However, the viewpoints of YGBM and their families are largely missing from HIV prevention research and intervention development. To address this gap, we solicited the opinions of YGBM and their parents as to why YGBM engage in unsafe sex and what might be done to help them avoid HIV. Participants discussed youth's sense of invulnerability, sexual arousal, parental disapproval, and lack of societal acceptance as contributors to unsafe sex. Participants called for gay-sensitive sex education and community programming as well as increased societal acceptance. Overall, respondents recommended interpersonal and structural-level interventions that emphasized the importance of reducing stigma as a key component of HIV prevention.
Collapse
Affiliation(s)
- Michael C LaSala
- Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - James P Fedor
- Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Elyse J Revere
- Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Robert Carney
- Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| |
Collapse
|
35
|
Rose ID, Friedman DB. HIV information needs of parents of young men who have sex with men. Health Info Libr J 2016; 33:308-322. [PMID: 27381945 DOI: 10.1111/hir.12152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 05/21/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Young men who have sex with men (YMSM) have unique health concerns, including high rates of HIV infection. To prevent HIV, YMSM need credible information from trusted sources, specifically parents. Little is known about what health information resources parents of YMSM need to communicate with their child about HIV prevention. The primary objective of this study was to examine the proxy health information seeking behaviours of parents of YMSM and to identify information resources that parents need to communicate with their YMSM identified child about HIV prevention. METHODS Qualitative findings were grouped into four categories: parents' current health information sources; barriers to seeking health information; parents' health information needs; and recommendations for delivery of health information for parents. Ten in-depth interviews were conducted with parents of YMSM. RESULTS Parents reported consulting physicians and the Internet for HIV/AIDS information. They reported finding limited information targeted towards parents of YMSM and provided suggestions for improving the delivery of health information including training, websites and the local news. CONCLUSIONS Delivery of tailored HIV prevention information to parents may be effective in helping combat HIV among YMSM. Given that YMSM bear the greatest burden for HIV, this study highlights the need to include parents of YMSM in future interventions aimed at reducing YMSM's risk of HIV/AIDS.
Collapse
Affiliation(s)
- India D Rose
- Health, Research, Informatics, and Technology Division, ICF International, Atlanta, GA, USA
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| |
Collapse
|
36
|
Piercy FP. A Time to Reflect on JMFT. JOURNAL OF MARITAL AND FAMILY THERAPY 2015; 41:255-259. [PMID: 26179390 DOI: 10.1111/jmft.12131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Fred P Piercy
- Marriage and Family Therapy Doctoral Program, Department of Human Development, Virginia Tech, Blacksburg, VA, 24060.
| |
Collapse
|
37
|
Piercy FP. On maps, shapeshifting, and my syllabus: family therapies today. JOURNAL OF MARITAL AND FAMILY THERAPY 2015; 41:1-4. [PMID: 25615812 DOI: 10.1111/jmft.12108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Fred P Piercy
- Marriage and Family Therapy Doctoral Program, Department of Human Development, Virginia Tech, Blacksburg, VA 24060.
| |
Collapse
|