HIV pre-exposure prophylaxis (PrEP), a daily regimen of two medications in a single pill, could prevent many new HIV infections, especially in at-risk populations. For example, research shows PrEP could prevent around 70 percent of new HIV infections in adolescent cisgender sexual minority males (ASMM) and transgender and gender diverse adolescents (TGDA), populations that are disproportionately affected by the disease. However, despite growing awareness of PrEP among ASMM/TGDA, uptake of the treatment is still less than 5 percent.
A new study published in the journal Sexuality Research and Social Policy looks at the influences that parents of ASMM/TGDA may have on their adolescent hypothetically using PrEP. The study led by Christopher Owens, assistant professor in the Department of Health Behavior at the Texas A&M University School of Public Health, explores PrEP-related knowledge, attitudes and self-efficacy in parents of ASMM/TGDA. This study joins prior research by Owens into concerns about PrEP among parents of sexual and gender minority adolescents. Parents are thought to be key factors in using PrEP, so a better understanding of their knowledge, attitudes and self-efficacy is crucial.
Owens and colleagues found that more than 60 percent of parents that completed the study’s online cross-sectional questionnaire had heard of PrEP, with only one stating their adolescent had ever taken it. Parent questionnaire scores showed relatively low levels of PrEP knowledge but generally positive attitudes toward it. The respondents were in overall agreement that PrEP is effective at preventing HIV and that adolescents who take PrEP are responsible. Scores on PrEP safety were fairly neutral and levels of stigma were low, with strong disagreement that adolescents taking PrEP are promiscuous. However, parents scored low on intention and self-efficacy to engage in their adolescent’s PrEP care, with higher intention and self-efficacy scores for early steps like discussing PrEP and lower scores for later stages like getting PrEP for their adolescent.
“Parents had generally positive attitudes about their teen using PrEP, but we see they generally are unknowledgeable about it,” said Owens. “It’s possible that educating parents about PrEP and how to communicate with their teen about HIV prevention might increase their self-efficacy and intention to talk to their teens. PrEP is another tool that adolescents, their parents, and their healthcare providers can use in their HIV prevention toolkit.”
Further analysis comparing parents of sexually active and inactive adolescents found differences in scores. For example, parents of sexually active adolescents scored higher on PrEP knowledge and reported being more willing to talk about PrEP or get a prescription for their adolescent.
The findings of this study point to the role that parental knowledge, attitudes and behaviors could play in PrEP uptake in ASMM/TGDA. This study is the first to focus on parents’ PrEP-related knowledge, attitudes and self-efficacy. The findings of this work highlight avenues for further study and serve as a starting point for efforts to improve knowledge, attitudes and self-efficacy in parents of ASMM/TGDA.