Developing an HIV prevention intervention for young MSM through improved parent-child communication

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Project Summary Young men who have sex with men (MSM) are at high risk for HIV infection in the United States, representing 80% of all infections among youth ages 14-24, and 92% of infections among boys ages 14-19. Despite these risks, the field has not even one HIV prevention intervention shown to be effective in decreasing sexual risks or increasing HIV testing among adolescent MSM (AMSM). Historically, reaching AMSM for HIV prevention has been challenging, given their relative geographic isolation and lack of access to traditional gay congregating spaces (e.g., bars and many gay-related social networking websites). However, our team has developed a novel online platform for delivering interventions to parents of LGB youth that currently sees thousands of visitors each year. HIV prevention advocates have identified parents of AMSM as an untapped resource for reducing HIV risk in this population. Parent-child communication about sex has well-demonstrated associations with adolescent risk behaviors, and interventions with parents of heterosexual youth have been shown to be effective in increasing parent-adolescent communication, and thereby, reducing adolescent health risks. Thus, the goal of the proposed study is to develop an online intervention to increase and improve parent communication with AMSM about sexuality and HIV, with the ultimate goal of decreasing adolescent sexual risk and increasing HIV testing. To achieve this goal, we proposed four specific aims: (1) Identify the ways to best educate, motivate, and guide parents in communicating about sexuality and HIV with their sons by conducting interviews and focus groups with AMSM and their parents, (2) Develop a web-based, multimedia, intervention that motivates and teaches parents how to communicate effectively with their sons about HIV-related topics, (3) Pilot test the acceptability of the intervention and functionality of the system, and (4) Conduct a pilot randomized, controlled trial of the intervention. Aims 1-3 will be achieved by collecting interview and focus group data from AMSM and their parents, and then collaborating with a team of parents and adolescent to synthesize existing data, design the intervention, and test its acceptability and functionality. Aim 4 will be achieved by randomizing parents who come to seek resources on our existing website to receive either our new intervention or control, and then gathering longitudinal, online data from parents in both study arms and their AMSM sons over a 2-4 month period. Importantly, our study team has already demonstrated the feasibility of (a) recruiting parent-AMSM dyads into qualitative research, and (b) utilizing our website to enroll parent-AMSM dyads into longitudinal quantitative research. Thus, our proposal is innovative in that it uses our existing, proven resources to address many of the barriers that have historically plagued research on AMSM and their parents, as well as efforts to intervene with this population. If found to be effective, this would be the first ever HIV prevention intervention shown to work for AMSM – the population of adolescents who are at highest risk for HIV infection.