JMIR Publications

ABSTRACT

Background:

Youth account for 22% of new HIV diagnoses in the US, with 81% occurring among males who have sex with men (MSM). HIV prevalence among African American MSM is 59%. When youth lack socially protective resources (parents/teachers/community networks), mentors may play a role in promoting health behaviors, especially for youth at risk for HIV, such as sexual and gender minority (SGM) youth. In the past decade, mentoring has proliferated as a key prevention and intervention strategy to improve outcomes for young people at risk for poor academic, social, and health issues. Mentors appear able to facilitate health promotion among young SGM by modeling healthy behaviors, but mentors’ knowledge and resource needs regarding sexual health topics including HIV is understudied, as is the potential role of mobile technology in enhancing mentoring relationships.

Objective:

To explore how mentoring plays a role in the sexual health of African American sexual and gender minority (SGM) youth who have sex with men and understand how mentoring relationships can be strengthened through mobile technology to promote youth HIV prevention behaviors.

Methods:

In-depth interviews were conducted with African American SGM youth mentees (n=17) and mentors to such youth (n=20) in three Mid-Atlantic cities. Mentee interviews focused on discussions regarding sexual health and HIV and how a mentor could broach such topics. Mentor interviews explored whether sexual health and HIV are mentoring topics, mentors’ knowledge, confidence in mentoring on these issues, and barriers to discussions. All participants were asked how a mobile app may help facilitate mentoring on sensitive health issues, particularly HIV and sexual health. Data were transcribed, coded, and analyzed for relevant themes.

Results:

Sexual health was a common topic in mentoring relationships, occurring more in natural mentorships compared to those from mentoring programs. Mentors and mentees felt positively about such discussions. Mentors expressed having limited knowledge beyond condom use and HIV testing and expressed a need for resources to be better mentors. Both mentors and mentees had mixed comfort when discussing sexual health. Sufficient trust and shared lived experiences made these discussions easier. Mentees have multifaceted needs, but mentors felt an app resource that provided self-training, resources, support from other mentors, and tips for better mentoring could help.

Conclusions:

For the African American SGM community, access to natural mentors is crucial for young people to learn healthy behaviors. A mobile resource to assist mentors in confidently having discussions with mentees may be a promising way to promote healthy practices.