JMIR Publications

ABSTRACT

Background:

Among US teenagers, 79% of HIV infections are attributable to male-to-male sexual contact, yet few interventions have been shown to effectively reduce sexual risk among gay and bisexual adolescents (GBA). Parent communication about sex is associated with adolescent sexual risk, and interventions to improve parent communication have been shown to successfully reduce sexual risk among heterosexual samples. However, no interventions designed specifically for parents of GBA have been tested in clinical trials. Parents and Adolescent Talking about Healthy Sexuality (PATHS) is an online intervention we created for parents of GBA that aims to improve parent communication about sexuality and HIV and increase parent behaviors supportive of GBA sexual health.

Objective:

The current trial aims to test whether delivering PATHS to parents of GBA ages 14-19 will improve GBA sexual health outcomes. A secondary aim is to test whether the intervention’s effects are mediated through specific parent behaviors.

Methods:

Three-hundred fifty parents of GBA will be recruited and randomized to receive either PATHS or an active control. Both parents and their GBA sons will complete assessments every 3 months over a 1-year period. Primary outcomes will be evaluated at 6 months post-intervention, and then the control arm will crossover and receive PATHS, and dyads will be followed for another 6 months. Primary outcomes include both adolescent sexual preparedness (e.g., condom skills), as well as HIV-related sexual risk behavior (i.e., condomless anal/vaginal sex that is not protected by pre-exposure prophylaxis).

Results:

We hypothesize that GBA whose parents receive PATHS will be more prepared for intercourse, and will have fewer CAVS partners, relative GBA whose parents receive only LWL, at 6 months post intervention; and when control parents cross over and receive PATHS, we will observe similar improvements in that group. We further hypothesize that families originally assigned PATHS will maintain intervention-related gains 1-year post intervention. Finally, we hypothesize that intervention effects will be mediated by the specific parent behaviors described above.

Conclusions:

If proven efficacious PATHS will be among the first HIV prevention interventions shown to reduce sexual risk for GBA. Moreover, as other adolescent-focused interventions emerge, PATHS’ unique focus on parents will offer a complementary, additional means for researching GBA who are not touched by other intervention options. Clinical Trial: ClinicalTrials.gov NCT05852600