HIV Prevention in Adolescent Men Who Have Sex with Men May Be Linked to Perceived Parental Support

Father and son sitting on steps having a deep discussion.

Adolescent men who have sex with men (AMSM) account for more than 80% of new HIV infections among 13- to 19-year-olds in the United States. In 2018, the U.S. Food and Drug Administration (FDA) approved a type of medication called pre-exposure prophylaxis (PrEP), which can prevent HIV infection, for use by adolescents. PrEP could help protect AMSM from HIV infection, but they may face different barriers to using it than adults do. Understanding those barriers will be key to encouraging PrEP use by AMSM.

An NIMHD-supported study aimed to find out how parents affect adolescents’ feelings about PrEP. The researchers surveyed 491 AMSM, ages 13 to 18, between July 2018 and February 2019 as part of a trial to test HIV prevention programs for AMSM. The survey was conducted online nationwide and did not require parental permission. Participants answered questions about their knowledge of PrEP, their attitudes toward PrEP, how likely they were to use it, and how they thought their parents would react if they started taking PrEP.

The survey results showed that most of the participants had heard of PrEP but thought their parents would not support their using it. Participants reported that they thought their parents would likely be “extremely upset or angry” and, in some cases, would punish them if they found out about PrEP use. More than 80% of participants responded that if they could get PrEP for free and without their parents’ knowledge, they would probably or definitely take it.

This study reveals AMSM fears about how their parents might react to PrEP use. In addition, the researchers’ analysis shows that these fears—and concerns about how to raise the topic with parents—make AMSM less likely to seek this type of HIV prevention. The findings suggest that addressing this barrier will require a variety of approaches. Educating parents and encouraging them to start conversations about PrEP would be one way to help increase PrEP use among AMSM. But the researchers suggest that a more effective approach would be to expand adolescents’ access to PrEP without parental consent—which most states currently require. This, the researchers write, could reduce disparities in HIV infection among youth.


Moskowitz, D. A., Macapagal, K., Mongrella, M., Pérez-Cardona, L., Newcomb, M. E., & Mustanski, B. (2020). What if my dad finds out!?: Assessing adolescent men who have sex with men’s perceptions about parents as barriers to PrEP uptake. AIDS and Behavior, 24(9), 2703–2719. doi:10.1007/s10461-020-02827-z

Page updated January 14, 2022