Poster #186 - Surveillance Studies Involving HIV Testing Are Needed: Will Sexual Minority Adolescent Males Participate?

• In Event: 1-061 - Poster Session 02
  In Poster Session: PS 02 Section - Sex, Gender

Integrative Statement

Background. Adolescent males who have sex with males (AMSM) disproportionality account for new HIV diagnoses (CDC, 2018). To inform prevention strategies, HIV risk research requires behavioral data and HIV testing. However, national youth surveys include few questions on sexual orientation and HIV risk, and CDC surveillance data is limited to identified seropositive adults or youth. As states expand minors’ independent access to HIV services (Chin et al., 2016), inclusion of HIV testing in behavioral research will increase. This study examined AMSM attitudes toward and the influence of “outness” to guardians and primary healthcare providers (PCPs) on participation in such studies.
Methods. 198 sexually active HIV negative AMSM ages 14 – 17 (34% Hispanic, 50% non-Hispanic white; 16% other) participated in an online survey on sexual orientation, sexual behaviors, family and PCP disclosure, and attitudes toward HIV risk and testing. Following description of a hypothetical HIV risk behavioral study including HIV testing, youth completed 20 Likert-type items assessing motivations to participation.
Results. Tables 1 and 2 provide descriptive statistics and logistic regressions on participation attitudes. 66.7% of youth had disclosed their sexual orientation to guardians, but only 29.8% indicated guardians knew they had male sexual partners. Overall, 68.2% would agree to study participation and indicated access to HIV testing, counseling and referrals were a benefit; however, only 24.7% would agree if guardian permission was required with youth not out to guardians about sexual orientation or male sexual partners significantly less likely to participate. Beliefs that guardians would be happy to know their son could receive HIV testing or would be supportive if he tested positive was also significantly related to willingness to participate (χ2 = 8.47 and 19.93, p < .01, respectively). Although 70.7% had engaged in condomless anal sex, only 34.8% had received HIV testing. Perceived likelihood of HIV infection (r = .16, p = .03) and perceived benefits of research-provided sexual health care (r = .16 to .43, p < .05 ) were significantly related to participation. Over half had never spoken to a PCP about their sexual orientation or sex with male partners, and 37.4% had avoided HIV testing due to worry they would be outed or criticized. Youth who had not disclosed their sexual orientation or behaviors to physicians were more likely to believe it would be easier to get HIV testing in a study than on their own and were concerned about test confidentiality in a doctor’s office than in research.
Conclusions. Behavioral studies contributing to the development of empirically validated HIV prevention services for AMSM will require an understanding of facilitators and barriers to youth study participation. Our findings indicate that AMSM are willing to participate in such studies, but underscore the need for strategies addressing barriers to participation related to guardian permission.
Our data also suggest that behavioral studies involving HIV testing may not only be important for establishing developmentally evidence-based services, but also serve as a critical gateway for HIV testing, prevention services and counseling, and HIV treatment referrals for this underserved population.

Authors

• Aaliyah Gray, Fordham University
  Presenting Author

• Kathryn Macapagal, Northwestern University
  Non-Presenting Author

• Brian Mustanski, Northwestern University
  Non-Presenting Author

• Celia B. Fisher, Fordham University
  Non-Presenting Author