Abstract
This study employs the ecodevelopmental theory to examine the influence of mother and father bonding, family engagement in healthcare, and family support on PrEP stigma among BLMSM. We used a cross-sectional sample from wave five of the Healthy Young Men (HYM) study, with a survey sample of 399 participants aged 16–24 years. We conducted two-path analyses to test multiple hypotheses: (1) mother/father bonding is associated with an increase in family engagement in healthcare; (2) family engagement in healthcare is associated with family social support; and (3) family social support is associated with PrEP stigma. Family social support was negatively correlated with PrEP stigma (r = −0.15; p < 0.001). The findings show that families either led by a Black/Latino father or mother have a significant impact on the sexual health-seeking behavior of BLMSM and their perception of HIV and PrEP.
Highlights
Pre-exposure prophylaxis (PrEP) proves efficacious in reducing HIV transmission, not all populations benefit from the advancement [1,2]
Intersectionality can complement and enhance the ecodevelopment theory, as intersecting stigmas may be critical drivers of pre-exposure prophylaxis (PrEP)-related stigma among BLMSM [23]. While both ecodevelopment theory and intersectionality research enhance our understanding of oppression and disparities in public health and the family context, these theoretical frameworks can jointly highlight the importance of family and health and how to reduce stigma around PrEP and HIV
Our study results indicated that mother bonding both positively predicted family engagement in healthcare but not for father bonding (Figure 1), which is consistent with prior literature that parental bonding influences communication, self-esteem, positive health outcomes, and positive attitudes towards HIV prevention behaviors [13–17]
Summary
Pre-exposure prophylaxis (PrEP) proves efficacious in reducing HIV transmission, not all populations benefit from the advancement [1,2]. Findings show some inconsistency in the role of family and HIV prevention behaviors with mother support positively predicting condom use compared with a negative prediction by father bonding [15–17,19]. More research is needed to understand the role of parental bonding and other familial factors in reducing HIV and PrEP-related stigma. To address the gaps in knowledge surrounding this area, this study used the ecodevelopmental theory to examine how mother and father bonding, family engagement in healthcare, and family support influence PrEP stigma among BLMSM and fills a critical gap in the literature on the same. In understanding how stigma influences HIV prevention behaviors such as PrEP, it is critical to recognize the intersecting identities of BLMSM and the potential operation of these identities in the family context. While both ecodevelopment theory and intersectionality research enhance our understanding of oppression and disparities in public health and the family context, these theoretical frameworks can jointly highlight the importance of family and health and how to reduce stigma around PrEP and HIV
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