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LGBT youth study finds parents key to healthy sexual behaviors

Photo by Adam Ismail

Despite ongoing efforts by HIV prevention specialists, young gay and bisexual men are engaging in unprotected anal sex all too frequently, according to one study by a Rutgers professor. 

According to the Center for Disease Control, HIV infection among men who have sex with other men rose 22 percent from 2008 to 2010. 

Driven by this statistic, Michael LaSala, an associate professor in the School of Social Work, conducted a study, titled “Condoms and Connection: Parents, Gay and Lesbian Youth, and HIV Risk,” to explore the role of the family in preventing high-risk behaviors that lead to HIV in the lesbian, gay, bisexual and transgender community.

“In literature, there was virtually nothing about the role of the family in helping gay and youth avoid unsafe sex — it was all about straight kids,” said LaSala, author of “Coming Out, Coming Home: Helping Families Adjust to a Gay or Lesbian Child.”

His recently published report found in gay and bisexual young adults, family support and connectedness are linked to safe-sex practices, while family rejection is correlated to high-risk sexual behavior.

LaSala and research assistant James Fedor interviewed 38 gay and bisexual males between 14 and 21 years of age and one interviewee’s parents. 

They asked both parents and sons about their knowledge of HIV, their parent-child relationship and the impact that relationship has on the youths’ sexual behaviors. Parent-child closeness appeared to be the key to avoiding high-risk sexual behaviors. 

Open communication and effective dialogue can create this relationship, LaSala said.

When a young adult understands how his decisions affect his parents, HIV is more likely to be prevented, LaSala said. For example, one son reported that his mother’s love was what kept him grounded. 

“I know if I did, if I were to come home with a positive result … she would be hurt,” the son said. 

Twenty of the 38 participants reported family influence having an impact on their sexual behaviors. Eighteen of those 20 also reported that their parents directly discussed HIV prevention with them, including promoting the use of condoms.

An authoritarian style of parenting in which commands are given is less effective in family-based HIV prevention, LaSala said.

“If a parent were to say to their child something like, ‘Young man, you need to use condoms. Don’t be stupid,’ this would cause the child to withdraw,” LaSala said. 

He believes parents feel it is harder to talk to their gay sons about sex because the topic is stigmatized and feels foreign. 

Half the youth who reported having no parental influence also engaged in unprotected anal intercourse over the past year. They often had experienced disruption in their relationship with their parents, either due to abuse, a parent’s death, drug or health problems or rejection due to their sexual orientation.

Kathy Ahearn O’Brien, executive director of Hyacinth AIDS Foundation, a service organization with an office in New Brunswick, said many cases they work with involve young adults who “come out of the closet” and are kicked out of their house. 

“They are then facing a riskier life on the streets, which forces them to engage in riskier behavior,” she said. 

One boy in the study described his close relationship with his mother before coming out at the age of 16. After coming out, their relationship became strained, and a short time later, he tested HIV positive. 

When families have healthy, two-way communications about sexual health, including HIV and AIDS, sexual orientation and gender identity, the children can ask questions and know that they will find support, said Abby Maisonave, a Parents, Families, Friends and Allies United With LGBT People North Atlantic regional director.

The Jersey Shore PFLAG is an LGBT peer support group that provides information and discussion about LGBT issues in a confidential and nonjudgmental environment three times a week. 

“Education starts in the home,” Maisonave said.

But in the absence of family influence, PFLAG can offer the type of support that leads to HIV prevention, she said. 

Despite varying degrees of family support found in the study, almost all parents agreed that public schools should have more education about HIV transmission during male-to-male sexual activity, LaSala said. 

“School districts are squeamish around sex education. That goes double for homosexual sexual behavior,” he said. “There is a fear in school districts that if they teach students how to avoid HIV during anal sex, some parents will see it as recruiting kids into homosexuality.”

Maisonave agrees that public schools, starting at the elementary level, need to include the risks of same-sex intercourse in health curriculums for multiple reasons.

Research published in the Journal of Epidemiology shows the risk of HIV transmission from receptive anal sex is up to 18 times higher than from receptive vaginal sex. For this reason, specifically educating LGBT youth on the importance of condom use is highly important, Maisonave said. 

“When the viral load is high within a particular community, that community is more susceptible,” O’Brien said. 

The conversation with young gay men needs to be done in the context that their risk of contracting HIV is greater. 

Allies need to act as a source of confidentiality and provide LGBT friends under distress about sexual problems with correct information and advice.

“Education starts in the home,” Maisonave said. “But in some cases, it starts in the schools. Schools have to provide information where the parents aren’t.”