Challenges to Adolescent Pre-exposure Prophylaxis (PrEP) Uptake: an Exploration of Black and Latino American Parents’ Beliefs, Attitudes, and Receptivity to PrEP

Abstract

Background: Pre-exposure prophylaxis (PrEP) uptake among adolescents has been slow. This has been attributed to factors such as stigma, lack of PrEP awareness, financial burdens, and provider apprehension about prescribing PrEP. In this study, we sought to understand the impact of familial factors on PrEP uptake among youth. Methods: We conducted three focus groups with parents of Black and Latino adolescents to gather insights about attitudes, beliefs and receptivity to PrEP uptake among adolescents. Parents were recruited through a teen health clinic in New York City. Data were transcribed, codes were developed, data were coded, and an inductive and deductive analytical approach was employed. Results: We recruited 26 parents. Most participants were female (85%), Black (63%), and an average age of 41 years old. Emergent themes included adherence skepticism, preference for parental consent for PrEP, increased sexual risk-taking concerns, PrEP scientific merit skepticism, and medical mistrust. Subcategories of medical mistrust included historical precedence, governmental genocide conspiracies, and classism. Conclusion: Parents of Black and Latino adolescents have reservations about PrEP. Attitudes, beliefs, and receptivity to PrEP may have a significant impact on youth seeking and accessing PrEP. Increasing PrEP uptake may include trust-building within minoritized communities to assure parents and youth of just and safe health practices and including parents in HIV prevention initiatives, with special consideration to Black and Latino communities and families.