Margaret Matson, Research staff
Attitudes, Adolescents, HIV, Research, Race/Ethnicity, Urban/Rural
Background Sexual and gender minority (SGM) youth, particularly youth of color and youth living in rural areas, are disproportionately impacted by HIV, yet underrepresented in HIV prevention research. Race, ethnicity, and rural vs. urban residency is linked with different levels of research participation in general samples. Combined with established barriers to research participation in SGM youth such as parental permission requirements, it is possible youth of color and those living in rural areas may experience further barriers to research participation. Yet there is a paucity of research looking at potential differences in barriers and facilitators of SGM youth’s participation in HIV prevention research based on race/ethnicity and geography, which our project sought to address. Method Two different samples of SGM youth ages 14-17 completed online surveys as part of a larger study. The combined samples included 63.8% youth of color and 11.4% rural residents. The first survey (N = 164) measured dichotomous endorsement of facilitators to participation in HIV prevention research. The second survey (N = 154) used a 7-item scale (α=0.893) to assess worry about parental permission in studies for SGM youth. Multiple logistic regression and multiple linear regression were used to assess racial/ethnic and geographic differences in both these facilitators and parental permission barriers, respectively. Results Nearly all (95%) SGM youth endorsed at least one facilitator to participate in HIV testing and PrEP (a HIV prevention drug) studies, with every facilitator showing minimum endorsement levels of 30%. Logistic regression did not detect differences by race/ethnicity or rural vs. urban area. Multiple linear regression showed youth of color reported greater concern about parental consent (B=0.546, p<.05) than non-Hispanic White youth. Attitudes toward parental permission did not differ by rural vs. urban location. Conclusion Youth across race/ethnicity and geographic location endorsed multiple and varied reasons for why participating in HIV prevention research would be of value to them. However, youth of color were significantly more likely to cite barriers related to parental consent, such as fears of being outed about their SGM identity, causing conflict, and personal safety. Parental permission may result in underrepresentation of SGM youth of color in HIV prevention research. Researchers and IRBs can use these findings to make better informed decisions about requiring parental permission to ensure protection of adolescent participants and equitable participation in HIV prevention research. Additional input from SGM youth of color and youth living in rural areas is needed to better understand the role of race/ethnicity and geography as potential barriers and facilitators of research participation and to identify strategies for recruitment and retention of participants from populations disproportionately underrepresented in HIV prevention research.