(114) Tell me straight up: a mixed methods analysis of what black adolescent and young adult women want from sexual health conversations

Background: The Centers for Disease Control and Prevention recommends that pre-exposure prophylaxis (PrEP) should be discussed with all sexually active individuals. However, more data is needed to identify how providers who work with adolescents, including pediatricians and adolescent gynecologists, along with supportive adults such as parents and relatives, can initiate conversations about sexual health and PrEP with Black young women in diverse settings. We present preliminary results from a secondary data analysis of interviews from 4 qualitative studies exploring attitudes about sexual health and PrEP discussions between Black young women and their support networks.

Methods: Youth ages 14-24 years old and residing in rural and urban Alabama settings were interviewed in 4 different studies. The original studies were grounded in either cognitive theories or behavioral models. Interviews from young Black women who met the aforementioned inclusion criteria were pooled together for a larger analysis. All studies contained an introductory set of questions about engaging in sexual health discussions with peers, parents, and other adults that were developed by the same study team member. Rapid qualitative analysis was used to identify major themes. Content analysis was used to identify patterns in sexual health discussion initiation and key desired sexual health topic areas.

Results: There was a total of 41 participants. Median age is 20 years. 44% of participants initiated sexual health conversations with support persons; 24% of participants waited for support person to initiate sexual health conversations; 15% of participants said medical provider initiated sexual health conversations. Themes include Black women want to have these conversations; Black women desire to have conversations with their parents but assume parents aren't knowledgeable about sex because they don't talk about it; and Black women feel they lack information on specific topics within these conversations. The two sexual health topics that participants wanted to discuss the most were general sex education (17%) and PrEP (15%).

Conclusions: Black young women want to have conversations about sexual health with a support person such as a parent/guardian or a medical provider and many are initiating these conversations. More studies are needed to increase support person engagement in sexual health conversations and increase Black young women’s knowledge about general sex education and PrEP.