Family-Based Discrimination, Non-disclosure of Sexual Orientation or Gender identity, and Initiation of Oral Pre-exposure Prophylaxis Among Adolescents

Bibliographic Data

ID15337117
AuthorsGabriel Marinho (0000-0001-5233-5177, Universidade Federal da Bahia, corresponding author), Bianca Oliveira Leite (0000-0002-4137-9809, Universidade Federal da Bahia), Beo Oliveira Leite (Universidade Federal da Bahia), Diana Zeballos (0000-0003-2045-765X, Universidade Federal da Bahia), Fabiane Soares Gomes (0000-0003-4067-7860), Fabiane Veloso Soares (0000-0002-8036-3244, Universidade Federal da Bahia), Fabiane Soares, Nila Mara Smith Galvão (0000-0002-3106-6366, Universidade Salvador), Leila Denise A F Amorim (0000-0002-1112-2332), Leila Denise Amorim (Universidade Federal da Bahia), Suelen Seixas (0000-0001-6267-245X, Universidade Salvador), Dirceu Bartolomeu Greco (0000-0002-4419-5634), Dirceu Greco (Universidade Federal de Minas Gerais), Alexandre Grangeiro (0000-0001-5157-0597, Universidade de São Paulo), Ines Dourado (0000-0003-1675-2146, Universidade Federal da Bahia), Laio Magno (0000-0003-3752-0782, Universidade Salvador)
Year2026
Volume30
Issue8
Pages2488-2502
Publication date2026-03-09
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAIDS and Behavior (JOURNAL)
Journal identifiersISSN: 1090-7165 • E-ISSN: 1573-3254
PublisherSpringer Science+Business Media (PUBLISHER • DE)
DOI10.1007/s10461-026-05075-9
PMID41801658
OpenAlexW7134270147
LanguageEN
References cited91

This study analyzed the association between family-based discrimination and non-disclosure of sexual orientation or gender identity (SOGI) and the initiation of oral pre-exposure prophylaxis (PrEP) for HIV prevention among adolescent men who have sex with men (AMSM) and transgender women (ATGW). This analysis used baseline data from the PrEP1519 project. Latent class analysis (LCA) was applied to identify patterns of family-based discrimination and non-disclosure of SOGI using three categorical indicators. Descriptive, bivariate, and multivariate analyses were conducted, and logistic regression models estimated the adjusted odds ratios (aOR) for the association between latent classes and PrEP initiation. The majority of the 1,309 participants identified as AMSM (91.4%) were aged 18-19 years (74.9%), were Black and Pardo or mixed race (72.1%), had enrolled in high school (71.9%), resided in São Paulo (49.6%), and lived with parents or other family members (81.9%). Overall, 79.5% of patients initiated oral PrEP. LCA identified three distinct profiles: (i) low discrimination (67.6%, n = 885), (ii) high discrimination (22.4%, n = 293), and (iii) no disclosure within the family context (10.0%, n = 131). Multivariate analysis revealed non-disclosure of SOGI within the family was significantly associated with lower odds of initiating oral PrEP (aOR: 0.54; 95% CI: 0.33-0.78), whereas high levels of family discrimination were not significantly associated with oral PrEP initiation (aOR: 1.22; 95% CI: 0.84-1.76. Enhancing, structural interventions, stronger community support systems, and expanded access to alternative prevention options such as injectable PrEP may improve the initiation and adherence to HIV-prevention efforts among adolescents who experience family-related barriers to disclosure

Context (archaeology · Health psychology · Latent class model · Logistic regression · Multivariate analysis · Odds · Odds ratio · Sexual orientation · Adolescent Sexual and Reproductive Health · HIV/AIDS Research and Interventions · LGBTQ Health, Identity, and Policy

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