Reproductive intentions among HIV-negative gay and bisexual men initiating pre-exposure prophylaxis in the Sustainable Health Center Implementation pre-exposure prophylaxis pilot study, 2014–2016

Introduction We assessed reproductive intentions and associated characteristics among men enrolled in the Sustainable Health Center Implementation pre-exposure prophylaxis (PrEP) Pilot (SHIPP) Study. Methods We analyzed baseline data from 1275 men who self-identified as gay or bisexual and participated in the SHIPP study. SHIPP was a cohort study of PrEP implementation in five community health centers in Chicago, Jackson, Philadelphia, and Washington, D.C. conducted from 2014 to 2016. Participants completed audio computer-assisted self-interviews querying intentions to have a child in the future. We estimated the association between participants’ reproductive intentions and their characteristics using Poisson regression models. Results Approximately 47% of participants indicated their intentions to have a child. Black/non-Hispanic (aPR = 1.40; 95% CI: 1.10–1.78) and other/non-Hispanic participants (aPR = 1.40; 95% CI: 1.01–1.93) were more likely to report intentions to have a child than white/non-Hispanic participants. Participants were less likely to report intentions to have children as age increased (18–29 years, reference group; 30–39 years, aPR = 0.80, 95% CI: 0.64–0.99; 40–49 years, aPR = 0.49, 95% CI: 0.33–0.72; 50+ years, aPR = 0.07, 95% CI: 0.02–0.21). Conclusions Clinicians offering PrEP to black and other/non-Hispanic gay and bisexual men should assess their reproductive intentions as family-planning counseling may be an opportunity to introduce PrEP to HIV-negative gay and bisexual men.

[1]  A. Malmquist,et al.  Childless Bisexual and Gay Men’s Expectations of Obstacles and Enabling Factors for Pursuing Parenthood , 2021 .

[2]  D. Duncan,et al.  Sexual Identity, Sexual Behavior and Pre-exposure Prophylaxis in Black Cisgender Sexual Minority Men: The N2 Cohort Study in Chicago , 2021, AIDS and Behavior.

[3]  T. Finlayson,et al.  Assessment of PrEP Awareness, PrEP Discussion with a Provider, and PrEP Use by Transmission Risk Group with an Emphasis on the Southern United States , 2021, AIDS and Behavior.

[4]  T. Antoniou,et al.  An exploration of the fertility desires and intentions of men living with HIV in Ontario, Canada , 2020, AIDS care.

[5]  J. Schneider,et al.  Parenting and child-caretaking among black men who have sex with men and associated sexual and reproductive health factors: a brief report , 2020, Journal of gay & lesbian social services.

[6]  Amare Minyihun,et al.  Fertility Desire And Associated Factors Among HIV Positive Women Attending ART Clinics In Amhara Region Referral Hospitals In Northwest Ethiopia, 2017 , 2019, HIV/AIDS.

[7]  Emma C Spencer,et al.  Changes in HIV Preexposure Prophylaxis Awareness and Use Among Men Who Have Sex with Men — 20 Urban Areas, 2014 and 2017 , 2019, MMWR. Morbidity and mortality weekly report.

[8]  L. Bowleg,et al.  “Having a Child Meant I had a Real Life”: Reproductive Coercion and Childbearing Motivations Among Young Black Men Living in Baltimore , 2019, Journal of interpersonal violence.

[9]  C. Patterson,et al.  Predictors of Parenting Intentions Among Childless Lesbian, Gay, and Heterosexual Adults , 2019, Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association.

[10]  P. Halkitis,et al.  Structural Barriers to Pre-exposure Prophylaxis Use Among Young Sexual Minority Men: The P18 Cohort Study. , 2018, Current HIV research.

[11]  J. Chmiel,et al.  Parenting Desires Among Individuals Living With Human Immunodeficiency Virus in the United States , 2018, Open forum infectious diseases.

[12]  J. Baeten,et al.  Fertility Intentions, Pregnancy, and Use of PrEP and ART for Safer Conception Among East African HIV Serodiscordant Couples , 2018, AIDS and Behavior.

[13]  Étienne Meunier,et al.  Reproductive Desires and Considerations of HIV-Positive Men in Heterosexual Relationships in New York City , 2018, AIDS and Behavior.

[14]  Rachel G Riskind,et al.  Sexual Orientation and Future Parenthood in a 2011–2013 Nationally Representative United States Sample , 2017, Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association.

[15]  D. Cohan,et al.  “Is It All Right for Me to Have a Baby or Not?”: Men Living With HIV Discuss Fertility Desires and Interactions With Providers , 2017, The Journal of the Association of Nurses in AIDS Care : JANAC.

[16]  A. Morgan,et al.  A Medical Care Missed Opportunity: Preexposure Prophylaxis and Young Black Men Who Have Sex With Men. , 2016, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[17]  L. Haddad,et al.  Future desire for children among women living with HIV in Atlanta, Georgia , 2016, AIDS care.

[18]  Douglas J. Taylor,et al.  Pregnancy and Contraceptive Use Among Women Participating in the FEM-PrEP Trial , 2015, Journal of acquired immune deficiency syndromes.

[19]  K. Smith,et al.  "I Always Felt I Had to Prove My Manhood": Homosexuality, Masculinity, Gender Role Strain, and HIV Risk Among Young Black Men Who Have Sex With Men. , 2015, American journal of public health.

[20]  J. Baeten,et al.  Pre-exposure prophylaxis does not affect the fertility of HIV-1-uninfected men , 2014, AIDS.

[21]  K. Brewster,et al.  Demographic Characteristics of Lesbian Parents in the United States , 2013, Population Research and Policy Review.

[22]  K. Mosack,et al.  Physician Awareness of Sexual Orientation and Preventive Health Recommendations to Men Who Have Sex With Men , 2011, Sexually transmitted diseases.

[23]  C. Patterson,et al.  Parenting intentions and desires among childless lesbian, gay, and heterosexual individuals. , 2010, Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association.

[24]  M. Trent,et al.  Understanding High Fertility Desires and Intentions Among a Sample of Urban Women Living with HIV in the United States , 2010, AIDS and Behavior.

[25]  Maureen Miller,et al.  Sexual diversity among black men who have sex with men in an inner-city community , 2005, Journal of Urban Health.

[26]  Ariane L. Bedimo-Rung,et al.  Reproductive decision-making among HIV-Infected women. , 2005, Journal of the National Medical Association.

[27]  L. Ortíz Hernández,et al.  [Internalized oppression and high-risk sexual practices among homosexual and bisexual males, Mexico]. , 2005, Revista de saude publica.

[28]  S. Greenland,et al.  Associations of Race/Ethnicity With HIV Prevalence and HIV-Related Behaviors Among Young Men Who Have Sex With Men in 7 Urban Centers in the United States , 2004, Journal of acquired immune deficiency syndromes.

[29]  Daryl J. Higgins Living with contradictions : experiences of same-sex attracted men within heterosexual marriage , 2004 .

[30]  L. O'donnell,et al.  Ethnic and gay community attachments and sexual risk behaviors among urban Latino young men who have sex with men. , 2002, AIDS education and prevention : official publication of the International Society for AIDS Education.