Developmental Barriers to Couples' HIV Testing and Counseling Among Adolescent Sexual Minority Males: A Dyadic Socio-ecological Perspective

AIDS Behav. 2021 Mar;25(3):787-797. doi: 10.1007/s10461-020-03044-4. Epub 2020 Sep 17.


Couples HIV Testing and Counseling (CHTC) is now a standard of care for partnered sexual minority men. While adolescent sexual minority men (ASMM; ages 15-19) face disproportionate HIV risk, the emergent nature of relationships and communication skills may present challenges to accessing and engaging in CHTC. This study utilized qualitative data from 28 ASMM recruited in 4 urban centers in the USA during the formative stage of Adolescent Trials Network study ATN-156. Participants were cis-male, HIV-negative, and in a relationship with a similarly-aged cis-male partner. Thematic analysis indicated low and high levels of commitment were barriers to CHTC. Concerns about caregiver attitudes towards HIV testing were salient. Adolescents' perception of structural barriers highlighted reliance on caregiver resources, which limited access to sexual health services. Prevention programming must address structural barriers to access encountered by adolescents. ASMM in relationships may benefit from programming that includes options for individual and dyadic participation.

Keywords: Adolescence; Couples HIV testing; Gay couples; HIV prevention.

MeSH terms

  • AIDS Serodiagnosis*
  • Adolescent
  • Communication*
  • Counseling / methods*
  • HIV Infections / diagnosis*
  • HIV Infections / prevention & control
  • HIV Infections / psychology
  • HIV Testing
  • Health Services Accessibility
  • Humans
  • Male
  • Patient Acceptance of Health Care
  • Qualitative Research
  • Sexual Partners / psychology*
  • Sexual and Gender Minorities*
  • Urban Population
  • Young Adult