Why parents should talk to their teens about sex and PrEP

My mother and I were sitting on my old bed upstairs, talking about PrEP, of all things. The topic came up after I told her that I had the opportunity to interview HIV/AIDS activist Peter Staley about PrEP. I wasn’t planning on discussing it, but I guess it was the only real conversation that we’d ever had about sexual health, so maybe it wasn’t a bad thing.

Needless to say, she’d never heard of it before. “Preeep?” she repeated.

“No, ‘PrEP,’ like P-R-E-P.” It was awkward to hear her say it.

I told her that it stands for “pre-exposure prophylaxis,” which didn’t make it any clearer for her, so I simplified: If you take a pill daily, it reduces the risk of sexual transmission of HIV by over 99 percent. I admitted that I had used to use it at one point, but when I lost my benefits at work to go freelance, I had to stop because of the cost. It’s much more accessible in America, I added, excluding the fact that I’d taken generics for a little while after that — that would only freak her out.

“How much is it?” she asked.

“Over $1,000 per month in Canada,” I explained. She gasped, and we both agreed that it was somewhat criminal to charge so much for something that can prevent HIV.

Though a PrEP conversation with one’s mother may seem strange to some, it can have positive outcomes, particularly if it happens at an early age. For many though, this unfortunately isn’t the case.

In a study published in The Journal of Sex Research, Laura Widman and her colleagues assessed early adolescent sexual communication with 603 participants, ages 12 to 15. They found that 54 percent of them did not discuss any sexual topics with their dating partners, and 25 percent didn’t discuss them with their best friends, let alone their parents (29 percent).

Another study, which focused specifically on parent-child communication, found that more than 40 percent of teens in the study ages 13 to 17, had intercourse before discussing any sexual topics, such as STIs, condom use, birth control or partner condom refusal. And we can only assume that any conversations had didn’t include PrEP.

I grew up in a strict Muslim household where abstinence was expected, so my parents assumed that such conversations were irrelevant. Luckily, I went to a high school that educated us about STIs, HIV and safe sex. They even taught us how to put on a condom correctly by demonstrating on a wooden dildo. As a result, I’ve always been cautious, and have — for the most part — taken very few sexual risks (that I know of).

It was interesting, though, as we sat there talking about PrEP, to find that my mother felt comfortable enough to mention my father’s friend from the mosque whose son was HIV-positive. He’d recently passed away, she said, so she believed that if you get the virus, it’s still a death sentence like it was in the ’80s and ’90s. I said how strange that was, and uncommon, that he would have passed away from it, considering the antiretroviral therapy we have today.

“Was he not taking his medication?” I asked. “Or could he not afford them?”

“I don’t know,” she said, shrugging her shoulders.

I explained that antiretroviral therapy suppresses the amount of HIV in the body fluids to the point where it cannot be detected by tests used in clinics. I hated mentioning Charlie Sheen, especially after his unproven goat milk HIV therapy fiasco, but she was a fan of Two And A Half Men so I knew it was something she could relate to.

“Charlie Sheen is undetectable, for example,” I said, “And he’ll live a long and healthy life. He also can’t pass the virus onto anybody else because he’s undetectable.”

“They were talking about that on Dr Oz,” she said, “But I didn’t realize that’s what it meant.”

She seemed relieved to learn more about my sexual health since we’d never had these sorts of conversations. It opened us up for future conversations about it too — or anything else for that matter. I’m also a firm believer that if you don’t talk about things like sex with those you love, it creates a sort of shame around it. It starts to feel like it’s something that should never be talked about.

So while some may think these conversations are too awkward to have, I can’t help but feel that they can improve one’s health and sex life, especially when these conversations happen during early adolescence.

According to the Centers for Disease Control, , youth aged 13 to 24 accounted for 22 percent of all new HIV diagnoses in the United States in 2014. That’s 9,731 youth and some studies, like this one in the Journal for Adolescent Health, have shown that communication interventions between parents and youth can reduce sexual health risk for the youth.

So although my mother and I had missed the boat on having such conversations, I’m glad that we were finally able to make up for lost time.

PrEP School runs every other Monday on Daily Xtra. Columnist Mike Miksche explores and navigates the world of sex and PrEP.

>Read more PrEP School columns here.