The Impact of Parent Reaction to Sexual Orientation on Depressive Symptoms and Sex Risk Among Hispanic Men Who Have Sex with Men

Friday, 25 July 2014

Victoria B. Mitrani, PhD1
Joseph P. De Santis, PhD, ARNP, ACRN2
Brian E. McCabe, PhD1
Natalie LeBlanc, BA, MPH, BSN3
Diego Deleon, MD1
(1)School of Nursing and Health Studies, University of Miami, Coral Gables, FL
(2)School of Nursing & Health Studies, University of Miami, Coral Gables, FL
(3)School of Nursing and Health Studies, University of Miami School of Nursing and Health Studies, Coral Gables, FL


The study aimed to examine the impact of parents’ reaction to their sons’ sexual orientation on the son’s depressive symptoms and sexual risk behaviors among Hispanic adult men who have sex with men (MSM). We also sought to examine whether the son’s level of acculturation would moderate the relationship between parental reaction and the outcome variables. The study tested the following hypotheses:

  1. Lower parental acceptance will be related to depressive symptoms
  1. Lower parental acceptance will be related to sexual risk behavior behaviors
  2. The relationship between lower parental acceptance and depressive symptoms will be stronger for men who are less acculturated 
  3. The relationship between lower parental acceptance and sexual behaviors will be stronger for men who are less acculturated


 This is a secondary analysis from a larger mixed methods study that assessed cultural influences on risk behaviors and mental health among Hispanic MSM. The segment of the study being reported in this presentation used a quantitative cross-sectional design. Participants for the study were recruited from a community-based organization that provides HIV testing and counseling to MSM. After participation in the study, men were provided business cards with study information and were encouraged to refer other potential participants. The study was approved by the University of Miami Institutional Review Board and participants were compensated for their time.

The sample consisted of 125 community-dwelling Hispanic MSM. Most (53%) of the men were born in Cuba, 14% born in the U.S., 10% born in Puerto Rico, and the remainder in other Latin American nations. Participants had a mean of 14.26 (SD = 3.20) years of education, and 58% were currently employed. Most men identified themselves as homosexual (87%).  The mean age of the participants was 43.02 years (range 21-65, SD = 10.34).  Of 125, 78 (62%) said their mother (or mother-figure) and 55 (44%) said their father (or father-figure) knew about their sexual orientation. Only those men with at least one parent who knew about their sexual orientation contributed data for this analysis, and mother and father reactions were analyzed separately. GZLM in SPSS 19 was used for all analyses. 

Parental reaction to their son’s sexual orientation was assessed using the Perceived Parent Reaction Scale (Willoughby, Malik, & Lindahl, 2006).  This measure includes 32 items that assess an individual’s perception of their parent’s level of general homophobia, shock, denial, anger, bargaining, depression, and acceptance of their child’s sexual orientation. Scores range from 32 to 160 and higher scores indicate more negative perceptions (i.e., lower acceptance), The study asked participants to report separately on their mother and father’s current attitudes.  Cronbach’s alpha for this sample were .96 for mother, and .96 for father; reactions were standardized when testing interactions.

Acculturation was assessed using the Bidimensional Acculturation Scale (Marin & Gamba, 1996). This measure includes 24 items regarding the respondent’s English and Spanish language behaviors in the domains of language use, language proficiency, and language use in media. Two subscales of 12 items each assess Hispanicism and Americanism. Cronbach’s alpha for this sample were .94 for Americanism and .83 for Hispanicism. Only acculturation to the U.S., i.e., Americanism, was used in this study; acculturation was standardized when testing interactions.

Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977). The CES-D includes 20 items that measure the frequency of depressive symptoms. Cronbach’s alpha for this sample was .90.

Sexual risk was assessed using the Safer Sex Behavior Questionnaire (DiIorio, Parsons, Lehr, Adame, & Carlone, 1992).  The measure includes 27-items addressing condom usage, high risk sexual behaviors, and sexual communication and negotiation. Lower scores indicate higher sexual risk. Cronbach’s alpha for this sample was .82.


Lower acceptance from mother, B = 3.61, SE = 1.68, p = .032, and from father, B = 5.35, SE = 1.88, p = .004, were related to higher depressive symptoms. Mother and father reaction were not directly related to sexual risk. There was no significant interaction between mother or father reaction and acculturation to the U.S. with respect to depression. There was a significant interaction between mother reaction and acculturation to the U.S. with safer sex behaviors, B = -2.64, SE = 1.27, p= .037. Acculturation to the U.S. was directly linked to lower sexual risk behavior, but lower acceptance from the mother tempered the protective effects of acculturation. There was no significant father reaction x acculturation interaction with safer sex behaviors.


This study demonstrates the importance of parental acceptance for the mental health of Latino MSM. Men who perceived that their mother or father currently held a negative attitude towards their sexual orientation experienced more depressive symptoms. Men who were less acculturated and who perceived their mothers as non-accepting of their sexual orientation were also more likely to engage in riskier sexual behaviors. This study suggests the need for family-based interventions to improve relationships among Latino MSM and their parents. It is noteworthy that parental reactions were influential in this sample of grown men, whose average age was in their 40’s, suggesting that family acceptance is important well into adulthood.