149. Caregiver Perspectives on Explanation of Benefits Forms, Confidential Sexual Health Care, and Communication with Adolescents

Adolescent sexual minority and/or gender diverse assigned males (ASM/GDM) are an understudied group at high risk of acquiring sexually transmitted infections (STIs) including HIV. One barrier to health for youth is challenging communication (SHC) with caregivers (e.g., parents, trusted adults), whereas SHC that open and inclusive (e.g. non-judgemental, identities outside cisgender heterosexual norms) has been shown decrease adolescent STI risk. Explanation benefits (EOB) forms–letters sent by insurance companies policyholders which can disclose sensitive information about a minor caregivers–have cited in prior studies as confidential care. However, few have evaluated caregivers’ perspectives on EOBs the context care, STI/HIV prevention, communication. We conducted individual in-depth interviews via video-conference N=12 English-proficient US. included regardless their child’s orientation or identity, given some ASM/GDM not disclosed behaviors. Interviewers used semi-structured guide sample EOB form hypothetical scenario–a caregiver receives after seeks testing. Caregivers were asked share general, also if was own child. A detailed debrief written immediately following interview, content analysis debriefs determine preliminary data relevant future work. primarily between ages 35 50 (n=8), female (n=12), non-Hispanic (n=11), White (n=8). Most aware (n=9). (n=7) had SHC, while (n=5) either less minimal SHC. nuanced complex especially when considering value care desire monitor supervise Some valued both similarly, others one more than other. For example, child, acknowledged felt would allow her positive way. Additionally, who reported discuss child (n=6) largely expressed sentiments: disappointment seek testing without telling them first, skepticism wide ranging confidentiality, communication, forms such male children, adolescents general. Future work should address key factors efforts improve outcomes adolescents.