“They Knew Nothing About Sex”: Cultural Silence, Gendered Expectations, and Barriers to PrEP for Young Black Women

This study explores how memorable messages of parent-child sex communication (PCSC) influence sexual agency and sexual health decision-making among 26 young Black women (YBW) through an integrated, intersectional framework. Data from the focus groups revealed that sociocultural stigma, gendered expectations, and structural barriers, including concerns about preexposure prophylaxis (PrEP) access due to insurance and confidentiality, limited open dialogue, and reinforced restrictive sexual scripts. Many participants relied on peers or the internet due to judgmental or absent parental messaging. PCSC was often moralistic, heteronormative, and emotionally limited. Findings highlight the urgent need for culturally responsive, sex-positive education and communication strategies that empower YBW in sexual health.