'Don't cross a man's feet': Hmong parent-daughter communication about sexual health

Parent-adolescent communication about sexual health is one strategy to encourage healthy adolescent sexual behaviour. However, this literature has largely overlooked immigrant families. Hmong youth, identified as facing extreme challenges to parent-adolescent communication, are considered. Content analysis was used to examine parent-adolescent communication about sexual health for forty-four pregnant or parenting Hmong adolescent girls. The minority of adolescents recalled an actual conversation about sexual health in their families with mothers most often identified as the source. Their stories reflect discussions about abstinence, puberty, pregnancy, and STIs - with much information being inaccurate. With culture being a recurrent theme, communication was reported to be hindered by cultural traditions, comfort level, applicability, and perceived consequences. The results identify opportunities for culturally-relevant sex education materials in the Hmong community.     

Hmong American Parents’ Views on Promoting Adolescent Sexual Health

Parents play an important role in the promotion of adolescent sexual health, but little is known about parents’ attitudes and beliefs in immigrant families. We examine Hmong American parents’ attitudes about adolescent sexual health using survey data from 202 parents of adolescents with attention to parental gender differences. Breaking from traditional views, Hmong American parents most often viewed teen pregnancy as challenging, not beneficial, and advocated the involvement of parents and community leaders in its prevention. The parents also strongly endorsed addressing comprehensive sex education topics for adolescents. Findings encourage proactive efforts to involve Hmong American parents in the promotion of adolescent sexual health, both directly by enhancing parental knowledge and communication with youth and indirectly through parents’ support of comprehensive sex education.     

Factors shaping parent–adolescent communication about sexuality in urban China

Within a rapidly changing cultural and socio-economic context, young people in China are increasingly engaging in romantic experiences and sexual behaviours with consequences such as unwanted pregnancies and sexually transmitted infections. Across a range of contexts, parental communication about sexuality has been recognised as protective in terms of increasing the likelihood of sexual abstinence and safer sexual practice. This study focuses on the factors shaping parent–adolescent communication about sexuality. Thirty-eight young people and twenty-seven parents, recruited from two high schools in a Northern-Eastern city of China, were interviewed. Thematic analysis of their interview responses was conducted using a social constructionist framework. Four main themes were identified: timing; discomfort and uncertainty; assumptions; and the parent–adolescent relationship. Findings suggest that communication between parents and children is influenced by individual as well as interpersonal factors and factors relating to the broader Chinese sociocultural context. To facilitate communication, both parents and young people need support from health and other professionals, while parents need more help and support in overcoming historical, social and cultural barriers to open communication about sex.     

A Review of Parent-Based Barriers to Parent–Adolescent Communication about Sex and Sexuality: Implications for Sex and Family Educators

Although adolescents' sexual health is generally better when parents and adolescents communicate about sex and sexuality, researchers have found parents can be reluctant to engage adolescents in conversations about those topics. To better understand why, we reviewed prior literature and identified four types of parent-based barriers to communication with adolescents about sex: limited sexual health knowledge, believing adolescents are not ready to discuss sex, discomfort discussing sex, and demographic factors. We then used the Theory of Planned Behavior to develop recommendations for how health educators can address these barriers, thereby increasing parent–adolescent sexual health communication.     

“We Talked About Sex.” “No,We Didn't”: Exploring Adolescent and Parent Agreement About Sexuality Communication

Family communication about sex can protect adolescents from risky behavior, like early sex and sex without protection. However, adolescents and parents often disagree about whether they talked with each other about sexual issues, limiting the protective effects of communication. Few studies explore these disagreements. This study included 27 pairs of early adolescents and parents. Adolescent and parent interviews were coded for agreement in reports of sexuality communication. Adolescents’ interview themes were compared across levels of agreement between adolescent–parent dyads. Adolescents who highly agreed with their parents were more likely than those who did not to describe positive parental approaches to sexuality communication and awareness of parental perspectives, while no group differences were found for responses to parents’ viewpoints. Study findings highlight the importance of sex education programs that support adolescent–parent sexuality communication, particularly for middle school students.     

Secret languages of sex: disabled youth’s experiences of sexual and HIV communication with their parents/caregivers in KwaZulu-Natal,South Africa

Various health promotion strategies have been implemented in South Africa aiming to encourage young people to talk about issues of sexuality and HIV with their parents/caregivers. Although parent/caregiver sexual communication may be an effective method of influencing sexual behaviour and curbing the incidence of HIV, very little is known about how young people with disabilities in South Africa communicate about these traditionally difficult subjects with their parents/caregivers. Based on findings from a participatory study conducted amongst 15–20-year-old Zulu-speaking youth with physical and visual disabilities, this paper explores how they perceive youth–parent/caregiver communication about sexuality and HIV. Using Foucauldian discourse analysis, the paper outlines how disabled youth–parent/caregiver sexual communication is governed by cultural customs, sexual secrecy and constructs of innocence. It also argues that the experiences and perceptions of young people with disabilities are critical to the development of future interventions to assist parents/caregivers develop communication strategies that help disabled young people make sense of sexual behaviour.     

Sex and Risk: Parental Messages and Associated Safety/Risk Behavior of Adult Children

The importance of both parent–child conversations about sex and general family communication climates has been emphasized in numerous studies. This study compared general family communication via family communication patterns (FCP) to specific parental communication about sex in understanding young adults’ sexual communication/risk (avoidance, threat, and risk behavior). Results suggest that FCP were stronger predictors of adult children’s perceptions of sexual communication as threatening and overall avoidance of sexual communication with their partners compared to the frequency of and overall quality of parent–child conversations about sex. Theoretical and practical implications of these findings are also discussed.     

Topics discussed with mothers and fathers for parent–child sex communication among African-American adolescents

The purpose of this study was to examine gender differences in parent–child sex communication for 14 topics among early adolescent African-American youth. Similar to prior research, a larger percentage of participants reported they discussed sex with their mother in comparison to their father. In contrast to prior research, more males than females reported they discussed sexual topics with their mothers and fathers. Binary logistic regression analysis found significant differences for males versus females for father–child conversations on 12 of the 14 topics. Only two of the analyses were significant for males versus females on mother–child discussion of the topics. Finally, parent–child conversations tended to focus on general versus personal information. For example, a larger percentage of participants reported discussing general information on HIV/AIDS compared to discussing sexual orientation. The importance of research that focuses on the role of fathers in parent–child sexual socialisation is discussed.     

Does parental monitoring moderate the relation between parent–child communication and pre-coital sexual behaviours among urban,minority early adolescents?

This study examined parental monitoring (PM) as a potential moderator of the relation between parent–child communication (PCC) and pre-coital sexual behaviours (PCSB) in an urban, minority, early adolescent population. Seventh-grade students (n = 1609) reported PCC, PM and PCSB. Multivariable logistic regression was conducted to assess for moderation. PM moderated the association between PCC and PCSB. Specifically, young people reporting both high PCC and high PM had the lowest odds of PCSB. Findings suggest that PCC is more protective in combination with high PM. However, young people reporting low levels of PM had an increased probability of PCSB with higher levels of PCC. No moderating effect between PCC, PM and PCSB was found by race/ethnicity or gender. However, race/ethnicity was found to moderate the effect of PCC on PCSB. This knowledge highlights the protective role of parental factors on PCSB and may inform the development of more effective parent-based adolescent sexual health interventions that address both PCC and PM.     

HIV knowledge and risk among Zambian adolescent and younger adolescent girls: challenges and solutions

In sub-Saharan Africa, young women are at the highest risk of HIV infection. Comprehensive sexuality education and open parent–child communication about sex have been shown to mitigate risky sexual practices associated with HIV. This study aimed to identify sources of HIV prevention knowledge among young women aged 10–14 years and community-based strategies to enhance HIV prevention in Zambia. Focus group discussions were conducted with 114 young women in Zambian provinces with the highest rates (~20%) of HIV. Discussions were recorded, transcribed and coded, and addressed perceived HIV risk, knowledge and access to information. Participants reported that limited school-based sexuality education reduced opportunities to gain HIV prevention knowledge, and that cultural and traditional practices promoted negative attitudes regarding condom use. Parent–child communication about sex was perceived to be limited; parents were described as feeling it improper to discuss sex with their children. Initiatives to increase comprehensive sexuality education and stimulate parental communication about sexual behaviour were suggested by participants. Culturally tailored programmes to increase parent–child communication appear warranted. Community-based strategies aimed at enhancing protective sexual behaviour among those most at risk are essential.     

Adoptive Gay Father Families: Parent–Child Relationships and Children's Psychological Adjustment

Findings are presented on a U.K. study of 41 gay father families, 40 lesbian mother families, and 49 heterosexual parent families with an adopted child aged 3–9 years. Standardized interview and observational and questionnaire measures of parental well‐being, quality of parent–child relationships, child adjustment, and child sex‐typed behavior were administered to parents, children, and teachers. The findings indicated more positive parental well‐being and parenting in gay father families compared to heterosexual parent families. Child externalizing problems were greater among children in heterosexual families. Family process variables, particularly parenting stress, rather than family type were found to be predictive of child externalizing problems. The findings contribute to theoretical understanding of the role of parental gender and parental sexual orientation in child development.     

Reviews

Introduction: Despite government support of culturally appropriate sex and relationships education (SRE), young people's access to information is limited and sexual health needs are not being met, particularly among youth from black and minority ethnic groups. Joint‐working between health, education, voluntary sectors and parents has been heralded as key in redressing inequalities in sexual health outcomes and access to information. Our study focuses on SRE provision for young Muslim Bangladeshis, highlighting the complexities involved in streamlining SRE messages.

Objective: To explore stakeholder views about SRE and ways to improve SRE delivery.

Design: Sixteen semi‐structured interviews were conducted in 2005 with stakeholders from schools, National Health Service, and parent and voluntary sector bodies in a London borough.

Results: Two key factors enhancing Bangladeshi youth's risk of infection and unwanted pregnancy were identified: inadequate parental understanding about sexual health and limited parent‐delivered SRE; and patchy provision of culturally appropriate, school‐based SRE. Factors affecting SRE provision included culturally rooted perceptions of sex/sexuality and limited participation of stakeholders, (religious leaders, parents), in developing and delivering SRE.

Conclusions: This study highlights the importance of widespread community engagement, underlining that joint‐working, and the development and delivery of culturally appropriate and consistent SRE, necessitates communication and collaboration among stakeholders in young people's health and well‐being.     

Sexual harassment victimization in adolescence: Associations with family background

Sexual harassment has been studies as a mechanism reproducing inequality between sexes, as gender based discrimination, and more recently, as a public health problem. The role of family-related factors for subjection to sexual harassment in adolescent has been little studied. Our aim was to study the role of socio-demographic family factors and parental involvement in adolescent's persona life for experiences of sexual harassment among 14–18-year-old population girls and boys. An anonymous cross-sectional classroom survey was carried out in comprehensive and secondary schools in Finland. 90 953 boys and 91 746 girls aged 14–18 participated. Sexual harassment was elicited with five questions. Family structure, parental education, parental unemployment and parental involvement as perceived by the adolescent were elicited. The data were analyzed using cross-tabulations with chi-square statistics and logistic regressions. All types of sexual harassment experiences elicited were more common among girls than among boys. Parental unemployment, not living with both parents and low parental education were associated with higher likelihood of reporting experiences of sexual harassment, and parental involvement in the adolescent's personal life was associated with less reported sexual harassment. Parental involvement in an adolescent's life may be protective of perceived sexual harassment. Adolescents from socio-economically disadvantaged families are more vulnerable to sexual harassment than their more advantaged peers.     

Developmental Trajectories of Acculturation in Hispanic Adolescents: Associations With Family Functioning and Adolescent Risk Behavior

This study examined longitudinal acculturation patterns, and their associations with family functioning and adolescent risk behaviors, in Hispanic immigrant families. A sample of 266 Hispanic adolescents (M_age = 13.4) and their primary parents completed measures of acculturation, family functioning, and adolescent conduct problems, substance use, and sexual behavior at five timepoints. Mixture models yielded three trajectory classes apiece for adolescent and parent acculturation. Assimilated adolescents reported the poorest family functioning, but adolescent assimilation negatively predicted adolescent cigarette smoking, sexual activity, and unprotected sex indirectly through family functioning. Follow‐up analyses indicated that discrepancies between adolescent and parent family functioning reports predicted these adolescent outcomes. Results are discussed regarding acculturation trajectories, adolescent risk behavior, and the mediating role of family functioning.     

Sexual health discussions between African-American mothers and mothers of Latino descent and their children

We examined approaches used by African-American mothers and mothers of Latino descent for informal sex-related discussions with their children to inform sexually transmitted infection (STI)/HIV intervention development efforts. We recruited mothers (of children aged 12–15) from youth service agencies and a university in southern California. Fourteen focus groups were conducted: eight with African-American mothers (n = 31) and six with mothers of Latino descent (n = 24). Data were transcribed, coded for most common themes by four of the authors and reviewed for differences by gender of child. Four key themes emerged when focusing on parent–child discussions about sex: (1) sexual activity discussions took place for both sons and daughters; (2) protection from STI/HIV and pregnancy was a key topic; (3) the use of a direct, honest approach was preferred by mothers; and (4) seizing the moment was important for discussion opportunities. These data help broaden our understanding about the strategies used by African-American mothers and mothers of Latino descent for sexual health discussions with their sons and daughters. Evaluations of these for their potential impact on youth sexual health outcomes are warranted. The data can also contribute to the development of new culturally tailored parent–child communication strategies and HIV prevention interventions for young people of colour.     

Teen Perceptions of the Promotion of Safer Sexual Practices: A Focus Group Study

Teens' own thoughts on fostering safe sexual practice are important perspectives in promoting adolescent sexual health yet are relatively absent in the literature. This focus group study explored teens' perceptions about the supports and challenges that exist as teens strive to engage in healthy sexual practices. Seventy-five teens participated in 11 focus groups using a semi-structured interview guide. School-based health centers provided the setting and facilitated sample recruitment. Focus groups were audiorecorded and transcribed verbatim. Data were analyzed using the focus group guide as a template and typologies, or clusters of concepts, were extracted to establish teen perceptions of the factors that support and challenge their ability to engage in safe sexual practices. The socio-ecological model provided the framework to identify these factors within the individual, family/parent, relational (peer/partner), community, or societal spheres of influence. Results discussed the importance of parents, the value of confidentiality, respect for teen decision-making, relationships skills, developmental aspects of the adolescent years, and social interpretations of gender. These findings revealed important considerations as adults develop policies, messages, and programs designed to promote safe sexual behavior in teens.     

Substance abuse and behavioral correlates of sexual assault among South African adolescents

OBJECTIVE: The aim of this article is twofold: first, to examine the prevalence of being the victim of actual and attempted rape among a large representative sample of Cape Town high school students; and second, to identify the correlates of sexual assault for both boys and girls, including alcohol, tobacco and other drug use, behavioral problems, and suicidality. METHOD: Data for this study were derived from the 1997 South African Community Epidemiology Network on Drug Use (SACENDU) school survey. A stratified sampling procedure was used to select students in Grades 8 and 11 at non-private high schools in Cape Town. A total of 2,946 students completed a survey consisting of socio-demographic questions and items about substance abuse, sexual activity, and other adolescent health risk behaviors. A subsample of 939 was randomly selected to complete items about sexual violence. RESULTS: The results revealed that 8.4% of respondents were victims of attempted rape, while 5.8% were victims of actual rape. Ordinal logistic regression showed that girls were 3.9 times more likely than boys to have been victims of sexual abuse. Family structure was also significantly related to rape as persons who lived with a single parent (OR = 1.74, CI = 1.00-3.04) and those who resided with one biological parent and one step parent (OR = 2.59, CI = 1.34-5.01) were more likely to have been have been victims of sexual abuse than those living with both biological parents. Alcohol use (OR = 2.0, CI = 1.10-3.62), anti-social behavior (stolen property, caused physical damage to property, bullied others, or been in physical fights) (OR = 1.44, CI = 1.12-1.86), suicidal dialogue (OR = 2.48, CI = 1.19-5.19), and suicidal attempts (OR = 3.2, CI = 1.65-6.30) were also significant predictors of sexual abuse victimization. Racially classified social groups (RCSG), age, drug use, and cigarette smoking were not significant predictors of sexual abuse victimization, while socioeconomic status was found to be marginally significant. CONCLUSION: This study reinforces the importance of multiple factors including alcohol use, anti-social behavior, suicidal thoughts and actions, and family structure with respect to sexual assault of adolescents in South Africa. Establishing and strengthening intervention programs, school based child protective protocols, professional education of teachers and school personnel, community prevention programs, and initiatives could help prevent adolescent sexual violence and reduce the sequelae associated with this problem.     

Sexual consent in K–12 sex education: an analysis of current health education standards in the United States

In the USA, universities have recently developed policies and programmes on sexual consent education. But waiting until students enroll in higher education may be too late to begin this work. To examine the extent that K–12 health education standards promote sexual consent education, we conducted a pilot study and found that only two of eighteen states explicitly mentioned sexual consent in their health education standards. Using a small sample (n = 4 states), we then identified four themes as making implicit reference to sexual consent: communication skills, decision making, personal space and interpersonal relationships. Finally, in a robust sample (n = 18 states), we conducted a content analysis of published standards regarding these themes related to sexual consent. Our analysis suggests that sexual consent is likely not discussed in sex education at K–12 schools. We recommend the more explicit inclusion of sexual consent in health education curricula via the identified themes that already exist in most or all standards, emphasising the importance of teaching young people about the nuances of sexual consent and its communication before they become sexually active.     

Are parents reliable in reporting child victimization? Comparison of parental and adolescent reports in a matched Chinese household sample

There is ongoing debate about the reliability of parental reports on child victimization. Some studies have shown that they are useful, whereas some others have provided contrary evidence suggesting that parents are not accurate in reporting child victimization, especially when they are the one who inflicted the violence. This study aimed to (a) examine the reliability of parental reports of adolescents’ experiences of victimization, including that inflicted by parents as well as others, by comparing them with self-reports using a parent–child matched sample from China; and (b) explore the possible reasons underlying any disagreement between the parental and adolescent reports. A total of 2,624 parent–adolescent pairs were recruited during 2009 and 2010 in 6 cities in China. Parents were asked to report the victimization experiences of their child using of the Juvenile Victimization Questionnaire, and these reports were matched with the adolescents’ self-reports of victimization. Low levels of parent–adolescent agreement in reporting were found (Cohen's kappa = .04–.29). Except for sexual violence, parents were significantly less likely to report all types of victimization. Overall, lower levels of agreement were found in the reporting of (a) less severe types of victimization, (b) victimization outside the family, and (c) victimization involving parents as perpetrators. Intimate partner violence between parents was significantly associated with discrepancies between reports. The findings suggest that parents might not be reliable as a single source of information on certain types of adolescent victimization.     

‘Youth in a void’: sexuality,HIV/AIDS and communication in Kenyan public schools

The disappearance of traditional sex education during rites of passage in African societies has left many youth uncertain of where to look for information. Against this backcloth, the objectives of this study were to identify knowledge gaps amongst adolescents in Kenya regarding sexuality, HIV/AIDS and reproductive health. A thematic analysis was conducted of questions posed by 735 school youth aged 12–18 years from Meru and Kajiado Districts. Results show that many questions showed curiosity and anxiousness. Knowledge appeared to be fragmented and sometimes revealed misconceptions, which may put youth at risk. The raised themes differed by gender and age. Questions on saying no to sex, sexual violence and female circumcision were a great concern for girls. Boys were more concerned with managing boy–girl relationships, preventing STI/HIV infection, and condoms. Concern about transition to adulthood, sexuality, STI and HIV/AIDS, myths and misconceptions, and intergenerational communication cut across both genders. Older teens were more concerned with questions on boy–girl relationships, norms and values regarding sexuality, and STI. Younger teens ( < 15 years) wanted to know about reproduction, saying no to sex, HIV/AIDS, condoms, sexual violence and female circumcision. Compounding these challenges was the lack of intergenerational communication. The study identified important knowledge and communication gaps in sexual and reproductive health among in-school adolescents in Kenya. There is a need for sex education interventions for different age groups and genders. These interventions should work with parents, teachers and health professionals.