Attitudes that affect the ability of African American preadolescent girls and their mothers to talk openly about sex

The Continuum of Sexual and Reproductive Health Talk Types Daughters have with Mothers and Siblings

INTRODUCTION

Although sexual and reproductive health (SRH) is considered an important discussion topic for parents and their children, there is great variance in communication style and contradictory results on the effects of these contrasting styles. Research has explored SRH topics, yet still needs to investigate the types of parent-child SRH conversations to investigate how content gets relayed, and their effects, particularly among college-aged children.

METHODS

Data come from qualitative interviews in 2013 with 20 undergraduate Latina students about SRH conversations they had with their mothers and siblings.

RESULTS

Analysis revealed that mother-daughter SRH conversation types fell along a four-category continuum, irrespective of daughters' sexual practices, with open (n = 4) and no talk (n = 3) at the poles. The two middle categories, be careful (n = 6) and responsible sex (n = 7), were limited conversations that provided little guidance and tended to use risk language. Daughters in the no talk and be careful conversation categories tended to be more religious and have higher rates of sexual activity. Daughters' conversations with their siblings, particularly sisters, directly reflected the conversation types that they reported having with their moms.

CONCLUSIONS

Most daughters made assumptions about their mothers' statements and views due to the lack of straightforward communication and reported that most mothers did not alter their conversation styles to match their daughters' specific sexual histories. Moreover, these conversation styles could potentially affect the whole household due to siblings being other sources of sexual socialization and having talk types that reflected parental talk types, irrespective of siblings' sexual activity.

POLICY IMPLICATIONS

We recommend more attention and funding for SRH education programs that include extended family, especially siblings, given their importance in sexual socialization, and include college-aged children who still desire, and need, SRH information. Programs should equip parents and children with the tools to navigate multiple SRH conversations that evolve with and are sensitive to children's specific behaviors and circumstances.

Parents ASSIST: Acceptability and Feasibility of a Video-Based Educational Series for Sexuality-Inclusive Communication between Parents and Gay, Bisexual, and Queer Sons

Young men who have sex with men (YMSM) between the ages of 13 and 24 are a key population for HIV prevention. The parents of gay, bisexual, and queer (GBQ) adolescent males and the sex communication they have with their sons has yet to be explored as an HIV prevention intervention. We developed an online video series called Parents ASSIST (Advancing Supportive and Sexuality-Inclusive Sex Talks) to educate parents about sexual health topics pertinent to GBQ males. We pilot tested the series with a sample of 54 parents of GBQ males using a single-group post-test design. Participants viewed the videos and completed a survey measuring the acceptability and feasibility of an online video series to educate parents. Most of the parents (70.4%) believed that the videos would make parents more likely to initiate talking about sex with their sons. The results suggest that online videos are an acceptable way for parents to learn about GBQ sexual health topics.

Asian American Women's Recall of Conversations With Their Mothers About Sexual Health: A Secondary Analysis of Qualitative Data

ABSTRACT

Between 2010 and 2016, Asian Americans (AA) had a 35% increase in HIV diagnosis. Although mother-daughter sexual communication was found to be protective in minority populations, the opposite is true among AAs. The purpose of this study was to explore AA women's experiences of sexual communication with their mothers. Secondary qualitative analysis using analytic expansion with a phenomenological approach was used. Thematic analysis was used to search for common patterns and themes that emerged using qualitative description methodology. Twenty East and Southeast AA cisgender women, ages 18-33 years, were interviewed. The primary finding was an intergenerational gap with two themes: (a) mothers' attitudes about sexual communication and (b) content of sexual communication. Indirect sexual communication included cautionary messages consistent with previous studies. AA mothers' strong cultural beliefs created a barrier to communication. Future research should focus on the young women who want open sexual communication and could influence the next generation.

Sex behaviours and family sexuality communication among Hispanic adolescents

This study compared the extent to which Hispanic teenagers talk with mothers, fathers and extended family members about risks of sex, protection and relational sex, as well as the moderating role of teenagers' gender on the association between sexuality communication and risky sexual behaviours. Analysis is based upon 474 Hispanic young people's responses to a school-based survey recruited from six New England high schools. We (1) calculated descriptive statistics and tests of difference by teenagers' gender, and (2) ran logistic regression models for three sexual behaviours (vaginal sex, oral sex and number of sex partners) separately by gender. There were significant gender differences in teenagers' talk with mothers and fathers, but not extended family members. There was consistent "gender matching" between teenagers and the extended family member they talked to. The content of sexuality communication, the family member the teenager talked to and the gender of the teenager all contributed to whether communication was protective for teenagers' sexual behaviour. There are substantial differences in the types of sexuality communication Hispanic teenagers have with different family members, which are closely tied to teenager's and the family member's gender. Results suggests that one size does not fit all when it comes to family communication about sex and sexuality.

A scoping review: The utility of participatory research approaches in psychology

Consistent with community psychology's focus on addressing societal problems by accurately and comprehensively capturing individuals' relationships in broader contexts, participatory research approaches aim to incorporate individuals' voices and knowledge into understanding, and responding to challenges and opportunities facing them and their communities. Although investigators in psychology have engaged in participatory research, overall, these approaches have been underutilized. The purpose of this review was to examine areas of research focus that have included participatory research methods and, in turn, highlight the strengths and ways that such methods could be better used by researchers. Nearly 750 articles about research with Indigenous Peoples, children/adolescents, forensic populations, people with HIV/AIDS, older adults, and in the area of industrial-organizational psychology were coded for their use of participatory research principles across all research stages (i.e., research design, participant recruitment and data collection, analysis and interpretation of results, and dissemination). Although we found few examples of studies that were fully committed to participatory approaches to research, and notable challenges with applying and reporting on this type of work, many investigators have developed creative ways to engage respectfully and reciprocally with participants. Based on our findings, recommendations and suggestions for researchers are discussed.

"You've Gotta be Careful": Familial Messages Regarding Sexual Behavior and Sexual Relationships among African American Adolescents

BACKGROUND

Research on the sexual behaviors of African American youth has primarily focused on associated risks, with a dearth of studies examining a fuller representation of African American adolescents' sexual lives. This study explored the range of messages African American adolescents receive from family members regarding sexual behavior and sexual relationships.

METHODS

Participants were 52 sexually experienced African American youth (male = 32, female = 20) between the ages of 15 and 17 recruited from community-based organizations in the United States. Youth participated in individual in-depth qualitative interviews, and data were analyzed using a phenomenological framework.

RESULTS

Participants received a variety of messages about sexual behavior and sexual relationships from a range of family members including parents, siblings, grandmothers, aunts/uncles, and cousins. Types of messages clustered into three domains: sexual decision-making, quantity and quality of sexual activity, and sexual health promotion; with themes and sub-themes emerging within each area.

CONCLUSION

Gender differences in the types of messages received are explored, and applications of the findings to the development of family-involved community interventions that promote sexual and reproductive health are discussed.

Youth Perspectives on Sexuality Communication With Parents and Extended Family

OBJECTIVE

To explore extended-family sexuality communication and compare it with parent sexuality communication.

BACKGROUND

Family communication about sex can protect teens from sexual risk behavior. However, most studies on this topic focus exclusively on the parent-teen dyad; few capture the broader context of teens' family communication.

METHOD

Using a mixed-methods approach, a convenience sample of 22 teens from diverse racial and ethnic backgrounds were interviewed. Participants were asked to identify family members with whom they talk about sex and relationships, topics discussed, messages shared, and the teens' comfort talking about sex and relationships. Thematic analysis was used to explore participants' shared meanings and experiences.

RESULTS

Eighty-six percent of teens reported talking with both parents and extended family about sex. Teens were more likely to report that parents than extended family shared messages about delaying sex and avoiding teen pregnancy and gave advice or shared information about sex. Teens were more likely to view extended family than parents as easy to talk with and as having shared life experiences, and some reported avoiding talk with parents about issues related to sexuality due to feeling awkward or fearing a negative reaction.

CONCLUSION

Extended family may play a somewhat different role than parents in teens' sexuality communication, but family members showed a largely common set of family values.

IMPLICATIONS

Extended family may be a valuable teen resource for sexuality communication, particularly when teens feel uncomfortable talking with parents.

The birds and the bees: do Puerto Rican mothers and daughters talk about sex?

Introduction

Effective communication skills that foster responsible sexual decisions are known to have the potential to reduce the risky adolescent sexual behavior. It is well understood that maternal communication is a key element in modifying the adolescent sexual behavior. The objective of this qualitative study was to explore if Puerto Rican mothers of adolescent girls have conversations about sexuality with their daughters and the content of such conversations.

Methods

A total of 22 HIV-seropositive mothers and 22 HIV-seronegative mothers were enrolled. Six focus groups were conducted, sessions were transcribed ad-verbum and coded for specific topics. All qualitative analysis was incorporated into Atlas.ti.

Results

Participants in both groups had a similar average age (mean=41 years old); but, the HIV-seropositive mothers were more likely single, less educated and unemployed. Regarding having engaged in conversations about sexuality and the topics covered, however, there were no differences revealed among HIV-seropositive mothers and seronegative mothers. In both groups, mothers understood the importance of these conversations, but most said they were difficult and uncomfortable.

Conclusion

These findings reinforce the importance of communication between mothers and daughters for the prevention of STIs, HIV/AIDS, and teenage pregnancy in minority populations.Interventions are needed for mother and daughter to improve communication skills, communication about sexuality, and addressing prevention.

21st Century Parent-Child Sex Communication in the United States: A Process Review

Parent-child sex communication results in the transmission of family expectations, societal values, and role modeling of sexual health risk-reduction strategies. Parent-child sex communication's potential to curb negative sexual health outcomes has sustained a multidisciplinary effort to better understand the process and its impact on the development of healthy sexual attitudes and behaviors among adolescents. This review advances what is known about the process of sex communication in the United States by reviewing studies published from 2003 to 2015. We used the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, SocINDEX, and PubMed, and the key terms "parent child" AND "sex education" for the initial query; we included 116 original articles for analysis. Our review underscores long-established factors that prevent parents from effectively broaching and sustaining talks about sex with their children and has also identified emerging concerns unique to today's parenting landscape. Parental factors salient to sex communication are established long before individuals become parents and are acted upon by influences beyond the home. Child-focused communication factors likewise describe a maturing audience that is far from captive. The identification of both enduring and emerging factors that affect how sex communication occurs will inform subsequent work that will result in more positive sexual health outcomes for adolescents.

Adapting cognitive interviewing for early adolescent Hispanic girls and sensitive topics

Cognitive interviewing is a research technique commonly used in survey research to improve measurement validity. However, this technique is useful to researchers planning to use self-report measures in intervention research because invalidity of such measures jeopardizes detection of intervention effects. Little research currently exists regarding the use of cognitive interviewing techniques with adolescent populations, particularly those who are Hispanic. This article describes common challenges to conducting cognitive interviewing with early adolescent girls and how these challenges are impacted by Hispanic culture and sensitive topics. A focus group approach is recommended over the traditional one-on-one cognitive interview format, and experiences from actual focus groups conducted in preparation for an intervention study are used to illustrate strategies for accomplishing the goals of cognitive interviewing. Creative and careful planning, attention to developmental considerations, and incorporation of cultural values are essential to the success of this approach.

Condoms and Connection: Parents, Gay and Bisexual Youth, and HIV Risk

The family has long been considered a powerful influence on youth's high-risk behaviors. However, little is known about preventive family influences for gay and bisexual youth, a group at high risk for HIV infection. For this study, qualitative interviews from a sample of 38 gay and bisexual youth and their parents/guardians underwent a thematic analysis. Youth described parent-child closeness, parental warnings, and urgings to use condoms as influences. Youth denying family influence came from families in which parent-child relationships were disrupted or HIV-related discussion was lacking. Most families reported discomfort discussing HIV risk. These findings, along with a case example, suggest how family therapists can enhance parental influence by helping these families strengthen their relationships and discuss this important topic. Video Abstract.

Will it help? Identifying socialization discourses that promote sexual risk and sexual health among African American youth

Because much of the existing research examining sexual communication to African American youth focuses on demographic and parental factors predicting sexual risk behaviors, less is known about factors predicting sexual health, and little is understood about the contributions of peer communications. The current study aimed to expand existing approaches by assessing which socialization discourses communicated by parents and peers contribute to sexual risk and health outcomes (sexual assertiveness, positive sexual affect, and condom self-efficacy). Participants were 631 African American undergraduates (73% female) who indicated the extent to which they had received from their parents and peers each of 28 messages representing four cultural discourses: abstinence, relational sex, sex positive, and gendered sexual roles. As expected, parents were perceived to emphasize relational sex and abstinence messages more than peers, and peers were perceived to communicate sex-positive and gendered sex role messages more than parents. Greater exposure to abstinence messages predicted lower levels of sexual experimentation, whereas exposure to sex-positive messages predicted higher levels. In addition, exposure to relational sex and sex-positive messages predicted higher levels of sexual assertiveness and positive sexual affect. Implications are discussed concerning sexual communications that could help Black youth develop healthy sexual perspectives.

Adolescents' Views Regarding Uses of Social Networking Websites and Text Messaging for Adolescent Sexual Health Education

BACKGROUND: Adolescents frequently report barriers to obtaining sexual health education. PURPOSE: The purpose of this study was to determine adolescents' views regarding how new technologies could be used for sexual health education. METHODS: Focus groups were conducted with a purposeful sample of adolescents between 14 and 19 years old. Facilitators asked participants for their views regarding use of social networking web sites (SNSs) and text messaging for sexual health education. Tape-recorded data was transcribed; transcripts were manually evaluated then discussed to determine thematic consensus. RESULTS: A total of 29 adolescents participated in 5 focus groups. Participants were 65.5% female. Three themes emerged from our data. First, adolescents preferred sexual health education resources that are accessible. Second, adolescents preferred online resources that are trustworthy. Third, adolescents discussed preference for "safe" resources. DISCUSSION: Adolescents were enthusiastic and insightful regarding technology for enhancing sexual health education. The themes that influence adolescents' preferences in sexual health education using technology are similar to barriers that exist in other aspects of adolescent health communication. TRANSLATION TO HEALTH EDUCATION PRACTICE: Findings suggest ways in which health organizations can understand adolescents' views and concerns about how their interactions with professionals take place regarding sexual health.

"I got caught up in the game": generational influences on contraceptive decision making in African-American women

PURPOSE

Reproductive health disparities are a significant issue for African-American adolescents. This study was designed to explore the cross-generational influences on adolescent sexuality in a cohort of daughters/granddaughters of U.S. born African-American women.

DATA SOURCES

Data were generated through interviews with triads of African-American women: grandmothers, and their daughters and granddaughters, to gain insight into the phenomena of early sexual debut, high rates of unintended pregnancies, HIV/AIDS, and other sexually transmitted infections from a cross-generational perspective.

CONCLUSIONS

Six themes emerged from the data: southern influences; a worldview of relationships; communication-key to preparedness; seeking information from mom; "I got caught up in the game"; and contraceptive use and beliefs. In this sample, mothers' and grandmothers' culture, values, and beliefs significantly influenced the adolescents' sexual and reproductive decision making.

IMPLICATIONS FOR PRACTICE

Clinicians' knowledge of African-American culture, beliefs, and family values is key when providing guidance about contraception to these young women.

"It Takes a Village:" Familial Messages Regarding Dating Among African American Adolescents

There is a dearth of research regarding the influence of family members on adolescent dating. This study explored messages that African American adolescents received from family members regarding dating attitudes, norms and behaviors. Qualitative interviews were conducted with sexually experienced urban African American heterosexual adolescents (N = 51) between the ages of 15-17. Analyses revealed that participants received a diversity of messages from a range of both nuclear and extended family members, and that these messages were organized around three temporal phases of dating: initiation, maintenance, and termination. Types and sources of messages are discussed, as well as implications for intervention development.

Gender, sex, and HIV: how well are we addressing the imbalance?

PURPOSE OF REVIEW

Heightened interest in sex and gender differences in HIV warrant a review of the status of current understanding of their determinants and progress in addressing them.

RECENT FINDINGS

The proportion of women among people living with HIV continues to increase in most countries; however, women are proportionately more likely to be on antiretroviral treatment than are men. Inadequate representation of women in clinical trials is compounding the dearth of information on sex-based differences in response to life prolonging antiretroviral medication. Progress in addressing gender inequalities and inequities, though incremental, is too slow to reach Millennium Development Goal 6 of halting and reversing the HIV epidemic by 2015. Structural determinants, such as food insufficiency, poverty, decreased access to credit, and inequitable inheritance practices, continue to act with social gender norms to shape the increased risk of exposure to HIV that women and adolescent girls face in many settings.

SUMMARY

Special measures should be taken to overcome barriers and facilitate enrolment and retention of women in biomedical HIV prevention and treatment trials. Law reform, economic empowerment, gender transformative work, and political mobilization are needed if women and men are to share the power, influence, rights, responsibilities, and opportunities that can create resilience to HIV.

The hopes and dreams of Honduran women regarding their daughters' sexuality

In Tegucigalpa, the capital city of Honduras, 22 local women participated in two focus groups. This article was written to give voice to these native Honduran women's unique perspective on their sexuality. We used a phenomenological qualitative approach, and asked them what sexual advice mothers have for their daughters. Data gathering and analysis were conducted using the principles of consensual qualitative research. These sessions were recorded, transcribed, and analyzed for themes. Primary themes include the participants' cultural understanding of respect, women's control of sexual discourse, the role of mothers as protectors, and women's sexual power, attachment, and desire.

School nurses and sex education: surveillance and disciplinary practices in primary schools

AIM

This paper is a report of a study to explore how school nurses perceive the influence of schools on their role in delivering sex and relationship education in primary schools.

BACKGROUND

School nurses play a key role in sex education in English schools. However, sex education is a contentious issue meaning the sex education of children is often an area of tension within the curriculum. However, the impact of these tensions upon school nursing practice is poorly described.

METHOD

Three focus groups with a convenience sample of 16 nurses experienced in conducting sex and relationship education were conducted during 2006. Focus groups were audio-taped, transcribed verbatim and subjected to a thematic analysis.

FINDINGS

Four themes were identified in the data: 'covert surveillance' refers to school staff conducting clandestine surveillance of the classroom actions of the nurse; 'overt surveillance' reflects how nurses felt they were being openly monitored by teachers in the classroom; 'Teacher attitude' refers to the interventions of the supervising teacher in the classroom during the sex education session and 'resistance practices' detailed how nurses attempted to manage the disciplinary practices of the school.

CONCLUSION

School nurses need to be pragmatic about the fact that there will be some attempts by the school to regulate sex education. Developing an early dialogue with the school can mediate this. Closer working practices and the involvement of school nurses in the development of sex education policy and practice is vital to ensure that they continue to make a valuable contribution to sex education in schools.