Inclusive and Age-Appropriate Timing of Sexual Health Discussions at Home According to Gay, Bisexual, and Queer Adolescent Males

PURPOSE

The exclusion of gay, bisexual, and queer (GBQ) adolescent males' specific sexuality concerns in standard classroom education heightens the need for parents to be primary sources of trusted sexual health information. The aim of this study was to collect GBQ adolescent males' suggestions for a comprehensive list and age-appropriateness of topics that parents may use for inclusive discussions at home throughout the elementary, middle school, and high school years.

METHODS

Semistructured interviews and card sorts of 48 topics were conducted with a sample of 30 racial and ethnic diverse GBQ adolescents in central North Carolina. Thematic analysis of the interview transcripts and a calculation of card sort responses followed.

RESULTS

Topics chosen for elementary-age GBQ youth were focused on core issues about human anatomy, safety, and the continuum of sexual orientations and gender identities. Participants designated the majority of topics for home-based discussions in middle school and emphasized considerations for engaging in sex, relating with others socially, options for HIV/STI risk reduction, issues around interpersonal safety, and pleasure. They reserved topics for high school focused on complex sociorelational issues and technology-based concerns.

DISCUSSION

Participants' varied rationale for timing of topics centered on the age-appropriateness and level of details that they deemed acceptable for discussions with parents. To address disproportionate negative sexual and mental health outcomes noted in this youth subgroup, parents should focus on being supportive by providing factual and sequential information crucial for their GBQ childrens' anticipated developmental needs and sexual identity milestones.

Determinants of communication on sexual issues between adolescents and their parents in the Adaklu district of the Volta region, Ghana: a multinomial logistic regression analysis

BACKGROUND

Poor communication on sexual issues between adolescents and their parents results in high rates of negative sexual practices such as teenage pregnancy. Contributing factors to this poor communication on sexual issues between adolescents and their parents in a high teenage pregnancy setting have not been adequately explored. We sought to fill this gap by examining the factors that predict communication on sexual issues between adolescents and their parents in the Adaklu district of the Volta region of Ghana.

METHODS

A baseline cross-sectional household survey of 221 adolescents aged 10-19 years in 30 randomly selected communities was used. A well-structured questionnaire was developed. A multinomial logistic regression analysis was used to examine factors that significantly influenced communication between adolescents and their parents regarding sex.

RESULTS

Only 11.3% of adolescents had discussions on sexual issues with both parents while 27.6% of communicated sexual issues with only one parent in Adaklu district. Adolescent males (AOR = 0.21, CI = 0.06-0.75), those aged 10-14 years (AOR = 0.41, CI = 0.04-0.57), non-members of adolescent health clubs (AOR = 0.46, CI = 0.21-1.00), and those living with only a father (AOR = 0.19, CI = 0.06-0.61) had lower odds of communicating with their parents on sexual issues.

CONCLUSIONS

Adolescent-parental communication on sexual issues in Adaklu district is very low. This situation requires more empowerment of adolescents to enable them to discuss sexual issues with their parents through increased engagement with adolescent health club activities and capacity building capacity of parents with the right information on sexual and reproductive health by health staff within the district. Additionally, parents need to be equipped with communication skills to enable them to communicate effectively with their children.

Hispanic Mother-Daughter Communication About the Risks of Sex, Drugs, and Alcohol: Influences and the Strategies Mothers Use

PURPOSE

U.S. Hispanic adolescents are at risk for negative health outcomes due to risk-taking behaviors involving sex, drugs, and alcohol. Mother-daughter communication can reduce these risk-taking behaviors and reinforce parents' expectations. The purpose of this study was to explore mothers' descriptions of their communication about risk-taking behaviors with their early adolescent Hispanic daughters.

DESIGN AND METHODS

This qualitative descriptive study involved focus groups with 21 Hispanic mothers of 7th grade (12-14 years old) girls. Conventional content analysis was conducted to identify the strategies they used during these conversations.

RESULTS

Strategies mothers used included warning, focusing on negative consequences, creating opportunities to express maternal expectations, and stressing the importance of positive influences. Communication was also influenced by daughters' physical development and social media.

CONCLUSIONS

The mothers were concerned about their daughters' exposure to risk-taking behaviors but were unsure about how to talk to their daughters about how to avoid them, particularly regarding topics related to sex.

PRACTICE IMPLICATIONS

Our study results have implications on how to facilitate parent-child conversations about risk-taking behaviors and to equip mothers and parents to teach their children how to avoid engaging in these behaviors.

Family Characteristics in Sex Communication and Social Support: Implications for Emerging Adult Men Who Have Sex with Men's PrEP Engagement

While emerging adulthood (ages 18-25) is marked by increased independence from parents, parental support remains a strong correlate of positive sexual health outcomes for heterosexual youth. With the emergence of pre-exposure prophylaxis (PrEP), few studies have examined the potential for parent-child sex communication and PrEP adoption among emerging adult men who have sex with men (MSM). We aimed to describe the extent to which parents/family characteristics play supportive roles in emerging adult MSM's current PrEP use. PrEP-indicated participants (N = 222) were recruited via social media to complete an online survey. Multivariable logistic regression assessed associations between emerging adult MSM's current PrEP use and comfort with parent-child sex communication, family social support, family outness, and family prioritization, adjusted for sociodemographic variables. Thirty percent of participants reported current PrEP use. Only 20% reported moderate/high comfort with parent sex communication, 80% reported any family sexual identity disclosure, 70% reported moderate/high family social support, and 70% ranked family as a high/very high priority. Our multivariable model demonstrated an association between comfort with parent-child sex communication with current PrEP use only (AOR= 1.55, 95% CI 1.04-2.32). Our findings support that parents of emerging adult MSM possess a critical potential to reduce their sons' risk of HIV and promote PrEP uptake. Interventions that facilitate parents' efficacy to foster affirming, non-judgmental environments and discussions about their child's sexual behaviors, attractions/relationships, and health (e.g., PrEP) may be impactful in reducing the high HIV incidence rate that burdens emerging adult MSM.

Pathways from Resilient Coping to Safer Sex Communication Among African, Caribbean, and Black Women in Toronto, Canada: Results from a Cross-sectional Survey

PURPOSE

African, Caribbean, and Black (ACB) women in Canada are disproportionately impacted by HIV and other sexually transmitted infections. Although there is reported suboptimal consistent condom use with ACB women, limited research has explored safer sex communication among this population. Coping frameworks highlight the role that resilient coping and condom use self-efficacy may play in facilitating safer sex communication. Structural perspectives stress the need to explore associations between HIV vulnerabilities and food insecurity. We examined pathways from resilient coping to safer sex communication through the mediator of condom use self-efficacy among ACB women in Toronto.

METHOD

We conducted a cross-sectional survey with a purposive sample of ACB women aged 16 and older across Toronto, Canada. We conducted path analysis to test the direct effects of resilient coping on safer sex communication, and indirect pathways through the mediator (condom use self-efficacy) while controlling for food insecurity.

RESULTS

Participant (n = 80; mean age 27, SD 7.93) ethnicities included African (58.8%, n = 47), Caribbean (30%, n = 24), and others (11.3%, n = 9). Participants with food security reported significantly higher safer sex communication. We found no direct effect of resilient coping on safer sex communication. Findings support the hypothesized mediation process; resilient coping was associated with condom use self-efficacy, which in turn was associated with safer sex communication.

CONCLUSION

Findings that condom use self-efficacy mediated the association between resilient coping and safer sex communication align with theoretical assertions of the protective role of adaptive coping strategies. Findings can inform tailored HIV and STI preventive interventions with ACB women.