Predictors of Caregiver Communication About Reproductive and Sexual Health and Sensitive Sex Topics

Numerous studies examining parent–teen communication about sex (PTCS) have focused on reproductive and sexual health information (i.e., pregnancy, physical development, contraception), with significantly fewer addressing communication about sensitive sex topics (i.e., sexual pleasure, masturbation). This study compares predictors of communication about reproductive and sexual health to those of sensitive sex topics with early adolescents. Participants were 465 rural caregivers and their African American youth. Positive attitudes and self-efficacy for PTCS, open communication style, and older youth age predicted caregiver reports of communication about reproductive and sexual health topics. Open communication style and self-efficacy for PTCS predicted caregiver reports of communication about sensitive sex topics. For youth, only older age and being female predicted communication about reproductive and sexual health, while only being female predicted communication about sensitive sex topics. This study may inform interventions that seek to increase PTCS by highlighting strategies for improving communication about both reproductive and sensitive sex topics

How Does Pubertal Development Impact Caregiver-Adolescent Communication About Sex in Rural, African American Families? An Examination of Mediation Effects

This study examined the relationship between pubertal development and type of caregiver-adolescent communication about sex (CACS) among 441 African American caregivers participating in an intervention trial in rural North Carolina. We assessed CACS about general sexual health topics and positive aspects of sexuality. Caregivers’ attitudes and self-efficacy for CACS, and open communication style were examined as potential mediators. Caregivers engaged in low levels of communication about sex regardless of type. Among caregivers of males, pubertal development was associated with greater communication about general sexual health, which was mediated by self-efficacy for CACS. Among caregivers of females, pubertal development was associated with less communication about general and positive sexual health topics; however, there were no mediating factors. These findings highlight the predictors of CACS among young men and women after pubertal onset. Age appropriate, practical guidance for initiating CACS may be critical for ensuring caregiver talk about sex

Views of young, rural African Americans of the role of community social institutions in HIV prevention.

BACKGROUND: We explored rural African American youths' perceptions about the role of community social institutions in addressing HIV. METHODS: We conducted four focus groups with African Americans aged 16 to 24 years in two rural counties in North Carolina. Groups were stratified by gender and risk status. We used a grounded theory approach to content analysis. RESULTS: Participants identified four social institutions as primary providers of HIV-related health promotion efforts: faith organizations, schools, politicians, and health agencies. They reported perceiving a lack of involvement in HIV prevention by faith-based organizations, constraints of abstinence-based sex education policies, politicians' lack of interest in addressing broader HIV determinants, and inadequacies in health agency services, and viewed all of these as being counter-productive to HIV prevention efforts. CONCLUSIONS: Youth have important insights about local social institutions that should be considered when designing HIV prevention interventions that partner with local organizations

Understanding the Relationship between Religiosity and Caregiver–Adolescent Communication About Sex within African-American Families

Caregiver–adolescent communication about sex plays a critical role in the sexual socialization of youth. Many caregivers, however, do not engage their youth in such conversations, potentially placing them at risk for negative sexual health outcomes. Lack of caregiver–adolescent communication about sex may be particularly harmful for rural African American youth, as they often report early sex initiation and are disproportionately impacted by STIs. Moreover, sexual communication may be particularly challenging for families with strong religious backgrounds, potentially affecting the occurrence and breadth of topics covered during communication. Study aims were to: determine whether there was a relationship between caregiver religiosity and type of topics covered during communication about sex (e.g., general sexual health vs. positive aspects of sexuality) among 435 caregivers of early adolescent, African American youth; and if so, identify factors that might explain how religiosity affects communication about sex. Results indicated that caregiver religiosity was positively associated with communication about general, but not positive aspects of sexuality for caregivers of males. Attitudes towards communication about sex and open communication style mediated the relationship. There was no association between religiosity and communication about sex for caregivers of females. The findings from this study could provide a base to better understand and support the sexual socialization process within religious, African American families

Evaluating Teach One Reach One - An STI/HIV Risk-Reduction Intervention to Enhance Adult-Youth Communication About Sex and Reduce the Burden of HIV/STI

Purpose: Parents and caregivers play an important role in sexual socialization of youth, often serving as the primary source of information about sex. For African American rural youth who experience disparate rates of HIV/sexually transmitted infection, improving caregiver-youth communication about sexual topics may help to reduce risky behaviors. This study assessed the impact of an intervention to improve sexual topic communication. Design: A Preintervention-postintervention, quasi-experimental, controlled, and community-based trial. Setting: Intervention was in 2 rural North Carolina counties with comparison group in 3 adjacent counties. Subjects: Participants (n = 249) were parents, caregivers, or parental figures for African American youth aged 10 to 14. Intervention: Twelve-session curriculum for participating dyads. Measures: Audio computer-assisted self-interview to assess changes at 9 months from baseline in communication about general and sensitive sex topics and overall communication about sex. Analysis: Multivariable models were used to examine the differences between the changes in mean of scores for intervention and comparison groups. Results: Statistically significant differences in changes in mean scores for communication about general sex topics (P <.0001), communication about sensitive sex topics (P <.0001), and overall communication about sex (P <.0001) existed. Differences in change in mean scores remained significant after adjusting baseline scores and other variables in the multivariate models. Conclusions: In Teach One Reach One intervention, adult participants reported improved communication about sex, an important element to support risk reduction among youth in high-prevalence areas