Understanding African American youth and adult perspectives on sex education in rural North Carolina

African American youth in the US rural South are at elevated risk for poor sexual health outcomes, including sexually transmitted infections and teenage pregnancy. Historically, the southeastern USA has lagged behind in providing comprehensive sexuality-based education in secondary school, which may contribute to poor reproductive and sexual health outcomes. This study aimed to understand the perspectives of African American youth and adults on comprehensive sexuality-based education in rural North Carolina. Twenty-four individuals (12 youth and 12 adults) participated in both semi-structured interviews and small discussion groups. Data were analysed and coded using inductive and deductive approaches to thematic analysis. Results indicated that comprehensive sexuality-based education was viewed as highly desirable; however, current efforts were seen as insufficient. While both young people and adults agreed that abstinence was the most desirable path for youth, participants also acknowledged young people’s autonomy in engaging in sexual activity and suggested that comprehensive sexuality-based education was needed to protect against unintended consequences. The findings of this study have practical implications for addressing challenges associated with providing sexuality-based education to African American youth in rural communities and offers suggestions regarding directions for future research

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

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

Adaptive Challenges, Adaptive Work, and Adaptive Leadership Among Women Living With HIV in the Southern United States: Findings From a Qualitative Study

Women living with HIV have a higher burden of non-AIDS comorbidities and prevalence of chronic conditions. The Adaptive Leadership Framework for Chronic Illness clarifies living with complex health challenges by delineating the technical work of health care providers as well as the adaptive work and leadership behaviors of patients and their providers. We conducted a descriptive, qualitative study of women residing in the Southern United States who were participating in the Women's Interagency HIV Study in North Carolina. Twenty-two participants (mean age = 52.2 years; 90.9% self-identifying as Black or African American) completed semi-structured qualitative interviews. We identified adaptive challenges (e.g., affective and disclosure challenges) and adaptive work and leadership behaviors. Women learned skills to care for their health and support their families and to work with their providers to manage their care. Findings support the importance of identifying leadership behaviors for the purpose of developing person-centered interventions

Exploring Resilience among Black Women Living with HIV in the Southern United States: Findings from a Qualitative Study

Black women living with HIV (WLWH) face individual and sociostructural challenges. Despite these challenges, many exemplify remarkable levels of resilience and coping. Yet, research on resilience and coping in this population is limited. Twenty Black WLWH in the Southern United States completed semi-structured interviews that explored challenges facing WLWH. We identified six themes related to resilience and coping: self-acceptance, disclosure, self-compassion, social support, will to live, and service. Of these, social support was a driving protective element and an essential component to building and sustaining resilience and coping. Women who experienced positive support often expressed a will to live as well as a desire to support other WLWH. Resilience and social support were characterized by patterns of reciprocity, in that they were mutually sustaining, stabilizing, and strengthening