The Influence of Parental Communication and Perception of Peers on Adolescent Sexual Behavior

Sex differences in the association of childhood sexual abuse severity with premarital sex among Chinese college students in Luzhou, China

PURPOSE

The adverse health consequences of premarital sex and childhood sexual abuse (CSA) are both global public health problems. Based on a random sample of college students from a Chinese city, this study investigated the relationship between CSA severity and premarital sex among students, focusing on sex differences.

METHODS

A total of 2722 college students from 4 schools in Luzhou were recruited by multistage random sampling. Self-administered questionnaires were used to measure CSA experiences and premarital sex. Binary logistic regression analyses were conducted to analyse the relationship between CSA and premarital sex.

RESULTS

The prevalence of CSA was 9.39%, and that of mild, moderate and severe CSA was 4.04%, 2.90% and 2.46%, respectively. The premarital sex reporting rate was 22.42%. After adjusting for confounding variables, CSA was positively associated with premarital sex. Notably, a cumulative effect of CSA on premarital sex was observed among students. Further stratification analyses showed that males who experienced CSA had a higher premarital sex rate than females, and this sex difference was also observed among students with different CSA severities.

CONCLUSION

CSA and its severity were associated with premarital sex among college students. Furthermore, this association was stronger for males than females. Therefore, it is important to emphasize CSA prevention, especially for boys. These findings can promote understanding of the effects of CSA on premarital sex, and CSA prevention and intervention strategies should consider CSA severity and sex differences.

The Impact of Parent-Adolescent Communication on Reduction of Sexual Risk Possibility Among Adolescents: Findings from the Suubi-Maka Study

Sexual risky behaviors among adolescents and young people remain a major public health problem worldwide. This study examined the impact of parent-adolescent communication on adolescents' possibility to engage in risky behaviors. The study used baseline data from the Suubi-Maka Study (2008-2012) implemented in 10 primary schools in Southern Uganda. Binary logistic regression models were conducted to determine the association between parent-adolescent communication and sexual risk possibility. Results indicate that gender [OR 0.220, 95% CI 0.107, 0.455], age [OR 1.891, 95% CI 1.030, 3.471], household size [OR 0.661, 95% CI 0.479, 0.913], and comfort level of family communication [OR 0.944, 95% CI 0.899, 0.990] were significantly associated with lower levels of sexual risk possibility among adolescents. There is a need to build interventions that make it easy and comfortable for adolescents to have open discussion and communication with parents on sexual risk possibility, risky behaviors, and risky situations.

Attitudes and risky sexual behavior among youth in Kampala, Uganda: Empirical analyses of risk factors by gender

OBJECTIVE

This study sought to examine gender differences and the influence of peer and parental perceptions on sexual risk behaviors among an at-risk sample of youth living in Kampala, Uganda.

METHODS

Using the cross-sectional Kampala Youth Survey (2014) based in Kampala, Uganda (n = 1134), bivariate and multivariable logistic regressions were conducted to determine the odds of sexual risk behaviors based on peer and parental influence variables and gender.

RESULTS

The perceptions of peer, adult, and parental opinions on sexual activity were significantly associated with varying levels across all risky sexual behaviors explored. When indexed and adjusted for other variables, females compared to males were at increased odds of participating in 3-4 risky sexual behaviors (OR: 0.63, 95% CI: 0.44, 0.90) and 5-6 risky sexual behaviors (OR: 0.38, 95% CI: 0.21, 0.68) compared to zero risky sexual behaviors.

CONCLUSIONS

Adolescent sexual risk behaviors are subject to peer and parental influence and vary between genders.

INNOVATION

This study emphasizes the importance of peer influences in adolescent sexual risk behaviors. Many of these youth are orphans, which may explain the lack of association between parental influences and sexual risk behavior. School-based and community-based interventions may be effective at preventing risky sexual behaviors for this vulnerable population.

Being fast or cautious? Sociocultural conditions influencing the sexual pathways of Black females in the United States

BACKGROUND

Black females in the United States face unique sociocultural conditions that impact their sexual development and increase their risk for sexually transmitted infections (STI), including but not limited to chlamydia, gonorrhea, and HIV. Research has not adequately explained how sociocultural conditions contribute to this increased risk. The purpose of our investigation was to explore the sociocultural conditions that influence Black cisgender females risk for STI.

METHODS

This grounded theory study involved in-depth audio-recorded interviews with 20, primarily heterosexual, Black females ages 19-62.

RESULTS

Findings informed a conceptual model that builds on previous theory about the sexual development of Black females and explains how sociocultural conditions impact two, participant identified, sexual pathways: Fast and Cautious. Movement on these sexual pathways was not always a linear trajectory; some participants shifted between pathways as their sociocultural contexts changed (i.e., sexual assault, STI, and level of protection). The Fast sexual pathway often led to greater STI risk.

CONCLUSIONS

This model may inform future research designed to prevent STI/HIV and promote the sexual health of Black females across the life course.

Relationship between childhood sexual abuse and attitudes toward premarital sexual permissiveness among middle school students in Luzhou, China

BACKGROUND

In recent years, the number of adolescents engaging in premarital sex has increased, and an increasing number of childhood sexual abuse (CSA) cases have been reported in China. Many studies have indicated that CSA has a well-established association with risky sexual activities. However, only a limited number of studies have explored possible reasons for this association among middle school students, a population that may engage in premarital sex, which is critical for the development of interventions to prevent risky sexual behavior. Based on random samples of middle school students from a Chinese city, this article investigated the relationship between CSA and students' premarital sexual permissiveness (PSP).

METHODS

In a cross-sectional study conducted between 2016 and 2017 in Luzhou, China, 2292 middle school and high school students aged 12-18 years were recruited by multistage random sampling. All students were administered anonymous questionnaires. Multiple linear regression and binary logistic regression analyses were conducted to analyze the relationship between CSA and PSP.

RESULTS

The prevalence of CSA was 15.4% (354/2292; 95% CI: 14-16.9%). A higher percentage of male respondents (18.2%) than female respondents (12.9%) had experienced CSA. A positive association between CSA and PSP was found among students. Respondents who had suffered CSA exhibited greater PSP, and this relationship was observed in the male sample, female sample and the total student sample in Luzhou (β = - 3.76, P < 0.05; β = - 2.79, P < 0.05; and β = - 2.84, P < 0.05, respectively). Respondents who had suffered CSA were also more likely to express a double standard about premarital sex (odds ratio [OR] =1.41, P < 0.05), especially among male students (odds ratio [OR] =1.63, P < 0.05).

CONCLUSIONS

Sex differences in CSA and the relationship between CSA and PSP were significant among this large sample of middle school students in Luzhou (China). The findings suggest that experiencing CSA may be closely related to youth attitudes toward premarital sex, especially among males. Therefore, it is important to emphasize the prevention of CSA and provide adolescent reproductive health programs to reduce the impact of CSA on sexual cognition and attitude, prevent premarital sex and promote positive attitudes toward sexual equality for middle school students.

Relationship between Perceived Peer and Adolescents' Sexual Behaviors: The Moderating Role of Gender

In Malaysia, sexual health risks such as unprotected sex, teenage pregnancies, abandoned babies, abortion, and sexually transmitted diseases are on the rise because adolescents are increasingly engaging in such sexual behaviors. The present study aimed to investigate the relationship between perceived peer sexual behaviors and sexual behaviors among adolescents as well as to examine the interacting role of gender in such a relationship. This cross-sectional study recruited a sample of 338 school-going adolescents (M_age = 16.7; SD_age = 1.53) using the purposive sampling method. Participants were required to complete questionnaires consisting of the modified Human Sexuality Questionnaire-Orgasmic Experience Scale and the Peer Norms Scale. Results indicated that adolescents who perceived their peers to be actively engaging in sexual behaviors were more prone to being sexually active themselves. The results also showed gender as a significant moderator in the relationship between adolescents' perceived peers' sexual behaviors and sexual behaviors. Besides, the impact of perceived peer sexual behaviors on sexual behaviors was found to be stronger in male than female adolescents. Overall, the findings from this study hinted at the importance of peers and gender differences during the planning and implementation of sexual and health education.

Exploring Parent-gender Differences in Parent and Adolescent Reports of the Frequency, Quality, and Content of Their Sexual Health Communication

Parent-adolescent sexual health communication (SHC) is a protective factor that can reduce adverse adolescent sexual health outcomes, and the frequency, quality, and content of SHC predicts its effectiveness. However, research on this topic has been limited in scope, overwhelmingly focused on mothers; and often has only included the parent or adolescent perspective, not both members of the dyad. Using secondary cross-sectional data, this study used ANCOVA, logistic regression, correlational, and chi-square analyses to investigate parent-gender differences in parent-adolescent SHC. Participants included 341 parent-adolescent dyads. Compared to fathers, mothers rated parent-adolescent SHC as more important and more comfortable, and had greater self-efficacy for and fewer reservations about SHC than fathers. Mothers also reported talking more frequently and more broadly with their child about sexual health than fathers. Adolescent-reported frequency, quality, and content of parent-adolescent SHC did not differ significantly by parent gender, except for one sexual health topic. Dyadic analyses revealed that mothers and their children tended to agree more in their reports of parent-adolescent SHC than fathers and their children. These findings suggest that fathers may need additional resources to help them confidently engage in effective parent-adolescent SHC.

Exploring sexual awareness and Decision-making among adolescent girls and boys in rural Nicaragua: A socio-ecological approach

OBJECTIVE

To explore how individual, relational, and social contexts influence adolescents' sexual awareness and decision-making in rural Nicaragua.

METHODS

Eighteen semi-structured interviews were conducted with adolescent boys and girls aged 15 to 19 years. Thematic analysis identified patterns of meaning applying a socio-ecological approach. A thematic map illustrates how the themes are organized according to the socio-ecological model and suggests their interactions.

RESULTS

Six main themes emerged as (1) Adolescence - a period of life changes, (2) Fears as a pathway to awareness and decision-making, (3) Awareness about protective measures, (4) Relational influences on adolescents' sexual health, (5) Service provision and institutional influences on awareness and decision-making and (6) Sociocultural determinants on adolescent sexual health. Informants of both genders expressed concern in several issues of their sexuality. They identified fear of pregnancy, STIs, and their impact on future goals, family communication, and school-based sexual education as protective factors for their sexual decision-making. Adolescents of both genders are challenging social and cultural norms by developing sexual agency.

CONCLUSION

These findings imply that personal and societal factors in rural Nicaragua produce a multi-dimensional effect on adolescent sexual self-efficacy. Our study is relevant for a wider discussion about sexual awareness to promote positive development and health outcomes particularly among adolescents' girls and boys living in rural settings.

Theory-Based Behavioral Intervention Increases Mother-Son Communication About Sexual Risk Reduction Among Inner-City African-Americans

PURPOSE

African-American adolescent males are at increased risk for HIV, yet there are few sexual risk-reduction interventions targeting this population. Interventions that include mothers can influence parentingbehaviors and in turn, reduce risky behaviors in adolescents. This study tests the efficacy of the Mother-Son Health Promotion Project at increasing mother-son communication about sexual risk reduction.

METHODS

African-American mothers with their sons (ages 10-15 years) residing in public housing in Philadelphia, Pennsylvania were randomized into a HIV/sexually transmitted infections risk-reduction intervention consisting of 16 1-hour modules or an attention-matched health-promotion control intervention.Mothers and sons completed surveys pre-intervention, immediately postintervention, and at 3-, 6-, 12-, 18- and 24-months postintervention.

RESULTS

Of 525 mother-son dyads, 366 (69.7%) completed the 24-months postintervention follow-up survey. Generalized-estimating-equations models using both mothers' and sons' reports revealed that over 24 months, mothers and sons in the HIV/sexually transmitted infections risk-reduction intervention were more likely to communicate about sexual health, including sexual intercourse, birth control, HIV/AIDS prevention, and condoms. Intervention efficacy was found to weaken over time.

CONCLUSIONS

This culturally grounded, theory-based intervention was efficacious in increasing mother-son communication about sexual risk reduction. The work highlights the value of the intervention toincrease parental protective factors, including communication by mothers, to decrease HIV risk behaviors of African-American adolescent males.

Sexual Health Knowledge, Self-Efficacy and Behavioral Intentions Following a Health Fair for Adolescents

High rates of human immunodeficiency virus (HIV) exist among urban African American youth. There is a need to provide HIV information to youth prior to the onset of sexual activity. The Stomping Out HIV intervention combines a health fair and step show to increase awareness and healthy behaviors among this population. Questionnaires were administered to youth and parents before and after Stomping Out, and focused on health knowledge, satisfaction with Stomping Out, intended behavior changes and self-efficacy to make healthier choices related to HIV and STI prevention. Youth and adults reported increased knowledge and self-efficacy after Stomping Out. These findings suggest that health initiatives focusing on sociocultural issues can greatly impact adults and youth.

Identification of Key Beliefs Explaining Male Circumcision Motivation Among Adolescent Boys in Zimbabwe: Targets for Behavior Change Communication

Male circumcision (MC) significantly reduces HIV acquisition among men, leading WHO/UNAIDS to recommend high HIV and low MC prevalence countries circumcise 80% of adolescents and men age 15-49. Despite significant investment to increase MC capacity only 27% of the goal has been achieved in Zimbabwe. To increase adoption, research to create evidence-based messages is greatly needed. The Integrated Behavioral Model (IBM) was used to investigate factors affecting MC motivation among adolescents. Based on qualitative elicitation study results a survey was designed and administered to a representative sample of 802 adolescent boys aged 13-17 in two urban and two rural areas in Zimbabwe. Multiple regression analysis found all six IBM constructs (2 attitude, 2 social influence, 2 personal agency) significantly explained MC intention (R² = 0.55). Stepwise regression analysis of beliefs underlying each IBM belief-based construct found 9 behavioral, 6 injunctive norm, 2 descriptive norm, 5 efficacy, and 8 control beliefs significantly explained MC intention. A final stepwise regression of all the significant IBM construct beliefs identified 12 key beliefs best explaining intention. Similar analyses were carried out with subgroups of adolescents by urban-rural and age. Different sets of behavioral, normative, efficacy, and control beliefs were significant for each sub-group. This study demonstrates the application of theory-driven research to identify evidence-based targets for the design of effective MC messages for interventions to increase adolescents' motivation. Incorporating these findings into communication campaigns is likely to improve demand for MC.

A systematic review and qualitative synthesis of adolescents' views of sexual readiness

AIM

The aim of this study was to synthesize the qualitative evidence investigating adolescents' views on heterosexual readiness.

BACKGROUND

Adolescents' understandings of sexual readiness are often missing in research and debates on sexual health and related concepts like sexual consent. Research to date has predominantly focussed on age and socio-cultural predictors of sexual debut, thus failing to explain how adolescents themselves conceptualize their readiness for heterosexual relations.

DESIGN

A systematic review and thematic synthesis of qualitative evidence.

DATA SOURCES

CINAHL, Psychinfo, PubMed, Web of science were searched, 1985-Feb 2016.

REVIEW METHODS

Critical Appraisal Skills Programme checklist was used to assess methodological quality. A thematic synthesis focused on commonalities and variations in the data from included studies on adolescents' perspectives of their readiness for sex.

RESULTS

Sixteen studies were included. Themes identified were: social learning, relationships and implications for sexual health promotion and practice.

CONCLUSIONS

Adolescents may not view initiating sex as problematic, focusing instead on the rewards sex brings and less on health concerns. Adolescents tend to reproduce dominant gender norms of masculinity and femininity in communication about sexual decision-making, which are sometimes influenced by social scripts of career aspirations and ethnic identity. Age was also significant in adolescents' accounts. Early adolescence is a critical period when understandings of gender equality become embedded, thus an opportunity to engage adolescents in critiquing ideas about gender equality and sexual rights. Further research exploring adolescents' understandings of sexual readiness is required. We recommend a participatory approach to support the inclusion of adolescent voices to inform contextually relevant sexual health promotion strategies.

The association between parental attitudes and alcohol consumption and adolescent alcohol consumption in Southern Ireland: a cross-sectional study

Background

Alcohol plays a complex role in society. A recent study showed that over half of Irish adults drink hazardously. Adolescents report increased levels of alcohol consumption. Previous research has inferred the influence of the parent on their adolescent. Thus, the aim of the current study was to investigate the association between adolescent alcohol consumption and their parent’s consumption pattern and attitude toward alcohol use in Southern Ireland.

Methods

A cross-sectional survey was undertaken in November 2014. This involved distributing a survey to adolescents (n = 982) in their final two years of second level education and at least one of their parents from a local electorate area in Southern Ireland. This survey included: alcohol use, self- reported height and weight, smoking status, mental health and well-being along with attitudinal questions. Chi-square tests and multivariate logistic regression were utilised.

Results

A 37 % response rate was achieved. Over one-third (34.2 %) of adolescents and 47 % of parents surveyed reported hazardous drinking. Over 90 % of parents disagreed with allowing their adolescent to get drunk and rejected the idea that getting drunk is part of having fun as an adolescent. The majority (79.5 %) of parents surveyed believed that their alcohol consumption pattern set a good example for their adolescent. Multivariate logistic regression highlights the association between adolescent hazardous alcohol consumption and hazardous drinking by the father. Furthermore either parent permitting their adolescent to drink alcohol on special occasions was associated with hazardous alcohol consumption in the adolescent.

Conclusion

The findings of this research notes a liberal attitude to alcohol and increased levels of consumption by the parent are linked to hazardous adolescent drinking behaviour. Future action plans aimed at combatting adolescent hazardous alcohol consumption should also be aimed at tackling parents’ attitudes towards and consumption of alcohol.