Kim S. Miller

Parent-adolescent discussions about sex and condoms: impact on peer influences of sexual risk behavior.

This research examined how parent-adolescent communication about initiating sex and condoms influenced the relationship between peer norms and behavior. African American and Hispanic adolescents reported on parent-adolescent discussions about initiating sex and condoms, perceived peer norms about sex and condom use, and their own behavior. Communication about sex and perceived peer norms about sex were each related to sexual behavior, and communication about condoms and peer norms about condoms were related to condom use behavior. For both sex and condom use, the peer norm–behavior relationship was moderated by parental communication: Peer norms were more strongly related to behavior among adolescents who had not discussed sex or condoms with a parent. Communication was also related to teens naming a parent as their best source of information about sex. Results suggest that a lack of communication may cause adolescents to turn to peers and that peers may then influence their behavior.

Family communication about sex: what are parents saying and are their adolescents listening?

CONTEXT Communication between parents and adolescents about sex, particularly in minority families, has been understudied; more information is needed both on which sex-related topics are discussed and on how their content is transmitted. METHODS Parent-adolescent communication about 10 sex-related topics was examined in a sample of 907 Hispanic and black 14-16-year-olds. Chi-square analyses were performed to test for significant differences across the 10 topics in discussions reported by the adolescents (with either parent) and by the mothers. The openness of communication, parent-adolescent agreement about communication of topics and differences by gender and ethnicity were also examined. RESULTS Significantly higher proportions of mothers and adolescents reported discussions of HIV or AIDS (92% by mothers and 71% by adolescents, respectively) and STDs (85% and 70%, respectively) than of issues surrounding sexual behavior, contraceptive use and physical development (27-74% for these other eight topics as reported by mothers vs. 15-66% as reported by adolescents). The gender of the adolescent and of the parent holding the discussion, but not the familys ethnicity, significantly influenced findings, with adolescents of both sexes more likely to report discussions with mothers than with fathers, and with parents more likely to discuss any of the 10 topics with an adolescent of the same gender than of the opposite gender. The likelihood of a topic being discussed and of mother-adolescent agreement that a topic was discussed both increased with an increasing degree of openness in the communication process. CONCLUSIONS Consistent with research among white samples, mothers of black and Hispanic adolescents are the primary parental communicators about sexual topics. To facilitate communication, educational programs for parents should cover not only what is discussed, but how the information is conveyed.

Adolescent Sexual Behavior in Two Ethnic Minority Samples: The Role of Family Variables.

Family structural variables and process variables were investigated as predictors of indices of adolescent sexual behavior and risk due to sexual behavior in 907 Black and Hispanic families from Montgomery Alabama; New York City; and San Juan Puerto Rico. The family structural variables examined were family income parental education and maternal marital status while the following process variables were considered: maternal monitoring mother-adolescent general communication mother-adolescent sexual communication and maternal attitudes about adolescent sexual behavior. Family structure variables failed to predict adolescent sexual behavior. However each of the family process variables predicted multiple indices of adolescent sexual behavior and risk due to sexual behavior. Neither adolescent gender nor ethnicity qualified these findings. Differences were however observed among the 3 locations and by reporter of the family process variables.

Sexual initiation with older male partners and subsequent HIV risk behavior among female adolescents.

Data from a 1993-1994 survey of 150 black and Hispanic teenagers were used to examine differences in HIV risk-related behavior between young women who have a first sexual partner three or more years older than themselves and those whose first partner is their age. Compared with teenagers whose first partner had been roughly their age, the 35% of adolescents with an older partner had been younger at first intercourse (13.8 years vs. 14.6) and less likely to use a condom at first intercourse (63% vs. 82%). They also were less likely to report having used a condom at last intercourse (29% vs. 44%) or having used condoms consistently over their lifetime (37% vs. 56%) or in the previous six months (44% vs. 66%). Some 38% of teenagers with an older first partner had ever been pregnant, compared with 12% of those with a peer-age first partner. The mean number of partners and history of sexually transmitted diseases did not differ between the two groups.

Why Parents Matter!: The Conceptual Basis for a Community-Based HIV Prevention Program for the Parents of African American Youth

The Parents Matter! Program (PMP) is a community-based family intervention designed to promote positive parenting and effective parent-child communication about sexuality and sexual risk reduction. Its ultimate goal is to reduce sexual risk behavior among adolescents. PMP offers parents instruction and guidance in general parenting skills related to decreased sexual risk behavior among youth (e.g., relationship building, monitoring) and sexual communication skills necessary for parents to effectively convey their values and expectations about sexual behavior—as well as critical HIV, STD, and pregnancy prevention messages—to their children. We briefly review the literature concerning parental influences on adolescent sexual risk behavior and present the conceptual model and theoretical foundation upon which PMP is based.

Barriers and Facilitators to Maternal Communication with Preadolescents about Age-Relevant Sexual Topics

The present study examined factors that promote parent–child discussions about sex topics. A sample of 1,066 dyads of African American mothers and their 9–12-year-old children participated completing computer-administered surveys. After controlling for all other covariates, mother’s sexual communication responsiveness (i.e., knowledge, comfort, skills, and confidence) was the most consistent predictor of discussions. Mothers with higher responsiveness had significantly increased odds of discussions about abstinence, puberty, and reproduction, based on both mother and child reports. In addition, child’s age, pubertal development, readiness to learn about sex, and being female were positively associated with an increase in the odds of discussions in most models. Findings indicate that encouraging parents to talk with their children early may not be sufficient to promote parent–child sex discussions. Parents also need the knowledge, comfort, skills, and confidence to communicate effectively and keep them from avoiding these often difficult and emotional conversations with their children.

Impact of Parent-Child Communication Interventions on Sex Behaviors and Cognitive Outcomes for Black/African-American and Hispanic/Latino Youth: A Systematic Review, 1988–2012

PURPOSE We reviewed human immunodeficiency virus (HIV) and sexually transmitted infection (STI)- behavioral interventions implemented with disproportionately affected black/African-American and Hispanic/Latino youth and designed to improve parent-child communications about sex. We compared their effectiveness in improving sex-related behavior or cognitive outcomes. METHODS A search of electronic databases identified peer-reviewed studies published between 1988 and 2012. Eligible studies were U.S.-based parent-child communication interventions with active parent components, experimental and quasiexperimental designs, measurement of youth sexual health outcomes, and enrollment of ≥ 50% black/African-American or Hispanic/Latino youth. We conducted systematic, primary reviews of eligible papers to abstract data on study characteristics and youth outcomes. RESULTS Fifteen studies evaluating 14 interventions were eligible. Although youth outcome measures and follow-up times varied, 13 of 15 studies (87%) showed at least one significantly improved youth sexual health outcome compared with controls (p < .05). Common components of effective interventions included joint parent and child session attendance, promotion of parent/family involvement, sexuality education for parents, developmental and/or cultural tailoring, and opportunities for parents to practice new communication skills with their youth. CONCLUSIONS Parent-child communication interventions that include parents of youth disproportionately affected by HIV/STIs can effectively reduce sexual risk for youth. These interventions may help reduce HIV/STI-related health disparities and improve sexual health outcomes.

Family Influences on Adolescent Females’ Sexual Health

Sexual behavior that puts adolescents, particularly female adolescents, at risk for adverse health outcomes is an overwhelming public health problem in the United States. Sexual risk behaviors, including early sexual initiation, unprotected intercourse, and sex with multiple partners, place female adolescents at risk for unintended pregnancy and sexually transmitted diseases (STDs), including infection with the human immunodeficiency virus (HIV). Approximately one million teenagers become pregnant each year (Alan Guttmacher Institute, 1993) and 3 million adolescents, about one of every eight teens or one in four sexually active teens, acquire an STD annually (Eng & Butler, 1997). About 20% of all new HIV infections occur in young people under age 25 (Office of National AIDS Policy, 1996).

A Multidimensional Framework for the Meanings of the Sexual Double Standard and its Application for the Sexual Health of Young Black Women in the U.S

There has been debate in the literature as to whether a sexual double standard (SDS) currently exists in the United States. Studies vary greatly in how the SDS is operationalized, making it difficult to interpret findings across studies and translate academic literature into applied fields such as public health. To advance academic and applied research, we propose a multidimensional framework for the SDS that can accommodate complex and nuanced meanings, is flexible enough to allow for the dynamic nature of social ideologies, and is grounded in an understanding of social systems of inequality. In this article, we describe three dimensions that define the broad elements of the SDS: (a) polarized (hetero)sexualities, (b) active male and passive female roles, and (c) the power struggle narrative. To illustrate the use of the framework, we contextualize each dimension in terms of the intersection of race and gender for young Black women in the United States. And finally, to apply the framework, we explore the effects the SDS can have on sexual health and suggest some directions for public health interventions. These analyses lay the groundwork for more complex and comprehensive investigations of the SDS and its effects on sexual health.

Factors Associated with Parent–Child Communication About HIV/AIDS in the United States and Kenya: A Cross-Cultural Comparison

This study explored parent–child communication about HIV/AIDS among two populations disproportionately affected by HIV. Similar computer-assisted surveys were completed by parents of pre-teens, including 1,115 African American parents of 9–12-year-old children in southeastern US and 403 parents of 10–12-year-old children in Nyanza Province, Kenya. Multivariate analyses identified factors associated with parental report of ever talking to their child about HIV/AIDS. Twenty-nine percent of US parents and 40% in Kenya had never talked to their pre-teen about HIV/AIDS. In both countries, communication was more likely if parents perceived their child to be ready to learn about sex topics, had gotten information to educate their child about sex, and had greater sexual communication responsiveness (skill, comfort, and confidence communicating about sexuality). Programs are needed that help parents assess children’s readiness to learn about sexual issues; access accurate information about adolescent sexual risks; and acquire the responsiveness needed to discuss sexual issues, including HIV/AIDS.