Community perspectives on parental influence on engagement in multiple concurrent sexual partnerships among youth in Tanzania: Implications for HIV prevention programming

Abstract

Although concurrent sexual partnerships (CPs) have been hypothesized to be an important risk factor for HIV in sub-Saharan Africa, the social and cultural factors that encourage CPs are not well understood. This study explored the community's perspectives on the role that parents can play in influencing their children's decision to engage in CPs. We conducted 16 in-depth interviews, 32 focus group discussions, and 16 key informant interviews with 280 adult participants in Tanzania. Data were coded; findings and conclusions were developed based on themes that emerged from coding. Three parental influences on CPs emerged: parent-child communication about sex, both silent and explicit encouragement of CPs, and parental behavior modeling. Parents are typically either too busy or too "embarrassed" to talk with their children about sex and CPs. The information parents do give is often confusing, fear-based, inadequate, and/or only focused on daughters. Parents themselves also encourage CPs through complicity of silence when their daughters come home with extra cash or consumer goods. In some cases, parents overtly encourage their children, particularly daughters, to practice CPs due to the promise of money from wealthy partners. Finally, when parents engage in CPs, the children themselves learn to behave similarly. These results suggest that parents can influence their children's decision to engage in CPs. HIV prevention interventions should address this by promoting parent-child communication about sexuality; associated disease risks and gender-equitable relationships; promoting positive parental role modeling; and educating parents on the implications of encouragement of CPs in their children.

Health literacy in adolescents with sickle cell disease: The influence of caregiver health literacy

“…Based upon the family and peer influence construct of the framework for studying adolescent health literacy (Manganello, ), it was postulated that caregiver health literacy would be a significant influencing factor on the health literacy of adolescents with SCD. Furthering this hypothesis was that several studies show that caregivers remain a primary socializing agent of health related‐behaviors during adolescence (Fehringer et al, ; Kajula, Darling, Kaaya, & De Vries, ; Markham et al, ). Preliminary evidence also suggest that health literacy is related to health information seeking from family sources (Jennifer A Manganello & Sojka, ) and may be a leading predictor of adolescent literacy.…”

Gender Differences in Sexual and Reproductive Health Protective and Risk Factors of Batswana Adolescents: Implications for Parent and Adolescent Interventions

“…These findings are congruent with previous research about cultural norms in Botswana that noted Batswana tend to avoid discussions about sexuality between parent and child (Denbow & Thebe, 2006; Ntsayagae et al, 2008). Additional research has found that both parents and adolescents expressed a desire to be able to discuss sensitive topics with one another, but felt they do not have adequate knowledge or communication skills and were hesitant to do so (Fehringer et al, 2013; Nam et al, 2009; Seloilwe et al, 2013; St. Lawrence et al, 2013), which may explain why adolescents perceived low parental responsiveness to discussing sensitive issues.…”

Assessing the Impact of Parents’ Adolescent Reproductive and Sexual Health Knowledge on Sexual Health Education by Parents in the Asutifi (North and South) Districts of Ghana

“…In a matched internal and external control experiment, Mellanby et al (1995) compared control populations which received their own sex education programmes with populations which received a novel sex education intervention that included medical and peer led teaching, and found among other things that, even though parents want to talk to their children about topics related to sexual behaviours, they feel embarrassed, uncomfortable and have neither the skills nor the knowledge to do so. Again a qualitative study in Tanzania found that the sexual and reproductive health information parents do give is often confusing, fear-based, inadequate, and or only focused on daughters (Fehringer et al, 2013) In a review by Bastien et al in Sub-Saharan Africa, lack of parental knowledge was reported as a barrier to sexual health education of adolescents by both parents and young people alike (Bastien et al, 2011). However the review showed that studies on adolescent sexual and reproductive health in Ghana is minimal, few areas such as risks of pregnancy and sexually transmitted by Karim et al(2003), monitoring of unmarried adolescents by parents by Kumi-Kyereme et al (2007), the influence of three dimensions of parenting-material support (co-residence), monitoring and communication on adolescent sexual behavior by Biddlecom, Awusabo-Asare and Bankole ( 2009), the relationship between family communication about HIV/ AIDS, sexual activity and condom use among secondary school students by Adu-Mireku(2003) were found (Bastien et al, 2011).No study on parent"s knowledge on adolescent sexual and reproductive health have been conducted .This study will add to existing knowledge on parents knowledge on adolescent sexual and reproductive health in the Asutifi district and Ghana as a whole.…”