Factors Associated with Parent–Child Communication About HIV/AIDS in the United States and Kenya: A Cross-Cultural Comparison
First Online: 11 September 2009 Received: 26 March 2009 Accepted: 25 August 2009 DOI:
Cite this article as: Poulsen, M.N., Miller, K.S., Lin, C. et al. AIDS Behav (2010) 14: 1083. doi:10.1007/s10461-009-9612-4 Abstract
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.
Keywords Pre-teens Sexual risk communication Parent–child communication Sexual risk prevention Kenya References
UNAIDS, 2008 Report on the global AIDS epidemic. 2008 UNAIDS.
World Health Organization Department of Child and Adolescent Health. Broadening the horizon: balancing protection and risks for adolescents. Geneva: WHO; 2002.
World Health Organization. Helping parents in developing countries improve adolescents’ health. Geneva: WHO; 2007.
Leland NL, Barth RP. Characteristics of adolescents who have attempted to avoid HIV and who have communicated with parents about sex. J Adolesc Res. 1993;8(1):58–76.
Holtzman D, Rubinson R. Parent and peer communication effects on AIDS-related behavior among US high school students. Fam Plann Perspect. 1995;27:235–40. & 268.
Romer D, Stanton B, Galbraith J, Feigelman S, Black MM, Li X. Parental influence on adolescent sexual behavior in high-poverty settings. Arch Pediatr Adolesc Med. 1999;153:1055–62.
Albert B. With one voice: America’s adults and teens sound off about teen pregnancy. Washington DC: National Campaign to Prevent Teen Pregnancy; 2007.
Miller KS, Levin ML, Xu X, Whitaker DJ. Patterns of condom use among adolescents: the impact of maternal-adolescent communication. Am J Public Health. 1998;88(10):1542–4.
Whitaker DJ, Miller KS, May DC, Levin ML. Teenage partners’ communication about sexual risk and condom use: the importance of parent-teenager discussions. Fam Plann Perspect. 1999;31(3):117–21.
Kotchick BA, Dorsey S, Miller KS, Forehand R. Adolescent sexual risk-taking behavior in single-parent ethnic minority families. J Fam Psychol. 1999;13(1):93–102.
Dutra R, Miller KS, Forehand R. The process and content of sexual communication with adolescents in two-parent families: associations with sexual risk-taking behavior. AIDS Behav. 1999;3(1):59–66.
Miller KS, Kotchick BA, Dorsey S, Forehand R, Ham AV. Family communication about sex: what are parents saying and are their adolescents listening? Fam Plann Perspect. 1998;30(5):218–22.
Fasula AS, Miller KS. African-American and Hispanic adolescents’ intentions to delay first intercourse: parental communication as a buffer for sexually active peers. J Adolesc Health. 2006;38:193–200.
Amuyunzu-Nyamongo M, Biddlecom AE, Ouedraogo C, Woog V. Qualitative evidence on adolescents’ views of sexual and reproductive health in Sub-Saharan Africa. New York: Alan Guttmacher Institute; 2005.
Namisi FS, Flisher AJ, Overland S, et al. Sociodemographic variations in communication on sexuality and HIV/AIDS with parents, family members and teachers among in-school adolescents: a multi-site study in Tanzania and South Africa. Scand J Public Health. 2008;00:1–11.
Adegoke AA. Pubertal development and traditional support systems in Africa: an overview. Afr J Reprod Health. 2001;5(1):20–30.
Pacific Institute for Women’s Health. Youth sexuality: action research from Burkina Faso and Senegal. Los Angeles: Pacific Institute for Women’s Health; 2002.
Muyinda H, Kengeya J, Pool R, Whitworth J. Traditional sex counseling and STI/HIV prevention among young women in rural Uganda. Cult Health Sex. 2001;3(3):353–61.
Mbugua N. Factors inhibiting educated mothers in Kenya from giving meaningful sex-education to their daughters. Soc Sci Med. 2007;64:1079–89.
Fuglesang M. Lessons for life: past and present modes of sexuality education in Tanzanian society. Soc Sci Med. 1997;44(8):1245–54.
Kiragu K, Obwaka E, Odallo D, Hulzen CV. Communicating about sex: adolescents and parents in Kenya. Sex Health Exch. 1996;3:11–13.
Rosenthal DA, Feldman SS, Edwards D. Mum’s the word: mothers’ persectives on communication about sexuality with adolescents. J Adolesc. 1998;21:727–43.
Kirkman M, Rosenthal DA, Feldman SS. Talking to a tiger: fathers reveal their difficulties in communicating about sexuality with adolescents. In: Feldman SS, Rosenthal DA, editors. Talking sexuality: parent-adolescent communication. San Francisco: Jossey-Bass; 2002. p. 57–74.
Jaccard J, Dittus PJ, Gordon VV. Parent-teen communication about premarital sex: factors associated with the extent of communication. J Adolesc Res. 2000;15(2):187–208.
DiIorio C, Resnicow K, Dudley WN, et al. Social cognitive factors associated with mother-adolescent communication about sex. J Health Commun. 2000;5:41–51.
Lehr ST, Demi AS, DiIorio C. Predictors of father-son communication about sexuality. J Sex Res. 2005;42(2):119–29.
Miller KS, Whitaker DJ. Predictors of mother-adolescent discussions about condoms: implications for providers who serve youth. Pediatrics. 2001;108(2):e28.
Raffaelli M, Bogenschneider K, Flood MF. Parent-teen communication about sexual topics. J Fam Issues. 1998;19(3):315–33.
CDC. HIV/AIDS surveillance in adolescents and young adults (through 2006). [Slide set] 2006; Available from:
CDC, Youth risk behavior surveillance - United States, 2007. 2008: CDC.
National AIDS and STI Control Programme Ministry of Health Kenya, Kenya AIDS indicator survey 2007: Preliminary report. 2008; Nairobi, Kenya.
Amornkul PN, Vandenhoudt H, Nasokho P, et al. HIV prevalence and associated risk factors among individuals aged 13–34 years in rural Western Kenya. PLoS ONE. 2009;4(7):1–11.
Vandenhoudt H, Amornkul PN, Odhiambo F, et al. First sexual intercourse and exposure to HIV infection among young women in a high HIV prevalence area in Western Kenya. Paper presented at: XVth International AIDS Conference; 2004; Bangkok, Thailand [abstract # LBOrC22].
Forehand R, Miller KS, Armistead L, Kotchick BA, Long N. The Parents Matter! program: an introduction. J Child Fam Stud. 2004;13(1):1–3.
Poulsen MN, Wyckoff SC, O’bongo C, et al. The cultural adaptation of an evidence-based family-level HIV/AIDS prevention intervention: from Parents Matter! in the US to Families Matter! in Kenya. Under review.
Yang H, Stanton B, Cottrel L, et al. Parental awareness of adolescent risk involvement: implications of overestimates and underestimates. J Adolesc Health. 2006;39:353–61.
Jaccard J, Dittus PJ, Gordon VV. Parent-adolescent congruency in reports of adolescent sexual behavior and in communications about sexual behavior. Child Dev. 1998;69(1):247–61.
Marhefka S, Mellins CA, Brackis-Cott E, Dolezal C, Ehrhardt AA. Perceptions of adolescents’ sexual behavior among mothers living with and without HIV: does dyadic sex communication matter? Arch Sex Behav. 2007: 10 Jan 2008 [Epub ahead of print].
DiIorio C, Pluhar E, Belcher L. Parent–child communication about sexuality: a review of the literature from 1980–2002. J HIV AIDS Prev Child Youth. 2003;5(3):7–32.
Miller KS, Fasula AM, Dittus P, Wiegand RE, Wyckoff SC, McNair L. Barriers and facilitators to maternal communication with preadolescents about age-relevant sexual topics. AIDS Behav. 2007;13(2):365–74.
Lefkowitz ES, Romo LF, Corona R, Au TK, Sigman M. How Latino American and European American adolescents discuss conflicts, sexuality, and AIDS with their mothers. Dev Psychol. 2000;36(3):315–25.
Botvin GJ, Baker E, Dusenbury L, Tortu S, Botvin EM. Preventing adolescent drug abuse through a multimodal cognitive-behavioral approach: results of a 3-year study. J Consult Clin Psychol. 1990;58(4):437–46.
CrossRef PubMed Copyright information
© Springer Science+Business Media, LLC 2009