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Association of Adolescent- and Parent-Reported Relationship Functioning with HIV Sexual Risk Among Adolescents in Botswana


Globally, adolescents in sub-Saharan Africa are the youth most affected by HIV. Parent–adolescent relationships can be protective in child and adolescent development and may be implicated in lowered adolescent HIV sexual risk. However, the importance of parental and adolescent perceptions of their relationship and assessing the implications of family functioning in adolescents’ risk for HIV or other sexually transmitted infections are not well established in the research literature. This dyadic study simultaneously assessed both parents’ and adolescents’ perceptions of family functioning and their relationships with adolescent sexual behaviors in Botswana. Seventy-two parent–adolescent dyads completed audio computer-assisted self-interview surveys. Surveys, independently completed by parents and their adolescent, assessed multiple indicators of their relationship and is the first such study in Botswana to collect the perspectives of both the parents and their adolescents. The results highlight significantly discrepant views of their relationships and revealed that the magnitude of those discrepancies was associated with greater adolescent HIV sexual risk behavior across multiple measures of family relationships. Parents’ inaccurate perceptions of their adolescents’ sexual activity were also associated with greater adolescent sexual risk. These findings elucidate the importance of improving parent–adolescent communications and relationships, which may subsequently assist in lowering adolescents’ sexual risk for HIV and other negative sexual health outcomes.

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The authors would like to thank all parents and adolescents who participated in this study.


The research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under Award Number R01HD094512 and the Agency for Healthcare Research and Quality under Award Number K12HS022981. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Agency for Healthcare Research and Quality.

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Correspondence to Christina J. Sun.

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All procedures performed in studies involving human participants were in accordance with the Ethical Standards of the Institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study. Parents provided informed consent for themselves and for their adolescents’ participation. After parental permission was obtained, adolescents provided assent.

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Sun, C.J., Seloilwe, E.S., Magowe, M. et al. Association of Adolescent- and Parent-Reported Relationship Functioning with HIV Sexual Risk Among Adolescents in Botswana. AIDS Behav 24, 975–983 (2020).

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  • HIV
  • Adolescent
  • Dyads
  • Parent–adolescent relationship
  • Family functioning