AIDS and Behavior

, Volume 17, Issue 7, pp 2540–2553 | Cite as

Maternal HIV Serostatus, Mother–Daughter Sexual Risk Communication and Adolescent HIV Risk Beliefs and Intentions

  • Julie A. Cederbaum
  • M. Katherine Hutchinson
  • Lei Duan
  • Loretta S. Jemmott
Original Paper


Daughters of HIV-positive women are often exposed to the same factors that placed their mothers at risk. This cross-sectional study (N = 176 dyads) examined HIV status, parent-teen sexual risk communication (PTSRC), and daughters’ abstinence and condom use beliefs and intentions. Maternal HIV status was not associated with PTSRC. Path analyses show that maternal depression was associated with PTSRC behavioral and normative beliefs; relationship satisfaction was associated with PTSRC normative and control beliefs. Control beliefs were solely predictive of maternal PTSRC intention. PTSRC was associated with adolescent behavioral and normative beliefs. Abstinence beliefs were associated with abstinence intentions; condom beliefs were associated with condom use intentions. Relationship satisfaction was associated with adolescent control beliefs about both abstinence and condom use. There is a need for interventions that help HIV-positive mothers recognize their daughter’s HIV risk and provide them with relationship building and parent process skills to help reduce these risks.


Parent–child sexual risk communication Adolescent sexual risk Maternal HIV Relationship satisfaction 


  1. 1.
    Centers for Disease Control and Prevention. Pregnancy and childbirth. 2007. Accessed 22 June 2011.
  2. 2.
    Brackis-Cott E, Mellins CA, Block M. Current life concerns of early adolescents and their mothers: influence of maternal HIV. J Early Adolesc. 2003;23(1):51–77.CrossRefGoogle Scholar
  3. 3.
    Chabon B, Futterman D, Hoffman ND. HIV infection in parents of youths with behaviorally acquired HIV. Am J Public Health. 2001;91(4):649–50.PubMedCrossRefGoogle Scholar
  4. 4.
    DiIorio C, Pluhar E, Belcher L. Parent–child communication about sexuality: a review of the literature from 1980–2002. J HIV/AIDS Prev Educ Adolesc Child. 2003;5(3–4):7–32.CrossRefGoogle Scholar
  5. 5.
    Guilamo-Ramos V, Jaccard J, Dittus P, Bouris AM. Parental expertise, trustworthiness, and accessibility: parent–adolescent communication and adolescent risk behavior. J Marriage Fam. 2006;68(5):1229–46.CrossRefGoogle Scholar
  6. 6.
    Hutchinson MK. The parent-teen sexual risk communication scale (PTSRC-III): instrument development and psychometrics. Nurs Res. 2007;56(1):1–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Hutchinson MK, Jemmott JB III, Jemmott LS, Braverman P, Fong GT. The role of mother–daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: a prospective study. J Adolesc Health. 2003;33(2):98–107.PubMedCrossRefGoogle Scholar
  8. 8.
    Markham CM, Lormand D, Gloppen KM, et al. Connectedness as a predictor of sexual and reproductive health outcomes for youth. J Adolesc Health. 2010;46(3):S23–41.PubMedCrossRefGoogle Scholar
  9. 9.
    Jemmott JB III, Jemmott LS, Braverman PK, Fong GT. HIV/STD risk reduction interventions for African American and Latino adolescent girls at an adolescent medicine clinic. Arch Pediatr Adolesc Med. 2005;159(5):440–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Aspy CB, Vesely SK, Oman RF, Rodine S, Marshall L, McLeroy K. Parental communication and youth sexual behaviour. J Adolesc. 2007;30(3):449–66.PubMedCrossRefGoogle Scholar
  11. 11.
    Wilson KM, Klein JD. Just say no? The impact of messages from parents and sex education classes. J Adolesc Health. 2002;30(2):105.CrossRefGoogle Scholar
  12. 12.
    Guzmán BL, Schlehofer-Sutton MM, Villanueva CM, Dello Stritto ME, Casad BJ, Feria A. Let’s talk about sex: how comfortable discussions about sex impact teen sexual behavior. J Health Commun. 2003;8(6):583–98.PubMedCrossRefGoogle Scholar
  13. 13.
    Hutchinson MK. The influence of sexual risk communication between parents and daughters on sexual risk behaviors. Fam Relat. 2002;51(3):238–47.CrossRefGoogle Scholar
  14. 14.
    Kapungu CT, Baptiste D, Holmbeck G, et al. Beyond the “birds and the bees”: gender differences in sex-related communication among urban African–American adolescents. Fam Process. 2010;49(2):251–64.PubMedCrossRefGoogle Scholar
  15. 15.
    Martin KA, Luke K. Gender differences in the ABC’s of the birds and the bees: what mothers teach young children about sexuality and reproduction. Sex Roles. 2010;62(3–4):278–91.CrossRefGoogle Scholar
  16. 16.
    Pluhar EI, DiIorio CK, McCarty F. Correlates of sexuality communication among mothers and 6–12-year-old children. Child Care Health Dev. 2008;34(3):283–90.PubMedCrossRefGoogle Scholar
  17. 17.
    Wyckoff SC, Miller KS, Forehand R, et al. Patterns of sexuality communication between preadolescents and their mothers and fathers. J Child Fam Stud. 2008;17(5):649–62.CrossRefGoogle Scholar
  18. 18.
    Ackard DM, Neumark-Sztainer D, Story M, Perry C. Parent–child connectedness and behavioral and emotional health among adolescents. Am J Prev Med. 2006;30(1):59–66.PubMedCrossRefGoogle Scholar
  19. 19.
    Bulanda RE, Majumdar D. Perceived parent–child relations and adolescent self-esteem. J Child Fam Stud. 2009;18(2):203–12.CrossRefGoogle Scholar
  20. 20.
    Boutelle K, Eisenberg ME, Gregory ML, Neumark-Sztainer D. The reciprocal relationship between parent–child connectedness and adolescent emotional functioning over 5 years. J Psychosom Res. 2009;66(4):309–16.PubMedCrossRefGoogle Scholar
  21. 21.
    Henrich CC, Brookmeyer KA, Shrier LA, Shahar G. Supportive relationships and sexual risk behavior in adolescence: an ecological–transactional approach. J Pediatr Psychol. 2006;31(3):286–97.PubMedCrossRefGoogle Scholar
  22. 22.
    Ream GL, Savin-Williams RC. Reciprocal associations between adolescent sexual activity and quality of youth–parent interactions. J Fam Psychol. 2005;19(2):171–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Jones DJ, Foster SE, Zalot AA, Chester C, King A. Knowledge of maternal HIV/AIDS and child adjustment: the moderating role of children’s relationships with their mothers. AIDS Behav. 2007;11(3):409–20.PubMedCrossRefGoogle Scholar
  24. 24.
    Brackis-Cott E, Mellins CA, Dolezal C, Spiegel D. The mental health risk of mothers and children: the role of maternal HIV infection. J Early Adolesc. 2007;27(1):67–89.CrossRefGoogle Scholar
  25. 25.
    Armistead L, Tannenbaum L, Forehand R, Morse E, Morse P. Disclosing HIV status: are mothers telling their children? J Pediatr Psychol. 2001;26(1):11–20.PubMedCrossRefGoogle Scholar
  26. 26.
    Cederbaum JA. The experience of sexual risk communication in African American families living with HIV. J Adolesc Res. 2011. doi:10.1177/0743558411417864.PubMedGoogle Scholar
  27. 27.
    Lee MB, Lester P, Rotheram-Borus MJ. The relationship between adjustment of mothers with HIV and their adolescent daughters. Clin Child Psychol Psychiatry. 2002;7(1):71–84.CrossRefGoogle Scholar
  28. 28.
    Mellins CA, Brackis-Cott E, Dolezal C, Meyer-Bahlburg HFL. Behavioral risk in early adolescents with HIV+ mothers. J Adolesc Health. 2005;36(4):342–51.PubMedCrossRefGoogle Scholar
  29. 29.
    Gurung RAR, Taylor SE, Kemeny M, Myers H. “HIV is not my biggest problem”: the impact of HIV and chronic burden on depression in women at risk for AIDS. J Soc Clin Psychol. 2004;23(4):490–511.CrossRefGoogle Scholar
  30. 30.
    Ciesla JA, Roberts JE. Meta-analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry. 2001;158(5):725–30.PubMedCrossRefGoogle Scholar
  31. 31.
    Morrison MF, Petitto JM, Ten Have T, et al. Depressive and anxiety disorders in women with HIV infection. Am J Psychiatry. 2002;159(5):789–96.PubMedCrossRefGoogle Scholar
  32. 32.
    Richardson J, Barkan S, Cohen M, et al. Experience and covariates of depressive symptoms among a cohort of HIV infected women. Soc Work Health Care. 2001;32(4):93–111.PubMedCrossRefGoogle Scholar
  33. 33.
    Remien RH, Exner T, Kertzner RM, et al. Depressive symptomatology among HIV-positive women in the era of HAART: a stress and coping model. Am J Community Psychol. 2006;38(3–4):275–85.PubMedCrossRefGoogle Scholar
  34. 34.
    Yi MS, Mrus JM, Wade TJ, et al. Religion, spirituality, and depressive symptoms in patients with HIV/AIDS. J Gen Intern Med. 2006;21(5):S21–7.PubMedCrossRefGoogle Scholar
  35. 35.
    Murphy DA, Marelich WD, Dello Stritto ME, Swendeman D, Witkin A. Mothers living with HIV/AIDS: mental, physical, and family functioning. Aids Care. 2002;14(5):633–44.PubMedCrossRefGoogle Scholar
  36. 36.
    Forehand R, Jones DJ, Kotchick BA, et al. Noninfected children of HIV-infected mothers: a 4-year longitudinal study of child psychosocial adjustment and parenting. Behav Ther. 2002;33(4):579–600.CrossRefGoogle Scholar
  37. 37.
    Lester P, Rotheram-Borus MJ, Lee SJ, et al. Rates and predictors of anxiety and depressive disorders in adolescents of parents with HIV. Vulnerable Child Youth Stud. 2006;1(1):81–101.CrossRefGoogle Scholar
  38. 38.
    Pilowsky DJ, Zybert PA, Hsieh PW, Vlahov D, Susser E. Children of HIV-positive drug-using parents. J Am Acad Child Adolesc Psychiatry. 2003;42(8):950–6.PubMedCrossRefGoogle Scholar
  39. 39.
    O’Sullivan LF, Dolezal C, Brackis-Cott E, Traeger L, Mellins CA. Communication about HIV and risk behaviors among mothers living with HIV and their early adolescent children. J Early Adolesc. 2005;25(2):148–67.CrossRefGoogle Scholar
  40. 40.
    Corona R, Cowgill BO, Bogart LM, et al. Brief report: a qualitative analysis of discussions about HIV in families of parents with HIV. J Pediatr Psychol. 2009;34(6):677–80.PubMedCrossRefGoogle Scholar
  41. 41.
    Marhefka SL, 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. 2009;38(5):788–801.PubMedCrossRefGoogle Scholar
  42. 42.
    Ajzen I. Perceived behavioral control, self-efficacy, locus of control, and the theory of planned behavior. J Appl Soc Psychol. 2002;32(4):665–83.CrossRefGoogle Scholar
  43. 43.
    Ajzen I. From intentions to actions: a theory of planned behavior. In: Kuhl J, Beckmann J, editors. Action control: from cognition to behavior. Berlin: Springer; 1985. pp. 11–39.Google Scholar
  44. 44.
    Madden TJ, Ellen PS, Ajzen I. A comparison of the theory of planned behavior and the theory of reasoned action. Pers Soc Psychol Bull. 1992;18(1):3–9.CrossRefGoogle Scholar
  45. 45.
    Hutchinson MK, Wood EB. Reconceptualizing adolescent sexual risk in a parent-based expansion of the theory of planned behavior. J Nurs Scholarsh. 2007;39(2):141–6.PubMedCrossRefGoogle Scholar
  46. 46.
    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.CrossRefGoogle Scholar
  47. 47.
    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.PubMedGoogle Scholar
  48. 48.
    Lorig KR, Sobel DS, Ritter PL, Laurent D, Hobbs M. Effect of a self-management program on patients with chronic disease. Eff Clin Pract. 2001;4(6):256–62.PubMedGoogle Scholar
  49. 49.
    Wahler HJ. The physical symptoms inventory: measuring levels of somatic complaining behavior. J Clin Psychol. 1968;24(2):207–11.PubMedCrossRefGoogle Scholar
  50. 50.
    Little TD, Cunningham WA, Shahar G, Widaman KF. To parcel or not to parcel: exploring the question, weighing the merits. Struct Equ Model. 2002;9(2):151–73.CrossRefGoogle Scholar
  51. 51.
    Cheung MWL. Comparison of methods of handling missing time-invariant covariates in latent growth models under the assumption of missing completely at random. Organ Res Methods. 2007;10(4):609–34.CrossRefGoogle Scholar
  52. 52.
    Bentler PM. Comparative fit indexes in structural models. Psychol Bull. 1990;107(2):238–46.PubMedCrossRefGoogle Scholar
  53. 53.
    Bentler PM, Bonett DG. Significance tests and goodness of fit in the analysis of covariance structures. Psychol Bull. 1980;88(3):588–606.CrossRefGoogle Scholar
  54. 54.
    Bradley KL, Bagnell AL, Brannen CL. Factorial validity of the center for epidemiological studies depression 10 in adolescents. Issues Ment Health Nurs. 2010;31(6):408–12.PubMedCrossRefGoogle Scholar
  55. 55.
    Chou CP, Bentler PM. Model modification in covariance structure modeling: a comparison among likelihood ratio, lagrange multiplier, and Wald tests. Multivar Behav Res. 1990;25(1):115–36.CrossRefGoogle Scholar
  56. 56.
    Cederbaum JA, Marcus SC, Hutchinson MK. The influence of knowing someone with AIDS on youth HIV sexual risk behaviors. J HIV AIDS Prev Child Youth. 2008;8(2):31–44.CrossRefGoogle Scholar
  57. 57.
    Palekar R, Pettifor A, Behets F, MacPhail C. Association between knowing someone who died of AIDS and behavior change among South African youth. AIDS Behav. 2008;12(6):903–12.PubMedCrossRefGoogle Scholar
  58. 58.
    Deptula DP, Henry DB, Shoeny ME, Slavick JT. Adolescent sexual behavior and attitudes: a costs and benefits approach. J Adolesc Health. 2006;38(1):35–43.PubMedCrossRefGoogle Scholar
  59. 59.
    Markham CM, Tortolero SR, Escobar-Chaves SL, Parcel GS, Harrist R, Addy RC. Family connectedness and sexual risk-taking among urban youth attending alternative high schools. Perspect Sex Reprod Health. 2003;35(4):174–9.PubMedCrossRefGoogle Scholar
  60. 60.
    Lester P, Peterson K, Reeves J, et al. The long war and parental combat deployment: effects on military children and at-home spouses. J Am Acad Child Adolesc Psychiatry. 2010;49(4):310–20.PubMedGoogle Scholar
  61. 61.
    Murphy DA, Marelich WD, Herbeck DM, Payne DL. Family routines and parental monitoring as protective factors among early and middle adolescents affected by maternal HIV/AIDS. Child Dev. 2009;80(6):1676–91.PubMedCrossRefGoogle Scholar
  62. 62.
    Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice-Hall; 1986.Google Scholar
  63. 63.
    Adhikari AB, Cederbaum JA. Maternal and peer influences on sexual intention among urban African American and Hispanic female adolescents. Under review and unpublished data.Google Scholar
  64. 64.
    Centers for Disease Control and Prevention. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in healthcare settings. MMWR Recomm Rep. 2006;55(RR14):1–17.Google Scholar
  65. 65.
    Institute of Medicine. Clinical preventive services for women: closing the gaps. Accessed 15 July 2011.

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Julie A. Cederbaum
    • 1
  • M. Katherine Hutchinson
    • 2
  • Lei Duan
    • 1
  • Loretta S. Jemmott
    • 3
  1. 1.School of Social Work, University of Southern CaliforniaLos AngelesUSA
  2. 2.College of Nursing, New York UniversityNew YorkUSA
  3. 3.School of Nursing, University of PennsylvaniaPhiladelphiaUSA

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