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Typologies and Correlates of Caregiver-adolescent Sexual Health Communication among Adolescent Girls in Southwestern Uganda

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Abstract

Caregiver-adolescent sexual health communication can reduce sexual risk attitudes and behaviors, but less is known about caregiver-adolescent sexual health communication in Uganda. Using a risk-focused approach, this paper seeks to characterize caregiver-adolescent sexual health communication and associated individual and family-based attributes, and associations with adolescents’ sexual risk attitudes. We used latent class analyses to derive typologies (classes) of sexual health communication and assess their relationships with respondents’ socio-demographic characteristics and sexual risk-taking attitudes. We derived three latent classes of sexual risk communication characterized as avoidant (class 1; 48%), functional (class 2; 22.2%) and comprehensive (class 3; 29.8%), each representing varying levels of frequency and type of content covered in the caregiver-adolescent sexual health communication. Primary caregiver’s sex and respondents’ comfort talking to their caregiver were significantly associated with membership in the functional class (RRR = 1.52; 95% CI: 1.05–2.19; p < 0.05) and comprehensive class (RRR = 1.68; 95% CI: 1.13–2.49; p < 0.05). Caregivers and their adolescents are attempting to engage in conversations related to sexual health, but many caregivers tend to shy away from potentially embarrassing topics such as sex. The wide variations in type and content of covered in caregiver-adolescent sexual health communications may compromise adolescents’ sexual health knowledge, putting them at risk for poor sexual health outcomes. Given the cultural taboos around caregiver-adolescent communications on sex related topics, family interventions to address to strengthen caregiver-adolescent communication on sexual health are required.

Highlights

  • Study findings revealed three latent caregiver-adolescent sexual health classes, dominated by avoidant communication.

  • Caregiver gender and adolescents’ comfort enhanced caregiver-adolescent sexual health communication.

  • Interventions must tackle cultural norms and taboos for better caregiver-adolescent sexual health communication.

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Data Availability

The data that support the findings of this study are available on request from the author and study principal investigator, FMS. The data are not publicly available due to restrictions as they contain information that could compromise the privacy of research participants.

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Acknowledgements

The authors are grateful to the staff and the volunteer team at the International Center for Child Health and Development in Uganda for monitoring the study implementation process. Our special thanks go to all the children and their caregiving families who agreed to participate in the study. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the NIMH, or the National Institutes of Health (NIH).

Funding

This Financial support for the Suubi4Her study comes from the National Institute for Mental Health (NIMH), grant # R01MH113486 (PI: Fred M. Ssewamala, PhD).

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Authors and Affiliations

  1. Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI, USA

    Massy Mutumba

  2. Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA

    Rachel Brathwaite, Proscovia Nabunya, Flavia Namuwonge & Fred M. Ssewamala

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Correspondence to Massy Mutumba.

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This study was performed in line with the principles of the Declaration of Helsinki. Study participation was voluntary. All caregivers provided written consent for their children to participate in the study. Similarly, all adolescent girls provided written assent to participate. We obtained children’s permission to participate in the study separately from their caregivers to avoid coercion. The study received Institutional Review Board approval from Washington University in St. Louis (IRB- #201703102), the Uganda Virus Research Institute (GC/127/17/07/619), and the Uganda National Council of Science and Technology (SS4406). The study is registered in the ClinicalTrials.gov database (NCT03307226).

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Mutumba, M., Brathwaite, R., Nabunya, P. et al. Typologies and Correlates of Caregiver-adolescent Sexual Health Communication among Adolescent Girls in Southwestern Uganda. J Child Fam Stud (2024). https://doi.org/10.1007/s10826-024-02851-w

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