Inter-generational Communication for Promoting Safer Sex among Adolescents

INTRODUCTION

Poor communication between parents and teens is one factor that can affect safe teen sex, including contraceptive use, infection, and condom use. There are both practical and theoretical reasons why parents may act as mediators of sexuality for young people. From this perspective, parents can play an important role in conveying sexual messages and can have a significant impact on young people’s sexuality, values, and attitudes.¹

Parents discuss with their teens topics such as sexual relationships, pregnancy, and sexually transmitted infections (STIs), including acquired immune deficiency syndrome, the less likely teens are to engage in risky sexual behaviors, and thus rather, they delay their first sexual act.²

Adolescents make up almost a quarter of Nepal’s 28 million population. The average age at first sexual encounter among adolescents was 17.5. Only 58.6% of adolescent students aged 15–19 years used a condom at their first sexual intercourse. Furthermore, risky sexual behaviors involving more than one sexual partner, intercourse with a prostitute, and inconsistent condom use were prevalent in this population. In Nepal, children mostly live with their parents. However, it is uncommon and uncommon.³

Family members can discuss problems related to sexual reproductive health (SRH). Primarily due to a lack of adequate communication, followed by a lack of proper information, education, and guidance, adolescents at this age remain confused. They may tend to depend on their close friends, who may not always be a reliable source of information and support. Such situations expose adolescents to various health risks, so it is crucial to provide them with appropriate support and services.⁴

The influential role of parents on child and adolescent behavior is also widely accepted in developmental and health behavior theory. Bronfenbrenner’s classic ecological system theory of human development suggests that individuals live in several nested systems – including the family system – that are dynamic, reciprocal, and can, directly and indirectly, influence behavior. Based on this approach, parent–adolescent sexual communication is increasingly incorporated into health behavior theories that explain youth sexual behavior such as the multisystem perspective on adolescent sexual risk behavior.⁵

Although practical and theoretical considerations suggest that communication with parents should be strongly associated with adolescent safe-sex behavior, there is a surprising inconsistency. Several studies have found positive associations between parental communication and youth contraceptive use or condoms. Some studies have found no significant or even negative effects. Furthermore, parental communication about sex may be protective for youth for open sexual behavior and safer sex. The objective of the study is to review the association between inter-generational communication and safer sex behavior among adolescents and to explore the barrier to inter-generational communication and the way forward.

METHODS

Literature reviews were conducted to synthesize evidence on the association between parent–adolescent sexual communication and adolescent sexual health outcomes. The study adhered to preferred reporting items for systematic reviews and meta-analysis guidelines to ensure transparency and rigor. Relevant studies were identified through a comprehensive search of databases, including PubMed, Scopus, Web of Science, and Google Scholar. Search terms included combinations of keywords such as parent–adolescent communication, sexual health outcomes, contraception use, adolescent sexual behavior, comprehensive sex education, and barriers to communication, with Boolean operators (AND, OR) applied to refine the search. The review included studies published in English from 2000 to the present.

Eligibility criteria encompassed peer-reviewed articles and gray literature that explored parent–adolescent communication on sexual health topics and reported quantitative or qualitative outcomes such as contraception use, STI prevention, or perceptions of sexual norms. Adolescents aged 10–19 years were the target population. Studies not focused on communication or lacking sufficient data or methodological transparency were excluded. The screening process involved three steps: Removal of duplicates using reference management software (Mendeley).

Data extraction was performed using a standardized sheet to collect information on study characteristics (author, year, country, and design), population details (age, gender, and sample size), measures of parent–adolescent sexual communication, reported sexual health outcomes, and barriers or facilitators of communication. Related research has been systematically considered to extract important information manually analyzed to identify laws and associations. The results were generalized to emphasize the relationship between communication between parents and teenagers and more secure sexual practices. As the study involved secondary analysis of existing data, ethical approval was not required. However, all included studies were properly acknowledged and cited [Figure 1].

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Figure 1:

Flow diagram of the selection of article.

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RESULTS

The results indicate a beneficial connection between consistent sexual discussions between parents and adolescents and the adolescents’ capacity to make knowledgeable choices about their sexual health. Teenagers who have candid discussions with their parents about sex tend to demonstrate more responsible sexual practices, including the use of contraception and awareness of the risks linked to sexual activity. Yet, discomfort and embarrassment continue to be major obstacles, hindering numerous parents and teenagers from starting these vital conversations. Tackling these obstacles by promoting supportive and nonjudgmental communication environments can lead to better discussions and improved sexual health for adolescents.

Studies examining the influence of parent–adolescent sexual communication on perceptions of peer sexual behaviors, condom usage, and societal disapproval of sex yielded mixed results. Although certain studies indicated notable correlations, like heightened acceptance of condom use among friends, others revealed no significant link. Cultural and societal norms significantly influence the content and timing of these discussions, highlighting the necessity for culturally aware approaches to enhance communication. These results highlight that although communication between parents and adolescents is essential, its efficacy differs based on social, family, and personal influences.

The importance of thorough sex education arises as a vital addition to discussions with parents. Teens who undergo comprehensive, age-suitable sex education are more inclined to have significant conversations with their parents regarding sexual matters. This type of education equips teenagers with essential information regarding anatomy, contraception, consent, and relationships, enabling them to manage sexual health wisely. A cooperative effort between families and schools is crucial to overcome communication obstacles and equip adolescents with a solid basis for making educated choices regarding their sexual health.

DISCUSSION

One notable aspect highlighted in the articles is the positive correlation between regular parent–adolescent sexual communication and informed decision-making among adolescents. Studies consistently reveal that those who engage in open conversations with their parents about sex are more likely to make responsible choices regarding their sexual health. However, the discussion also delves into the persistent challenges surrounding these conversations. Both parents and adolescents often experience discomfort when broaching the subject of sex, necessitating the development of strategies to overcome these communication barriers. Creating a safe and non-judgmental space for dialogue is identified as a crucial factor in facilitating these important discussions.⁶

One study stated that sexual communication between parents and adolescents was significantly higher in adolescent perceptions prevalence of intercourse and contraceptive use among their peers.⁷ Three studies reported non-significant associations between parent–child sexual communication and adolescent perceptions of their peers’ sexual activities^8,6 and condom use.⁹ One study found that parent-adolescent sexual communication was significantly associated with adolescent perceptions of elicitation social disapproval of sex.¹⁰

Two studies have reported mixed results: Receiving reports of the social consequences of sex predicted greater expectations of social disapproval among adolescents of pregnancy, but not of sex.^11,12 The extent of sexual communication between parents and adolescents was associated with greater perceived acceptability of condom use, but not delayed intercourse, among peers. Two studies reported non-significant results between parents’ sexual communication between adolescents and its social consequences and benefits of sex¹³ and adolescents’ evaluative judgments (positive or negative) of their peers who have sex and their abstinent peers.¹⁴ Finally, one study reported that a greater range of parental sexual communication was associated with adolescent’s greater perceived acceptability of sex among peers.¹

Parent–child sexual communication is crucial for improving sexual health outcomes for young people, but there is limited research on what prompts these conversations and the barriers to having them more often. Parents often feel that their child is too young to discuss sexual topics, regardless of the child’s age, which acts as a major barrier. However, communication self-efficacy and perceived value in sexual communication were associated with more frequent conversations.¹⁵

The most frequent barriers to fathers’ sexual communication with both genders were the adolescent’s embarrassment and the possibility of provoking their curiosity about sex. The study shows embarrassment and not trusting them and approving of them having sex were barriers to father– adolescent sexual communication. Conversely, adolescents asking more private questions were positive predictors of father–adolescent sexual conversation.¹⁶

The influence of cultural and societal factors on parent– adolescent sexual communication is another key focus. The cultural norms and values shape the timing and content of these conversations. Recognizing and addressing these cultural nuances become imperative for developing effective communication strategies that resonate with families from various backgrounds.

Intergenerational sexual communication is neither appropriate nor legal. Instead, efforts should focus on fostering open and honest discussions within families and communities about sexuality, relationships, and consent. Age-appropriate comprehensive sex education is essential, providing adolescents with accurate information about anatomy, contraception, STIs, and the significance of consent.

Open communication channels between parents or guardians and adolescents create a supportive environment where questions can be addressed without judgment. Emphasizing healthy relationships, respect, and communication, as well as teaching skills to navigate peer pressure, plays a vital role in empowering adolescents to make informed decisions. Access to confidential healthcare services, including reproductive health information and counseling, ensures that adolescents have the resources they need. Ultimately, promoting safe sexual behavior involves education, communication, and creating an environment where adolescents feel respected and supported, without involving inappropriate intergenerational sexual communication.

Furthermore, the role of comprehensive sex education emerges as a significant component in the discourse. Adolescents who receive comprehensive sex education are more likely to engage in open conversations with their parents about sexual topics. This emphasizes the need for a collaborative approach between school-based education and parental communication to provide a well-rounded foundation for adolescent sexual health.

CONCLUSION

Sexual communication between parents and adolescents most professional attention is paid to the direct relationships between sexual communication between parents and adolescents’ sexual intentions and/or behavior. Parent and adolescent sexual communication underscores the need for proactive and open engagement. Overcoming communication barriers, understanding cultural influences, and integrating comprehensive sex education are crucial elements in fostering an environment that supports informed decision-making and healthy attitudes toward sexuality among adolescents. Implementing a holistic approach involves collaboration among parents, adolescents, educators, and policymakers to address the essential aspects of adolescent development. By working together, these stakeholders can create a supportive environment that fosters healthy growth, informed decision-making, and well-rounded development in adolescents.