The Influence of Sexual Risk Communication Between Parents and Daughters on Sexual Risk Behaviors*
Two hundred thirty-four 19- to 21-year-old women completed interviews that assessed parent-adolescent relations, sexual communication, and selected sexual risk behaviors and outcomes. Overall, Hispanic-Latina respondents reported less parent-adolescent sexual communication than others. Early parent-adolescent sexual communication was associated with later age of sexual initiation, consistent condom use and, indirectly, less likelihood of sexually transmitted diseases. Mother-daughter communication about condoms was associated with consistent condom use. Recommendations for family-based HIV-STD prevention are presented.
Key Words: adolescents, family processes, parent, sexual behavior.
Although all sexually active persons are at some risk for negative sexual outcomes or "sexual risks" (Hutchinson, 1999), adolescents are a group at great risk. Every year, nearly one million unintended pregnancies and more than three million new cases of sexually transmitted diseases (STDs) occur among American adolescents (Alan Guttmacher Institute, 1994). Adolescents account for one-fourth of all STDs (American Social Health Association [ASHA], 1998) and a significant proportion of new HIV infections (Centers for Disease Control and Prevention [CDC], 1999).
In response to high rates of sexual risk behaviors and negative outcomes among adolescents, delaying the initiation of sexual intercourse and increasing condom use among adolescents are identified as two public health priorities in Healthy People 2000 (Department of Health and Human Services [DHHS], 1991). Recent studies have challenged popular beliefs that parents have no influence over the sexual behavior of the adolescent children. Several well-designed studies found parents' sexual values and sexual communication with their children exert significant influences on adolescents' attitudes toward sexuality, their initiation and participation in sexual activity, and their use of contraceptives and condoms (e.g., Jaccard & Dittus, 2000; Jaccard, Dittus, & Gordon, 1996; Miller, Norton, Fan, & Christopherson, 1998). Although mothers have consistently been found to be the primary sexual communicators with children, particularly daughters (e.g., Dilorio, Kelley, & Hockenberry-Eaton, 1999; Dutra, Miller & Forehand, 1999; Hutchinson, 2000a; Hutchinson & Cooney, 1998), fathers may play an important role through the discussion of sociosexual issues with daughters (Hepburn, 1981). Fathers may be able to provide daughters with unique perspectives, enhance their overall understanding of men, and provide opportunities to role-play communication strategies with men (Hutchinson, 1999, 2000b). However, much of the recent research on parent-adolescent sexual communication and family influences of adolescent sexual risk behaviors has been limited to communication and relationships with mothers. The purpose of the present study was to examine the influence of sexual communication with mothers and fathers on the sexual risk behaviors of adolescent daughters.
Sexual Risk Behavior of Adolescent Females
Female adolescents face even greater risk for STD transmission than their male peers and older adult women (Donovan, 1993; Hatcher et al., 1994: Panchaud, Singh, Feivelson, & Darroch, 2000). Teenage girls are more likely to be unmarried, have multiple sexual partners, and have unprotected sex (CDC, 2000; Panchaud et al.). Compared to adult women, adolescent females are also at greater biological risk to contract an STD, if exposed (CDC, 2000; Donovan, 1993, 1997; Santelli, DiClemente, Miller, & Kirby, 1999). Women face more severe long term sequelae from STD infections than men. Undiagnosed and untreated STDs in women may result in pelvic inflammatory disease, increased risk for ectopic pregnancy, infertility, devastating congenital infections in infants born to infected women (Hutchinson & Sandall, 1995; Institute of Medicine [IOM], 1997), and cervical cancer (Donovan, 1997). …