Duby Zoe, Verwoerd Wilmé, Isaksen Katja, Jonas Kim, Maruping Kealeboga, Dietrich Janan, Lovette Ashleigh, Kuo Caroline, Mathews Catherine
Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
Division of Social and Behavioural Sciences in the School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
SAHARA J. 2022 Dec;19(1):8-21. doi: 10.1080/17290376.2022.2060295.
Parent-adolescent sexuality communication, the process in which parents and their adolescent children discuss sexuality and sexual and reproductive health, is a key component for adolescents' protective behaviours. Open communication with parents, particularly mothers, enables informed sexual and reproductive health (SRH) decision-making amongst adolescent girls and young women (AGYW). As part of a qualitative study evaluating a South African combination HIV prevention intervention for AGYW, we explored perspectives on SRH communication among AGYW and mothers of AGYW, and the effects of the intervention on sexuality communication as perceived by AGYW, mothers of AGYW, intervention facilitators and implementers, and community leaders. In-depth interviews and focus group discussions were conducted with 185 AGYW aged 15-24 years who had participated in the intervention, seven mothers of AGYW intervention recipients, 14 intervention facilitators, six community leaders, and 12 intervention implementers. Key themes that emerged in analysis were (1) Barriers to Sexuality communication, (2) Implications of Gaps in Sexuality Communication, and (3) Addressing Barriers to Sexuality communication. Barriers to sexuality communication included inability or unwillingness to discuss sex, a generation gap, proscriptive socio-cultural guidelines, and mothers' discomfort, lack of knowledge and self-efficacy, and fear of encouraging promiscuity. AGYW described making poorly-informed SRH decisions alone, expressing a desire for more open communication with and support from parents/mothers. Framed within the social cognitive theory, these findings can help to guide efforts to address barriers around parent-adolescent sexuality communication, inform interventions aimed at targeting SRH issues amongst AGYW, such as unintended pregnancy and HIV, and support meaningful engagement of parents in supporting AGYW in navigating pathways to achieving their SRH goals.
父母与青少年之间的性健康交流，即父母与他们的青春期子女讨论性、性健康和生殖健康的过程，是青少年采取保护行为的关键组成部分。与父母，尤其是母亲进行开放交流，能使青春期女孩和年轻女性（AGYW）在性健康和生殖健康方面做出明智的决策。作为一项评估针对AGYW的南非艾滋病综合预防干预措施的定性研究的一部分，我们探讨了AGYW及其母亲对性健康交流的看法，以及该干预措施对性交流的影响，这些影响是由AGYW、AGYW的母亲、干预促进者和实施者以及社区领袖所感知到的。我们对185名年龄在15至24岁且参与了该干预措施的AGYW、7名AGYW干预接受者的母亲、14名干预促进者、6名社区领袖和12名干预实施者进行了深入访谈和焦点小组讨论。分析中出现的关键主题包括：（1）性交流的障碍；（2）性交流差距的影响；（3）解决性交流的障碍。性交流的障碍包括无法或不愿意讨论性、代沟、规范性的社会文化准则，以及母亲的不适感、知识和自我效能的缺乏，还有对鼓励滥交的恐惧。AGYW表示独自做出性健康和生殖健康方面信息不足的决策，表达了渴望与父母/母亲进行更开放交流并获得支持的愿望。基于社会认知理论，这些发现有助于指导消除父母与青少年性健康交流障碍的努力，为针对AGYW中性健康和生殖健康问题（如意外怀孕和艾滋病）的干预措施提供信息，并支持父母积极参与，帮助AGYW找到实现其性健康和生殖健康目标的途径。
