Pathways to sexual health communication between adolescent girls and their female caregivers participating in a structured HIV prevention intervention in South Africa
| Autor: | Maretha Visser, Brian Luckett, Johanna Nice, Tonya R. Thurman |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Health (social science)
Anger management Adolescent Sexual Behavior medicine.medical_treatment Psychological intervention HIV Infections Structural equation modeling Developmental psychology South Africa 03 medical and health sciences 0302 clinical medicine History and Philosophy of Science medicine Humans Active listening 030212 general & internal medicine Reproductive health business.industry Communication 030503 health policy & services Mental health Focus group Caregivers Health Communication Adolescent Behavior Survey data collection Female Sexual Health 0305 other medical science business Psychology |
| Zdroj: | Social Science & Medicine. 260:113168 |
| ISSN: | 0277-9536 |
| DOI: | 10.1016/j.socscimed.2020.113168 |
| Popis: | Rationale. Interventions that promote sexual health communication between adolescents and their parents or other primary caregivers are an important tool for reducing female adolescents’ behavioral risk. Understanding the mechanisms by which interventions effectively foster communication can inform future programs. Objective An initial evaluation of Let’s Talk, a structured, family-centered HIV prevention intervention for vulnerable adolescents in South Africa, found an increase in caregiver-adolescent sexual communication. This analysis expands upon initial findings to explore the role of parental knowledge, the quality of the parent-adolescent relationship, and the mental health of both parties on caregiver-adolescent sexual health communication. Method Using mixed methods data collected in 2015 and 2016, structural equation modeling of differenced pre- and postintervention survey data from 64 female Let’s Talk participants ages 13-17 and their caregivers was used to explore the pathway to increased frequency of caregiver-adolescent sexual health communication. Focus group discussions (FGDs) were held with intervention participants (n = 25) and facilitators (n = 6). Results The path analysis indicates that caregivers’ mental health indirectly affected caregiver-adolescent relationship quality, and adolescents’ mental health exerted a direct effect. Relationship quality, in turn, directly affected the level of parental sexual communication reported by the adolescent. FGDs suggested that cultural norms inhibit frank discussions between caregivers and adolescents about sexual health, but that thoughtfully designed interventions such as Let’s Talk can mitigate this barrier. Qualitative findings also echoed quantitative findings about the role of caregiver-adolescent relationship quality and mental health on communication frequency and highlighted the importance of enhancing participants’ technical knowledge and particularly their skills related to expression, listening, and anger management to help enable sensitive conversations. Conclusions Findings overall suggest that a holistic intervention approach emphasizing caregiver-adolescent relationship development and designed to support the mental health of both parties may hold significant promise for enhancing sexual health communication. |
| Databáze: | OpenAIRE |
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