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

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.

Keywords: Adolescents; Caregivers; Family strengthening; HIV prevention; Latent class.

Fig. 1

Consort diagram outlining enrollment and follow-up in Suubi4Her study (2017–2020). BSOC = bolstered standard of care; MFG = Multiple-family group; YDA = youth development accounts BSOC = bolstered standard of care; MFG = Multiple-family group; YDA = youth development accounts.

Fig. 2

Marginal predictive probabilities (and 95% confidence intervals) for class membership for sexual health communication. Average Prob-abilities for Each Measured Indicator by Class Membership