Sexual Communication Within Families And Influence On Sexual Behaviour And Contraception Among Young People In The Brong Ahafo Region

ABSTRACT

Background: Young people aged 10-24 years represent a significant proportion of the Ghanaian population. Many are sexually active and are at considerable risk of negative health outcomes due to lack of adequate sexual and reproductive health knowledge. Although growing international evidence suggests that parent-child communication about sex has significant positive influence on young people’s sexual behaviours, this subject has been poorly explored among Ghanaian families. Little is known about how sexual communication transpires, its determinants and the types of topics parents talk about when they engage their children in sexual discussion. Knowing the predictors of parental sexual communication, nature and the extent to which sexual communication influences young people’s sexual behaviours are important for any intervention to reduce sexual risk behaviours among young people.

Objective: To explore the relationship between parental sexual communication and young people’s sexual behaviours and contraception in the Brong Ahafo region of Ghana.

Methods: A cross-sectional design was used to sample 823 parent-child dyads through a two-stage systematic sampling technique with probability proportional to size. Interviewer-administered questionnaire method was used to gather quantitative data on parent-child communication and sexual behaviour. Twenty specific sexual topics categorized into biological/physical development, sexual risk prevention and experiential sex were investigated to describe the patterns, contents and frequency of communication. Congruence between parent and child reports about whether sexual discussions had occurred was also examined. The Pearson’s chi-square and hierarchical multiple regression techniques were utilized to analyse sexual topics and predictors of parental communications respectively. In-

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depth interviews were used collect qualitative data to flesh-out relevant issues that standard questionnaire could not cover satisfactorily.

Results: Mean (SD) age of young people was 16.9 (4.0) years and 47.3(10.1) years for parents. Majority (74.4%) of parents had ever discussed sexual issues with their children. Mothers communicate more to children than fathers. Discussions centred on sexual risk prevention topics, including sexual abstinence, HIV/AIDS, STDs, puberty, menstruation, physical development, premarital sex, and substance use. Parents discussed different sexual topics at different child ages. About 43% (50% females and 36% males) of young people reported being sexually active, of which 65% had had multiple sexual partnerships. Young men were two times more likely than young women to have engaged multiple sex partners; odds ratio (95% confidence interval) = 1.9 (1.22 – 3.06). Multiple logistic regression revealed that family religiosity, parental sexual knowledge, parent discipline and parental trustworthiness increase the odds of parents discussing sexual issues with their children. Additionally, on-time communication (sexual discussion occurring before a child initiates sex) appeared to be protective against sexual activities.

Conclusions: Parent-child sexual communication promises to be an important medium to effect protective behaviours and behavioural change among young people. Educational interventions for parents could enable parents to communicate more effectively with their children for healthy development.