A review of studies of parent-child communication about sexuality and HIV/AIDS in sub-Saharan Africa

Improving the sexual and reproductive health of young people is a global priority. Interventions which aim to promote healthy sexual behavior typically aim to delay sexual debut, decrease the number of sexual partners and increase condom use. In spite of concerns that sexuality education may contribute to early sexual experimentation among young people, this is not supported by evidence [1]. On the contrary, findings from studies conducted in developing countries suggest that sexuality education has the potential to positively impact knowledge, attitudes, norms and intentions, although sexual behavior change has been more limited [2,3].Adolescent sexual decision making and behavior are influenced by myriad factors at the individual level as well as peer, family, community and societal levels. Parents in particular play a substantial role in the gender and sexual socialization of their children. Discussing topics related to sexuality has been associated with a range of important psychosocial attributes including increased knowledge, better interpersonal communication skills, including sexual negotiation skills, and self-efficacy [4-8]. Communication about sexuality between parents or caregivers and offspring has also been identified as a protective factor for a range of sexual behaviors, including a delayed sexual debut, particular for females [9].Studies focusing on parent-child communication have focused on a range of processes that may influence effectiveness in decreasing sexual risk behavior among young people such as frequency of discussions and perceptions of quality and comfort of communication [10,11]. The timing of communication is also of importance and is most likely to be effective prior to sexual debut to reinforce protective factors, but may also facilitate behavior change in those already sexually active [12]. The content of the message and how it is transmitted have also been identified as being particularly important [13]. Some studies have investig