Societal Norms and Open Communication about Sex-Related Issues as Predictors of Safer Sex
Author(s): M. S. Selvan1, M.W. Ross2, P. Parker3
Vol. 30, No. 4 (2005-10 - 2005-12)
Introduction:
Human immunodeficiency virus (HIV) and acquired
immunodeficiency syndrome (AIDS) are pandemic and are
one of the greatest challenges to worldwide public health
including India. According to the United Nations, there are
about 4 million HIV infected people in India, and India is
considered a high-risk country1. Adolescents and young adults
15 to 24 years old are the hardest hit by HIV infection worldwide
and a significant proportion of them live in India. Despite the
high prevalence of HIV/AIDS, it has been reported that many
adolescents do not know the transmission mode of this
disease.
One way to promote safer choices among adolescents is by
having open communication and discussions about sex and
condom use. In India, due to the deep-seeded taboo on
discussing sexuality2 adolescents and their parents do not
freely discuss sex and HIV related topics. Indian girls are
more restricted than boys, and therefore it is essential to find
out if there are still sex differences even in the face of the
threat of HIV/AIDS.
Methods:
The study population was selected from 3 of the largest senior
higher secondary schools in differnt regions in Mumbai, India.
The questionnaire consisted of the health-behavior questions
from the U.S. Centers for Disease Control Safer Choices
project, and AIDS Social Assertiveness Scale. More details
about the questionnaire, study and data collection approval
can be found elsewhere3.
The respondents were 1250 eleventh and twelfth grade (known
as "plus two") higher secondary school students between 15
and 18 years of age. An overwhelming number of the
respondents parents were college graduates (66%, of the
fathers and 50% of the mothers) suggesting that these
students were from highly educated upper middle class
families. Eighty percent of the respondents lived with both
their parents in nuclear families or in traditional Indian joint
families (with their parents and grandparents). Twenty percent
of the children lived in single-parent families.
The questions assessed how comfortable students were in
discussing sex-related and HIV-related issues. Six questions
measured if and how much the students discussed sex-related
matters with parents, other adults in the family and friends. In
addition, two questions were asked about abstinence and condom use. The students were given the option to read a
book if they were not interested in answering the questionnaire.
Out of 1250 students, 11 did not respond to any item and
returned blank questionnaires. Several other students who
participated chose not to respond to a few items, so the
responses do not total to 1250 for all of the questions. To
analyze the data we used SPSS Version 10.1.3 (SPSS Inc.,
Chicago, IL).
Results and Discussion:
The major difference between boys and girls was in their
comfort level talking about sex with their friends. Statistical
significant sex differences were reported in discussing sexrelated
issues with parents, other family members and friends.
About 30% males were comfortable in discussing sex-related
issues "a lot" with their friends whereas it was only 16% girls.
Most male and female Indian students do not have open
communication with their parents and other family members.
It was known that in United States students feel that
discussing sexual safety, development, and societal concerns
with their parents is important4 and was positively associated
with intended condom use5. Although the numbers who
discussed about sex-related issues with parents and others
family members a lot was low for both girls and boys, it was
lower for girls than boys. The possible reasons for poor
communication are religious beliefs, and the traditional belief
that sex is considered appropriate for discussion only after
marriage with one's partner.
Also, safer sex norms and beliefs about protection through
condom use were higher for boys compared to girls. The only
possible explanation for the higher proportion of boys reporting
open communication with friends may be because they were
more westernized than girls. More studies are needed to further
explain this possibility.
One of the strengths of this study is that it is the first published
study assessing the communication patterns of adolescents
with regard to sexual behavior, condom use, and HIV/AIDS in
India. Neither discussions of sexual matters with significant
others nor gender differences among teenagers in discusing
sex and drug related issues with parents have been widely
studied. However, fear of AIDS has made sex a legitimate
topic of discussion in the Indian mass media. Such discussions
will increase students awareness and knowledge about highrisk
behaviors and how to avoid them. More research in this
area will also help policy makers and health education
professionals plan appropriate policies to control HIV/AIDS.
References:
- UNAIDS. Global HIV/AIDS & STD Surveillance:
Epidemiological Fact Sheet by country. 2002. http://www.unaids.org/hivaidsinfo/statistics/fact_sheets/pdf/India_en.pdf.
- International AIDS Vaccine Initiative (IAVI). The AIDS
Pandemic in India. IAVI Report-February/March 2001-2001. http://www.aegis.com/pubs/iavi/2001/IAVI 2001-0303.html.
- Mathai R, Ross MW, Hira S. Concomitants of HIV/STD risk
behaviours and intention to engage in risk behaviours in
adolescents in India. AIDS Care. 1997; 563-75.
- Rosenthal, D.A., & Feldman, S. The importance of
importance: adolescents perceptions of parental
communication about sexuality. Journal of Adolescence,
1999; 111-118.
- Whitaker DJ, Miller KS, May DC. et al. Teenage partners
communication about sexual risk and condom use: the
importance of parent-teenager discussions. Family
Planning Perspectives, 1999; 117-121.
1. Deptt. of Epidemiology,
2. Center for Health Promotion and
Prevention Research,
3. Deptt. of Behavioral Science, The
University of Texas M.D. Anderson Cancer Center, Houston, TX,
USA.
Introduction:
Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are pandemic and are one of the greatest challenges to worldwide public health including India. According to the United Nations, there are about 4 million HIV infected people in India, and India is considered a high-risk country1. Adolescents and young adults 15 to 24 years old are the hardest hit by HIV infection worldwide and a significant proportion of them live in India. Despite the high prevalence of HIV/AIDS, it has been reported that many adolescents do not know the transmission mode of this disease.
One way to promote safer choices among adolescents is by having open communication and discussions about sex and condom use. In India, due to the deep-seeded taboo on discussing sexuality2 adolescents and their parents do not freely discuss sex and HIV related topics. Indian girls are more restricted than boys, and therefore it is essential to find out if there are still sex differences even in the face of the threat of HIV/AIDS.
Methods:
The study population was selected from 3 of the largest senior higher secondary schools in differnt regions in Mumbai, India. The questionnaire consisted of the health-behavior questions from the U.S. Centers for Disease Control Safer Choices project, and AIDS Social Assertiveness Scale. More details about the questionnaire, study and data collection approval can be found elsewhere3.
The respondents were 1250 eleventh and twelfth grade (known as "plus two") higher secondary school students between 15 and 18 years of age. An overwhelming number of the respondents parents were college graduates (66%, of the fathers and 50% of the mothers) suggesting that these students were from highly educated upper middle class families. Eighty percent of the respondents lived with both their parents in nuclear families or in traditional Indian joint families (with their parents and grandparents). Twenty percent of the children lived in single-parent families.
The questions assessed how comfortable students were in discussing sex-related and HIV-related issues. Six questions measured if and how much the students discussed sex-related matters with parents, other adults in the family and friends. In addition, two questions were asked about abstinence and condom use. The students were given the option to read a book if they were not interested in answering the questionnaire. Out of 1250 students, 11 did not respond to any item and returned blank questionnaires. Several other students who participated chose not to respond to a few items, so the responses do not total to 1250 for all of the questions. To analyze the data we used SPSS Version 10.1.3 (SPSS Inc., Chicago, IL).
Results and Discussion:
The major difference between boys and girls was in their comfort level talking about sex with their friends. Statistical significant sex differences were reported in discussing sexrelated issues with parents, other family members and friends. About 30% males were comfortable in discussing sex-related issues "a lot" with their friends whereas it was only 16% girls.
Most male and female Indian students do not have open communication with their parents and other family members. It was known that in United States students feel that discussing sexual safety, development, and societal concerns with their parents is important4 and was positively associated with intended condom use5. Although the numbers who discussed about sex-related issues with parents and others family members a lot was low for both girls and boys, it was lower for girls than boys. The possible reasons for poor communication are religious beliefs, and the traditional belief that sex is considered appropriate for discussion only after marriage with one's partner.
Also, safer sex norms and beliefs about protection through condom use were higher for boys compared to girls. The only possible explanation for the higher proportion of boys reporting open communication with friends may be because they were more westernized than girls. More studies are needed to further explain this possibility.
One of the strengths of this study is that it is the first published study assessing the communication patterns of adolescents with regard to sexual behavior, condom use, and HIV/AIDS in India. Neither discussions of sexual matters with significant others nor gender differences among teenagers in discusing sex and drug related issues with parents have been widely studied. However, fear of AIDS has made sex a legitimate topic of discussion in the Indian mass media. Such discussions will increase students awareness and knowledge about highrisk behaviors and how to avoid them. More research in this area will also help policy makers and health education professionals plan appropriate policies to control HIV/AIDS.
References:
- UNAIDS. Global HIV/AIDS & STD Surveillance: Epidemiological Fact Sheet by country. 2002. http://www.unaids.org/hivaidsinfo/statistics/fact_sheets/pdf/India_en.pdf.
- International AIDS Vaccine Initiative (IAVI). The AIDS Pandemic in India. IAVI Report-February/March 2001-2001. http://www.aegis.com/pubs/iavi/2001/IAVI 2001-0303.html.
- Mathai R, Ross MW, Hira S. Concomitants of HIV/STD risk behaviours and intention to engage in risk behaviours in adolescents in India. AIDS Care. 1997; 563-75.
- Rosenthal, D.A., & Feldman, S. The importance of importance: adolescents perceptions of parental communication about sexuality. Journal of Adolescence, 1999; 111-118.
- Whitaker DJ, Miller KS, May DC. et al. Teenage partners communication about sexual risk and condom use: the importance of parent-teenager discussions. Family Planning Perspectives, 1999; 117-121.
1. Deptt. of Epidemiology,
2. Center for Health Promotion and
Prevention Research,
3. Deptt. of Behavioral Science, The
University of Texas M.D. Anderson Cancer Center, Houston, TX,
USA.