Family-Based Sex Education Promotes Safe Sex Among Teens

By Lisa Rapaport

May 08, 2020

(Reuters Health) - A sexual health education intervention that involves both adolescents and their mothers makes teens less likely to engage in sexual intercourse and more likely to use condoms when they do, a recent experiment suggests.

Researchers recruited 900 adolescents 11 to 14 years old and their female caregivers to participate in a randomized trial of a sexual health intervention that included: one-on-one sessions with mothers; workbooks for mothers to use with teens to talk about safe sex; and follow-up calls to mothers to reinforce safe sex messages. Researchers randomized participants to this intervention; an active control group where mothers got help sessions and other support around nutrition; and a passive control group of mothers who agreed to participate but were not selected for any sessions.

At the 12-month follow-up, 5.2% of teens in the intervention group reported having sexual intercourse, compared with 18% in the two control groups.

In addition, just 4.7% of teens in the intervention group reported having their sexual debut within the past 12 months, compared with 14.7% in the control groups.

"Research shows that when sexual debut is delayed, adolescents are more likely to adopt strategies in preventing unplanned pregnancies, sexually transmitted infections, and HIV infection due to having more time to mature, both physically and cognitively," said coauthor Vincent Guilamo-Ramos, director of the NYU Center for Latino Adolescent and Family Health in New York City.

Among teens in the study who did report being sexually active, 74.2% of youth in the intervention group and 49.1% in the control group said they used condoms the last time they had intercourse.

"Delaying premature sexual debut, and condom use among adolescents, results in less likelihood of health, social, and economic consequences for youth, their families and society as a whole," Guilamo-Ramos said by email.

Out of the 900 dyads participating in the study, 73.4% identified as Hispanic and 20.4% identified as African-American.

Mean maternal age was 38.8 years. All of the teens were in grades six through eight in middle school, with a mean grade level of 6.9.

At the start of the study, 3% of the teens reported that they had previously had sexual intercourse.

Compared with teens in the intervention group, youth in the control groups were more likely (relative risk 3.50) to report ever having vaginal intercourse by the end of the study and to report having sex for the first time by the end of the study (RR 3.12). Teens in the intervention group were more likely (RR 1.48) to report condom use if they did have sex, compared with those in the control group.

Beyond just encouraging teens to wait to have sex and to practice safe sex, the intervention also focused on encouraging parents to monitor teens' activities after school and plans with friends, as well as expectations about checking in regularly, calling when late, and consequences for breaking rules.

Outcomes were self-reported, and there's a potential for teens to give researchers answers that they think are socially expected, even if their responses aren't entirely truthful, the study authors note.

Even so, the results underscore the importance of early conversations about sexual health, and the importance of healthcare providers giving parents the support the need to have these difficult discussions, they add.

"There is not an age at which children or teens are 'too young' for conversations about sexuality and relationships," said Laura Widman, an associate professor of psychology at North Carolina State University in Raleigh who coauthored a commentary accompanying the study.

"Ideally, these will be ongoing conversations throughout a child's life that become more detailed or advanced as kids get older," Widman said by email.

Parents can begin open conversations about sexuality when children are very young, for example, by naming body parts and answering basic questions about how bodies work, Widman advised. Then as kids move into adolescence, parents can be having conversations about sexual activity, reproduction, sexual health, and how to prevent pregnancy and sexually transmitted infections.

If parents wait too long to start these discussions, they may have a harder time getting through to their teens, Widman said.

"By the age of 12 or 13, the majority of teens are talking about these topics with their friends and many teens have already been exposed to pornography or will be soon," Widman said. "So, if parents wait 'until a child is old enough,' it will probably be too late."

SOURCE: https://bit.ly/2xCtuPr and https://bit.ly/35GFMD2 Pediatrics, online April 28, 2020.

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