The influence of maternal HIV serostatus on mother-daughter sexual risk communication and adolescent engagement in HIV risk behaviors

Title: The influence of maternal HIV serostatus on mother-daughter sexual risk communication and adolescent engagement in HIV risk behaviors

Author: Julie A Cederbaum

Date: January 1, 2009


Objective . There is a growing body of literature that demonstrates positive parental influences on adolescents’ sexual initiation and sexual risk behaviors; little is known about how these processes operate when mom is HIV-positive. Youth of HIV-positive women are an extremely vulnerable population. They are often exposed to the same factors that placed their mothers at risk; many live in low-income, high seroprevalence inner-city areas. As these children come of age, we have the opportunity to understand parent-child sexual risk communication (PTSRC) and monitoring among HIV infected mothers, and how these behaviors may influence their child’s sexual decision-making.

Methods . Guided by a family-expansion of the Theory of Planned Behavior, this study employed a sequential mixed methods design to understand impact of maternal HIV status on maternal sexual risk communication and monitoring and in turn, how these behaviors effect daughters’ beliefs and behaviors. Phase one included 7 focus groups; this information was used to inform the development the survey instrument. Phase II was a self-administered survey completed by 110 mother-daughter dyads.

Results . Maternal HIV status was not a predictor of PTSRC or monitoring. Predictors of PTSRC included behavioral beliefs about PTSRC; relationship satisfaction was a predictor of parental monitoring. Maternal HIV status did significantly and positively influence daughters’ behavioral beliefs about the negative outcomes of sex and hedonistic beliefs about condoms. Further, maternal HIV status predicted daughters’ intentions to abstain. Child age, and normative and control beliefs also significantly predicted adolescent intention to have sex.

Conclusion . This study is one of few to explore the impact of maternal HIV status on adolescent risk behaviors. Knowledge of mother’s HIV status was predictive of behavioral beliefs; however, daughters of HIV-positive women were more likely to report ever having had sex. This shows that there is a disconnect between knowing and doing; it is this juncture that future HIV intervention must target. Important to include in future clinical and research interventions are: attention to structural factors in both physical and social community; helping families build healthy and satisfying relationships; and finding ways to create and influence community norms around abstinence and safer sex behaviors.

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