Perceptions of adolescents' sexual behavior among mothers living with and without HIV: does dyadic sex communication matter?

Previous studies suggest that mothers can help adolescents make responsible sexual decisions by talking with them about sexual health. Yet, it is not clear how and when mothers make decisions about talking with their adolescents about sex. We sought to determine: (1) the accuracy of mothers' and adolescents' predictions of adolescents' age of sexual debut; and (2) if mothers' beliefs about their adolescents' sexual behavior affected the frequency of mother-adolescent communication about sexual topics and, in turn, if mother-adolescent communication about sexual topics affected mothers' accuracy in predicting adolescents' current and future sexual behavior. Participants were 129 urban, ethnic minority HIV-negative youth (52% male and 48% female; ages 10-14 years at baseline; ages 13-19 years at follow-up) and their mothers; 47% of mothers were HIV-positive. Most mothers and adolescents predicted poorly when adolescents would sexually debut. At baseline, mothers' communication with their early adolescents about sexual topics was not significantly associated with mothers' assessments of their early adolescents' future sexual behavior. At follow-up, mothers were more likely to talk with their adolescents about HIV prevention and birth control if they believed that their adolescents had sexually debuted, though these effects were attenuated by baseline levels of communication. Only one effect was found for adolescents' gender: mothers reported greater communication about sex with daughters. Studies are needed to determine how mothers make decisions about talking with their adolescents about sex, as well as to examine to what extent and in what instances mothers can reduce their adolescents' sexual risk behavior by providing comprehensive, developmentally appropriate sex education well before adolescents are likely to debut.