Barriers and Enhancers to Parent-Adolescent Discussion on Sexual Reproductive Health Issues and HIV Prevention Methods in Mount Darwin

Abstract

Adolescents are those people between 10 and 19 years. There are 1.2 billion adolescents in the world, making up 16% of the world’s population. Parent-adolescent discussion influences adolescents’ knowledge, attitudes and behavior. The more parents discuss issues such as sexual intercourse, the lesser the probability that the adolescents will be engaged in risky sexual behaviors. Today, parents find it difficult to discuss sexual reproductive health issues with their adolescents. This increases the chances of having unplanned pregnancies, early marriages and infections of sexually transmitted diseases particularly HIV/AIDS among adolescents. Mount Darwin district has the highest teenage pregnancies prevalence in the country standing at 37%. Mount Darwin district recorded a total of 1716 cases of teenage pregnancies, 833 of them among girls between the 16 and 17-year age group during the lockdown period stretching from March 2020 to February 2021. The aim of this study was to identify barriers and enhancers to parentadolescent discussion on sexual reproductive health issues and HIV prevention methods in Mount Darwin. Both cross sectional quantitative and phenomenology qualitative study designs were used where 220 participants (120 adolescents and 100 parents) from Mount Darwin and Chironga high schools were recruited into the study. Schools were purposively sampled whilst stratified random sampling was used to sample adolescents. Parents/guardians for the selected adolescents were then automatically recruited into the study. Questionnaires and interview guides were used to collect data during interviews and focus group discussions (FGDs) respectively. Quantitative data was analyzed using SPSS version 22 through descriptive statistics and bivariate statistics and was presented using tables and percentages. Qualitative data was analyzed thematically and presented using narrative notes. The study revealed that 48.5% of the adolescents were exposed to the discussions by the parents (p-value = 0.384). Girls had significantly higher odds of engaging into sexual reproductive health (SRH) related discussions than boys (Odds Ratio [OR] = 1.2; 95% CI: 0.7 – 2.1; p= 0.046). Adolescents aged 15-17-years had significantly higher odds of engaging into SRH discussions with their parents (OR = 2.4; 95% CI: 0.5 – 11.8; p = 0.029). Female parents had significantly higher odds of engaging into discussions on SRH issues with their children compared to male parents (OR = 1.3; 95% CI: 0.7 – 2.1; p = 0,038). Parents aged 45-49 years had significantly higher odds of discussing SRH related issues with their children (OR = 4.9; 95% CI: 1.0 – 25.0; p = 0.05). During FGDs the themes that came up included cultural construct, low parental knowledge as main problems and perceived benefits as an enhancer to discussions. The study concludes that parent adolescent discussion on SRH related issues is not a common practice in Mount Darwin and culture, religion parental low knowledge and parental responsibility denial are some of the barriers to discussions whilst perceived benefits and fear for stigma are enhancers to discussions. The study recommends that the hospital outreach programs and community health workers must do community based awareness campaigns targeting parent's knowledge and attitudes providing much needed information to boost their knowledge and clearing cultural misconceptions on parent-adolescent discussion on SRH related issues.