Research That Matters (January 17 - 20, 2008)

Purpose: Parents foster their children's development through day-to-day counseling and directing their children's behavior in reference to standards or role expectations communicated through child-parent interactions (Peterson and Rollins, 1987). In Uganda—a country especially threatened by AIDS, with over 1 million children who have lost one or both parents due to the disease (UNAIDS, 2006)—many adolescents do not witness the normally expected parental-child trajectory. Many orphaned and vulnerable children (OVC) are not able to count on the guidance and support of their parents, which can make the transition into adulthood challenging.

The quality of family relationship aids in the overall adjustment of children and reduces engagement in high risk behaviors, e.g. delays onset of sexual intercourse (McNeely, 2002). Most studies on parenting and risk taking behaviors are based on the western industrialized countries with different socio-economic influences. Therefore, this study tests the role of family relations in influencing sexual risk taking of OVC in the traditional context of rural Uganda. Moreover, sexual risk taking (SRT) in Africa is usually analyzed in respect to HIV, focusing on safe sex practices and ignoring other SRT behaviors (early sexual relations and multiple sexual partners). The current study ascertains the socio-demographic and family factors necessary to protect OVC from risk taking behavior in an African setting.

Method: This study uses data from the NIMH funded SUUBI Research Project testing an intervention promoting life options (including health) for OVC. The study used an experimental design to recruit 284 OVC from fifteen comparable schools in Southern Uganda. A 90-minute individual interview was adapted from previously tested scales in the US and South Africa (Levy, 1993; Auslander, 1992). (1) Family relations were measured on 4-point scales and included 3 components: family cohesion, perceived caregiver support, and communication about risk taking behaviors (“Family members feel very close to each other”, “How often do your parents talk with you about having sex?”). (2) Outcome variables included a 6-item SRT Attitudes scale (“I believe it's OK for people my age to have sex with someone they've just met”) and SRT Behaviors (history of sexual intercourse; age at the first intercourse; number of sexual partners; and frequency of unprotected sex).

Results: The bivariate analysis indicated that SRT attitudes were negatively associated with caregiver support (r=-.224, p<.000) and the number of boy/girlfriends was negatively associated with the family cohesion (r=-.861, p=.006). Regression analysis showed that after controlling for demographic differences, caregiver support was the only significant component (B = -.156, p=.007) affecting SRT attitudes. Meanwhile the frequency and comfort level of talking about sex did not show any significant impact.

Implications: The study revealed that even with the devastation of family structures created by HIV/AIDS, traditional African family networks are important and still relatively strong. The results demonstrate the importance of family interventions when targeting prevention of risk taking behaviors among adolescents. Having conversations in the family about sex and other risk taking behaviors is not sufficient if family cannot provide the actual emotional support and guidance to the child.