In the JournalsPerspective

Parents can improve teen condom use but do not delay sex

Photo of Laura Widman
Laura Widman

A meta-analysis of nearly 3 decades of research showed that parent-based interventions can increase condom use among teenage children but they do not delay the teens’ sexual activity.

Study researcher Laura Widman, PhD, an associate professor in the department of psychology at North Carolina State University, and colleagues wrote that youth aged 15 to 24 years account for half of the 20 million annual STI cases, even though they make up only 25% of the sexually active population. Additionally, teens are at an increased risk for unintended pregnancy.

“Parents play a major role in shaping the norms, values and sexual decision-making capacity of their children,” Widman told Infectious Diseases in Children. “Parents’ level of familiarity with their own values around sex, as well as their child’s development and interpersonal context, makes them able to tailor sexual information to best suit their child’s needs. In this way, parents provide an important perspective that a physician or other trusted adult may not be able to offer.”

The researchers examined 31 studies published through March 2018 that were related to parents’ involvement in sexual health interventions and their effect on delayed sexual activity and condom use, as well as communication about sex between the parent and child.

Parent speaks with teenage son 
Source: Adobe Stock

The average age of the 12,464 teens included in the studies was 12.3 years. The researchers observed that parent-based interventions significantly improved condom use (standard mean difference = 0.32; 95% CI, 0.13-0.51) as well as communication about sex (standard mean difference = 0.27; 95% CI, 0.19-0.35). However, parent-based interventions did not significantly delay the teen’s sexual activity compared with control programs (standard mean difference = –0.06; 95% CI, –0.14 to 0.02).

Further analyses demonstrated that interventions that targeted younger teens, black or Hispanic youth, both parents and teens, and consisted of 10 or more hours were more effective compared with interventions that targeted older adolescents, mixed race and/or ethnicity samples, parents only, and took less time.

Widman said that only two of the studies included in the meta-analysis included newer technology-based approaches, such as engaging families through online programs or smartphone apps. She suggested that more of these programs are needed to make this information readily available for parents.

“Additionally, only one-third of the studies in our review had a 100% parent completion rate,” she added. “This suggests that we need to improve the way that families are engaged and retained in sexual health programs, especially those families at highest risk.”

In a related editorial, Vincent Guilamo-Ramos, PhD, MPH, LCSW, ANP-BC, AAHIVS, the director and founder of the Center for Latino Adolescent and Family Health at the New York University Silver School of Social Work, and colleagues wrote that although teens are traditionally the target of interventions to promote safer sexual practices, less attention has been placed on parents’ involvement in those interventions.

“The renewed interest in reconfiguring national approaches to address persistent adolescent and young adult sexual and reproductive health disparities provides an opportunity to align national policies and programmatic efforts to emphasize the important role of parents in adolescent and young adult sexual and reproductive health,” they wrote. – by Katherine Bortz

Disclosures: Widman reports receiving grants from the Office of Population Affairs for the U.S. Department of Health and Human Services during the conduct of the study. Please see the study for all other authors’ relevant financial disclosures. Vincent Guilamo-Ramos and colleagues report no relevant financial disclosures.

Photo of Laura Widman
Laura Widman

A meta-analysis of nearly 3 decades of research showed that parent-based interventions can increase condom use among teenage children but they do not delay the teens’ sexual activity.

Study researcher Laura Widman, PhD, an associate professor in the department of psychology at North Carolina State University, and colleagues wrote that youth aged 15 to 24 years account for half of the 20 million annual STI cases, even though they make up only 25% of the sexually active population. Additionally, teens are at an increased risk for unintended pregnancy.

“Parents play a major role in shaping the norms, values and sexual decision-making capacity of their children,” Widman told Infectious Diseases in Children. “Parents’ level of familiarity with their own values around sex, as well as their child’s development and interpersonal context, makes them able to tailor sexual information to best suit their child’s needs. In this way, parents provide an important perspective that a physician or other trusted adult may not be able to offer.”

The researchers examined 31 studies published through March 2018 that were related to parents’ involvement in sexual health interventions and their effect on delayed sexual activity and condom use, as well as communication about sex between the parent and child.

Parent speaks with teenage son 
Source: Adobe Stock

The average age of the 12,464 teens included in the studies was 12.3 years. The researchers observed that parent-based interventions significantly improved condom use (standard mean difference = 0.32; 95% CI, 0.13-0.51) as well as communication about sex (standard mean difference = 0.27; 95% CI, 0.19-0.35). However, parent-based interventions did not significantly delay the teen’s sexual activity compared with control programs (standard mean difference = –0.06; 95% CI, –0.14 to 0.02).

Further analyses demonstrated that interventions that targeted younger teens, black or Hispanic youth, both parents and teens, and consisted of 10 or more hours were more effective compared with interventions that targeted older adolescents, mixed race and/or ethnicity samples, parents only, and took less time.

Widman said that only two of the studies included in the meta-analysis included newer technology-based approaches, such as engaging families through online programs or smartphone apps. She suggested that more of these programs are needed to make this information readily available for parents.

“Additionally, only one-third of the studies in our review had a 100% parent completion rate,” she added. “This suggests that we need to improve the way that families are engaged and retained in sexual health programs, especially those families at highest risk.”

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In a related editorial, Vincent Guilamo-Ramos, PhD, MPH, LCSW, ANP-BC, AAHIVS, the director and founder of the Center for Latino Adolescent and Family Health at the New York University Silver School of Social Work, and colleagues wrote that although teens are traditionally the target of interventions to promote safer sexual practices, less attention has been placed on parents’ involvement in those interventions.

“The renewed interest in reconfiguring national approaches to address persistent adolescent and young adult sexual and reproductive health disparities provides an opportunity to align national policies and programmatic efforts to emphasize the important role of parents in adolescent and young adult sexual and reproductive health,” they wrote. – by Katherine Bortz

Disclosures: Widman reports receiving grants from the Office of Population Affairs for the U.S. Department of Health and Human Services during the conduct of the study. Please see the study for all other authors’ relevant financial disclosures. Vincent Guilamo-Ramos and colleagues report no relevant financial disclosures.

    Perspective
    Edward W. Hook III

    Edward W. Hook III

    Although there was no significant impact on the timing of sexual debut — despite a significant impact on intention to delay onset of sexual activity — parental involvement led to increased self-reported condom use and increased parent-adolescent communication regarding sexuality and sexual health. The greatest impact was on those with the highest STI rates: younger participants, as well as black and Hispanic adolescents. Conversations initiated at an earlier age were more impactful, and the more parents communicated with their children, the better. 

    Although this large study described the impact of interventions targeting parent-child interventions, there is a crucial role for clinicians to play in effective implementation of the findings. Clinicians have a privileged status in advising parents on health matters and can play a central role in encouraging parents to initiate “the conversation” earlier as an ongoing conversation, not as an event.

    • Edward W. Hook III, MD
    • Endowed professor of infectious disease translational research
      Departments of medicine, epidemiology and microbiology
      University of Alabama at Birmingham

    Disclosures: Hook reports no relevant financial disclosures.