Parent-Adolescent Sexual and Reproductive Health Communication Is Very Limited and Associated with Adolescent Poor Behavioral Beliefs and Subjective Norms: Evidence from a Community-Based Cross-Sectional Study in Eastern Ethiopia
Outcomes: Human Immunodeficiency Virus, Sexual and Reproductive Health
View SourceKey Social Norms Take-Aways Adolescents’ poor communication with parents about sexual and reproductive health is strongly influenced by social norms and beliefs. Many adolescents believe that talking about sexual and reproductive health with parents is inappropriate, embarrassing, or could lead to negative consequences. These subjective norms—especially when reinforced by peer expectations—discourage open dialogue. Gender norms also play a role, with boys less likely than girls to receive information from parents. Norms that frame parents as uninformed or uncomfortable discussing sexual matters further reduce communication. Programs aiming to improve adolescent-parent communication must directly challenge these deeply held beliefs and build supportive environments that promote open and informed conversations.
Objectives The study aimed to identify the factors influencing parent-adolescent communication on sexual and reproductive health in Harar, Eastern Ethiopia, particularly focusing on adolescents’ beliefs, perceived social norms, and the quality of their relationships with parents.
Methods This cross-sectional study surveyed 4,559 adolescents aged 13–18 living in Harar. Communication was assessed through a 9-item scale measuring the frequency of discussions with either parent on topics related to sexual and reproductive health. Additional scales captured adolescents’ self-disclosure to parents, general communication quality, behavioral beliefs about discussing these issues, subjective norms (peer influence), and perceived parental knowledge. Responses were categorized as very poor, poor, or satisfactory communicators. Data were analyzed using generalized ordered logit models.
Results Communication between adolescents and parents was limited: only 31% were satisfactory communicators, while 39% were poor and 30% were very poor. Most adolescents had never discussed contraception or condom use with their parents, and conversations were more likely to happen with mothers than fathers. Factors linked with poor communication included being male, younger age, discomfort discussing sexual and reproductive health, low general communication quality, poor self-disclosure, and viewing parents as lacking knowledge. Negative behavioral beliefs (e.g., fear that such discussions might encourage sexual activity) and unsupportive peer norms were strong predictors of poor communication.
Conclusions Parent-adolescent communication on sexual and reproductive health in Ethiopia is very limited, largely due to stigma, misinformation, and perceptions of parental discomfort or inadequacy. Interventions must address these social and cultural barriers, improve parental knowledge, and foster open, supportive environments for communication.
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