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Children and young people are learning about sex and relationships from soaps, magazines, adverts and their friends. The media is full of confusing messages about sex — it can seem like everyone is doing it all the time.
Try out PMC Labs and tell us what you think. Learn More. The current study includes cross-sectional survey data from adolescents. For sexually active teens, talk about protection methods was associated with fewer sexual partners and talk about risks of sex was associated with more sexual partners regardless of teen gender and the generation of extended family with whom teens talk.
However, the direction of the effect depends on the content of the conversations. These findings suggest the need to explore whether and how extended family could be included in health prevention and intervention programs, because programs which include family largely focus on parents.
Contraception and safer sex
Risky sexual behaviors, such as early onset of sexual activity and lack of protection, leave teens vulnerable to sexually transmitted infections STIs and unplanned pregnancy [ 1 ]. This focus overlooks findings that over half of teens talk with extended family about sex or relationships [ 5 ].
Preliminary quantitative research shows ificant associations between extended-family sexuality communication and teen sexual beliefs and behavior [ 56 ], but existing research often uses a single item to assess extended-family sexuality communication [ 78 ] and does not examine under what conditions extended-family sexuality communication can be protective or risk-promoting. Studies support associations between parent—teen sexuality communication and teen sexual behavior. These studies primarily focus on family of sex communication [ 410 ] and suggest that teen gender can shape these associations [ 411 ], although prior studies have not shown evidence for the moderating role of teen—parent relationships, such as closeness or relationship satisfaction.
Extended-family sexuality communication may be particularly relevant for Black and Latinx teens. Second, Black and Latinx teens shower high rates of teen pregnancy compared to White teens [ 16 ]. Therefore, Black and Latinx teens were the primary focus for recruitment for this sample.
Communication with extended family may be particularly important as teens become sexually active. At this stage, teens may become reluctant to talk with their parents about sexual issues as they fear their parents might judge them or worry about their sexual behaviors [ 1718 ].
Hence, some teens seek out extended family as a more comfortable alternative to parents [ 19 ]. In addition, parents often focus their messages to teens on delaying sex [ 20 ] which can be protective before teens become sexually active [ 21 ] but may be less effective when teens have already had sex. Extended family may be more open to discussing protection methods with teens, rather than only focusing on messages to delay sex [ 20 ]. Whether messages about sex are protective may depend on which extended family member the teen talks to.
Familism is distinct from closeness in that it family of sex to a cultural value of family relationships, while closeness refers to how connected a teen feels to a specific family member. Findings are mixed regarding whether the impact of family sexuality communication differs for girls and boys [ 41126 ].
While closeness with extended family has not been assessed for teen sexual behaviors, close relationships with extended family are associated with positive teen health outcomes, such as adjustment [ 32 ]. Familism entails a cultural belief in the importance of family interdependence [ 13 ]. The value of familism is particularly relevant in Latino and Black cultures, where extended family provides critical support for childrearing [ 1433 ].
We had no expectations for extended-family sexuality communication to be associated with whether teens have had vaginal sex. We expected stronger associations between extended-family sexuality communication for teens who report higher familism and more closeness with extended family. Analyses assessing whether effects of communication differ by extended-family generation and teen gender were exploratory.
Data for this study came from 11th and 12th grade students at six urban schools. Schools were recruited through school and district offices. All participants gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Wellesley College Institutional Review Board 19 December An online survey was developed and field-tested with 10 high school students in a pilot phase.
In this field test, students took the survey then gave verbal feedback about their perceptions of the survey.
Adjustments were made to the survey based on pilot feedback. The final survey had a 6th grade reading level, established by the Flesch—Kincaid Grade Level readability test. The survey was administered using Qualtrics and was available in English and Spanish. Fifty-eight students filled out the survey in Spanish. In each participating school, the liaison worked with the research team to plan data collection procedures. Teachers and administrators in the schools did not have access to any student responses but were present in the classrooms during survey administration.
A total of surveys were collected. Fifteen surveys were excluded from analysis because students agreed to participate but did not answer any of the survey questions. The remaining participants were included in study analyses. Thirty-five percent of adolescents reported having vaginal sex. We conceptualized extended family to focus on nonparental familial relationships, including aunts and uncles, grandparents, older cousins and older siblings, and godparents.
These family members may live with the teen or in a different household. These scales were adapted from the parent—adolescent communication scale PACS [ 34 ] and a measure of parent—child communication about sex-related topics [ 35 ]. Risk Communication was measured as a latent variable comprising four items asking whether extended family members talk to teens about the negative consequences of sex, including teen pregnancy and STIs.
To create a measure representing the generation of the extended family members, a family of sex variable was created. The first category included individuals who were the same generation of the youth respondents, such as older siblings and cousins. The third category included grandparents. To reduce the possibility of omitted variable bias, a series of control variables were included in each analytical model. A small of youths who selected a non-binary gender were coded as missing.
Impact of the family on the sex lives of adolescents
Youth age ranged from 14—21 and was measured continuously. Household structure options included two parents living in the same place, two parents living in different places, mother only, father only, other relatives, and people outside the family. Sexual behavior outcomes included vaginal sex, of sexual partners, and condom use.
Youth reported the of vaginal sex partners using a six-point response scale where they indicated whether they had 1, 2, 3, 4, 5 or 6 or more vaginal sex partners in the past 12 months. Before testing analytical models exploring associations between extended-family sexuality communication and adolescent sexual behaviors, we conducted psychometric analyses that examined the proposed structure of the three direct communication scales protection, risk, and relational communication.
Following the psychometric modeling of the direct communication scales, analytical models examining the primary research questions were pursued.
First, separate structural equation models SEM were used to test associations among extended-family direct sexuality communication and each of the three youth sexual behavior outcomes vaginal sex, of partners, and condom use. Next, a series of interaction models examined whether the link between extended-family sexuality communication and teen sexual behavior outcomes varied in relation to the generation of the extended family member, teen gender, closeness with extended family member, and teen familism values.
Each SEM comprised a measurement model and a structural model described ly and listed in Figure 1 below. The measurement model contained latent variables representing each of the three direct communication scales protection, family of sex, and relational communication. In the structural model, each of the observed exogenous variables and the three latent variables representing direct sexuality communication were regressed on the youth sexual behavior outcome.
In the moderation models, additional latent variables representing each moderating effect were also regressed on the youth sexual behavior outcome. The control variables described ly in the measures section were included in all models. Given that vaginal sex was measured dichotomously, model parameters were generated using a diagonally weighted least squares estimator WLSMV and pairwise estimation of missing data.
All analyses were conducted in the lavaan package version 0. Following the testing of the direct effect models, the interaction models assessing extended family generation, teen gender, closeness of extended family member, and teen familism values as potential moderators of the link between direct communication and teen sexual behaviors were pursued. Teen gender and extended family generation as moderators of the relationship between extended-family EF communication and teen sexual behaviors.
Teen familism and teen extended family EF closeness as moderators of the relationship between EF communication and teen sexual behaviors. showed that youth with higher reported condom use had either 1 low familism values and infrequent protection communication with extended family members or 2 high familism values and frequent protection communication with extended family members.
Talking about sex
Figure 2 displays the interaction between protection communication and familism values in predicting condom use. Teen familism values as a moderator of the link between extended-family protection communication and teen condom use. By contrast, extended-family messages about the risks of sex reasons not to have sex may strike a dissonant chord with teens who are already sexually active. For this group of teens, messages about delaying sex do not acknowledge their sexual behavior and suggest that sexual behavior is bad or inappropriate, while also failing to provide tools or information to support safer sex behaviors.
Future research may help to understand this unexpected finding. Relational communication was also not predictive of teen sexual risk behavior.
It may be that communication needs to focus on specific safer sex practices in order to be protective. As hypothesized, extended-family sexuality communication was not associated with having vaginal sex. The lack of ificant moderation findings for generation of extended family suggests that the protective potential of extended-family messages about sex does not depend on the age of the extended family member. This runs counter to findings that same-generation family members, such as siblings, promote risky sexual behavior among their younger teen relatives [ 24 ].