Role of Primary Caregiver Support as a Protective Factor against High Risk Sexual Behavior among African-American Adolescent Females

Background: African-American adolescent females are among those at highest risk for contracting an STI. Positive familial factors such as parental monitoring and social support have been found to influence adolescents' sexual risk-taking. This study examined the role of primary caregiver support as a protective factor against high-risk sexual and substance use behaviors.

Methods: Sociodemographic, family, and self-reported behavioral data were obtained from 701 African-American adolescent females (ages 14-20 years) seeking services at reproductive health clinics. Data were obtained at baseline, prior to randomization and participation in an HIV prevention trial. Bivariate and logistic regression analyses were performed to explore associations between primary caregiver support (operationalized as the ability or inability of the caregiver to provide encouragement, open communication, and trust) and behavioral outcomes (smoking, alcohol and drug use, condom use, contraceptive use, and number of lifetime sexual partners).

Results: Bivariate analyses indicate primary caregiver support was positively associated with increased contraceptive use (p=.001) and negatively associated with marijuana use in the past 90 days (p=.001). Regression analyses revealed that participants reporting positive primary caregiver support were more likely to have used a condom at last sex (OR = 2.4; p=.032) and abstained from drug and alcohol use in the past 60 days (OR = 3.4; p= .002).

Conclusions: Primary caregiver support is an important protective factor mitigating against adolescent participation in high-risk sex and substance use behaviors. Designing preventive interventions that incorporate parents and modify the home environment may be an important strategy influencing adolescents' avoidance of adverse health behaviors.