Influence of Maternal HIV Serostatus on Mother-Daughter Sexual Risk Communication and Adolescent Engagement in HIV Risk Behaviors

Background: Daughters of HIV-positive women are often exposed to the same factors that placed their mothers at risk; many live in low-income, high seroprevalence inner-city areas. The specific aims of this study were to: assess the relationship between maternal HIV status, parent-teen sexual risk communication [PTSRC], and daughter's HIV sexual risk beliefs and intentions.

Methods: Guided by a family-expansion of the Theory of Planned Behavior, this study collected survey data from 176 mother-daughter dyads in the Northeastern U.S. Mothers identified as HIV-positive or negative; all daughters were HIV-negative. Valid and reliable measures were used to collected data on demographics, parent-child relationship factors, communication, and behaviors. Multivariate and mediation analyses were conducted.

Results: Among mothers, 37% were HIV-positive; 86% were African American. Maternal HIV status did not predict PTSRC but did significantly influence daughters' behavioral beliefs about the negative outcomes of sex and hedonistic beliefs about condoms. Daughters of HIV-positive moms were, however, more likely to report ever having sex; no differences were found in condom use. Relationship satisfaction was predictive of PTSRC and of adolescents' intention to abstain.

Conclusions: Although mother's HIV status was predictive of beliefs, daughters of positive women were also more likely to report ever having had sex. This shows a disconnect between knowing and doing. Because these adolescents often remain in oppressed environments, their social conditions place them at risk for HIV. Important for future interventions: helping families build satisfying relationships to reduce risky behaviors of adolescents and influencing community abstinence and safer sex norms.