237653 Parental Influence on Child Risk Behaviors in HIV-endemic South Africa

Monday, October 31, 2011

Caroline Kuo, DPhil , Department of Psychiatry and Alpert Medical School, Rhode Island Hospital and Brown University, Providence, RI
Lucie D. Cluver, DPhil , Department of Social Policy and Intervention, Oxford University, Oxford, United Kingdom
Marisa Casale, MSc , Health Economics and HIV/AIDS Research Division, University of KwaZulu Natal, Durban, South Africa
Tyler Lane, MSc , Department of Social Policy and Intervention/Health Economics and HIV/AIDS Research Division, University of Oxford/University of KwaZulu Natal, Oxford, United Kingdom
Lebo Sello , Health Economics and HIV/AIDS Research Division, University of KwaZulu Natal, Durban, South Africa
Background: Growing emphasis has been placed on the need for family-centered interventions to support HIV-affected families. However, few studies among HIV-affected families examine how parenting style influences children's engagement in substance use and risky sexual behavior.

Methods: A cross-sectional survey of 5,238 participants (2,619 children 10-17 years and their carers 18+ years) was conducted in KwaZulu-Natal (HIV prevalence 36.3-41.6%). A representative community sample was obtained from random sampling of census enumeration size areas and visits to all households. The Alabama Parenting Questionnaire, Child Behavior Checklist, National Survey of HIV and Risk Behavior amongst Young South Africans, and Demographic and Health Survey were used to assess parenting, substance use, and sexual behavior. ANOVAs and regressions assessed the relationship between parenting and risk behaviors.

Results: Adult and child reports of parenting style were highly correlated (p<0.01). Children reported substance use (3.8%) and sexual activity (7.6%). Among sexually active children, 63.3% used condoms inconsistently; 30.6% engaged in sex with casual, paid, or older partners, or had sex while using alcohol or drugs; 13.9% reported transactional sexual exploitation, for example, having sex for money, drinks, clothes, food, etc. Independent of sociodemographic covariates, poor parental supervision was associated with children's sexual activity (p<0.01) and engagement in transactional sexual exploitation (p<0.02).

Conclusions: Public health interventions need to address substance use and risky sexual behaviors among children in HIV-affected communities. Family interventions, particularly those involving parental supervision, may play a critical role in reducing children's HIV risk in HIV-affected communities.

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Chronic disease management and prevention

Learning Objectives:
1. Describe children’s substance use and sexual risk behaviors in HIV-endemic communities. 2. Identify whether parenting relates to children’s risk behaviors in HIV affected families. 3. Compare the influence of different parenting styles on children’s risk behavior in HIV affected families.

Keywords: Child/Adolescent, Developing Countries

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a post-doctoral fellow at Rhode Island Hospital/Brown University with a doctoral degree from the University of Oxford. I have given oral presentations at the last two APHA meetings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.