Promoting healthy families: Advice from HIV+ parents on how to talk about prevention

BACKGROUND: Parents can play a critical role in HIV prevention efforts by using effective parenting practices and communicating their values and expectations. Despite the protective role of parent-child communication on adolescent risk behavior, much remains unknown about the strategies parents use to communicate with adolescents. This is particularly true for youth in families already affected by HIV, who are often considered among the highest risk for contracting HIV themselves. OBJECTIVE: To investigate how HIV+ talk about HIV prevention with adolescents, including what they deem effective versus less effective communication. METHODS: Mothers and fathers living with HIV were recruited through HIV service organizations in the Midwest. Parents underwent a semi-structured interview and filled out a questionnaire to assess the strategies they used to discuss HIV prevention with their 10-18 year old children. Interviews were audio-recorded, transcribed, and analyzed by two coders for recurring themes. RESULTS: 90 parents reported on their communication strategies. Collectively, these parents cared for 317 children. Strategies viewed as effective included enlisting support, using an effective talking style (open, supportive, relaxed), and instilling values and expectations. Strategies viewed as ineffective included using a maladaptive talking style (being harsh or sugar-coating reality), avoiding communication, and giving low quality information. CONCLUSIONS: Parents reported frequent communication about HIV prevention with adolescents. Parents' perceived effectiveness of those strategies overlapped considerably with what current health behavior research deems effective parent-adolescent communication. Communication programs aimed at increasing parent-adolescent communication could easily be tailored to meet the needs of families affected by HIV.