Family monitoring and sexually transmitted infections among African-American adolescent females

Background:  Parental monitoring is associated with reduced adolescent sexual risk. Other household family members’ knowledge about adolescents’ activities may also influence their sexual health.

Methods:African American females (n=701) aged 14-20 years participating in an HIV trial provided baseline self-reported data and a self-collected vaginal swab specimen assayed for chlamydia and gonorrhea.  Among 284 participants aged 14-17 years who reported a resident family member had the most knowledge about their activities, we assessed associations between family monitoring frequency and sexually transmitted infections (STIs).  Frequent family monitoring was defined as the resident family member with the most knowledge usually or always knows where the participant is and who she is with. Adjusted logistic regression models controlled for age and bivariate differences significant at p<0.1 among participants reporting frequent and infrequent monitoring.

Results:Over half (57%) reported frequent family monitoring.  Proportions positive for gonorrhea (5.0% vs. 14.6%, p=0.005) and both gonorrhea and chlamydia (19.3% vs. 28.5%, p=0.069) were significantly lower among participants reporting frequent monitoring; no significant difference in chlamydia prevalence was observed. Adjusting for age, parental communication about sex, physical abuse history, and alcohol use, frequent monitoring was associated with significantly decreased odds of testing positive for gonorrhea (AOR=0.25, 95% CI=0.10, 0.63) and either STI (AOR=0.55, 95% CI= 0.31, 0.99).

Conclusions: Extending the literature on parental monitoring and sexual risk, the findings suggest frequent family monitoring may be associated with reduced STI likelihood among African American adolescent females.  Family monitoring may offer an additional HIV/STI prevention opportunity for this vulnerable population.