Quality of Mother-Daughter Communication about Sex and Sexual Risk Behavior Among African American Girls Over Two Years

Background: Compared to Whites and Latinas, African American (AA) girls have higher rates of sexually transmitted infections (STI), including HIV. Mental health problems exacerbate STI vulnerability via increased sexual risk behavior. Mother-daughter communication about sex may reduce girls’ sexual risk, as mothers are the preferred source for sexual information. However, studies link increased sexual risk taking with both more and less parent-teen communication, but few studies examine the quality of communication on sexual risk over time, particularly among AA mothers and daughters seeking mental health services.

Methods: 266 AA mothers and their 12-16 year-old (M=14.5) daughters recruited from outpatient psychiatric clinics completed 5 waves of assessments over two years. Using ACASI, girls and mothers separately reported on girls’ mental health and mother-daughter sexual communication, and girls reported on their sexual behavior.

Results: At baseline, more parent-reported and teen-reported externalizing problems predicted less teen-reported open communication, but only parent-reported externalizing problems was negatively associated with parent reports of open communication. The trajectory of parent-reported open communication over time was negatively associated with girls' sexual risk behavior at 2-year follow up. Specifically, trajectories of decreasing openness were associated with more sexual risk behavior compared to trajectories of increasing openness. Girls' ratings of open communication were not related to sexual risk outcomes.

Conclusions: Findings underscore the potential protection of open mother-daughter communication on sexual risk for AA girls. Family-based interventions focused on the quality rather than the quantity of mother-daughter communication about sex may help reduce STI/HIV transmission risk.