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Parents' and teachers' communication about HIV and sex in relation to the timing of sexual initiation among young adolescents in Tanzania

Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, kkawai{at}hsph.harvard.edu

Sylvia F. Kaaya

Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Lusajo Kajula

Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Jessie Mbwambo

Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Gad P. Kilonzo

Department of Psychiatry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

Wafaie W. Fawzi

Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA, Department of Nutrition, Harvard School of Public Health, Boston, MA, USA

Aims: Early sexual debut is associated with increased HIV risk among young adolescents in sub-Saharan Africa. Our study examines parents' and teachers' communication about sexual matters in relation to the timing of sexual initiation among students aged 12—14 years old in Dar es Salaam, Tanzania. Methods: Virgin primary school students were followed prospectively for 6 months to assess sexual initiation. Socio-demographic, psychosocial, and behavioural factors were assessed with a structured questionnaire. Univariate and multivariate logistic regression analyses were performed. Results: Of 2477 adolescents, 26.9% of students reported communicating about HIV and sex with parents and 35.6% communicated with teachers. Communication with teachers about HIV and sex was associated with delayed sexual initiation among adolescents after adjusting for potential confounding factors (OR=0.59, 95%CI=0.40—0.89, p=0.01). However, parental communication was not associated with the timing of sexual initiation. The perception that most peers are sexually active was a significant predictor of early sexual debut (test for linear trend, p=0.002). Students who do not live with a biological mother were marginally more likely to initiate sex compared to those who live with a biological mother (OR=1.39, 95%CI=0.97—1.99, p=0.08). Conclusions: Teachers can play an effective role in discussing HIV and sex with young adolescents. Our study highlights the necessity of responsible adults discussing sexual matters with young adolescents in sub-Saharan Africa. More research is required to better understand the role of parental communication about sexual matters and strategies for improving the quality of parental communication.

Key Words: Adolescents • communication • HIV • parents • sexual initiation • Tanzania • teachers

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