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Rebecca Wind
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MANY PARENTS BELIEVE TALKING TO PRETEENS ABOUT SEX IS IMPORTANT,
YET FEEL UNPREPARED TO DO SO

Parents’ beliefs about the importance of talking to their children about sex may not be reflected in their behavior, according to “Parents’ Perspectives on Talking to Preteenage Children About Sex,” by Ellen K. Wilson et al., published in the March issue of Perspectives on Sexual and Reproductive Health. Participants in a series of 2007 focus groups for parents of children aged 10–12 were nearly unanimous that parents should talk to their children about sex, and 89% believed that talking to their child would make a difference in whether he or she had sex at a young age. However, many had not done so.

In focus group discussions, many parents suggested that although age 10–12 might be an appropriate time to talk about sex-related topics such as puberty and the biology of reproduction, it was too young to start talking to children—or at least to their children—about issues related to sexual intercourse. Additionally, parents discussed not knowing how to talk to their children about sex.

Parents also completed a questionnaire, in which the main barriers they reported were feeling uncomfortable (39%), thinking someone else would do it better (37%) and thinking it might encourage their children to have sex (32%). Other identified barriers were parents’ not knowing enough about sex, having poor communication with their children in general, being too busy and considering their children too young to talk about sex.

The authors recommend interventions that support parents in opening the lines of communication with their children, talking to them about sexuality throughout childhood and assessing what topics are appropriate at different ages. They suggest that providing parents with information about the stages of sexual development could help them understand their children’s need for information about sex even before their youngsters show signs of interest.

Sexual and Reproductive Health: Priorities for the Next Decade

The March issue of Perspectives on Sexual and Reproductive Health features a special Roundtable, in which leading experts in the field discuss what issues most need to be addressed in sexual and reproductive health research.

  • In “Reframing Research on Adolescent Sexuality: Healthy Sexual Development as Part of the Life Course,” Carolyn Tucker Halpern addresses the field’s history of treating adolescent sexuality strictly as a problem, and emphasizes the importance of approaching it as a developmental process, thereby helping young people make the transition from exploratory sexual activity to healthy sexual lives.
  • James Trussell and his coauthors express their disappointment that emergency contraceptive pills have not made a significant dent in reducing unintended pregnancy rates, and discuss ways to achieve that goal, in “Research Priorities for Preventing Unintended Pregnancy: Moving Beyond Emergency Contraceptive Pills.” They suggest the importance of helping women both to recognize when they need an emergency method and to get one in a timely way, as well as the importance of addressing the goal of reducing unintended pregnancy outside the context of emergency situations.
  • In “Family Planning Service Delivery Research: A Call to Focus on the Dynamics of Contraceptive Use,” Linda Hock-Long et al. examine the challenges faced by the service delivery system stemming from a lack of research on the changing dynamics and patterns of contraceptive use over a person’s reproductive life span. The authors write that without this information, providers frequently struggle to help patients make informed decisions. They suggest a need for advances in contraceptive service delivery that keeps pace with advances in available technologies.
  • “Behavioral Research on Biomedical Sexual Health Technologies: Opportunities and Directions,” by Gregory D. Zimet, focuses on how to maximize individuals’ willingness and intention to use emerging biomedical technologies to promote sexual health. Zimet suggests that until these technologies can be delivered by means that require no effort by individuals, behavioral research will be necessary to ensure their adoption by the greatest numbers of persons. He also explores the importance of cross-disciplinary research.

Also in this issue of Perspectives on Sexual and Reproductive Health:

Levels of unintended childbearing are rising, and repeat unintended births are common, according to “Repeat Unintended, Unwanted and Seriously Mistimed Childbearing in the United States,” by Elizabeth Wildsmith et al. Analyses based on data from the National Survey of Family Growth find that the identification of a birth as unintended depends not only on whether the birth is explicitly planned but also on the acceptability or suitability of having a birth in a particular social context. Women are more likely to identify a first birth as mistimed or seriously mistimed than as unwanted, while the opposite is true for higher parity births. Additionally, black women have higher levels of unintended childbearing than whites or Hispanics. The authors suggest that interventions increase their focus on identifying women who have experienced an unintended birth, as such women appear to be at high risk of having subsequent unintended pregnancies.

Sexual behavior among Latino youths is predicted by three sexual values, according to “Sexual Values and Risky Sexual Behaviors Among Latino Youths,” by Julianna Deardorff et al. Those values are the importance youths attach to virginity, the importance they attach to satisfying sexual needs and their comfort with sexual communication. The authors analyzed data collected from a sample of sexually active Latinos aged 16–22 in San Francisco in 2003–2006 and found that sexual values were associated with both protective and risk-enhancing sexual behaviors. Among women, the importance attached to female virginity was negatively associated with lifetime and recent numbers of sexual partners, and was positively associated with nonuse of condoms. Additionally, the greater women’s comfort with sexual communication, the lower their age at first sex. Among men, the greater the importance attached to satisfaction of sexual needs, the younger the reported age at first sex and the higher the lifetime number of partners. The authors suggest a need to integrate themes of virginity and sexual desire into intervention curricula, so that young people can understand how cultural sexual norms affect their behavior.

Understanding the link between nonromantic relationships and partner concurrency can help individuals assess the risks associated with their relationships, according to “The Contexts of Sexual Involvement and Concurrent Sexual Partnerships,” by Anthony Paik. In a sample of adult men and women drawn from the 1995 Chicago Health and Social Life survey, one in 10 of each gender reported that both they and their partners had had other partners. Men were more likely than women to have been nonmonogamous, and individuals who were sexually involved with a friend or a casual partner were more likely than those in a serious relationship to have been nonmonogamous. The author suggests that the more awareness people have about the relationship-building processes, the better they will understand the risks and rewards of their own relationships.

Adolescent sex may be intermittent, and teenagers’ pregnancy and STD prevention needs after a period of abstinence may depend on the length of that period, according to “Characteristics Associated with Sex After Periods of Abstinence Among Sexually Experienced Young Women,” by Mary A. Ott et al. Using longitudinal data gathered from a sample of teen women between 1999 and 2006, the authors find that different intrapersonal, relationship and STD-related characteristics were associated with the risk of having sex after periods of abstinence of varying lengths. For example, a recent STD diagnosis was associated with a reduced risk that a short period of abstinence ended with sexual activity, but with an increased risk that a period of intermediate length ended. Relationship quality and sexual interest were associated with an elevated likelihood that an abstinence period of any duration ended. To provide teens with sexual health counseling that is relevant to their typical pattern of sexual activity, the authors recommend that clinicians ask teens not only whether they are sexually active, but when they last had sex.

Knowing about a partner’s risky behavior outside a relationship can help individuals assess the extent to which sex within that relationship puts them at risk, but that knowledge is sometimes lacking, according to “Lack of Awareness of Partner STD Risk Among Heterosexual Couples,” by Susan S. Witte et al. As many as one in 10 participants in a couples-based study were unaware that their partner had recently had a concurrent partner, had used injection drugs or had had a recent STD diagnosis; 2% of women and 4% of men were unaware that their partner was HIV-positive. Individuals who are unaware of their partners’ risk behaviors and STD status may develop a false sense that they are protected from infection. The authors suggest that couples-oriented intervention strategies are needed to allay fears of stigmatization and rejection by a partner, and to provide a safe space for disclosure and follow-up.

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