Document Type



Doctor of Philosophy (PhD)


Public Health

First Advisor's Name

Mary Shaw-Ridley

First Advisor's Committee Title

Committee chair

Second Advisor's Name

William W. Darrow

Second Advisor's Committee Title

Committee Member

Third Advisor's Name

Jessy G. Dévieux

Third Advisor's Committee Title

Committee Member

Fourth Advisor's Name

Florence George

Fourth Advisor's Committee Title

Committee Member

Fifth Advisor's Name

Amy R. Paul-Ward

Fifth Advisor's Committee Title

Committee Member


adolescent sexual health, parent-teen sex conversations, Black, Haitian, Jamaican, Afro-Caribbean, African American, culture

Date of Defense



Parent-teen sex conversations reduce Black adolescents’ HIV/STI risk. Nationally, most studies about Black teens’ sexual risk behaviors omit Afro-Caribbean groups whom are disproportionately burdened by HIV/STIs. Therefore, this exploratory study guided by the PEN-3 model (a) characterized the nature, perceptions, enablers, and nurturers of sexuality conversations between Haitian and Jamaican parents and adolescents and (b) explained the relationship between sexuality conversations and adolescent sexual activity.

Using narrative inquiry, 6 Haitian and 8 Jamaican mother-teen dyads’ and triads’ (N=31) experiences were used to characterize the nature, perceptions, enablers, and nurturers of parent-teen sex conversations. Thematic content analysis generated common themes. In phase two, Black adolescents (African American, Haitian, and Jamaican) N=157, completed a validated 52-item questionnaire. Scales included ASAI; measuring recent pre-coital and coital activities; FSCQ measuring families’ orientation towards sex-conversations, and PTSRC-III measuring sexual topics discussed with each parent. Linear and logistic regression determined the relationship between parent-teen sex conversations and teens’ sexual activity.

Mothers’ mean age was (41.85±5.50) and teens’ mean age was (16±1.31). Qualitative findings suggest that Afro-Caribbean mothers’ limited childhood and adolescent sex conversations and outcomes of those interactions shaped mothers’ existing attitudes, beliefs, and behaviors about sexual topics, and hindered their ability to discuss sex with their teens. Dyads believed modifying parents’ approach, improving parents’ sexual health knowledge, and increasing families’ comfort with sex- conversations would improve sexual discussions.

Survey participants’ mean age was (16±1.49) and mean age of penile-vaginal/anal sexual debut was (14.95±1.71). Twenty percent of sexually active teens had their first parent-teen sex conversation after penile-vaginal/anal sexual debut, p=.01, and 27% after penile-oral/vaginal-oral sexual debut, p=.001. Haitians had lower comfort with family-sex conversations than African Americans, p=.03 and Jamaicans, p=.004. African American teens’ higher comfort for family-sex conversations was predictive of delayed penile-vaginal/anal sexual debut, p=.009 and virginity, OR=1.5, 95% CI [1.154, 1.866]. Teens who never spoke to their fathers about protection from HIV/STI were four times more likely OR= 4.41, 95% CI [1.466, 13.30] to not use condoms. In summary, culturally-responsive, family focused interventions are needed to equip Afro-Caribbean parents for sex conversations with their teens in order to reduce teens’ sexual risk.





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