Original Investigation
January 2016

Parent-Adolescent Sexual Communication and Adolescent Safer Sex BehaviorA Meta-Analysis

Author Affiliations
  • 1Department of Psychology, North Carolina State University, Raleigh
  • 2Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
  • 3School of Media and Journalism, University of North Carolina at Chapel Hill

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Pediatr. 2016;170(1):52-61. doi:10.1001/jamapediatrics.2015.2731

Importance  Parent-adolescent sexual communication has received considerable attention as a factor that can positively affect safer sex behavior among youth; however, the evidence linking such communication to youth contraceptive and condom use has not been empirically synthesized.

Objectives  To examine the effect of parent-adolescent sexual communication on safer sex behavior among youth and explore potential moderators of this association.

Data Sources  A systematic search of studies published from database inception through June 30, 2014, using the MEDLINE, PsycINFO, and Communication & Mass Media Complete databases and relevant review articles yielded 5098 studies, of which 52 studies with 25 314 adolescents met the study eligibility criteria. Analysis was conducted from July 1, 2014, to July 27, 2015.

Study Selection  Studies were included if they sampled adolescents (mean sample age ≤18 years), included an adolescent report of sexual communication with one or both parents, measured safer sex behavior, and were published in English.

Data Extraction and Synthesis  Correlation coefficients (r) and 95% CIs were computed from studies and meta-analyzed using random-effects models.

Main Outcomes and Measures  Safer sex behavior, including use of contraceptives or condoms.

Results  Fifty-two articles, including 71 independent effects representing more than 3 decades of research on 25 314 adolescents (weighted mean age, 15.2 years) were synthesized. Across studies, there was a significant weighted mean effect (r = 0.10; 95% CI, 0.08-0.13) linking parent-adolescent sexual communication with safer sex behavior, which was statistically heterogeneous (Q = 203.50, P < .001, I2 = 65.60). Moderation analyses revealed larger effects for communication with girls (r = 0.12) than boys (r = 0.04) and among youth who discussed sex with their mothers (r = 0.14) compared with their fathers (r = 0.03). Effects did not differ for contraceptive vs condom use or among longitudinal vs cross-sectional studies, indicating that parent sexual communication had a similar effect across study designs and outcomes. Several methodological issues were identified in the literature; future studies can improve on these issues by measuring parent-adolescent communication with robust, multi-item measures, clearly specifying the target parent, and applying multimethod longitudinal designs.

Conclusions and Relevance  Sexual communication with parents, particularly mothers, plays a small protective role in safer sex behavior among adolescents; this protective effect is more pronounced for girls than boys. We discuss the implications for practice and make suggestions for future research on parent-adolescent sexual communication.