AIDSImpact.com:: - Santa Fe, USA 2011

Abstract #238 - Family dynamics of substance use and sexual risk among children in HIV-endemic South Africa
Authors: Presenting Author: Dr. Caroline Kuo - HEARD, University of KwaZulu Natal
Additional Authors: Dr. Lucie Cluver, Ms. Marisa Casale, Mr. Tyler Lane, Ms. Lebo Sello,
Aim: There is an increasing recognition of the need for family-centered approaches to HIV-affected communities. However, few studies document the family dynamics associated with health related impacts among families in HIV-endemic communities. We examine the relationship between parenting style and children’s engagement in risky sexual health behaviors including substance use and sexual risk behavior among families in HIV-endemic communities. A better understanding of the relationship between parenting and children’s health behaviors can inform our responses to support the resilience of families in HIV-endemic communities.
Method / Issue: A cross-sectional survey of 5,238 participants (2,619 children 10-17 years and their primary adult carers) was conducted in 2010 in urban and deep rural KwaZulu-Natal (HIV prevalence 36.3-41.6%). Random sampling of census enumeration size areas was used and visits to all households undertaken. Measures included the Alabama Parenting Questionnaire, Child Behavior Checklist, National Survey of HIV and Risk Behavior amongst Young South Africans, and SA Demographic and Health Survey for substance use and sexual behavior. Analyses assessed the relationship between parenting and risk behaviors using ANOVAs and regressions.
Results / Comments: Adult and child reports of parenting style were highly correlated (p<0.01). Children reported substance use (3.8%) and being sexually active (7.6%) with an average age of first sex at 14.2 years (SD=2.9). Among sexually active children, 63.3% did not use condoms consistently; 30.6% engaged in sex with casual, paid, or older partners, or had sex while using alcohol or drugs; 13.9% reported transactional sexual exploitation, for example, having sex for money, drinks, clothes, food, etc. Poor parental supervision was associated with children’s sexual activity (p<0.01) and engagement in transactional sexual exploitation (p<0.02); positive parenting and inconsistent parenting were not associated with substance use, sexual activity, or engagement in risky sex.
Discussion: Substance use and risky sexual behaviors are a key public health concern amongst this population of children. By improving parental or caregiver supervision we can potentially reduce levels of exposure to HIV risk amongst children.
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