Although three-quarters of parents of Vietnamese youth say they sometimes or often talk with their child about romantic relationships, they rarely initiate discussions about sex.¹ In an analysis of baseline data from a reproductive health intervention study, three in five parents said they were uncomfortable or very uncomfortable discussing topics related to sexuality and relationships, and most of those whose child had had a girlfriend or boyfriend were not aware of the relationship. Parents with more education had spoken with their child about relationships and sex more frequently, and with less discomfort, than had parents who were not as highly educated.

Studies in developed countries have shown that adolescents who talk with their parents about sexuality are less likely than their peers to engage in sexual risk behaviors, and more likely to delay first intercourse. However, few studies in developing countries have examined parent-child communication about sex. In Vietnam, such communication, if it occurs at all, typically consists of parents telling their unmarried children not to have sex. Nonetheless, the prevalence of premarital sex may be rising in Vietnam; one recent study found that 24–33% of unmarried men aged 21–24 had had oral, vaginal or anal sex.

In the current study, researchers examined parent-child communication in a sample of Vietnamese youth who were taking part in a trial of three reproductive health interventions, one of which included a parental component. The study was conducted in 2006 in 12 communes (administrative subdivisions) in Hanoi (the capital), Nha Trang (a small city) and Ninh Hoa district (a primarily rural coastal area); these sites were chosen to provide diversity in location, population density and participants' socioeconomic status. Youth in these areas were randomly selected from census lists and were eligible for the trial if they were aged 15–20, unmarried (and not planning to marry in the next 12 months) and able to take part in the intervention for two hours per week for 10 weeks.

All youth completed baseline questionnaires that asked about demographic variables, social behavior and sexual activity. In the four communes that were randomized to the intervention with the parental component, parents who agreed to participate completed questionnaires that asked about their perceptions of their child's sexual behavior, their reproductive health knowledge and the frequency of (and their level of comfort with) their communication with their child about relationships, sex, pregnancy, contraceptives, standards of sexual behavior, and HIV/AIDS and other STIs. The researchers invited 359 parent-child dyads to take part in the study; 271 youth (76%) and 185 parents (52%) completed baseline questionnaires. In this analysis, which focused on the 185 parent-child dyads, researchers used chi-square tests to examine relationships between demographic variables and parents' knowledge of their child's relationships and sexual activity, and conducted linear regression analyses to identify associations between key variables and parent's reproductive health knowledge, frequency of communication about reproductive health and comfort level with such communication.

Forty-four percent of youth and 76% of parents were female. Youth had a mean age of 17; the vast majority (87%) were attending school, in most cases high school. About a third of both males (36%) and females (32%) reported having ever had a girlfriend or boyfriend. However, sexual activity was relatively uncommon: Just 19% of males and 4% of females reported having ever engaged in sexual touching, and only a few males (and no females) said they had had oral sex (2%) or vaginal sex (3%).

Parents were rarely aware of their child's relationships and sexual activity. Of the 36 parents whose son reported having had a girlfriend, only 10 (28%) knew about the relationship; similarly, of the 25 parents whose daughter had had a boyfriend, only five (20%) were aware. The proportions of sexually experienced adolescents whose parents knew or thought that their child had engaged in sexual touching was even lower (0–7%), although the sample sizes were very small (15 sons and three daughters).

Seventy-six percent of parents reported that they initiated conversations with their child about relationships "sometimes" or "often," but only 11% said the same about conversations concerning sexuality—and 76% had never had a discussion about the topic. Discussions about pregnancy and birth control were also uncommon: Nearly three in four parents (72%) had never broached these subjects. They were more willing, however, to discuss HIV, other STIs and standards of sexual behavior, as 57–74% of parents said they discussed these topics sometimes or often.

Most parents said they were "uncomfortable" or "very uncomfortable" discussing sexuality with their sons (62%) and daughters (61%). Far smaller proportions reported such discomfort when discussing pregnancy and birth control (46–51%), standards of sexual behavior (33–41%), relationships (23–32%) and HIV (19–30%). On average, parents rated their comfort level for talking about sexuality and relationships as 7.7 on an 18-point scale. Parents with more education spoke with their children about these topics more frequently, and with less discomfort, than less-educated parents; for example, compared with those who had no more than a primary education, parents who had attended college spoke about relationships and sexuality more frequently (9.3 vs. 5.2 on an 18-point scale) and reported higher levels of comfort (11.7 vs. 7.6). The most common barriers to talking about sexuality were concern that the child would become more interested in sex (87%), parental embarrassment (65%), lack of time (65%) and feeling uninformed (63%).

Linear regression analyses that controlled for parental education found that parents with higher levels of knowledge about reproductive health issues were more comfortable talking about sex than other parents, and that greater comfort was associated with more frequent conversations. Frequency of conversations was unrelated to parents' knowledge of their child's romantic and sexual activity.

The authors note that although the study had limitations—notably the small sample sizes and low recruitment rate for parents—the findings underscore "a need for interventions that provide [reproductive health] knowledge and communication skills to parents of adolescents." Programs aimed at adolescents themselves are also important, they add, but for most youth "parents remain a key potential resource." Interventions "may be particularly important in rural areas and for parents with lower education" levels, given that Vietnam is largely rural and that less- educated parents tended to be less knowledgeable about reproductive health issues and less comfortable talking about these issues than were other parents.—P. Doskoch

REFERENCE

1. Kaljee LM et al., Parent-youth communication and concordance between parents and adolescents on reported engagement in social relationships and sexually intimate behaviors in Hanoi and Khanh Hoa Province, Vietnam, Journal of Adolescent Health, 2011, 48(3):268–274.