velez gonzalez borges 2005 adolescence 2005 vgb (2)

8/15/2019 Velez Gonzalez Borges 2005 Adolescence 2005 VGB (2)

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FAMILY FUNCTIONBVG AND EARLY ONSET OF SEXUAL

INTERCOURSE IN LATINO ADOLESCENTS

Maria C. V61ez-Pastrana Rafael A. Gonzdlez-Rodriguez and

Adalisse Borges-Hemandez

ABSTRACT

The purpose of this study was to identify factors associated with early onset

of sexual intercourse. Within an ecological system s conceptual framework,

familial factors associated with early onset of sexual activity were identified

in a sample of

4 5

adolescents from San Ju an metro area schools. Measures

included questions about sexual activity, sexual permissiveness, and such fa-

milial variables

a s:

discipline, parental supervision, and parental support. Sig-

nificant rela tionsh ips were observed between early onset of sexual intercourse

and parental supervision, discipline, parental support, and parents marital

status.

Results suggest the key role of parents and family in prevention of

HlV-risk behaviors among adolescents in terms of delaying sexual onset. Over-

all,

th e study described youths

who

postponed sexual activity

as

having greater

support, supervision,

and

parental involvement.

SEXUAL HEALTH-RISK BEHAVIORS AMONG LATINO/HISPANIC YOUTH

An age and racial disparity in HIV/STD infection has been observed

in the U.S. (CDC, 2002), where young people, and minority youth in

particular, are hit hardest. Thus, Latino/Hispanic youth are at in-

creased risk for HIV/STD infection compared to their nonminority

peers.

According to the Youth Risk Behavior Survey's (YRBS) 2004

data, nationwide 46.7 of students in grades 9 to 12 have had sexual

intercourse. However, the prevalence is higher among African Ameri-

can (67.3 ) and Hispanic (51.4 ) than among white youth (41.8 ;

Centers for Disease Control and Prevention, May

21,

2004). The preva-

lence of sexual intercourse before age 13, of having 4 or more sex

partners, and the prevalance of unintended pregnancies show the same

trend. The prevalence of using a condom at last intercourse was lowest

among Latino/Hispanic students (57.4 vs. 62.5 in non-Hispanic

This study was supported by Grant Number 1 R24 MD00152-01, from the

National Center on Minority Health and Health Disparities, National Insti-

tute s of Health. The contents are solely the responsibility ofthe authors and do

not necessarily represent th e official views ofthe National Institu tes of Health.

Requests for reprints should be sent to Maria C. Velez-Pastrana, Ph.D.,


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white and 72.8 in African American stud ents; Cen ters for Disease

Control and Prevention, May 21, 2004). These findings suggest that

Latino/Hispanic youth are at greater risk for adverse health conse-

quences such as contracting HIV and other STDs, when compared to

non-Hispanic white youth. Furthermore, Kaberege et al. (2003) high-

light the fact that ^though the birth rates in U.S. adolescents had

decreased in the past years, African American and Latino/Hispanic

teens have higher birth rates when compared with non-Hispanic

white teens.

isparity in HIV Risk

Becoming sexually active at an early age places youth at increased

risk for contracting HIV and other sexually transmitted diseases

(STDs). The risk of acquiring

IV

and STDs is higher in you th, particu-

larly among minorities (Centers for Disease Control and Prevention,

2002). Four million teens in the U. S. contract an STD each year, and

half of the 40,000 new HIV cases in the U.S. are younger th an 25 (Alan

Guttmacher Institute, 2003). Furthermore, there has been a steady

increase in HIV/AIDS diagnoses among Latinos/Hispanics from 1999

to 2002 (Centers for Disease Control and Prevention, 2002). These

trends indicate an age and racial disparity in HIV/STD infection.

Sexual

ntercourse

and HIV Transmission

HIV infection through sexual contact is high, being the second mode

of HIV transmission after intravenous drug use. HIV infection often

occurs in late adolescence/young adulthood, but most cases are diag-

nosed years later, when they are in the 25 to 39 age group (Centers

for Disease Control and Prevention, 2002).

A significant number of adolescents become sexually active at an

early age. In Puerto Rico, it has been reported that

31

of 15- to 19-

year-olds are sexually active. Of these, only 34 used a condom at last

intercourse and 7 reported having 4 or more sexual partne rs in their

lifetime (Puerto Rico Department of Education, 1997). While in the

United States the adolescent birth rates have declined in the last de-

cade, from 62.1/1000 in 1991 to 48.5/1000 in 2000, the rates in Puerto

Rico have not declined as sharply, for example, from 72.4 in 1991 to

71.5 in 2000 (Centers for Disease Control and P revention, 2002).

In order to reduce the disparity in HIV/STD infection among young

Latinos/Hispanics, we need to identify the factors associated with risky

sexuEil behaviors such as becoming sexually active at an early age.

Thus, one approach to prevention is delaying the onset of sexual ac-

tivity.


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Theoretical

Framework

Ecological Systems Theory

Luster Small (1994) developed a 4-factor model based on Bronfen-

brenner's (1979, 1986) Ecological Systems Theory in order to under-

stand adolescent sexual activity. The model encompasses 4 levels of

factors. The individual level includes personal characteristics such as

alcohol, cigarette and substance use, attitudes, and self-esteem. The

family

level includes family characteristics; the level

of extra familial

factors includes peers and school. A fourth level, macro describes char-

acteristics of the greater community and social environment. The

model as applied to explaining risk factors includes the concept of

cumulative risk, which asserts that as exposure to risk factors (at any

level) increases, the probability of being sexually active increases (Per-

kins, Luster, Villamiel, & Small, 1998; Small & Luster, 1994). Re-

search assessing the ecological risk factor model has suggested that

alcohol use, low academic achievem ent, risk behaviors among peers, a

history of sexual abuse, and lack of parental supervision increase the

probability of risky sexual activities in youth (Perkins et al., 1998).

The curren t research is pa rt ofa larger project that evaluates factors

from the individual, family, and extrafamilial levels. The present paper

reports on the relevance of family characteristics with respect to early

sexual onset among Latino/Hispanic youth.

Familismo

Familism (Familismo) refers to att itude s, behaviors, and family

structures operating ^yithin an extended family system and is believed

to be the most important influence in the lives of Latinos (Romero,

Robinson, Haydel, Mendoza & Killen, 2004). Latino families who ex-

press a higher degree of Familismo a re characterized by positive inter-

personal familial relationships, high family unity, social support,

interdependence in the completion of daily activities, and close proxim-

ity with extended family members (Romero et al., 2004). In sum, Fami-

lismo refers to how strongly a person connects with his or her family.

It represen ts th e centra l position of the family in the life of the individ-

ual. As a result, parents usually tend to be overprotective of their

children (Marsiglia, 1990). Various studies have documented Familism

as being associated with higher academic achievement and educational

aspirations (Valenzuela Dombusch, 1994); it has been linked to posi-

tive health outcomes (Romero et al., 2004), and attenuated drug use

(Valenzuela & Dornsbusch, 1994). Given the importance of the family

ih Latino/Hispanic culture , it seems appropriate to explore family char-

acteristics associated with early sexual onset in Latino/Hispanic youth.

Traditionally, prevention efforts to address sexual risk behaviors have


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Furthermore, Hovell, Sipan, Blumberg, Atkins, Hoffstetter &

Kreitner (1994) explored mothers' attitud es about establishing adoles-

cent dating rules, about their children's sexual behavior, and about

abstinence in rela tion to the sexual behavior of Anglo and Latino ado-

lescents. Interestingly, they identified some ethnic differences in the

level of sexual experience am ong ado lescents, where nglo teens report

the greatest amount of sexual experience as compared to their Latino

peers.

Their findings suggest that conservative parental attitudes

about sex and the presence and enforcement of dating ru les may delay

the onset of sexual intercourse. Given cultural differences among Lat-

ino/Hispanic families, parenting styles and disciplinary practices

should be examined as they relate to early sexual onset in Hispanic/

Latino teens.

Parental Support Communication

Communication between mothers and daughters may contribute to

und erstanding the onset of sexual activity (O'SuUivan, Jaramillo, Mo-

reau, & Meyer-Bahlburg, 1999). O'Sullivan et al. examined the rela-

tionship among mother-daughter communication patterns, onset of

sexual activity, and o ther adolescent risky sexual behavior. Their find-

ings suggest that mother-daughter communication may contribute to

understanding the onset of sexual activity, although its relationship

to subsequent sexual experiences is not as clear.

Furtherm ore, in a study of young women ages 19 to 21, Hutchinson

(2002) assessed the timing and amount of parent-child communication

about sexual issues. Hispanic/Latina women reported lower levels of

communication about sexual issues with their parents as compared

with non-Latino/Hispanic women (Hutchinson, 2002). Women who dis-

cussed sexual issues with their parents and had good communication

with them were less likely to initiate sexual intercourse. These commu-

nication patterns were also associated with consistent condom use.

While

78

of African Am erican women reported communication about

sexual issues prior to the ir first sexual intercourse, only

53

of Latinas

and 50 of white women reported doing so.

As Jaccard, Dittus, and Gordon (1998) argue, typically research

about parent-child communication is based on reports of teens ' percep-

tions of the process. They examined the congruency of parent-child

communication as reported by both mother and child, and found that

mothers tend to underestimate the sexual activity of their children,

especially if conversations about sexual issues have not taken place

before. Additionally, they found that m others who strongly disapprove

of sexual engagement with their children are more likely to believe


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amily Structure

Family structura l and contextual characteristics such as living with

a single parent, having older siblings who are sexually active or preg-

nant sisters, living in a disorganized or dangerous neighborhood, low

socioeconomic sta tus or being sexually abused can place youths at risk

and infiuence adolescent sexual behavior (Miller, 2002). Living in a

two-parent family household is an important factor associated with

reduction in early onset of sexual activity (Young & Jensen, 1991).

According to these authors, family structure plays a key role in under-

standing adolescent sexual behavior, where a traditional two-parent

family may be related to less adolescent sexual activity (Young Jen-

sen, 1991). Hypothetically, both parents provide a more stable environ-

ment in which values can be reinforced. Fu rtherm ore, they a rgue that

single-parent families could model nonmarital sexual behavior and

provide less emotional support, which could lead the adolescent to rely

on peers for information about sexual issues and modeling of sexual

behavior. Family structure is an important factor in understanding

early sexual onset in Hispanic/Latino youth.

M THO

Participants

Four hundred and twenty-five Puerto Rican adolescents ages 12-16

(mean age 13.49) participated in the study. The sample was recruited

from grades 7 to 10 from ten public schools in the San Juan metropoli-

ta n area . It consisted of 270 (63.5 ) females and 155 (36.5 ) males.

With respect to the marital status of the participants' parents, 54

of the sample came from two-parent households (married or living

together),

41

from separated/divorced parents, and

4.7

from widow-

ers. As to pa rents' educational level, 57.4 finished high school; 13.5

hold a technical degree;

21.9

hold a college degree;

7.1

hold a gradu-

ate degree, and

15.1

did not finish high school.

Instruments and

easures

Data were collected on a large number of factors associated with

adolescent sexual activity as par t of a larger study. A self-report ques-

tionnaire to be completed by the adolescent, which included questions

about sexual behavior as well as individual, family, and extrafamial

variab les, was developed. It included questions on the following: coping

skills, self-esteem, talents and skills, alcohol, tobacco, and other drug

use,

sexual permissiveness, relations with peers, social support, and


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Sociodemographic Data

Basic sociodemographic information including the youth's age, gen-

der, grade, parents' educational level, and parents' marital status was

collected, as well as information about religious £iffiliation. Information

about academic achievem ent (grades, GPA, grades failed) was included

in the data sheet.

Measures of Family C haracteristics

Parentdl supervision I mon itoring

To assess parental monitoring,

five questions about the type and quality of monitoring/supervision

provided by participeuits' parents were asked. The items are con-

structed on a 4-point scale th at ranges from never to always. A

sample item inquires: When you're not home, how often do your par-

en ts know your whereabouts? Questions about parenta l supervision

when the youth is not in school, as well as supervision of the youth's

activities such as the use of the Intemet and video games were in-

cluded in this section.

Parental support Ten questions from the Parent-Child Involvement

Scale were used to assess parenta l support. The 10-item scale assesses

parental support as evidenced by involvement in their children's deci-

sion making, problem solving, and shared leisure activities, as reported

by the youth. Smith and Krohn (1995) reported an inte rnal consistency

coefficient of .78 with a Latino/Hispanic sample, while Bravo et al.

(2001) reported a .80 reliability coefficient in a Puerto Rican sample.

Items inquire about how oflen th e pa ren ts help with homework, listen

to their prohlems, and are availahle to do things together, and were

analyzed as individual items.

Discipline Eight questions from the Parental Discipline Practices

Scale (MECA/SURF; Goodman et al., 1998) were used to evaluate the

disciplinary practices employed hy the participants' pa ren ts. The scale

inquires ahout use of physical and nonphysical forms of punishment,

and is also divided into negative and positive types of disciplinary

measures. Responses range from 1 (never/almost never) to 2 (very of-

ten).

The reliability coefficients in a Puerto Rican sample for the non-

pimitive and physical punishment subscales were .64 and .69,

respectively, as reported by Goodman et al. (1998). Sample items in-

clude: How often do your paren ts pra ise you? ; How often do your

parents ignore you or act cold and indifferent as punishment?

Fam ily structure The paren t's marita l sta tus was used as an indica-

tor of family structure. This question was included in the sociodemo-

graphic data sheet.


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RESULTS

Sexual Behavior in Early Adolescence

A total of 425 12- to 16-year-old adolescents participated in the

study . Among these, 383 (91.8 ) reported not being sexually active,

while 34 (8.2 ) reported being sexually active. There was a significant

age difference between sexually active and abstinent teens .F (1,415)

= 15.01,

p <

.001). On average, active teens were one year older. The

mean age for sexually active participants was 14.15 years, while the

mean age for abstinent teens was 13.44. There was a weak b ut signifi-

cant association between gender and being sexually activity (Phi coef-

ficient = 0.124, p = 0.012), where more males reported being sexually

active. Specifically, 19 (12.7 ) males were sexually active, compared

to 15 (5.6 ) females.

The majority ofthe sexually active adolescents (55.6 ) reported hav-

ing only one sexual pa rtner in the ir lifetime, while 25.9 reported

having two sexual partne rs, and 18.5 having three or more partners.

With respect to condom use , 66.7 of participants reported using a

condom and 33.3 reported not using a condom during the ir last inter-

course. One subject reported an unin tended pregnancy; 9.7 of partici-

pants reported using alcohol and/or drugs during the ir last intercourse.

One-fourth of sexually active participan ts reported having anal inter-

course without a condom in their lifetime, while 15.6 reported having

anal intercourse without a condom in the last 6 months.

Familial Factors Related to Sexual Activity

Paren tal supervision, discipline, paren tal support, and family struc-

ture were significantly p


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Table 1

Comparison of Sexually Active and Abstinent Adolescents

in Terms of Parental/Familial Characteristics

Item

Parental supervision

Parents know what time

youth gets home

Youth goes home after

school

Parents always know youth's

whereabouts

Parents never know what youth is

doing at home

Received an invitation for adult

content website

Received a lot of invitations for adult

content website

Visited websites with sexual

content

Someone youth met through the Internet

suggested they meet in person

Meeting with someone youth met

through the Internet

All of youth's video games are violent

Active

(%)

52.9

61.8

55.9

11.8

44.1

22.6

40.6

50.0

31.3

17.6

Abstinent

(%)

69.9

81.8

76.6

1.6

17.2

7.1

82.2

27.5

11.3

2.8

Cramer's

.156

.148

.182

.201

.204

.19

.31

.14

.18

.25

Discipline

Parents frequently ignore/act cold or 26.4 10.4 .142*

indifferent as punishment

Parental support

Youth never discusses his/her 26.5 9.0 .17*

problems with parents

Fatnily structure

Parents are married 32.4 50.3 .18**


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site with adult content, compared to only

17.2%

of their abstinen t peers

(Cramer's

V

=

.204, p <

.001). Significantly more sexually active teens

(22.6%

vs. 7.1%) reported th at they received a lot of invitations to

adult content websites (Cramer's V = .19, p = .026). The majority of

nonactive teens (82.2%) reported not hav ing visited w ebsites with sex-

ual con tent at all, compared to less than half (40.6 ) of the ir sexually

active peers (Cramer's V =

.31,

p < .001). Fifty percent of sexually

active teens reported t ha t someone they met through the In ternet sug-

gested meeting them in person, compared w ith ahout a quarter (27.5%)

of nonsexually active peers (Cramer's V = .14, p = .023). Almost one

third (31.3%) of sexually active teens reported meeting someone they

found through the Intern et, compared with only 11.3% of abstinent

teens (Cramer's V = .18,

p =

.007). With respect to the type of video

games they play, a greater percentage (17.6% vs. 2.8% of sexually

active teens reported t ha t all of their video games a re violent (Cramer's

V = .25, p < .001).

Discipline.

More sexually active teens (26.4% vs. 10.4% of abstinent

teens) reported that their parents frequently ignore them or act cold/

indifferent as a form of punishment (Cramer's V =

.142,

p = .015).

Parental support A grea ter num ber (26.5%) of sexually active teens

reported that they never discuss their prohlems with their families,

compared to 9% of abstinen t teens (Cramer's V =

.17,

p = .02).

Family structure (parent s marital status). More of sexually absti-

nent teens (50.3%) reported that their parents are married, compared

to 32.4% of their sexually active peers (Cramer's V = .18, p = .009).

Using discriminant function analysis, a model that discriminates

sexually abstinent vs. active youth was built, incorporating all family

characteristics that were significantly (p < .05) associated with sexual

activity. The model included parent£il supervision, discipline, parenta l

support, and family structure as significant predictors of early sexual

onset. It was significant and classified correctly

79.5%

of youth as absti-

nent or sexually active (Wilks' Lambda = .801, x'' (17) = 49.49, p <

.001). It classified correctly 82% of abstinent teen s, compared to 60.7%

of sexually active teens.

IS USSION

All family characteristics examined in the present study were sig-

nificantly associated with early sexual onset in adolescence. These in-

clude family characteristics such as parental supervision/monitoring,

discipline, paren tal support/involvement, and p are nts ' miarital sta tus .


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of family variables was incorporated into a model that significantly

discriminated sexually active vs. abstinent 12- to 16-year-old youth.

Results show significant associations between family characteristics

such as parental supervision, discipline, and support with respect to

early sexual onset. There is evidence for the important role of parents'

involvement in their child's life, as well as the supervision, support

and discipline they can provide. Religious involvement on the part of

the family was

lso

associated with sexual abstinence.

Less parental supervision was associated with being sexually active

at an early age. Specifically, the quality of parent supervision was

related to sexual behavior. In situations where parents know their

children's whereabouts, know what they are doing, and spend time

with them after school, it is less likely that these youths will be sexu-

ally active. These results are consistent with those of studies which

suggest that parents who supervise their children may help delay the

onset of sexual activity (see Longmore et al., (2001) and Jacobson

Crocket (2000).

Our results also suggest a relationship between the disciplinary

practices used by pare nts (as reported hy the youth) and whe ther their

child is sexually active. Specifically, parents ignoring them or acting

cold or indifferent was more common among youth with early sexual

onset. Based on similar findings, Taris Semin (1998) proposed that

parenting styles have an im portan t infiuence on teenage sexual hehav-

ior. Specifically, they reported that parental involvement is associated

with an increase in sexual self-efficacy, while indifference on the part

of the paren ts was related to less self-efficacy. Others have suggested

that parents who hold more conservative views about dating and em-

ploy dating rules may delay the onset of sexual activity in their chil-

dren (Hovell et al., 1994).

The support provided by parents to their adolescent children and

their involvement in their life also play an important role with respect

to early sexual activity. It was more common among sexually active

teens to say that they never discuss their problems w ith family mem-

bers.

Studies suggest that parental involvement and support are im-

portant variables that need to be considered to better understand

adolescent sexual behavior. Lynch (2001) proposes that higher levels

of family interaction and attachment are associated with diminished

adolescent sexual activity. Furthermore, Upchurch et al. (1999) report

that adolescent males who receive more emotional support from their

parents have lower rate s of sexual onset, while findings about females

indicate that daughters who talk to their mothers more have less risk

of getting pregnan t (Fox Inazu, 1980), and that mother-daughter


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quency, is related to risky behavior in adolescents (Wilson

Donenberg, 2004). Moreover, female adolescents who reported having

good comm unication with the ir p are nts were less likely to initia te sex-

ual activity; in this study, parent-child communication was a predictor

of consistent condom use (Hutchinson, 2002).

We observed that a slightly greater number of abstinent teens live

in two-parent households, in comparison with sexually active teens.

Some studies have suggested a relationsh ip hetween family structu re

and adolescent sexual activity. For example, Upchurch et al. (1999)

suggest that having both parents in the home is a factor associated

with the delay of sexual onset, while Miller (2002) has suggested that

living with a single parent is related to greater probability of sexual

activity. Young Jen sen (1991) have proposed th at single-parent

households may provide less stability or emotional support, or may

serve to model nonmarital sexual behavior. However, results from

other studies are not consistent with these findings (Hovell et al.,

1994).

An alternative view to explain a possible relation between par-

ents'

marital sta tus and sexual behavior takes into account the possible

effect of diminished supervision, parental control or support that one

person may be able to provide in a single-parent household.

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