Mother-Daughter Communication about Sex in Afro-Caribbean Population

Cynthia Archibald, PhD, RNAssociate Professor

This project was supported by the National institute of HealthAward Number K01NR10685

from the National Institute of Nursing Research

Background(Archibald, 2007, 2010)

• Silence about sex in this population• Adolescents learn from sleeping in

overcrowding environments• Matriarchal dominance in the Caribbean

home.• Female teens are briefed about menarche• Some are still fearful that the onset of

menarche means sexual involvement

Specific Aims

• Develop a safe choice, culturally tailored HIV/AIDS risk reduction program for Afro-Caribbean adolescents through community collaboration.

• Test the effect of the risk reduction program on mother-daughter communication about sex, from pre-intervention to immediately post-intervention to three months post-intervention.

Hypothesis

• Mothers in the MPCCS! group will have significantly greater improvement in their communication skills about sex than their counterparts in the Comparison group

Method

• Community-based participatory approach– Stringer’s model- look-think-act sequence– Developed a Community Partnership Steering

Committee• Members of the Afro-Caribbean Community• members of Afro-Caribbean church

Method

• Culturally tailored Jemmott’s Making Proud Choices! To be specific for the Afro-Caribbean adolescents.

• Making Proud Choices-Caribbean Style (MPCCS)

Sample

• Phase I – 20 mothers and daughters• Phase II – 120 mother-daughter dyads• Adolescents 13-17• Caribbean parent(s)• Live in US• Actively involved in church• Attending school or college

• Experimental and Comparison Groups• Experimental group received the Making

Proud Choices Caribbean Style! HIV prevention Intervention.

• Comparison Group received a General Health Education program

• Conducted learning and skills sessions• Provided mother–daughter activities• Assigned mother–daughter homework• Video-taped role play activities• View/ Review Activities

Qualitative Results

• “ It was embarrassing at first to talk to my daughter, most times I was looking away from her.”

• “Oh my god! I can’t believe I signed up for this.”

• “My daughter and I have become very close… this three week seminar was so good”.

Qual. Results (Cont’d)

• “ I couldn’t wait to hear my mother say certain words”.

• “I felt bad for my mother as I knew it was hard for her…I already know what she was struggling to tell me”

• “I was proud of her”• “I feel like I can talk to her now”

Qual. Results (cont’d)

• Feelings of– “Mission accomplished”(mothers)– Embarrassment to listen (daughters)– “like talking to stranger” (mothers)

• Reluctant to say certain words such as penis, condoms etc.

• Mutual pride.

Quantitative Results

• To test the average change differences between groups, independent t-test were utilized.

Quant. Results (con’d)

• First differences between groups were tested on change scores between Time 1 and Time 2.

• Then the differences between the treatment and comparison groups were tested on change scores between Time 1 and Time 3.

Quant. Results (con’d)

• Stigma to HIV decreased• Mother daughter sexual communication

increased• Afro-Caribbean churches are discussing sex

and risky sexual behaviors• Adolescents are using the information gained

through this study to present at their high schools

• Community is anxiously awaiting the follow-up study to include male adolescents

• Growing interest for this work to be extended to the Caribbean where HIV is second to Sub-Sahara Africa.

• Archibald, C.M. (2007). Knowledge, attitudes and risky sexual behaviors in Afro-Caribbean youth. JANAC

• Archibald, C. M. ( 2010). HIV/AIDS-Associated stigma among Afro-Caribbean people living in United States. Archives of Psychiatric Nursing,24(5), 362-364.

• Hutchinson, M.K., Jemmott, J. B., Jemmott, L.S., Braverman, P., & Fong, G. (2003). The role of mother-daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: A prospective study. Journal of Adolescent Health, 33(2), 98-107.

• Jemmott, L.S., & Jemmott, J.B., & McCaffree, K. (1995). Be proud! Be responsible! Strategies to empower youth to reduce their risk for AIDS. NY: Select Media Productions.

• Lowe, J. (2007). The need for historically grounded HIV/AIDS prevention research among Native Americans. Journal of the Association of Nurses in AIDS Care, 18(2), 15-17.

• Stringer, E.T. (1999). Action Research (2nd ed.). Thousand Oaks: Sage.

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