Primary Submission Category: Social/relational factors
Perceptions about Adolescent Sexual and Reproductive Health in Western Kenya: Lessons Learned about Stigma and Parent-Child Communication
Authors: Abigail A. Lee Nema C.M. Aluku Catherine Muteithia Yvonne Wanjiru Priyanka Dubey Dara Jefferson William T. Story
Presenting Author: Abigail A. Lee*
Background: In Kenya, more than half of youth report being sexually active by age 18; however, parents rarely discuss sex with their children. Stigma makes sexual and reproductive health (SRH) communication challenging between youth and their parents. This study aims to investigate stigma and parent-child communication in the context of adolescent SRH.
Methods: This qualitative study was embedded in an SRH program in western Kenya called Stepping Up!. In March 2022, we conducted 12 focus group discussions (FGDs) with three group-types: youth ages 15-24 (n=72); parents (n=15); and a mixed group of religious leaders, teachers, and healthcare providers (n=12). FGDs were conducted in Kiswahili, transcribed, and translated to English. A codebook was developed and transcripts were analyzed using open coding before developing final code summaries on the following themes: SRH concerns; SRH stigma; and parent-child communication.
Results: Youth in western Kenya are concerned about unintended pregnancy, abortion, and sexually transmitted infections (e.g., HIV), and the potential impact on their life goals. Youth face multiple forms of stigma from parents and healthcare providers. Specifically, they fear punishment from their parents for engaging in sexual behaviors and accessing preventive services. Some youth report experiencing harsh treatment from healthcare providers for using SRH services, yet they go because they are hesitant to talk to their parents. Parents describe SRH behaviors and services as “unbiblical” and explain that cultural traditions make it difficult to talk to their children about sex. Conversely, parents believe it is their responsibility to advise their children about SRH. Youth shared that parents with open attitudes would build their confidence to discuss SRH.
Conclusion: This study demonstrates that stigma surrounding youth SRH impacts parent-child relationships and communication about SRH, which has implications for future adolescent SRH interventions.