Abstract

Sexual intercourse in absence of birth control has resulted in an epidemic of over one million teen pregnancies annually (Forrest & Singh, 1990), costing $17 billion in medical and social services each year (Hayes, 1987). About 1 in 7 teens have contracted one or more sexually transmitted diseases (STDs) (Quackenbush, 1987), accounting for 25% of the reported STD cases (Hingson et al., 1990). Among the nearly 285,000 adolescent and adult acquired immunodeficiency syndrome (AIDS) cases in the United States (Center for Disease Control, 1993a), nearly 11,000 were diagnosed between the ages of 13 and 24 (Center for Disease Control, 1993a). However, the actual number of adolescents infected with human immunodeficiency virus (HIV) is estimated to be much higher and doubling each year (Brooks-Gunn, Boyer, & Hein, 1988). Given a latency period as long as 10 years, the 20% of AIDS cases diagnosed in adults between the ages of 20 and 29 were most likely acquired during adolescence (Center for Disease Control, 1992; Rotherum-Borus & Koopman, 1992). HIV infection rates among larger samples range from .10% among military recruits to .65% among Job Corps residents (Select Committee on Children, Youth, and Families, 1992). Higher rates have been reported for select risk groups: One percent of females under 19 giving birth, 2.2% of youths attending STD clinics, and 6.7% of runaways (Rotherum-Borus & Koopman, 1992).Incomplete understanding of sexual development has limited our ability to effect public health programs to control teen pregnancies, STDs, or the AIDS epidemic. Biological and behavioral theories have proposed models of sexual development from which these epidemics might be controlled (Hagenhoff, Lowe, Hovell, & Rugg, 1987; Rugg, Hovell, & Franzini, 1989). However, though sexual practice is generally recognized as a function of both biological (e.g., hormonal changes with puberty) and social processes (e.g., peer pressure) (Panzarine & Santelli, 1987), the role of the family in determining sexual development has not been fully investigated. The family plays a key role in the formation of sexual attitudes and behavior by providing role models, a social and economic environment, and norms for sexual conduct (Thornton & Camburn, 1987). Parental and sibling sexual behavior, family structure, socioeconomic status, and religiosity are among the family's contributions to the development of adolescent sexual attitudes and behaviors. The degree to which parents communicate about sexual issues, express love and affection, or set rules to be followed by their adolescent children may influence their children's sexual behavior. Parental influence on sons' sexual behavior is less well studied and may be more subtle than that exerted on daughters' behavior, with male sexuality possibly more influenced by culture (Yarber & Greer, 1986). Family influence probably decreases during the adolescent years and, by college age, the previous impact of parents has probably become insignificant (Yarber & Greer, 1986).Adolescents traditionally report that their parents' role as a source of sexual information is minor; parents typically do not discuss sexual issues with their adolescent children (Hayes, 1987; Roberts & Holt, 1980). Instead, family communication regarding sex consists of rule making and the exercise of authority (Scales & Everly, 1977). Darling and Hicks (1982) found that most parental sexual messages tend to be negative, and convey double standards regarding sons' versus daughters' behaviors. Adolescent sexual attitudes are influenced by the frequency and type of communication that occurs within the family (Akpom, Apkom, & Davis, 1976; Darling & Hicks, 1982; Fisher, 1985; Fox, 1981; McNab, 1976; Rothenberg, 1980; Shelley, 1981). Fox (1981) reported that the frequency of discussions about sex and birth control was highest among those without a high school diploma, women no longer married to the adolescent's father, and those from low-income families. …

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