HIV/AIDS risks reduced when mothers educate daughters

Low-income African American teen girls in Chicago continue to be at high risk for contracting HIV, but the risk decreases when their mothers teach them about the dangers of the disease, according to a new study at the University of Illinois at Chicago.

"African American adolescents are more likely to delay early initiation of sexual activities if monitored by their mothers," said Barbara Dancy, professor of public health, mental health and administrative nursing in the UIC College of Nursing and primary researcher of the study. "Among all racial and ethnic groups of adolescent girls, African Americans from low-income backgrounds are the most vulnerable for HIV risk because of early sexual activity."

Of females between the ages of 13 and 19 who have AIDS, 68 percent are African American, and of those who are affected with HIV, 71 percent are African American, Dancy said. Those who are sexually active tend to have fewer sexual partners if their mothers have discussed sexual matters with them.

"We discovered that adolescents who rely on their parents, as opposed to their friends or others, for direction and guidance were significantly less likely to engage in high-risk HIV behavior."

Mothers learned about HIV over a 12-week period through the Mother/Daughter HIV Risk Reduction intervention, taught by UIC research teams. Topics consisted of sexual development; how the female and male reproductive systems function; sexually transmitted illnesses; HIV transmission, stages, risks and testing; and learning and practicing skills to reduce the risk of HIV.

While the curriculum primarily focused on sexual abstinence, it did provide information on how to correctly use male and female condoms. Once the training was completed, every mother was responsible for teaching a portion of the curriculum in which she felt most comfortable.

"Learning about HIV supports the protective value of sexual abstinence," Dancy said. "However, because this knowledge alone cannot be translated into behavioral change or sustain it, it is necessary to focus on self-efficacy, behavioral intentions and HIV risk reduction skills.

"A sense of self-efficacy to refuse sex and behavioral intention to refuse sex interact to influence sexual abstinence. A sense of self-efficacy has been found to predict behavioral intention, which in turn, predicts behavior."

To enhance mothers' coaching and guidance, the curriculum provided joint mother/daughter homework assignments and encouraged mothers to request daughters to sign agreements to practice sexual abstinence. Following the 12 weeks of intensive training, mothers brought their daughters to the group and shared with them what they learned about HIV.

"We wanted to teach the mothers separately, so the daughters could see them as educators," Dancy said. "The mothers were very enthusiastic about the program. They felt more confident talking to their daughters about the dangers of HIV because they had all of the information."

Two hundred and sixty-two girls aged 11 to 14 participated in the study.

Dancy determined the effectiveness of the Mother/Daughter HIV Risk Reduction program by comparing it to two other controlled interventions: the Mother/Daughter Health Promotion intervention, where mothers taught their daughters what they had learned from health experts about choosing healthy foods and activities (62 of the 262 girls were included in the study), and the Health Expert HIV Risk Reduction intervention. The Health Expert HIV Risk Reduction intervention was similar to the Mother/Daughter HIV Risk Reduction intervention, except that health experts, not mothers, taught the program to daughters, and there were no joint mother/daughter homework assignments and no abstinence agreement. Ninety-seven girls participated in the Health Expert HIV Risk Reduction program.

"Our preliminary data showed that mothers were effective in increasing the mediating variables -- knowledge of how HIV is transmitted, self-efficacy to refuse sex and the intention to refuse sex -- than the other two interventions," Dancy said.

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