Exploring caregiver-child communication about risky sexual behaviour in Cape Town
The effects of risky sexual behaviour (RSB) amongst adolescents are devastating in South Africa. Recent studies show that parent-child (PC) communication about RSB is associated with positive outcomes such as delayed sexual debut and increased autonomy among adolescents. There are however challenges on how to define caregivers within the South African context due the historical background of South Africa such as Apartheid and labour migration. For the purposes of this study, caregivers would be regarded as individuals who the have sole responsibility of caring for a child. The aim of this study was to explore caregiver-child communication in relation to RSB to gain an in-depth and contextualized understanding of how South African families interact, feel and experience their communication and the challenges they face, it therefore uses a qualitative approach. These aims translate into the following objectives a) exploring the process of communication i.e. how they communicate in terms of style, content, timing and frequency b) exploring the experiences of communication of RSB for both caregivers and children in terms of their thoughts and feelings as well as the challenges faced. Conducting focus group discussions and individual interviews was the method of data collection. Four focus groups (two focus groups with male adolescents and two focus groups with female adolescents) were conducted as well as three individual interviews with caregivers a total of 23 participants were used. Both groups of participants are of mixed racial backgrounds and from the Northern sub district of Cape Town. The data was analyzed by using thematic analysis. All ethical principles were adhered to. This study found mothers to be an influential source of sexual communication with their children and this communication hinged more on the health risks of early sexual debut and negative social outcomes. Caregivers highlight the barriers to communication with their adolescents which create caregiver anxiety and avoidance of sexual communication. School has also been identified as highly influential to both caregivers and adolescents especially with regards to the biological and physiological aspects of sex education. Two types ‘educational systems’ have been identified within the South African context. The impact of these systems on the quality of education and nature of the resources provided to both caregivers and learners are discussed in relation to sexual education and communication. The community and extended family of the participants are very involved in the socialisation of the adolescents in this study and often assist caregivers. Caregiver monitoring is the most utilized strategy used to ensure that adolescent whereabouts and activities are known at all times. Possible interventions such as additional strategies for caregivers to consider and communication workshops for caregivers and educators are discussed. The limitations of this study such as the limited amount of caregivers interviewed and the lack of male caregiver insight were identified and recommendations for future studies are provided.