title: Parents' and teachers' communication about HIV and sex in relation to the timing of sexual initiation among young adolescents in Tanzania.
abstract: OBJECTIVE
  Early sexual debut is associated with increased HIV risk among young adolescents in sub-Saharan Africa. Our study examines parents' and teachers' communication about sexual matters in relation to the timing of sexual initiation among students aged 12-14 years old in Dar es Salaam, Tanzania.
  
  
  METHODS
  Virgin primary school students were followed prospectively for 6 months to assess sexual initiation. Socio-demographic, psychosocial, and behavioural factors were assessed with a structured questionnaire. Univariate and multivariate logistic regression analyses were performed.
  
  
  RESULTS
  Of 2477 adolescents, 26.9% of students reported communicating about HIV and sex with parents and 35.6% communicated with teachers. Communication with teachers about HIV and sex was associated with delayed sexual initiation among adolescents after adjusting for potential confounding factors (OR=0.59, 95%CI=0.40-0.89, p=0.01). However, parental communication was not associated with the timing of sexual initiation. The perception that most peers are sexually active was a significant predictor of early sexual debut (test for linear trend, p=0.002). Students who do not live with a biological mother were marginally more likely to initiate sex compared to those who live with a biological mother (OR=1.39, 95%CI=0.97-1.99, p=0.08).
  
  
  CONCLUSIONS
  Teachers can play an effective role in discussing HIV and sex with young adolescents. Our study highlights the necessity of responsible adults discussing sexual matters with young adolescents in sub-Saharan Africa. More research is required to better understand the role of parental communication about sexual matters and strategies for improving the quality of parental communication.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA. kkawai@hsph.harvard.edu
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kawai
authors.forename: Sylvia F
authors.initials: SF
authors.lastname: Kaaya
authors.forename: Lusajo
authors.initials: L
authors.lastname: Kajula
authors.forename: Jessie
authors.initials: J
authors.lastname: Mbwambo
authors.forename: Gad P
authors.initials: GP
authors.lastname: Kilonzo
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D003140:Communicable Disease Control; D003142:Communication; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D011446:Prospective Studies; D012736:Sex Education; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D013636:Tanzania / Q000453:epidemiology; D013663:Teaching