title: Perceptions and experiences of adolescents, parents and school administrators regarding adolescent-parent communication on sexual and reproductive health issues in urban and rural Uganda.
abstract: BACKGROUND
  Evidence suggests that in spite of some adolescents being sexually active, many parents do not discuss sex-related issues with them due to lack of age-appropriate respectful vocabulary and skills. The likelihood of parent-adolescent communication improving sexual and reproductive health outcomes appears plausible. The desire to understand parent-adolescent communication and how to improve it for promotion of healthy sexual behaviours inspired this research. The paper is meant to describe perceptions of adolescents, parents and school administrators about parent-adolescent communication on sexual issues; describe the content of such communication and identify factors that influence this communication.
  
  
  METHODS
  The study was done among two urban and two rural secondary school students in their second year of education. Data were collected from 11 focus group discussions and 10 key Informants Interviews. Data management, analysis and interpretation followed thematic analysis principles. Illuminating verbatim quotations are used to illustrate findings.
  
  
  RESULTS
  Parental warmth and acceptability of children was perceived by parents to be foundational for a healthy adolescent- parent communication. Perceptions of adolescents tended to point to more open and frequent communication with mothers than fathers and to cordial relationships with mothers. Fathers were perceived by adolescents to be strict, intimidating, unapproachable and unavailable. While adolescents tended to generally discuss sexual issues with mothers, male adolescents communicated less with anyone on sex, relationships and condoms. Much of the parent-adolescent communication was perceived to focus on sexually transmitted infections and body changes. Discussions of sex and dating with adolescents were perceived to be rare. Common triggers of sexuality discussions with female adolescents were; onset of menstruation and perceived abortion in the neighbourhood. Discussion with male adolescents, if it occurred was perceived to be triggered by parental suspicion of having female 'friends' or coming home late. Peers at school and mass media were perceived to the main source of sexuality information.
  
  
  CONCLUSIONS
  Communication on sexuality issues between parents and their adolescent children was infrequent and critical elements like sex and specifics of protection against undesirable sexual behaviour consequences were avoided. Peers, schools and mass media should be creatively harnessed to improve parent-adolescent communication about sexuality issues.
authors.affiliation: Department of Psychiatry, Makerere University College of Health Sciences, School of Medicine, P. O. Box 7072, Kampala, Uganda. winstons.muhwezi@gmail.com.
authors.forename: Wilson Winstons
authors.initials: WW
authors.lastname: Muhwezi
authors.affiliation: Child Health and Development Centre, Makerere University College of Health Sciences, School of Medicine, P. O. Box 7072, Kampala, Uganda. annekatahoire@yahoo.co.uk.
authors.forename: Anne Ruhweza
authors.initials: AR
authors.lastname: Katahoire
authors.affiliation: Child Health and Development Centre, Makerere University College of Health Sciences, School of Medicine, P. O. Box 7072, Kampala, Uganda. cecily.banura@gmail.com.
authors.forename: Cecily
authors.initials: C
authors.lastname: Banura
authors.affiliation: Child Health and Development Centre, Makerere University College of Health Sciences, School of Medicine, P. O. Box 7072, Kampala, Uganda. herbieug@gmail.com.
authors.forename: Herbert
authors.initials: H
authors.lastname: Mugooda
authors.affiliation: Child Health and Development Centre, Makerere University College of Health Sciences, School of Medicine, P. O. Box 7072, Kampala, Uganda. dknnkwesiga@gmail.com.
authors.forename: Doris
authors.initials: D
authors.lastname: Kwesiga
authors.affiliation: University of Calgary, Global Health & International Partnerships, Faculty of Medicine, 2500 University Drive NW, Calgary, AB, T2N 1 N4, Canada. sbastien@ucalgary.ca.
authors.forename: Sheri
authors.initials: S
authors.lastname: Bastien
authors.affiliation: Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway. Knut-Inge.Klepp@helsedir.no.
authors.forename: Knut-Inge
authors.initials: KI
authors.lastname: Klepp
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001294:Attitude to Health; D002675:Child, Preschool; D003142:Communication; D003906:Developing Countries; D005260:Female; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D060728:Reproductive Health; D012423:Rural Health; D012574:Schools; D012736:Sex Education; D014454:Uganda; D014504:Urban Health; D055815:Young Adult