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African Journal of AIDS Research
ISSN: 1608-5906 (Print) 1727-9445 (Online) Journal homepage: https://www.tandfonline.com/loi/raar20
“The child can remember your voice”: parent–child
communication about sexuality in the South
African context
Esmeralda Vilanculos & Mzikazi Nduna
To cite this article: Esmeralda Vilanculos & Mzikazi Nduna (2017) “The child can remember your
voice”: parent–child communication about sexuality in the South African context, African Journal of
AIDS Research, 16:1, 81-89, DOI: 10.2989/16085906.2017.1302486
To link to this article: https://doi.org/10.2989/16085906.2017.1302486
Published online: 02 Apr 2017.
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African Journal of AIDS Research is co-published by NISC (Pty) Ltd and Informa UK Limited (trading as Taylor & Francis Group)
Copyright © NISC (Pty) Ltd
AJAR
ISSN 1608-5906 EISSN 1727-9445
http://dx.doi.org/10.2989/16085906.2017.1302486
African Journal of AIDS Research 2017, 16(1): 81–89
Introduction
Communication about sexual and reproductive health and
rights (SRHR) is important and central to health (Sen &
Govender, 2015). Whilst children listen to their peers, the peer
norm-behaviour is moderated by parental communication.
Research suggests that a lack of communication between
parents and their children may cause adolescents to turn
to peers and that peers may influence their behaviour
(Whitaker & Miller, 2000). Whilst research is unclear on the
temporal sequence of the relationships between parent–child
communication and preventative sexual behaviours, there
seems to be some benefits in parent–child communication as
it is reported to be associated with contraceptive and condom
use in other African countries (Biddlecom, Awusabo-Asare, &
Bankole, 2009; Hutchinson, Jemmott, Jemmott, Braverman,
& Fong, 2003). Studies on communication between parents
and their children about sexuality reflect the diversity of
this topic. Research in this field investigates parent–child
communication, parent–adolescent communication, parent–
preteen and mother–daughter communication (Bastien,
Kajula, & Muhwezi, 2011; Manu, Mba, Asare, Odoi-Agyarko,
& Asante, 2015; Whitaker & Miller, 2000; Wilson, Dalberth,
Koo, & Gard, 2010). In this paper, we broadly refer to
parent–child communication to acknowledge the role of both
mother and father as parents. The words “parent” and “child”
are used broadly in this study to honour the sometimes
idiosyncratic, discursive, constructed and contextual
experiences of being a child or a parent.
Bastien et al. (2011) state that in sub-Saharan Africa
parents use indirect communication strategies to talk with
their children about sex and direct strategies are used when
the communication is in the form of a warning, admonition
or a lecture. Williams, Pichon, and Campbell (2015)
highlight barriers of communication between religious
parents and their children about sexual histories as mainly
parents’ feelings of discomfort and embarrassment in
discussing sex with children. In Bastien et al. (2011)
both parents and young people report cultural norms and
taboos, including the lack of knowledge and skills, to hinder
open dialogue.
Across contexts, the frequency and content of discussion
between parents and their children about sexuality vary
(Bastien et al., 2011; Kunnuji, 2012; Phetla et al., 2008).
Sexual abstinence, HIV/AIDS, puberty, body changes and
unwanted pregnancy are the most frequently discussed
topics (Tesso, Fantahun, & Enquselassie, 2012). Topics
such as condom use, safer sex negotiation, menstruation,
abortion, family planning, sexual orientation, and gender
identity are infrequently discussed.
To reinforce protective factors the timing of communication,
including the content of the message and how it is
transmitted, is important and most likely more effective
early on. Parent–child communication faces challenges as it
usually begins after sexual debut (Phetla et al., 2008; Tesso
et al., 2012). This is because parents are mostly prompted to
communicate with their children about sex when they suspect
involvement in romantic relationships (Leser & Francis, 2014;
“The child can remember your voice”: parent–child communication about
sexuality in the South African context
Esmeralda Vilanculos and Mzikazi Nduna*
Centre of Excellence in Human Development, School of Human and Community Development, Department of Psychology,
University of the Witwatersrand, Johannesburg, South Africa
*Corresponding author, email: Mzikazi.nduna@wits.ac.za
There is a wealth of research on parent–child communication about sexual and reproductive health and rights
(SRHR) and its influence on young people’s sexual behaviours. However, most of it is from the global North. The
aim of this study was to explore parent–child communication in three South African provinces: Eastern Cape,
KwaZulu-Natal (KZN) and Mpumalanga. Nine, peer, focus group discussions (FGDs) were conducted with young
and adult black African men and women in their spoken languages. Data were analysed thematically. Findings
revealed that cultural and religious constructions of taboo silenced direct communication and restricted the
discussed topics. Parents’ older age, low educational level, lack of knowledge, and discomfort in talking about
sexuality matters were reported to restrict conversations with children about sex and sexuality. The influence of
these factors differed for parents residing in an urban setting who were more liberal than their counterparts residing
in more rural areas. The child’s age and gender were also reported to be a consideration in approaching these
conversations. There is a need for interventions to assist parents on how to communicate with their children about
SRHR topics beyond pregnancy and HIV/AIDS. These interventions should take into account and address factors
that seem to influence parent–child communication.
Keywords: culture, HIV/AIDS, religion, pregnancy, qualitative, sexual risky behaviours, SRHR
Vilanculos and Nduna
82
Tesso et al., 2012). This may be too late to prevent sexually
transmitted infections and unplanned pregnancy.
Whilst a wealth of research on this topic exists, it is
predominantly from the global North, suggesting that
research on this topic in the South is not yet matured.
Studies conducted in sub-Saharan African on the content,
time, and frequency of parent–child communication show
limited quality and quantity (Defo & Dimbuene, 2012). In
addition, it is difficult to compare across different studies
since the different studies pose the questions differently or
do not report how the questions are formulated (Bastien et
al., 2011). Qualitative research to explore the perceptions
and experiences of both the young people and adults on the
content, time and frequency of parent–child communication
about sexuality is useful to inform the development of
contextually relevant strategies that parents can use.
The goal of this study was to describe participants’
considerations of parent–child communication about SRHR
topics. Further, the paper explores the timing, content, and
frequency of parent–child communication, the manner of
communication, and any other factors that may affect the
communication about sexuality and SRHR.
Methods
The study is part of a descriptive, qualitative exploratory
study conducted to assess the influence of AIDS
Foundation of South Africa (AFSA) interventions aimed
at aligning religious and traditional systems with SRHR.
Participating communities were predominantly rural black
African populations from three provinces: Eastern Cape,
Mpumalanga and KwaZulu-Natal (KZN). Baseline data
were collected between December 2014 and January 2015,
transcribed in 2015, and analysis was completed in 2016.
The first site in Eastern Cape province at the OR Tambo
district municipality: ward 29, was mainly rural with most
of its population unemployed (Bisi-Johnson, Obi, Kambizi,
& Nkomo, 2010). Eastern Cape province suffers from a
quadruple burden of disease: HIV/AIDS and tuberculosis;
maternal and child mortality; non-communicable diseases;
and injury and violence (ECSECC, 2015a). This province
further experiences gender differences in mortality rates
and also suffers more sex-selective, out-migration,
particularly among young people (ECSECC, 2015a), leaving
the older generation behind, especially women. The OR
Tambo region, regarded as Pondoland, is divided into
five municipal areas, each with at least one urban service
centre. Pondoland is a traditional area of the Pondo people
(Mogotlane, Ntlangulela, & Ogunbanjo, 2004). In 2013, the
district had an estimated population of 1 961 815 which
has been growing since 2004 (ECSECC, 2015b). The
district’s poverty rate is higher than the provincial and the
national averages with an estimated 1 183 635 people
living in poverty (ECSECC, 2015b). Flagstaff, the study
site, is located in Ingquza Hill in the OR Tambo district.
Flagstaff has 1 district hospital, 7 community clinics, 24
elementary schools, 20 middle schools, 12 high schools,
and 36 preschools (“Schools in Flagstaff, AZ”, 2015).
Mufamadi and Shongwe (1997) report that Flagstaff clinics
suffer from historical challenges concerning the quality of
care and disease management. These challenges concern
the availability of treatment supplies and equipment such
as speculums and lights, staff shortages and inadequate
staff training, lack of privacy during consultations, lack of
information and education, and communication mediums
and healthcare users’ struggles with transportation to clinics
(Mufamadi & Shongwe, 1997).
The second and third sites, Eshowe and Pietermaritzburg,
are located in KZN. KZN is home to 21% of South Africa’s
total population (Garaba, 2013). Most people in KZN are
isiZulu-speaking individuals and Christian (Lesetla, 2015).
As mentioned in Denis, Parle, and Noble (2014), the HIV/
AIDS epidemic in KZN began earlier and its prevalence rates
have always been higher than in the rest of the country.
Pietermaritzburg is a Category B1 municipality in the
Msunduzi municipal authority (KZ225), situated in the
uMgungundlovu district municipality (DC22) and is the
capital city of KZN (Smith, 2010). Msunduzi is located 80
km from Durban along the N3 freeway; Pietermaritzburg
is the district’s main economic hub (Nicolson, 2010; SRK
Consulting, 2010). Urban housing covers large portions of
highly productive agricultural land in the district. This results
in scarcity of farming land, forcing citizens to rely primarily
on wage-related employment as the major source of income.
Population growth in Msunduzi is higher than the national
average and this is said to be one of the major contributing
factors to biophysical and socio-economic concerns within
the municipality, alongside air pollution that results from
industrialisation and growth in traffic (Nicolson, 2010). The
population is characterised by a complex racial mix, but
divided both by income and by race, reminiscent of other
South African cities.
Eshowe, accurately known as Ekhowe according to
Zulu-speaking authorities, is “the epicentre of the uMlalaze
municipality, one of the biggest in the country covering 2 217
km and home to more than 200 000 people” (Dardagan,
2010, p. 1). This town is set within a rural environment on
the north-east coast of KZN (Nkosi, 2005). Eighty per cent
of people in the district live in isolated and far-flung areas
(Dardagan, 2010). This district also faces unemployment
and an ailing rural community (Dardagan, 2010). In this
area, many families lack the necessary resources that
enable them to obtain “food commodities and experience
chronic food shortages” (Nkosi, 2005, p. ii). The burden of
food insecurity further intensifies the challenges posed by
HIV/AIDS on the already fragile social and economic fabric
of many families here (Nkosi, 2005).
The last site was Gert Sibande district in Mpumalanga.
This province has 3 districts, is ranked the third most rural
South African province with 60.9% of its population living in
rural areas; 86.7% of the households have access to water
(Peltzer, Chao, & Dana, 2009; Phaweni, Peltzer, Mlambo, &
Phaswana-Mafuya, 2010). Gert Sibande has 7 sub-districts
and 72 public health facilities. In 2009 the district had a
total population of 890 699 and the highest antenatal HIV
prevalence in the country. Mpumalanga has “consistently
had one of the lowest levels of PMTCT roll-out, although
its performance has improved substantially” (Peltzer et al.,
2009, p. 699).
African Journal of AIDS Research 2017, 16(1): 81–89
83
Sample and sampling
The entry point at all sites was a well-established civil society
community-based organisation (CBO): Nyangazezizwe in
Flagstaff, Gay and Lesbian Network in Pietermaritzburg,
KwaZulu-Natal Regional Christian Council in Eshowe and
Treatment Action Campaign in Gert Sibande. The study was
announced to key stakeholders through these organisations.
An information sheet was circulated in the community.
Participants were sought through convenience, snowball
sampling. Six to 10 male and female participants who were
18 years and above and were regular residents of the
communities were recruited for each focus group discussion
(FGD). These were young and older black African men and
women in the low to low-middle class.
In this study, we conducted same-sex peer FGDs, a
method that is used in similar research (Wilson et al., 2010).
The nine audio-recorded FGDs were same-sex peer group
discussions that were facilitated by a same-sex trained field
worker in all the sites. Four FGD transcripts were used in
this study. Separate same-sex FGDs are normative in
studies of SRHR where gendered experiences and sensitive
topics are discussed (Mahati et al., 2006). FGDs are good
for building consensus and for supporting shy respondents
(Macun & Posel, 1998). The field workers who collected the
data were trained for three days. Training and matching of
interviewers and participants in the interviews are significant
for ensuring study rigour (Lewis, 2009).
All FGDs were conducted on different days at venues
agreed upon with the participants in the villages: some
in schools, at the CBO office, or in homesteads. At the
beginning of the FGD, the facilitators introduced themselves
and briefly described the study, the people and the
organisations were involved in the study. Participants
were asked to sign consent forms and to decide on the
pseudonyms they would like to be addressed by for the
duration of the FGDs. When someone addressed someone
else using their real name, the facilitator reminded the
participants to stick to the pseudonyms. The interviewer
used a semi-structured interview guide and asked
non-leading and non-assuming open-ended questions. The
guide covered numerous aspects of SRHR and data on
parent–child communication emerged spontaneously.
To ensure accuracy, all FGDs were audio-recorded.
Data were simultaneously transcribed and translated
meaningfully, from the different indigenous languages to
English. Field workers who conducted the FGDs did most of
the transcription. To accelerate the completion time, some
data transcriptions were outsourced.
The study was approved by the University of the
Witwatersrand’s (non-medical) Research Ethics Committee
for research with human subjects. At recruitment, informed
consent was communicated in spoken languages that all
could understand. Participants had no known mental illness.
The facilitator reiterated the group consent and recorded it
at the beginning of the discussion. Audio-recorded group
consent was also transcribed with the full data. Participants
had the right to withdraw from the group discussion at any
time, but they could not withdraw their data as it was part
of the group. Anyone who was not keen to participate was
excused from the group. Participants were not guaranteed
confidentiality, but were encouraged to keep the information
discussed in FGDs confidential, as would the interviewer.
The approach to both data collection and analysis was
similar to that adopted by other researchers of this topic:
use of multiple coders, content analysis, an iterative data
examination process and reporting of themes (Wilson et
al., 2010). The text transcripts were analysed using critical
thematic analysis (Braun and Clarke, 2006). This method
offers both an accessible and a theoretically flexible
approach in the qualitative data analysis that can provide
a rich and detailed complex data account. The analysis
process used an inductive approach without pre-prepared
themes. The critical thematic analysis was used because
the meaning behind what was said by the participants was
equally important. The analysis was also done on a latent
level because the researchers identified the underlying
ideas, patterns, and assumptions that emerged from
the data. The authors analysed and coded the data and
compiled a list of themes and sub-themes separately. They
met to compare and contrast their codes. This allowed for
triangulation of the data codes to eliminate biases. Most of
the themes identified by the two researchers were similar.
Themes that emerged after each meeting were added
to the existing list and after thorough discussion, themes
were revised iteratively. After the authors compared their
separately coded themes, they agreed on cultural influences,
timing, content, the frequency of communication and manner
of communication, as meaningful sub-themes that describe
the overarching theme of parent–child communication here.
Four researchers, including the authors, undertook site
visits and presented preliminary findings to stakeholders for
member-checking. The audience was asked if the findings
were trustworthy and if they reflected what was happening
in their communities. A robust discussion followed the
presentation in each of the member-checking workshops.
Information that validated the findings and new information
on which to elaborate, was supplied. The audiences vouched
that the preliminary findings were true. The authors are
members of a research team at the university where they also
presented this research work and received peer feedback.
Findings
The findings showed that participants across gender and
age were in agreement about the importance of parent–
child communication about sexuality. Participants viewed
parent–child communication as a strategy to assist children
in avoiding early sexual debut, unplanned pregnancy, and
HIV infection. Participants suggested that:
It’s the right thing to sit down with your child and tell
them about everything related to sex and teach them
about all that so that when they start, they would
know…the results will be A and B (Mapitsela, young
women FGD, Flagstaff).
It is very important to let them and for them to hear
it from us as parents. This will help them correct
their mistakes because the child can remember your
voice when you warned them (Eddie, older men
FGD, Flagstaff).
Vilanculos and Nduna
84
Further to being forewarned, some parents encouraged
parent–child communication to remove culpability on their
side and avoid being blamed for not having played their
role as parents when the child contracted diseases later on.
These parents understood their role as being to protect their
children and the following expression suggested this:
It is important to sit them down and talk to them.
You will have played your role so that when children
get HIV they will not blame you as a parent for not
teaching them about AIDS (Lili, middle-aged women
FGD, Flagstaff).
Some participants vouched for the importance of parent–
child communication about SRHR aspects because they
were so advised. Whilst they were keen to heed the call,
they expressed difficulty in communicating with their children
about these topics, admitting that:
It’s hard to talk to a child telling her how to (.) What
can I say?… It’s hard to teach your child how to use a
condom. You cannot allow yourself because you love
your child, you cannot tell her how to wear a condom.
So I do not know how it could be possible that we
talk about this issue because you wish to talk to your
child, but still think they are too young whereas on
the other part they are grown, so we parents are in
trouble (Chido, older women FGD, Caluza).
The hesitation in this participant’s speech was evident and
matched the hesitation to translate a message about sex and
sexuality to a child, lest one was misinterpreted as promoting
early sexual activity. Parents’ low educational level was
perceived to shape the parent’s manner of communication or
lack thereof. The use of substitute words such as “kota-kota”
when referring to sex was reported to be common. This
approach to sex talks could reflect two things. This is either
a strategy used to manage the discomfort that some of the
parents felt when communicating with their children about
sex or it could be a strategic deployment of colloquial
language that young people understood, used and identified
with to facilitate ease of communication. Use of colloquial
language may ease the tension in talking about sexuality,
as this language tends to be less conservative and rather
jocular. Despite these efforts, youth seemed to disapprove
of parents’ use of colloquial language when communicating
with their children about sexuality. To the receiver, this
suggested a lack of confidence in communicating about
sexuality from the parents and could risk compromising the
clarity of their messages. This concern came from the youth,
who felt that:
Even when parents talk about these things they
cannot even call them by their names, I do not know
maybe it is because my parents are uneducated
(Mjwentu, young women FGD, Flagstaff).
Notably, parents seemed to use threats quite normatively
in their communication. This seemed to be motivated by
parent’s wishes to promote abstinence and talking about
condom use introduced a contradiction in the messages
about abstinence. Lili voiced this by saying:
It is difficult for us to take a condom and teach
them not to engage in sex... I call it (kota-kota) and
I always tell them that if they do (kota-kota) they
will die, it brings death (middle-aged women FGD,
Flagstaff).
Clearly, here the participant’s intention was to sway her
child(ren) away from having sex. Young women also said
that children should be told that when they engaged in sexual
activities, they would either fall pregnant or contract HIV and
then die because of AIDS. Amongst the participants were
parents who already practised parent–child communication
and told their children that sex resulted in pregnancy. The
tone that parents used when they communicated with their
children appeared to be authoritarian, admonishing and
threatening. Young women from Flagstaff felt that a parent
should explicitly tell their children they were not bought,
but were a result of their parents having had reproductive
sex and that girls should be told that pregnancy is possible
when they reach puberty. However, some parents cautioned
against overly emphasising negative consequences and
threatening with AIDS and pregnancy; they reckoned that
this closed doors for open communication.
You should not shout at the child but rather talk
nicely, she will do what you want her to do, and she
will be open with you and even tell you about other
things (Sisi, young women FGD, Mpophomeni).
Furthermore, some parents were uncomfortable to
communicate to their children at all. This was found to result
from a situation where:
At home if a parent, the father, is not approachable;
the mother is not approachable… the child is scared,
will inject [make use of contraceptives] secretively
because they want to hide it from the family (Tumza,
younger women FGD, Eshowe).
On the contrary, some parents, notably the young
ones, reported that they were comfortable to talk to
their children about SRHR and children were reported
to be knowledgeable of the SRHR topics due to open
communication. One participant boasted that:
Us at Nyanini we are free to talk about issues of sex
and HIV. Who doesn’t know?…We speak of this
thing. It is our food; our breakfast, lunch, and supper.
[Ok] even a child from home, my small sister knows
that if you ask her about a condom, she knows that
through a condom you prevent HIV and pregnancy…
(Katsana, younger women FGD, Eshowe).
Parents who held conservative views believed that open
communication with children was tantamount to promoting
sexual permissiveness and would inadvertently encourage
early sexual activity amongst children. A rhetoric question
was asked in Mpophomeni to this effect as a response to
those who encouraged open and honest communication. A
participant asked,
But does that not encourage the child to go out there
and have sex because now mom has granted me
the right? (young women FGD, Mpophomeni).
The conservativeness and disapproval communicated in
questions such as this, across all sites, was dismissed by
those who believed that:
The more you talk about it, the children will be
exposed to it…you are not promoting that they do
it, but they see, not that they don’t see, they know
what is happening, because now here is a situation,
you don’t talk about it but girls are getting pregnant
at the age of thirteen years old, and that’s happening
here in Ermelo, you see? Girls…by the time they get
African Journal of AIDS Research 2017, 16(1): 81–89
85
to twenty they have three children (Miguel, younger
men FGD, Ermelo).
The approach to parent–child communication in different
households was reported to vary owing to different parental
characteristics within different families. This was illustrated
by Zero, who said:
You see basically Sihle, the upbringing of a person,
the way your household and my household do
things, in my household, the children are taught what
sex is, and this is a condom. Some families even
if they see a condom on the television, you know
those adverts with SMS kiss those things, SABC1;
they just change the channel (Zero, younger men
FGD, Ermelo).
This paper demonstrates that participants agreed that
parent–child communication was a significant tool to protect
children. However, there were challenges that parents and
children faced in order to advance this. Some expressed
difficulty in doing so; they held different views about when
parents should start these conversations and what the
conversation should contain. The next section explores
these tensions through sub-themes such as timing and
content, gender and age influences, and the influence of
cultural and religious beliefs.
Timing of parent–child communication on SRHR topics
Participants held different views on when parents should
start to communicate with their children about sex. Some
perceived these talks to be appropriate when the child was
about 11 or 12 years old. However, others were in favour
of 10 years of age because they were advised by nurses
to communicate to their children around this age. These
perspectives were shared by women who said:
For real we have to give them knowledge about the
disease at least at the age of 12/11 and start telling
them about what AIDS is, where it comes from and
how it spreads so that they can understand (Luhle,
middle-aged women FGD, Flagstaff).
Maybe a 12- to 13-year-old child starts her periods…
when that kid becomes mature and that child is still
in primary school…I start getting worried and then I
sit down with that kid and maybe advise her in some
ways, and the girl will tell me that, “yes mom I hear
you” but when she goes to school I can’t really see
her…and she usually comes back around 14:00
and 15:00…but as a parent I will always stick to one
word which is that “my child take care of yourself”
(Tebogo, older women FGD, Eshowe).
Ten-year-olds are old enough to understand when
being told that they will contract AIDS. So that when
they meet other kids in school, they cannot say
to others that their parents did not tell them (Lili,
middle-aged women FGD, Flagstaff).
From these extracts, we deduce that it was not the
chronological age per se which participants found relevant
as a sign of readiness to receive this information, but
rather the indication that the child was mature enough to
understand the message and showed signs of puberty.
The coincidence with sexual maturity is aligned with the
parent’s motive for the talk and the conversation, hence it
becomes about risks for pregnancy and sexually transmitted
infection. Even so, other participants contested the idea
that parent–child communication about sexuality should be
initiated when the child was as young as 10 years old. Those
who held a different view argued that it would be too late
to prevent pregnancy and the contraction of diseases. This
was because some sex play and inquisitiveness about sex
were observed by some parents to start at younger ages,
around five to eight years. However, one participant also
expressed the challenge of communicating to a five year old
because she felt that the child would not comprehend what
was communicated to him or her. Mlindos argued:
Waiting for a child to be 10 years is too late…they
start talking about it at the age of five and this is also
difficult because they cannot understand anything
(middle-aged women FGD, Flagstaff).
A few younger women suggested that it would be better for
parents to talk to their children when they are seven or eight
years old. Here is what one said:
For me, I grew up living with my grandmother and
she would never say anything; now I am talking on
the note that these kids that we have; we must be
able to talk to them so that they won’t fall pregnant at
an early stage like we did (Sisi, young women FGD,
Mpophomeni).
Gender and its influence on parent–child communication
Gender differences between parents and children were
reported to make it difficult for parents to speak to their
children about the content of sex and its consequences.
One male participant mentioned that he found it difficult to
speak to his daughter about sex because he did not know
how to approach her. As a result, he requested her mother
to communicate with her. He said:
My son Tsodoyi knows because I always tell him
that sex results in pregnancy and he will have to
marry the girl even if she has one eye I am telling
you, then for my daughter I tell her mother to talk
to her because I do not know how to approach her
(Mafohlela, older men FGD, Flagstaff).
However, some participants felt parents should talk to their
children regardless of their gender:
Tell her what is wrong and right, so actually if you are
a child, whether girl or boy; you should talk to your
parent, be open with your parent and she should
also tell you what is wrong and right, you see? (Sisi,
young women FGD, Mpophomeni).
Religion and cultural influence on parent–child
communication about the SRHR
Sometimes one’s cultural values follow one’s religious
affiliation and beliefs and yet at times, some people may
hold what they believe are different and yet complementary
traditional and religious values. Be it Pondo parents in
Flagstaff, Zulu parents in Pietermaritzburg, and Eshowe
or Swati parents in Gert Sibande, being African and
subscribing to African culture was framed as a peculiar
barrier to sexuality conversations. Although conservatism
was presented as influenced by culture and religion,
shyness to communicate was attributed to ignorance about
sexuality and reproductive health information on the side
Vilanculos and Nduna
86
of the parent. The lack of knowledge and skill on how to
approach their children and the embodied distance between
parents and their children was summed up as follows:
Us Zulus we have this Zulu thing in us, I cannot have
my daughter…my daughter, she is old, but she can
never talk to me about her boyfriend but I know she
has one but she cannot tell me “mom, my boyfriend
and I went and did this.” No, it’s hard…even if I hint
and tell her to go to the clinic to get tested but I won’t
tell her straight. I will hint and she also won’t tell me
straight that she uses a condom she will just say,
“ey mom” and she gets up and leave me and I won’t
chase [go] after her… For us Zulus, our children fear
us even if you have not said anything because it is
in our blood as Zulus that respect comes naturally
(Sihle, older women FGD, Caluza).
My point that I want to raise is that parents should
focus on teaching other parents, I see that parents
are the ones who are having a problem because
they can’t talk about sex with their own kids, whereas
if they can be educated on how to approach their
kids about sex it will help them…both the kids and
the parent may meet so that the parent will tell the
kids the importance of and how to practise safe sex
and (guys shouting “The problem is our culture”)
(Kwanga, younger men FGD, Flagstaff).
It would seem that culture and religion hindered and also
fostered communication about sex. To serve the Christian
and African expectation that girls should not be pregnant
out-of-wedlock, parents who held leadership positions in a
church were reported to be compelled to talk to their children
to avoid being embarrassed by them lest they get pregnant
outside wedlock. Mapitsela explained the dilemma that
parents found themselves in, in the following words:
It starts with embarrassment that arises when the
child of a high profile parent in the church becomes
pregnant and then they start to do dirty things so that
they can look pure in front of the society; therefore,
they advise their children to go for abortions (young
women FGD, Flagstaff).
Though this might read like an opportunity that facilitates
a parent’s talk with her child, it is a problem solving, after
the effect solution, an instruction to the child to deal with
the pregnancy. It is not proactive communication about
pregnancy and abortion. Hence, we conclude that the moral
panic and reactive conversations need to be avoided in
favour of honest, open and proactive communication.
Discussion
This study reports participants’ views on parent–child
communication about sexual and reproductive health and
rights from three provinces in South Africa. These data
suggest that parent–child communication was viewed
as significant for protecting children from early sexual
debut, teenage pregnancy, and the contraction of sexually
transmitted infections. In a study from the United States that
used similar research methods, parents reported that they
believed that it is important to talk to their children about sex
(Wilson et al., 2010). Notably, here and elsewhere, religion
and culture shaped the parents’ manner of communication
with their children including the content discussed (Abrego,
2011). The communication was selective, unidirectional, with
the dominant party being the parent. Parents seemed to be
instructors while children were passive inactive information
receptors. Findings presented here mirror those of previous
findings that parent–child communication about sexuality
tends to be authoritarian and uni-directional (Bastien et al.,
2011). This suggests that anxieties about communicating to
children about sex may not be exclusive to South Africans.
The driving force behind some of this parent–child
communication was to avoid being shamed and embarrassed
by negative outcomes such as teenage pregnancy and
diseases. This means that some religious parents would
not talk about the SRHR unless they felt compelled to.
Nonetheless, some parents, especially in the KZN sites, were
more liberal in communicating about SRHR. Since KZN has
the highest prevalence rates of HIV, this may mean that there
is an acute awareness and enthusiasm to adopt protective
measures including flexibility in cultural conservatism.
Cultural interpretations of respect for the elderly or
parents as equating distance and aloofness negatively
affected parent–child communication. This is in agreement
with findings from studies conducted in Eastern Cape and
Mpumalanga which showed that silence on sensitive matters
between children and their parents characterised an approach
that is considered by adults to be culturally acceptable when
dealing with sexuality (Nduna & Jewkes, 2011; Nduna &
Sikweyiya, 2015). Cultural conservatism was similar across
all the sites, meaning children from families where parents
were apt to observe tradition and customs that promoted fear
as a sign of respect would not receive sexuality information
from their parents. This was unless there were other avenues
that parents were using to get their children informed such as
other adults, aunts, and grandparents within the home (Defo
& Dimbuene, 2012). In collective cultures such as those
mostly found in sub-Saharan Africa, older sisters, aunts,
and grandparents may play the role of communicating with
children about SRHR topics. However, the findings show
that the perceived cultural expectations about what an elder
and youth can talk about hinders parents from talking to their
children about SRHR. Children’s non-engagement with and
their fear towards parents is equated to respect. Therefore,
to maintain and enforce respect and adherence to parental
rule amongst the culturally adherent community, parent–
child communication about SRHR topics might be avoided.
This finding points out a need for further research to explore
whether other avenues such as the use of a third person
could be effective.
Another hindering factor reported in this study and in
earlier research is socio-economic status (Namisi et al.,
2015; Namisi et al., 2009). In South African communities,
low socio-economic status can also be a predictor of
education level and these can be related to levels of comfort
and confidence in talking liberally about sex. Parents’ level
of use of colloquial language shaped the manner in which
they communicated with their children. Given that there
are challenges with lack of education, information and
communication mediums in place (Mufamadi & Shongwe,
1997), this negatively affects parent–child communication
and may have a negative impact on children’s health due to
lack of knowledge about the SRHR related services.
African Journal of AIDS Research 2017, 16(1): 81–89
87
Our study findings suggest that there are different
views concerning the age that parents were supposed
to communicate with their children about sexuality. Even
though some participants felt that pre-puberty would
be appropriate for talking to children about sex, most
participants felt that the appropriate age was during early
adolescence. This was because those participants felt that
children at these ages were likely to understand what was
communicated to them, unlike when they were still younger.
However, other participants voiced that this was too late
to protect children from pregnancy and the contraction
of diseases because some children were already talking
about sex at age five while other girls have been found to
have engaged in sexual activities at the age of eight years
and younger. These findings support reported challenges
that hinder parents in other places from communicating
with their children, resulting in low levels of parent–child
communication (Biddlecom et al., 2009; Manu et al., 2015).
Chief amongst these is the young age of the child and finding
the right approach to broach the topic (Wilson et al., 2010).
Phetla et al. (2008) and Tesso et al. (2012) highlighted that
parents often discuss sexually related topics after sexual
debut. This relates to parents’ perceptions of their children
being too young to understand the content if they were to
initiate parent–child communication at an earlier stage.
Older female parents preferred and perceived puberty to be
the appropriate age for initiating parent–child communication
about SRHR. In contrast, younger female parents felt that
the appropriate age for initiating the communication was
earlier: pre-puberty. Evidently, the age of the parent affected
the timing of when parent–child communication about
sexuality topics would be initiated. This result is consistent
with that from previous studies that showed that younger
parents were better communicators on sexuality than older
parents (Ojo & Akintomide, 2010). This might be reflecting
the degree of comfort that younger parents had compared to
that of the older parents. The parents’ older age might have
negative effects on parent–child communication and, as a
result, on children. Drawing from demographic composition
of village inhabitants (ECSECC, 2015a), older parents who
seem to communicate to their children about SRHR matters
much later than younger parents are the ones who remain
behind as caregivers when the younger generation migrates
out of the rural provinces. This may put children raised by
grandparents at a disadvantage because it means they will
get informed about SRHR much later. This may be too late
to protect them against health risks, unlike if the younger
parents who preferred an earlier initiation of parent–child
communication were there. The concerns that have been
raised in this study demonstrate that there is no evidence
of change in this region: contraceptive use remains low
and so is the knowledge of SRHR, sexual debut is early
and teenage pregnancy still concerning (Buga, Amoko, &
Ncayiyana, 1996), even 20 years later.
Gender difference between parents and children affected
parent–child communication in the sense that parents, in
this case, fathers, preferred to talk to their sons and relied
on mothers to talk to their daughters. This is consistent with
the report of Namisi et al. (2013) that female adolescents
mostly prefer to talk to their mothers and that some males
from the Nigerian study prefer to talk to their fathers rather
than with mothers. Earlier research suggests that adolescent
females preferred to receive information from their mothers
whilst males preferred their fathers, however, both genders
reported very low rates of communication about sex with
their parents, with males much less likely to have received
information from their fathers (Manu et al., 2015; Namisi et
al., 2015; Namisi et al., 2009). This gender preference and
little communication between boys and fathers, at least in
South Africa, could be influenced by the predominance
families of single mothers (Makiwane, Makoae, Botsis, &
Vawda, 2012). However, in our study the parents were
uncomfortable about talking to their children who were
of the opposite-sex. These findings demonstrate that the
preference for not communicating to opposite sex parents
or children about the topics in SRHR could be two way. This
might bear negative implications for children who are living
in a family headed by a single parent, where the parent is
of the opposite sex. This implied that those children might
not have an opportunity to discuss their experiences on
the SRHR topics with their parents. This is especially so in
the area which is reported to have more women than men
heading households (ECSECC, 2015a), which may mean
that those female single-headed families might not afford
male children a platform to talk about the SRHR topics. In
addition, parents in this study seemed to place more focus
on talking and monitoring a girl child than a boy child.
There is need for further research to examine how parent–
child communication should be approached in households
headed by a single parent. From studies that report findings
for “parents”, it is not possible to tell if these included both
mothers and fathers when this information was not stated
(Biddlecom et al., 2009). Future research studies need to
specify the gender of the parent, as this cannot be assumed.
When parents talked to their children about sex, they
mostly used threats that sex leads to pregnancy or to death,
warnings, and admonitions. While on that, some parents
also seemed to use substitute words such as “kota-kota”
when referring to sex. The findings presented here illustrate
that parent–child communication tends to be characterised
by vague warnings rather than an open discussion as
reported in previous studies (Bastien et al., 2011). The
challenges with language, taboos, and cultural norms as
barriers to parent–child communication reported by parents
here are shared globally (Bastien et al., 2011; Wilson et al.,
2010). The most frequently reported content of discussion
appeared to be about sex, pregnancy, and HIV/AIDS.
This is consistent with some aspects of what Tesso et al.
(2012) report. There is a need for further research studies to
examine the frequency of parent–child communication and
the contextual factors that facilitate the discussions of some
SRHR topics over others.
Limitations
The study only recruited participants who were 18 years
and older who ordinarily resided in the villages or townships
where the interviews took place. As the interview took
place during the week, this systematically excluded working
adults. The researchers were not the facilitators of the
FGDs and this potentially limited the opportunity to probe for
more information. However, the study managed to extend
Vilanculos and Nduna
88
the findings of previous studies and communicate useful
information that can be used to design future studies.
Conclusion
Parent–child communication is significant for facilitating
behaviour change amongst children and youth. Only a few
topics on sexual and reproductive health rights dominate
parent–child communication. Also, parents were still unsure
of when parent–child communication about different aspects
of SRHR should be initiated, especially because younger
children are perceived not to understand the content of the
discussions. Some parents are still uncomfortable about
communicating with their children due to age and gender
differences. Parents’ lack of education and information
informed the basis of what parents communicated to their
children and how they conveyed it. As a result, there is a
need for parental guidance to advise those parents who
could communicate with their children about SRHR topics
and even topics beyond, such as sex, pregnancy and HIV/
AIDS. The findings from our study revealed that SRHR
interventions need to take into account various factors
that influence parent–child communication. Parents
would be encouraged to make use of third persons if they
themselves cannot do so, so children could be afforded
the knowledge necessary to protect themselves from
risky sexual behaviours and to make use of SRHR related
services. Most importantly, community dialogues dealing
with how the people’s religious and cultural beliefs had an
impact on parent–child communication about SRHR topics
also need to be addressed because these beliefs influenced
the silence or the manner in which parents communicated
with their children. This study suggests that although these
barriers were reported as context specific and located within
an ethnocentric framework in this study, these challenges
may be universal. The gap between what parents think they
should do and what they actually do needs to be closed.
The fact that parents show conviction indicates that they
may be receptive to interventions that support parent–child
communication. Parents need to be equipped with education
and communication skills so that they are able to improve
their communication with their children.
Acknowledgements — The authors thank the AIDS
Foundation of South Africa, the DST/NRF Centre of
Excellence for Human Development, and the Faculty
of Humanities at the University of the Witwatersrand for
funding this study. Furthermore, the authors thank the study
participants and colleagues at WITS for their participation in
the research process.
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