The study of Communication between mothers and their adolescent daughters on the subject of sexuality and HIV/AIDS was carried out in Rubaga division in Kampala district and Kabulasoke sub-county located in Mpigi district. The data presented and discussed in this study was collected from adolescent girls aged 12-18 years and their mothers. The data was collected between July and August of 1997. Data entry, analysis and report writing was done in the subsequent period.
A total of 186 adolescent daughters and 183 mothers were interviewed from Rubaga division in Kampala district and Kabulasoke sub-county in Mpigi district, respectively. 94% of adolescent daughters were in the age group 13 - 19 years, with a mean age of 15 years. More than 30% of adolescent girls have reported to be already sexually active by this age. In the same age group, HIV infection rates are six times more in females than male counterparts nationwide. Adolescent girls, therefore, need correct information on sexuality and HIV/AIDS from their parents to reduce morbidity and mortality due to sexual health problems.
It was also noted that the majority of mothers were relatively young , which suggested that even the mothers conceived at an early age. Thus, the phenomena of initiation of sexual activity at an early age, early pregnancies and early birth have been passed on from one generation to another due to lack of adequate sex education from parents with whom children spend most of their time.
The majority of respondents were of the catholic faith, followed by Protestants and Moslems, which reflected the national picture in general.
Most adolescents had attained primary and secondary education. Most of the mothers had their education levels skewed to primary education and a few to secondary levels. Mothers could thus experience communication problems due to their low education level, since most of the literature being circulated on sex education nationwide is in the English language. There is, therefore, a need to design IEC materials in languages mothers with communication problems can understand so that they can pass on this to their daughters.
It was observed that 50% or half of the daughters were from single or polygamous family backgrounds. Single mothers are in most cases busy trying to fend for their families, which could have an impact on time given to adolescent problems. Polygamous families are also often unstable and may influence the content of moral communication between mothers and their daughters as mothers from both single and polygamous families may find it difficult to impart moral messages to their daughters when they themselves are not doing the same. Most mothers were peasant farmers and housewives, which would supposedly give them enough time with their daughters.
Many adolescent girls received their information from parents and peers. This suggests that there is a need to equip both mothers (parents) and peers (girls) with correct information on sexuality and HIV/AIDS which they can pass on to their children and peers. There is also a need to equip them with IEC skills to effectively pass over the information to recipients.
It was also noted that a wealth of information ranging from sexually transmitted diseases and HIV/AIDS, menstrual hygiene, sexual abstinence, condom use and family planning was learnt from these sources. The content of the information, if put in practice, would enable adolescents to lead a reasonable quality of reproductive health status. It was revealed that these sources put emphasis on sexual abstinence more than other safer sex life styles like condom use and other family planning methods.
About 70% of mothers talked to their daughters about sexuality and HIV/AIDS. Most mothers started to talk to their daughters at the age of menarche (12 - 14 years). Most of the talk from mothers emphasized issues such as avoiding men, early pregnancies and menstruation hygiene.
It was also observed that with the coming of the AIDS epidemic in the past decade, mothers have taken on to warning their daughters from getting sexually transmitted diseases and HIV/AIDS mainly through abstinence and a few encouraging condom use. Mothers are also advising their daughters to avoid risky places such as discotheques and walking alone in dark places.
Many mothers use the occasion of their daughters' first menstruation to initiate the discussion on sexuality, since this is when they regard their daughters as having become sexually mature. However, many mothers also initiated the talk when they get evidence that their daughters have become sexually active. Tragedies like loss of a relative due to HIV/AIDS or unwanted pregnancy also provided mothers with opportunities to talk to their daughters. On average, mothers talked to their daughters about once a week. About half of the mothers experienced communication problems with their daughters, which ranged from fear, shyness or busy schedules and perceiving sex education as not being culturally appropriate. Traditionally, in Ugandan culture, it was a member of the extended family such as an auntie or granny who provided sex education to daughters. Mothers have always taken it as not being their primary responsibility to give sex education to their daughters. Other mothers felt that their daughters were still young or feared exposing their daughters to information on sex matters, which could stimulate them into sexual activity. Over 30% of the daughters revealed that their mothers never talk to them on issues about sexuality and HIV/AIDS. Most of the daughters did not indeed know why their mothers never provided them with sex education.
The majority of mothers, however, assisted their daughters to obtain correct information on sexuality and HIV/AIDS by encouraging them to watch television and listen to radio programs, providing them with relevant literature such as booklets, magazines and newspapers and sending them to visit their aunties.
There were a number of sources of information about sexuality and HIV/AIDS that adolescents could use. These sources included friends, teachers, films, books, newspapers, aunties, grandmothers, health workers and seminars among others. It was noted that many of these sources put emphasis on information regarding sexually transmitted infection, sexual abstinence and condom use. In spite of the presence of several sources of information on sexuality and HIV/AIDS, most of the adolescents still preferred to get this information from their mothers or auntie whom they trusted and felt comfortable with.
The majority of mothers (75.8%) talked to their daughters on issues of sexuality and HIV/AIDS. The mean age of daughters at which mothers reported they initiated the discussion did not significantly differ from that reported by daughters (P = 0.923).
The mothers' discussion put a lot of emphasis on issues of menstruation hygiene, avoiding early pregnancy, STDs, HIV/AIDS and sexual abstinence. Only a few mothers mentioned condom use and having one faithful partner. Traditionally, in many societies of Uganda, adolescent girls have been expected to keep their virginity till marriage. Thus, mention of condom use and faithfulness by mothers would be visualized as encouraging their daughters into sexual activity. It was also observed that a few mothers who discussed about family planning and condom use only did so after discovering that their daughters were already sexually active. It was further observed that many mothers were putting special emphasis on STDs and HIV/AIDS and how their daughters could avoid these, probably due to massive AIDS education campaigns that have been going on in Uganda. Many mothers, however, reported that they talked to their daughters more often than their daughters reported (P = 0.008942) which could probably suggest that on a number of occasions the discussion could be so vague or indirect that the daughters did not perceive it as part of sex education. This, therefore, suggested imparting IEC skills to mothers so that they could effectively communicate to their daughters.
The discussion about sexuality and HIV/AIDS was started in diverse settings such as while doing household work, seeing a PLWAs, when the daughter misbehaved or while watching television or listening to a radio program. On the contrary, many mothers reported that their daughters often started menstruation while at school and as such rarely used this occasion to initiate the discussion.
About one third of mothers (28.1%) revealed that they find communication barriers with their daughters. Most of these barriers stemmed from a feeling of shyness to talking to their daughters while others reported that their daughters were quite stubborn and would not listen to them. A number of mothers admitted that they did not know what and how to talk to their daughters.
Mothers gave several recommendations on how they could be assisted to improve their communication skills with their daughters. These included organizing training seminars and workshops for them, provision of relevant literature, provision of educative radio and television programs among others.
Mothers played a big role in accessing their adolescent daughters to information on sexuality and HIV/AIDS in addition to talking to them directly, mainly through encouraging them to benefit from TV and radio programs, sending them to their aunties for sex education and providing them with relevant literature. It was noted that many of these sources still, provided the same moral messages as mothers did talk to their daughters on issues such as STDs and HIV/AIDS, sexual abstinence, avoiding unwanted pregnancies. However, many of these sources put little emphasis on condom promotion, only mentioning it rarely in the context of HIV/AIDS prevention.
Many mothers had confidence that their daughters were receiving the right information from sources outside their families especially from aunties and counselors whom they claimed had enough experience in providing sex education . They cited examples, such as discipline of their daughters, openness of their daughters to them when they have adolescent problems and the special interest of the daughters in TV/radio sex education programs.
Thus, majority of the mothers had confidence in aunties, teachers, counselors and pastors as other persons who could be trusted to provide sex education to adolescents. Mothers were of the view that controversial issues like condom use should be left to such persons to avoid a cultural and moral conflict in case they themselves discussed such issues with their daughters.
