Gender differences in sexual and reproductive health education in the family: a mixed methods study on Romanian young people

BACKGROUND: The family is one of the key factors that can contribute to reducing the negative consequences of high-risk sexual behavior. This study examines the influence of parents’ communication with children on issues of sexuality on sexual behavior. METHODS: The study is based on a mixed research design. In 2013–2014, 1,359 people aged 18–30 years were randomly selected from urban areas covering the main university centers of Romania, and they completed a questionnaire with 60 items regarding sociodemographic data, family, sexual behavior and health risks. Out of the initial sample, 60 participants agreed to participate in face-to-face interviews, using a thematic interview guide. The quantitative data were analyzed using descriptive inferential statistics, including binary logistic regression. The qualitative data were investigated using thematic analysis. RESULTS: Exploring the issues of sexual and reproductive health (SRH) discussed with parents according to gender revealed that there was a greater concern in families to address issues of sexuality with girls. The manifestation of any form of sex education in the family was positively associated with a healthy sexual debut, both for women and men (χ2 = 7.759, χ2 = 7.866, p = 0.005). The results of the regression reinforced the idea that a lack of sex education in the family decreased the likelihood of a healthy sexual debut, both in women (OR: 0.668, p = 0.018) and in men (OR: 0.605, p = 0.013). In men, receiving information about sex at a younger age (OR: 0.335, p = 0.001) reduced the chance of a healthy sexual debut. Younger women and men were more likely than older women and men to experience a healthy sexual debut [odds ratio (OR): 1.861, p < 0.001 and OR: 1.644, p = 0.015, respectively]. Qualitative results revealed that SRH talks were generally initiated by young people, usually involved a parent of the same gender and often occurred after events in the sexual lives of young people (after first menstruation/after sexual debut). CONCLUSIONS: In designing health programs for adolescents and youth, the family should be involved in sex education. Modeling family sex education by gender can produce differentiated effects on the sexual debut of men and women.