Journal of Child and Family Studies (2020) 29:2967–2981

https://doi.org/10.1007/s10826-020-01713-5

ORIGINAL PAPER

Effects of Socialization on Adolescent Sexual Behaviors in Lao PDR

Ji-Eun Lee1 Ji-Hoon Park2
●

Published online: 1 May 2020

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract
Adolescent risky sexual behaviors are closely associated with adverse health outcomes, and losing future educational and
economic opportunities. Communication about sex-related topics with various people influences adolescent sexual behavior
through sexual socialization. This study aimed to examine the effects of the sex-related information on sexual behavior by
considering three important aspects which are multiple sources, messages, and frequency of communication. Data on this
study were from the cross-sectional survey on integrated health of 493 adolescents aged 15–19 from four secondary schools
in the Capital of Lao PDR. We used Firth’s penalized likelihood estimation to test hypotheses. The results showed that
several messages and sources of sexual information have significant effects on adolescent sexual engagement. Among the six
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different contents of sex, receiving messages about contraception from media and doctor decreased the probability of having
sex. Sibling’s information about pregnancy was significantly associated with having sex. Sexual messages from mother
increased the likelihood of having sexual activity. Regardless of sexual contents, partner’s information was closely related to
sexual engagement. However, none of the sexual messages from teacher had an impact on adolescents’ sexual behavior. This
study provides practical implications to parents, teachers, and policymakers in Lao PDR as well as novel insights to research
on sexual behaviors of adolescent.
Keywords Sexual behavior Sexual communication Sexual socialization Socio-cultural factors Lao PDR
● ● ● ●

Highlights
● We examine the effects of socialization on adolescent sexual engagement in Lao PDR.
● Various sources, messages, and frequency of communication are considered in analyses.
● The effects of socialization differ by contents and frequency of communication.

Risky sexual behaviors (RSBs) among adolescents are one
of the critical social and health issues around the world
(e.g., Ali and Dwyer 2011; Fatusi and Blum 2008; Le and
Kato 2006; Warren and Warren 2015). Adolescent RSBs—
e.g., early sexual engagement, having multiple partners, or
unprotected sex—may cause significant problems since
they not only result in unintended pregnancies, sexually
transmitted diseases (STDs), mental health problems, and
* Ji-Hoon Park
jihoonpark@hanyang.ac.kr
1 agents in sexual socialization theory, but a large number
Department of International Studies, Graduate School of
International Studies, Ewha Womans University, Seoul, Republic
of Korea
2
School of Business, Hanyang University, 222 Wangsimni-ro,
Seongdong-gu, Seoul 04763, Republic of Korea
other health risks, but are also closely associated with losing
future educational and economic opportunities (Fatusi and
Blum 2008; Hall et al. 2004; Spitalnick et al. 2007).
Adolescent sexual behavior is developed through sex-
ual socialization, which is the process that people acquire
values, norms, and attitudes about sexuality through
interacting with agents (Gravel et al. 2016; Grusec 2002;
Grusec and Hastings 2014; Ward 2003). Sexual commu-
nication is an integral part of sexual socialization because
the messages are transmitted to adolescents through sex-
ual communication with agents (de Looze et al. 2015). In
this context, studies of sexual communication have been
examined by different sources—which are socialization
of studies has heavily focused on parental and peer sexual
socialization and rarely considered other socialization
agents including siblings, teacher, partner and media (Ali
and Dwyer 2011; Averett and Estelle 2014; Holtzman and
2968
Rubinson 1995; Le and Kato 2006; Whitaker and Miller
2000). It is crucial to examine the variation of agents
because young people begin to develop their sexual
behavior by interacting with diverse agents of sexual
socialization (Grusec and Hastings 2014; Jones et al.
2011; Sprecher et al. 2008). Thus, this study is designed
to examine the impact of diverse sources of sexual com-
munication on adolescent RSBs with a consideration of
frequency and messages, thereby contributing to the cur-
rent understanding of sexual socialization.
Furthermore, much of the knowledge on sexual socia-
lization and adolescent RSBs is derived from the literature
of western countries mainly in the USA (e.g., Aspy et al.
2007; Bleakley et al. 2009; Sprecher et al. 2008). Com-
pared to the western countries, Asian countries including
Lao PDR, have different cultural and social backgrounds
which would differently affect the association between
adolescent communication and RSBs (Aspy et al. 2007;
Jones et al. 2011; Kim 2009; Kim and Ward 2007;
Sprecher et al. 2008). Thus, by studying Laotian adoles-
cents, this study would help to understand how socio-
cultural contexts of Asian countries differently formulate
sexual communication and affect adolescent RSBs from
western countries.
Hypotheses
Sexual Socialization Theory
The theoretical framework that guides the study linking
sexual communication and sexual behavior is predicted on
sexual socialization theory (e.g., de Looze et al. 2015;
Hutchinson et al. 2003; Miller and Fox 1987; Sneed 2008;
Ward 2003). Sexual socialization is the multidimensional
and long-term process that people acquire knowledge,
values, norms, and attitudes about sexuality through inter-
acting with various agents (Gravel et al. 2016; Grusec 2002;
Ward 2003). As an essential procedure of sexual sociali-
zation, people internalize the messages received from agents
through active interpretations and began to formulate cer-
tain attitudes and behaviors on sex and sexuality (Bandura
1986; Gravel et al. 2016; Maio et al. 2006). In this regard,
scholars considered communication as an essential part of
the sexual socialization, because the messages are trans-
mitted through the sexual communication with agents (de
Looze et al. 2015; Holtzman and Rubinson 1995). Although
a significant number of studies enhanced the knowledge of
this area, they were marked by several limitations. This
study is designed to advance the knowledge of sexual
socialization by filling these gaps in the previous research.
First, the extensive number of literature studied the effect
of sexual socialization and adolescent RSBs, but most of
Journal of Child and Family Studies (2020) 29:2967–2981
them focused on parents and friends as agents of sexual
socialization (e.g., Chia 2006; Coakley et al. 2017; Davila
et al. 2017; de Looze et al. 2015; DiIorio et al. 1999; Sneed
et al. 2015; Widman et al. 2016). Although parents and
friends are considered as primary agents of sexual sociali-
zation, it is important to consider multiple sources of sexual
communication because teenagers begin to interact with
various socialization agents (e.g., Grusec and Hastings
2014; Sprecher et al. 2008). Diverse agents of socialization
would provide dissimilar messages about sex that differ-
entially affect adolescent RSBs (Bleakley et al. 2009; Jones
et al. 2011; Sprecher et al. 2008; Ward 2003). Besides,
recent studies recognized the significant role of multiple
social agents, and began to study their effects on adolescent
RSBs (Bleakley et al. 2009; Secor-Turner et al. 2011; Ward
2003). However, these studies also have several limitations
including a small number of sample, no information about
the status of adolescents, and lack of consideration of
communication messages (Bleakley et al. 2009; Secor-
Turner et al. 2011; Ward 2003). Thus, our research studies
the effect of various agents of sexual socialization on ado-
lescent sexual behavior, including parents and friends, as
well as teachers, siblings, and media.
In addition, most of the studies on sexual socialization
and adolescent RSBs are conducted in western countries,
mainly in the USA (e.g., de Looze et al. 2015; Hutchinson
et al. 2003; Jones et al. 2011). Similarly, many interven-
tion studies on adolescent health have been conducted in
high-income countries (Patton et al. 2016). It is very cri-
tical to study low- and middle-income countries in Asia
region because they have different socio-cultural char-
acteristics that shape different pattern and process of
sexual socialization (Kim 2009; Kim and Ward 2007). For
example, in many Asian countries, there is a cultural
taboo on sexual expression or discussion about sex in
public, and women are expected to keep their virginity
until their marriage (Deardorff et al. 2010; Kim and Ward
2007; Okazaki 2002). In Asian culture, individuals are
mainly affected by social group, and sexual norm within
the society decreases the likelihood of taking RSBs
among Laotian adolescents (Le and Kato 2006). Thus, this
research focuses on one of the Asian countries to broaden
understanding of sexual socialization and adolescent
RSBs and to provide useful strategies and policy recom-
mendations to reduce sexual health risks of adolescents.
Among the Asian countries, Lao PDR has been recog-
nized as a country with high adolescent pregnancy and
birth rate (MoH & LSB 2012). Also, premarital sexual
activity has been increased among adolescents and put
them into adverse health outcomes in the Lao PDR (LYU
2014; MoH & UNFPA 2008).
Therefore, this study presents the impact of sexual
communication on adolescent sexual behavior, by
Journal of Child and Family Studies (2020) 29:2967–2981
considering multiple social agents. Then we discuss whe-
ther and how socio-cultural contexts of the country influ-
ence on the relationship between sexual communication and
adolescent sexual behaviors. We expect to deepen our
understanding of sexual communication and adolescent
sexual behaviors in a developing country, particularly
Lao PDR.
This study developed six hypotheses based on the pre-
vious literature on sexual communication and adolescent
sexual behaviors as well as the socio-cultural contexts of
Lao PDR. We argue that Laotian adolescents would con-
front strong traditional and cultural norms on sexuality
would have a different style of sexual communication.
First, parents are considered as one of the primary agents
of teenagers’ sexual socialization because children have
learned and observed attitudes and behaviors of parents
from early years (Clawson and Reese‐Weber 2003). Many
studies showed that parent–adolescent communication was
negatively associated with adolescent sexual behaviors
(DiClemente et al. 2001; DiIorio et al. 2007; Hutchinson
et al. 2003), whereas others provided opposite results that it
increased the likelihood of having sex (Bersamin et al.
2008; Clawson and Reese‐Weber 2003). However, when
adolescents received clear message on sexuality from par-
ents, such as guideline about sexuality, adolescents were
less likely to engage in sexual activity (Aspy et al. 2007).
Parents’ attitude on teenage sex is also a great matter in
terms of open sexual communication, as de Looze et al.
(2015) showed Dutch parents’ liberal attitude might lead
them to talk about protection and contraception which was
positively associated with sexual initiation of adolescents.
In many Asian countries, parents have very conservative
sexual attitude compared to those in Western countries due
to the cultural traditions (Chen et al. 2016; Okazaki 2002).
In Lao PDR, social group is more emphasized than indi-
viduals (Le and Kato 2006), and the society does not accept
having sexual activity before marriage especially for
women (Keobounphanh and Toole 2008). Thus, we
hypothesize that:
Hypothesis 1: communication about sex-related topics
with mother or father would reduce the likelihood of having
sexual intercourse among adolescents.
Cultural tradition in Lao PDR would also affect tea-
cher’s sex education at school. In Lao PDR, as a life-skill
curriculum was introduced to the schools, students began
to learn about reproductive health, and STDs and HIV/
AIDS (Sychareun et al. 2017). While providing sex edu-
cation, teachers would give warning messages to the
students not to engage in sexual activity, because similar
to parents, teachers would have conservative sexual atti-
tude due to the cultural taboo on premarital sex in Asian
countries (Nagamatsu et al. 2013). Also, the teacher
would encourage students to focus on schoolwork instead
2969
of paying attention to the relationship and sexual activity.
Therefore, we hypothesize that:
Hypothesis 2: communication about sex-related topics
with a teacher would reduce the likelihood of having sexual
intercourse among adolescents.
As a member of the family, sister or brother has a vital
role in adolescents’ sexual socialization (Kornreich et al.
2003). In particular, adolescents are affected by older sib-
lings by replicating their behaviors (Rodgers and Rowe
1988). Most of older siblings become sexually matured
earlier than younger siblings, and those with sexual maturity
are more likely to be curious about sex and engage in a
sexual relationship than other counterparts (Somers and Ali
2011). In particular, if an older brother is sexually active,
younger siblings are more likely to have sex, especially for
males (Widmer 1997). Furthermore, girls who had sexually
active sisters had more likelihood of having a liberal attitude
on sex and initiating sexual activity (East et al. 1993). With
this regard, we hypothesize that:
Hypothesis 3: communication about sex-related topics
with siblings would increase the likelihood of having sexual
intercourse.
Furthermore, peer norms strongly influence adolescents’
sexual behaviors (Maxwell 2002; Whitaker and Miller
2000). By talking about sex with friends, adolescents’
sexual behaviors would be affected by perceiving peers’
sexual attitude and behavior (Maxwell 2002; Secor-Turner
et al. 2011). If friends have conservative sexual attitudes
and want to be abstinent, teenagers are less likely to engage
in RSBs, whereas if friends are sexually active and have
liberal sexual attitudes, they have more RSBs (DiIorio et al.
1999; Saftner 2016). However, it is cultural taboo to openly
discuss sex in the case of many Asian countries (Nagamatsu
et al. 2013; Sychareun et al. 2013). Thus, talking about sex
with friends might also be not common in Lao PDR.
Teenagers who frequently talk about sex with their friends
would have more probability of having liberal attitudes
towards sex and initiating sexual activity than those who
rarely talk about it with friends. Many young people in Lao
PDR started to have a romantic relationship and engage in
sex with a dating partner through peer influence (Sychareun
et al. 2013). Therefore, we hypothesize that:
Hypothesis 4: communication about sex-related topics
with friends would increase the likelihood of having sexual
intercourse.
If adolescents talk about sex with their partner, it might
indicate that they are in a romantic relationship or at least
they are seeing someone or have sexual partners. Teen-
agers who are in a relationship with a boy or girl have
more probability to initiate sexual activity than those who
do not have any partners (Longmore et al. 2001). More-
over, talking about sex with dating partners can lead them
to engage in a sexual relationship (Guzmán et al. 2003).
2970
Many Laotian women in Vientiane Capital reported that
partner pressure was one of the most influential factors
affecting their sexual activity (Keobounphanh and Toole
2008). Partner pressure does not only indicate physical
force but also mean “verbal persuasion and manipulation”
through communication between adolescents and their
partners (Bay-Cheng and Eliseo-Arras 2008, p. 392).
Therefore, we expect that:
Hypothesis 5: sexual communication with a partner
would increase the likelihood of having sexual intercourse.
Media and internet use have been recognized as impor-
tant sources of receiving and sharing sexual information
among adolescents (e.g., L’Engle et al. 2006; Lou et al.
2012). Because of easy access and anonymity of the inter-
net, adolescents are easily exposed to an enormous amount
of sexual information (Simon and Daneback 2013). For
Asian adolescents, in particular, media is a relatively easy
and comfortable way of getting sex-related information,
because learning about sex from parents or teachers is
relatively uneasy for teenagers compared to those in western
countries (Lou et al. 2012). Most of the contents in the
media have appealing and stimulating messages and images
on sex, so adolescents are more likely to have a liberal
attitude towards sexual activity (Gonzalez-Ortega et al.
2015; Ward 2003). Furthermore, media is regarded as
“super peer” that is similar to sexually active friends whom
adolescents observe and imitate the sexual behavior from
(Brown et al. 2005; Strasburger et al. 2009). Therefore, we
hypothesize that:
Hypothesis 6: being exposed to information about sexual
intercourse through media would increase the likelihood of
adolescents’ having sexual intercourse.
Method
Data Collection
This study utilizes the data collected from September to
October 2017 from the project: “Training Girls’ Integrated
Health Care Specialists and Strengthening Girls’ Health
Empowerment in Laos.” This project aims to improve girls’
integrated health through training healthcare specialists and to
empower girls. The survey was conducted in the 1st year of
the project to understand the health status, behavior, and
lifestyle of Laotian students. The study protocol was reviewed
and approved by the Institutional Review Broad (IRB) of the
University of Health Sciences (UHS) in Lao PDR.
Participants and Procedures
In collaboration with the UHS in Lao PDR, a list of
schools in Vientiane Capital was prepared as a sampling
Journal of Child and Family Studies (2020) 29:2967–2981
frame, and four secondary schools were selected by using
random sampling. A total of 1050 students in grade of 2,
3, 5 and 6—about 250 students from each school—were
randomly selected from four schools. Informed consent to
participate in the survey was obtained from students, and
written parental consent was also received before the
survey. Students and parents received different consent
forms, which included research purpose, participation,
research procedures and methods, benefits of study par-
ticipation, signs of withdrawal from research, con-
fidentiality, contact information of research team, and
how to write a consent form. To ensure confidentiality,
this study identified students by the new code number,
which consisted of school, grade, sex, and the random
number in order. In total, 1007 students were included as
survey participants. In this study, a sub-sample of all
adolescents aged 15–19 were selected because this age
group has been studied in the areas of adolescent sexual
attitudes and behaviors (e.g., LSB 2018; MoH & LSB
2012; Saftner 2016). Thus, a total 493 adolescents aged
15–19 out of the 1050 study participants were included in
this study.
Field workers who were responsible for survey investi-
gations consisted of five UHS staff members as supervisors
and twenty school teachers. After the project team devel-
oped survey questionnaires in English and reviewed them
several times, Laotian researchers translated it into the Lao
language. A pilot test was conducted with 79 students at one
secondary school in July 2017. After the pilot test, all
questionnaires were reviewed and revised several times
through the workshops with project members and field
workers. In August and September, the supervisors pro-
vided training for investigators on survey procedures and
precautions. The survey investigators learned the sensitivity
of the topic such as sexual health and behavior, and the
importance of ensuring students’ confidentiality.
Measures
Sexual engagement
The main dependent variable we used in this quantitative
analysis was adolescents’ sexual engagement. In addition,
when adolescents reported that they had a sexual experience,
they were also asked about their age at first sexual intercourse,
a number of lifetime partner, and the use of contraceptive
method. These additional questions were only used to
describe the participants’ risky sexual behaviors by conduct-
ing the bivariate analysis. The questions were developed
based on the survey questionnaires on adolescent sexual
behaviors from studies of Cleland (2001) and Sychareun et al.
(2013). For example, sexual intercourse was measured by the
question “Have you ever had any sexual intercourse?”
Journal of Child and Family Studies (2020) 29:2967–2981
Sources of sexual communication
Our main independent variable, source of sexual com-
munication, refers to a person or an object that share sex-
related contents including knowledge, values, or beliefs
to another person. The questions about sources of sexual
communication were developed by referring to the related
literature (Berten and Van Rossem 2009; Bleakley et al.
2009; Sprecher et al. 2008). We listed four main topics of
sexual communication: sexual intercourse, pregnancy,
contraception, and STDs or HIV/AIDS. Within the
topics, six contents were listed as “sexual intercourse”;
“how to get pregnant”; “negative consequences of teen
pregnancy”; “how to use contraceptive methods”;
“importance of contraception”; and “STDs or HIV/
AIDS”. As above, two topics “pregnancy” and “contra-
ception” had two different contents of communication
each, for understanding the detailed messages of com-
munication between adolescents and sources. This study
developed the scales of sexual communication by
adapting the idea of Kim and Ward (2007) that Asian
adolescents might have a non-verbal and indirect style of
communication with agents of socialization. Thus, we
asked the participants whether they received any “infor-
mation” on each topic. For example, participants were
asked, “Have you ever received any information on
sexual intercourse?” “Have you ever received any infor-
mation on pregnancy?”. If the participant answered
“yes”, questions about sources and frequency of sexual
communication on six different contents were provided to
the students: “From where and how often did you get
information on sexual intercourse?” Participants were
asked to check each source on a four-point frequency
scale as “never”; “rarely”; “sometimes”; and “always”.
Also, response options for sources of communication
included “mother”; “father”; “siblings”; “friends”; “lover
or sex partner”; “teacher”; “doctor or other health pro-
vider”; “media”; and “other”.
Socio-demographic characteristics
To describe the characteristics of sample and to control
for demographic factors that may affect adolescent sexual
behaviors, seven variables were considered as socio-
demographic characteristics: Age, grade, sex, family
economic status, living arrangement—whether adoles-
cent lives with one, both, or no parent, parents’ level of
education, and substance use. These variables have been
considered as essential factors that affect adolescent
RSBs in the literature (Aspy et al. 2007; Bonell et al.
2006; Chiao and Yi 2011; Hong and Kang 2017; Le
and Kato 2006; Ramisetty-Mikler et al. 2004; Zapata
et al. 2008).
2971
Sexual attitude
Sexual attitude was included as statistical control because
previous studies have identified that sexual attitude guides
adolescent sexual behavior (Gravel et al. 2016; Maio et al.
2006). Participants’ sexual attitude was assessed by two items
which were also used in the study of Laotian adolescents
(Sychareun et al. 2013). Participants were asked to indicate
their agreement with each statement on a four-point scale:
“Young unmarried women should not have sex until they
marry”, and “Young unmarried men should not have sex until
they marry”. Response options include “strongly agree”;
“agree”; “disagree”; and “strongly disagree”.
Sexual knowledge
Sexual knowledge was also selected as one of the control
variables which was significantly associated with adolescent
sexual experience in the previous studies (Berten and Van
Rossem 2009; Swenson et al. 2010). The measure of sexual
knowledge was developed based on the related literature
(Cho 2005; Cleland 2001; Kim and Yang 2004; Sychareun
et al. 2013). There were 16 true–false questions on repro-
duction, pregnancy, contraception, STDs and HIV/AIDS in
order to measure the level of sexual knowledge. Participants
were asked to answer “true”; “false”; or “don’t know”. The
sample statements included “Menstruation is monthly
bleeding from the uterus”; and “Having sex more than one
partner can increase a person’s chance of being infected with
HIV”. Correct answers were counted, with considering
“don’t know” as an incorrect answer. Participants who get
higher scores were considered as having better sexual
knowledge.
Empirical Approach
The present study examined the effects of various sources
sharing sex-related information on adolescents’ sexual inter-
course. We began with a bivariate analysis that described
socioeconomic characteristics of the sample and family, as
well as characterized the prevalence of adolescent RSBs,
which were stratified by sex. We then conducted multiple
regression analysis to assess the relationship between sources
of information and sexual intercourse while controlling cov-
ariates. Because dependent variable—sexual intercourse—is
dichotomous, we used logistic regression. Since our data had a
small number of events that the participants ever had sexual
intercourse, there would be a separation problem in logistic
regression (Heinze and Schemper 2002). In this case, the
conventional logistic regression model might have a small-
sample bias (King and Zeng 2001). To overcome the problem
of separation, this study uses Firth’s penalized likelihood
estimation which many scholars have used to reduce the
2972 Journal of Child and Family Studies (2020) 29:2967–2981

potential bias (Firth 1993). To detect potential outliers and
heteroscedasticity issue, this study estimated all models in the
analysis with Huber–White standard error corrections. We
used Stata Statistical Software (STATA 13) for all analyses.
Statistical significance was considered at a p value lower
than 0.10.
Results
Key Characteristics of Participants: Sexual Attitudes
and Behaviors
A total of 493 adolescents were included in the study. Age
of the participants ranged from 15 to 19 years old. There
were 212 male respondents and 281 female respondents.
Respondents were mostly Lao-Tai (94.9%), and a few
participants had a different ethnic background including
3.25% Hmong-Mien, 0.61% Mone-Khmer, and 0.81%
others. As shown in Tables 1, 58.4% of respondents lived
with both parents, 21.06% lived with one parent, and
20.45% lived without parents during the school semester.
About family possession such as electricity, telephone,
bicycle, television, motorcycle, and refrigerator, about
65.3% of the students reported having 7 to 10 properties.
Tables 2 and 3 show that adolescents agreed or disagreed
with two statements regarding sexual behavior. About
76.2% of respondents agreed that young unmarried women
should not have sex until they marry. There were significant
differences in sex that more female than male adolescents
(69.3 vs. 81.1%, p < 0.001) disagreed women’s premarital
sex. Regarding men’s sexual intercourse, 74.1% of ado-
lescents believed that they should not have sex until mar-
riage. Similar to the first statement about women’s

Table 1 Descriptive Total Male Female p value

characteristics of adolescent
respondents by sex n % n % n %

Age
15 155 31.44 58 27.36 97 34.52 0.012
16 202 40.97 78 36.79 124 44.13
17 105 21.30 58 27.36 47 16.73
18 26 5.27 15 7.08 11 3.91
19 5 1.01 3 1.42 2 0.71
Living status during the semester
Living with both parents 286 58.49 127 60.19 278 57.19 0.078
Living with one parent 103 21.06 35 16.59 68 24.46
Living without parents 100 20.45 49 23.22 51 18.35
Father’s level of education
No schooling 9 2.95 4 3.03 5 2.89 0.957
Some primary school 28 9.18 12 9.09 16 9.25
Primary school 41 13.44 15 11.36 26 15.03
Lower secondary school 52 17.05 23 17.42 29 16.76
Upper secondary school 91 29.84 38 28.79 53 30.64
University 70 22.95 33 25.00 37 21.39
Postgraduate 14 4.59 7 5.30 7 4.05
Mother’s level of education
No schooling 27 7.94 13 9.03 14 7.14 0.436
Some primary school 54 15.88 20 13.89 34 17.35
Primary school 53 15.59 26 18.06 27 13.78
Lower secondary school 66 19.41 21 14.58 45 22.96
Upper secondary school 79 23.24 36 25.00 43 21.94
University 53 15.59 25 17.36 28 14.29
Postgraduate 8 2.35 3 2.08 5 2.55
No. of family properties (out of 13)
1–2 3 0.67 1 0.50 2 0.82 0.035
3–4 13 2.92 10 4.96 3 1.23
5–6 72 16.18 37 19.32 35 14.40
7–8 127 28.54 48 23.76 79 32.51
9–10 164 36.85 77 38.12 87 35.80
11–12 63 14.16 26 12.87 37 15.23
13 3 0.67 3 1.49 0 0.00

The total of adolescents is 493. The number of males and females are 212 and 281, respectively
Journal of Child and Family Studies (2020) 29:2967–2981 2973

Table 2 Sexual attitude of

Total Male Female p value
adolescents who agreed on the
statements Statement 1: young unmarried women should not have sex until they marry.
Strongly disagree 25 (5.13) 17 (8.21) 8 (2.86) <0.001
Disagree 84 (17.25) 47 (22.71) 37 (13.21)
Agree 191 (39.22) 80 (38.65) 111 (39.64)
Strongly agree 362 (37) 122 (30.7) 240 (41.5)
Statement 2: young unmarried men should not have sex until they marry.
Strongly disagree 32 (6.56) 22 (10.58) 10 (3.57) 0.001
Disagree 94 (19.26) 49 (23.56) 45 (16.07)
Agree 206 (42.21) 83 (39.90) 123 (43.93)
Strongly agree 156 (31.97) 54 (25.96) 102 (36.43)
This table lists numbers of adolescents who agreed with the two different statements. Percentages are in
parentheses

Table 3 Adolescents who agreed on the statements of sexual attitude Table 4 Responses for adolescents who had sexual behaviors and
health issues
Male Female p value
Total Male Female p value
Statement 1 2.91 (0.92) 3.25 (0.79) <0.001
n % n % n %
Statement 2 2.81 (0.94) 3.13 (0.80) <0.001
This table shows the means of adolescents’ level of agreement on two Ever had sexual intercourse
statements related to sexual attitudes. Standard deviations are in Yes 33 6.72 23 10.90 10 3.57 0.001
parentheses No 458 93.28 188 89.10 270 96.43
Age at the first sexual intercourse
abstinence, more female than male adolescents (65.8 vs. 13–14 2 6.90 1 5.26 1 10.00 0.473
80.3%, p = 0.001) disagreed with men’s premarital sex. 15–16 22 75.87 15 78.94 7 70.00
Only 6.72% of respondents reported that they ever had an 17–18 5 17.24 3 15.79 2 20.00
experience of having sexual intercourse. Among sexually Use contraceptive method at the first sexual intercourse
experienced adolescents, 6.9% of them had their first sexual Yes 11 34.38 6 27.27 5 50.00 0.210
intercourse before age 15 (Table 4). The mean age was 15.5 No 21 65.63 16 72.73 5 50.00
years for males, and 15.7 years for females. Sixty-five percent Partner at the first sexual intercourse
of them did not use any contraceptive method including pill,
Boyfriend or 26 81.25 16 72.73 10 100.0 0.340
condom, or injection, at the first sexual intercourse. All female girlfriend
adolescents reported that they had the first sex with their Stranger or 3 9.38 3 13.64 0 0.00
boyfriend. Among male respondents, 72.7% of them had first relative or
sexual intercourse with their girlfriend, while 13.6% of them another person
mentioned stranger, relative or another person as their first Who forced me 1 3.13 1 4.55 0 0.00
sexual partner. About 4.5% of male adolescents had forced One night stand 2 6.25 2 9.09 0 0.00
sex, and 9% reported one-night stand at the first sexual Ever had STIs symptoms
intercourse. Twelve percent of the sample reported the Yes 4 12.50 4 17.39 0 0.00 0.181
symptom of sexually transmitted infections (STIs) and they No 28 87.50 19 82.61 9 100.0
were all male adolescents. Lastly, when asking lifetime sexual Number of lifetime sexual partners
partners, sexually experienced males reported one (64%), two 1 16 64.00 8 47.06 8 100.0 0.085
(28%), or more than five (8%) partners. For female respon- 2 7 28.00 7 41.18 0 0.00
dents, all reported only one-lifetime sexual partner. +5 2 8.00 2 11.76 0 0.00

Effects of Receiving Sex Information from Sources

on Adolescent Sexual Intercourse
This study used logistic regression models to examine the
association between sexual intercourse and multiple sources
of sexual communication. As explained, a dichotomous
outcome variable was employed in logistic regression. In
addition, before running the regression models, we esti-
mated the Variance Inflation Factor (VIF) for all indepen-
dent variables. The test showed that the highest VIF value
was 2.79, less than the value of 10 that is usually considered
as an indicator of a severe multi-collinearity problem (Neter
et al. 1989). As Model 1 in Table 5 shows, among various
2974 Journal of Child and Family Studies (2020) 29:2967–2981

Table 5 The effects of sources of information about sexual intercourse on adolescents’ having sex
Model Dependent variable: sexual intercourse
1 2 3 4 5 6 7 8 9 10

Control variables
Age 1.64 1.10 1.25 1.31 1.34 1.58 1.33 1.35 1.26 1.10
Sex 0.77 0.28 0.54 0.49 0.58 0.61 0.49 0.54 0.53 0.37
Family property 1.12 0.93 0.98 0.97 0.95 0.96 0.96 0.94 0.96 0.93
Living with parent 1.68 1.33 1.43 1.39 1.31 1.99 1.41 1.31 1.35 2.51
Father’s education 0.96 0.99 1.04 1.09 0.99 1.08 1.05 1.02 1.02 1.07
Mother’s education 0.97 0.85 0.83 0.80 0.89 0.82 0.80 0.89 0.85 0.82
Substance use 3.33** 6.83*** 6.68*** 5.29*** 5.27** 3.31* 4.93** 5.03** 5.32*** 3.94*
Sexual knowledge 0.96 1.05 1.05 1.04 1.03 1.04 1.03 1.04 1.07 1.11
Independent variables
Mother 2.37* 1.31
Father 1.91 2.45
Siblings 1.42 0.61
Friends 0.90 0.86
Partner 2.44* 3.94**
Teacher 1.37 1.75
Doctor 0.94 0.41†
Media 0.76 0.77
The table presents adjusted odds ratios for sample cluster resulted from a series of multiple logistic regression analyses. *, **, ***, and † indicate
0.05, 0.01, 0.001, and 0.1 significance levels, respectively

Table 6 The effects of sources

Model Dependent variable: sexual intercourse
of information about how
pregnancy happens on 1 2 3 4 5 6 7 8 9
adolescents’ having sex
Control variables
Age 0.52 0.38 0.41 0.51 0.47 0.49 0.46 0.45 0.51
Sex 1.64 0.96 0.44 1.36 0.70 0.98 1.02 1.10 0.94
Family property 0.84 0.82 0.76 0.84 0.87 0.76 0.86 0.89 0.91
Living with parent 0.85 0.94 0.97 0.73 0.91 0.84 0.86 0.76 0.84
Father’s education 0.91 0.75 0.82 0.76 0.81 0.72 0.78 0.86 0.87
Mother’s education 1.16 1.31 1.66 1.41 1.13 1.55 1.22 1.14 1.07
Substance use 6.20** 6.99** 7.98** 4.54* 4.74* 7.07** 6.72** 6.40** 6.83*
Sexual knowledge 1.11 1.09 0.99 0.97 1.11 0.98 1.05 1.10 1.11
Independent variables
Mother 0.85 0.51
Father 1.86 1.32
Siblings 3.32* 1.96
Friends 2.16 1.09
Partner 2.22† 1.48
Teacher 1.70 1.48
Doctor 1.67 0.81
Media 1.79 1.51
The table presents adjusted odds ratios for the sample cluster resulted from a series of multiple logistic
regression analyses. *, **, ***, and † indicate 0.05, 0.01, 0.001, and 0.1 significance levels, respectively
Journal of Child and Family Studies (2020) 29:2967–2981 2975

Table 7 The effects of sources

Model Dependent variable: sexual intercourse
of information about the
negative consequences of teen 1 2 3 4 5 6 7 8 9
pregnancy on adolescents’
having sex Control variables
Age 0.66 0.60 0.49 0.30 0.56 0.56 0.64 1.15 0.61
Sex 1.82 1.27 0.99 12.06 0.59 1.18 0.48 1.02 1.07
Family property 0.76 0.77 0.83 0.65 0.80 0.79 0.98 0.87 0.75
Living with parent 0.82 0.87 0.95 0.55 0.93 0.85 0.99 1.02 1.15
Father’s education 0.87 0.81 0.81 0.83 1.05 0.78 0.40 0.55 0.64
Mother’s education 1.50 1.52 1.26 1.00 1.17 1.61 2.77 2.66 1.35
Substance use 5.67** 5.81** 5.93** 48.37† 5.47* 6.32** 5.62* 4.97** 6.76*
Sexual knowledge 1.03 1.01 1.06 1.57 0.96 0.99 1.12 1.14 1.05
Independent variables
Mother 0.83 3.47
Father 1.12 0.57
Siblings 1.32 1.38
Friends 0.31 0.52
Partner 2.80* 2.10
Teacher 1.22 1.04
Doctor 1.47 0.63
Media 0.69 0.70
The table presents adjusted odds ratios for the sample cluster resulted from a series of multiple logistic
regression analyses. *, **, ***, and † indicate 0.05, 0.01, 0.001, and 0.1 significance levels, respectively

demographic variables, with sexual intercourse as the
dependent variable, respondents’ substance use was a sta-
tistically significant factor that increased the likelihood of
having sexual intercourse.
The first series of multiple logistic regression analyses in
Table 5 show that several sources of information on sexual
intercourse influenced adolescents’ having sex. After con-
trolling demographic variables, individual multiple logistic
regression between each source of information and sexual
intercourse reveals that mother (AOR = 2.37, p = 0.014), and
partner (AOR = 2.44, p = 0.013) predicted having sexual
intercourse among adolescents (Model 2 and 6 in Table 5).
Dissimilar to Hypothesis 1, a mother’s information
increased the probability of respondents’ having sex.
Hypothesis 2 was not supported, since the effect of the
teacher on sexual intercourse was not statistically significant
in both Model 7 and 10 in Table 5. The series of regression
analyses from Table 5 to Table 9 showed similar results for
the relationship between teacher’s communication and
sexual intercourse. When all sources of information on
sexual intercourse were included in the multiple logistic
regression analysis at the same time, partner’s information
(AOR = 3.94, p = 0.006) was found to be a predictor of
sexual intercourse whereas doctor’s information decreased
the likelihood of having sexual intercourse (AOR = 0.41,
p = 0.075) (Model 10 in Table 5).
Table 6 presents the second set of regression analyses
that showed the relationship between sexual intercourse and
sources of information on how pregnancy happens.
Through conducting logistic regression analyses between
each source and sexual intercourse, two out of eight sources
were found to be predictive to sexual intercourse among the
sample: siblings (AOR = 3.32, p = 0.034), and partner
(AOR = 2.22, p = 0.061) (Model 3 and 5 in Table 6). These
findings indicate that Hypothesis 3 and 5 are supported.
Next set of analyses were conducted to examine the
association between sexual intercourse and sources of
information on the negative consequences of teenage
pregnancy (Table 7). After controlling demographic cov-
ariates, only one source, partner (AOR = 2.80, p = 0.029),
predicted sexual intercourse in individual multiple logistic
regression analysis (Model 5 in Table 7). No other source
significantly affects the probability of adolescent sexual
intercourse.
Doctor’s information about the importance of contra-
ception had a significant impact on reducing the likelihood
of having sexual intercourse (AOR = 0.31, p = 0.095)
(Model 8, Table 8).
The last set of regression analyses were conducted
regarding the association between sexual intercourse and
sources of information on STDs or HIV/AIDS. As shown in
Table 9, only partner (AOR = 1.73, p = 0.091) predicted
sexual intercourse among respondents (Model 5 in Table 9).
The series of regression analyses showed that informa-
tion from friends was not statistically significant in all of the
regression analyses indicating that Hypothesis 4 is not
2976 Journal of Child and Family Studies (2020) 29:2967–2981

supported. Furthermore, in most of the regression analyses,
the partner was statistically significant source predicting
sexual intercourse, except information about contraception
(Model 6 and 10 in Table 5, Model 5 in Tables 6–7, and 9).
Thus, the results show that Hypothesis 5 is supported.
Media as a source of information was statistically sig-
nificant in one of the regression analyses, but information
about the importance of contraception through media was
negatively associated with sexual intercourse indicating that
Hypothesis 6 was not supported (Model 8 in Table 8).
Discussion
The goal of this study was to reveal the effect of sexual
communication on adolescent sexual behavior by considering

Table 8 The effects of sources Model Dependent variable: sexual intercourse

of information about the
importance of contraception on 1 2 3 4 5 6 7 8 9
adolescents’ having sex
Control variables
Age 0.60 0.53 0.55 0.55 0.46 0.56 0.70 0.96 1.77
Sex 0.62 0.57 0.41 0.59 0.51 0.54 0.37 0.24 0.24
Family property 0.92 0.93 0.91 0.92 0.92 0.93 1.12 1.05 1.04
Living with parent 1.02 1.01 0.94 1.03 1.03 1.02 1.12 2.58 1.66
Father’s education 0.95 0.85 0.90 0.86 0.87 0.87 0.41 0.63 0.98
Mother’s education 1.09 1.16 1.14 1.15 1.10 1.21 2.26 2.18 1.55
Substance use 4.51** 4.67** 3.82* 4.77** 4.64** 4.49** 3.73* 4.21* 1.30
Sexual knowledge 1.03 1.02 1.03 1.02 1.04 1.03 1.09 1.03 1.16
Independent variable
Mother 0.82 0.39
Father 1.03 0.82
Siblings 1.11 1.31
Friends 0.93 1.38
Partner 1.46 2.04
Teacher 0.83 1.24
Doctor 1.34 1.38
Media 0.31† 0.35

The table presents adjusted odds ratios for the sample cluster resulted from a series of multiple logistic
regression analyses. *, **, ***, and † indicate 0.05, 0.01, 0.001, and 0.1 significance levels, respectively

Table 9 The effects sources of Model Dependent variable: sexual intercourse

information about stds or HIV/
AIDS on adolescents’ 1 2 3 4 5 6 7 8 9
having sex
Control variables
Age 0.90 0.88 0.89 0.99 0.99 1.13 0.89 1.22 1.30
Sex 0.90 0.85 0.90 0.80 0.81 0.54 0.86 0.63 0.71
Family property 0.92 0.95 0.95 0.96 0.94 1.16 0.93 1.11 1.16
Living with parent 1.07 1.11 1.06 1.01 1.08 1.24 1.05 1.31 1.14
Father’s education 0.96 0.96 0.96 1.09 0.96 0.72 0.97 0.74 0.88
Mother’s education 1.10 1.03 1.08 0.97 1.06 1.40 1.09 1.36 1.10
Substance use 4.66** 4.83** 4.60** 4.25** 3.33* 3.55* 4.72** 4.17** 3.02†
Sexual knowledge 1.04 1.06 1.04 1.08 1.06 1.15 1.05 1.13 1.14
Independent variables
Mother 1.15 0.84
Father 1.28 1.16
Siblings 1.39 0.98
Friends 1.86* 1.59
Partner 1.73† 1.29
Teacher 0.63 0.70
Doctor 0.85 1.01
Media 0.72 0.72

The table presents adjusted odds ratios for the sample cluster resulted from a series of multiple logistic
regression analyses. *, **, ***, and † indicate 0.05, 0.01, 0.001, and 0.1 significance levels, respectively
Journal of Child and Family Studies (2020) 29:2967–2981
multiple sources, messages, and frequency of communication.
The results of the study showed significant effects of sexual
socialization on adolescent behavior. Each agent of sexual
socialization exerts different effects on the probability of
adolescents’ sexual intercourse in terms of contents and fre-
quency of sexual communication. In the case of media, the
content of information mattered when we examined its
association with teenage sex. The impact of media on teenage
sex was found only in information about the importance of
contraception, but its impact was strongly significant. Dif-
ferent from previous studies, we found that adolescents who
received information from media were less likely to engage in
sexual activity. The reason would be because we examined
the effect of information about contraception, which is
regarded as sexual health information, whereas previous stu-
dies focused on sexually explicit contents from media (Guse
et al. 2012). In Lao PDR, the Vientiane Youth Center pro-
vides SRH information and promoted SRH services through
radio program as well as SNS (Phimmavong 2016). Those
who received SRH information and acknowledge the pro-
blems caused by teenage sex would be more cautious about
initiating sexual activity than others. It indicates that
depending on what messages or contents adolescents are
exposed to from the media, the impact of media on teenage
sex would be entirely different.
On the other hand, another finding showed that source—
i.e., who provided the message—is more important than the
contents of information. Regardless of the topics of infor-
mation, partner’s information significantly increased the
likelihood of having sex. Even when all sources of informa-
tion were included in one analysis, the partner was sig-
nificantly related to sexual intercourse. Particularly, regarding
information about the negative consequences of teenage
pregnancy and STDs or HIV/AIDS, the partner was the only
significant source that affected teenage sex. Discussion about
sex with a partner indicates that students were in a romantic or
sexual relationship, which might increase the possibility to
have sexual debut than those who never had any relationship
(Guzmán et al. 2003; Longmore et al. 2001). In addition,
some students would have unwanted sex with their partner,
because a previous study of young women in Vientiane
Capital found that significant rate of females decided to have
sex due to the pressure they received from their boyfriend
(Keobounphanh and Toole 2008).
This study’s findings have implications for school sex
education. First, despite the higher level of frequency on
receiving sexual information from a teacher than other sour-
ces, there was no significant association between teacher’s
information and adolescent sexual engagement. It means that
although the teacher frequently provided sex-related infor-
mation at school, it does not have any significant impact on
reducing or preventing risky sexual behaviors of students. It
might be because the teacher lacks confidence as well as
2977
ability to deliver effective sex education towards students
(Sychareun et al. 2017). Also, the teacher might provide
anatomical and biological knowledge rather than
proper sexual attitude and sexual behavior (Gao et al. 2001).
Second, regarding the information about how to use contra-
ceptive methods, there was no source which influences ado-
lescents’ sexual engagement. It may indicate that value-added
contents rather than factual information would have more
impact on changing adolescents’ behaviors.
Furthermore, there are several regression results that are
difficult to interpret. For example, the mother’s information
about sexual intercourse was positively associated with
sexual intercourse. The positive relationship between par-
ental communication and teenage sex was also found in
previous articles (Bersamin et al. 2008; Clawson and Reese‐
Weber 2003). As the authors presented, one reason would
be that parents only began to communicate about sex after
they found their children in a romantic or sexual relation-
ship (Atienzo et al. 2009), because parents are not com-
fortable talking to them about sex due to cultural taboo
(Jones et al. 2011) or may not know what to discuss or have
lack of accurate sexual knowledge (Coakley et al. 2017).
Parents might think that their teens were not sexually active
yet, even when their son or daughter already had sex
(Somers and Gleason 2001). Also, it might also be related to
“active information seeking” that when adolescents initiated
their sex, they started to find sexual information from var-
ious sources including parents (Berten and Van Rossem
2009, p. 1304). Another reason would be that parents do not
disapprove of their children to have sex unless they do not
result in problems such as pregnancy or STDs. It is parti-
cularly true for boys because parents give permissive
messages for male teenagers such as the importance of
having safer sex (Deutsch and Crockett 2016), whereas girls
are expected to be abstinent by giving them messages
regarding adverse outcomes of sexual engagement (Raf-
faelli and Green 2003; Wyckoff et al. 2008).
In addition to mother, siblings’ information about how
pregnancy happens was associated with having sexual inter-
course. Sexual communication with family members includ-
ing siblings would also be unfamiliar to adolescents in Asia
because they might not want to cause any trouble by talking
about sensitive topics (Gudykunst 2000). In this situation,
adolescents who talked about sexual issues with siblings
would have more curiosity than those who rarely or never
talked about it with siblings. Another reason would be that
student might already engage in sexual behavior, and wanted
to consult with siblings about how pregnancy happens. It is
necessary to consider the age and sex of siblings in order to
increase the understanding of how siblings’ information was
positively associated with sexual intercourse. Depending on
the sex and age of adolescents as well as siblings, the effect of
sibling’s information on having sex would be different. There
2978
are a few studies that examined their relationship by con-
sidering differences in sex and age. For example, Kornreich
et al. (2003) showed that teenagers with older siblings had a
more conservative sexual attitude and less likely to engage in
sexual activity than those without older siblings. East et al.
(1993) proved that girls who had sexually active sisters had
more likelihood of having a liberal attitude on sex, and
initiating sexual activity.
Finally, apart from sexual communication, this study found
that substance use was significantly associated with having
sexual intercourse in all regression analyses. This result is
consistent with previous studies that adolescents’ substance
uses greatly affect their sexual intercourse (e.g., Ramisetty-
Mikler et al. 2004; Yan et al. 2007; Zapata et al. 2008).
Similar to our study, Yan et al. (2007) considered smoking,
drinking alcohol, and drug use as indicators of substance use
and found that substance use is a risk factor for adolescents’
having sexual intercourse. A study of female youth in Lao
PDR also showed that drug use (12%) and drinking alcohol
(36.4%) made them have sexual intercourse (Keobounphanh
and Toole 2008). Teenager’s substance use might be closely
associated with sexual communication as well as adolescent
sexual behaviors. Also, substance use of young people would
also be related to socio-cultural contexts such as youth culture
of drinking alcohol at a festival or lack of policy to control
alcoholic beverages in Lao PDR (Keobounphanh and Toole
2008; LYU 2014). It might increase our knowledge by
studying the mechanism of how substance use affects the
relationship between sexual communication and adolescent
sexual behaviors.
This study had several limitations. First, there was a small
number of participants who ever had sexual intercourse,
which might have separation problems in the statistical ana-
lysis. The percentage of adolescents who had sexual inter-
course was lower than that of previous studies conducted in
Vientiane Capital (e.g., Keobounphanh and Toole 2008). One
reason would be that our sample only included in-school
students. Also, because the self-reported survey was con-
ducted in the school, students might have been reluctant to
report their sexual activity. To overcome the problems of
separation, we conducted the Firth’s penalized likelihood
estimation that has been widely used to reduce the potential
small-sample bias (Heinze and Schemper 2002).
Second, this study used cross-sectional data which has
limitations for causality. Because adolescents are socialized
through communication for an extended period, studying
with longitudinal data could provide more robust results for
a causal association between sources of communication and
adolescent RSBs. Also, the likelihood that the respondents
received information from multiple agents is not reflected in
the regression models.
Third, data were collected by a self-reported survey
conducted at the school. Adolescents might underreport
Journal of Child and Family Studies (2020) 29:2967–2981
their sexual behavior based on socially accepted norms or
desirable answers (Atienzo et al. 2009; Chiao and Yi 2011).
However, survey data was collected confidentially by pro-
viding a detailed introduction to the study and securing
survey environments so that respondents could report their
answers instead of socially acceptable ideas. Furthermore,
to enhance the quality of data, we excluded the number of
the sample whose answer was inconsistent or incomplete.
Finally, these findings are based on the report of students
in secondary schools located in the Vientiane Capital of Lao
PDR. Although these schools were randomly selected from
different areas with the various socioeconomic backgrounds,
it is difficult to generalize the results to all of the Laotian
adolescents. Because Lao PDR has various ethnicities with
different cultural backgrounds, it is not easy to generalize the
communication patterns and their impact on RSBs. However,
since most of the survey participants belong to the Lao ethnic
group which makes up about 53% of the total population
(LSB 2016), the results of this study could provide useful
insight into sexual health and behavior of teenagers in Lao
PDR. Furthermore, this study is expected to advance the
understanding of adolescents in Vientiane Capital where a
relatively small number of studies were conducted compared
to other regions in Lao PDR (Keobounphanh and Toole 2008;
Sychareun et al. 2013). The study of adolescents in Vientiane
Capital could contribute to the study of adolescent RSBs in
other cities in Asian countries.
Our research had several contributions. First, this study
considered three critical aspects that are multiple sources,
various topics of information, and frequency of communica-
tion. Previous studies on sexual communication and adoles-
cent sexual behaviors mostly focus on one or two sources,
mainly parents and friends, which are only parts of sources
adolescents are related with (e.g., de Looze et al. 2015;
DiIorio et al. 2007; Harper et al. 2004; Hutchinson et al.
2003). Since adolescents interact with various agents of
socialization, multiple sources can differently affect their
attitude and behavior by providing different messages about
sex (Bleakley et al. 2009; Somers and Gleason 2001). In
addition to the sources, various topics of information and the
frequency of communication were considered in the quanti-
tative study in order to deepen our understanding about the
complex relationship between sources of communication and
adolescent sexual behaviors. We found that partner and sib-
lings, which previous studies paid little attention to, were very
significant factors that predicted adolescent sexual activity.
Also, depending on the topic of information, the impact of the
sources on sexual intercourse was different from other studies.
For example, media was considered as a risk factor in several
studies (e.g., Brown et al. 2005; Gonzalez-Ortega et al. 2015;
L’Engle et al. 2006), but we found that receiving information
about contraception from media decreased the probability of
having sex.
Journal of Child and Family Studies (2020) 29:2967–2981
Moreover, based on the findings of the study, we con-
cluded that socio-cultural contexts of the country affect the
relationship between sexual communication and teenage
sex. However, our findings are not very different from
previous studies in Western countries. As scholars already
presented, parents think that having sex brings out more
harmful outcomes on girls than boys, so they give more
information about contraception, pregnancy, or abstinence
towards female adolescents than male adolescents (DiIorio
et al. 1999; Kapungu et al. 2010; Wilson et al. 2010; Wilson
and Koo 2010). It might be because even in Western
countries, remaining traditional sexual norms—such as
sexual double standards—influence sexual communications
between parents and adolescents (Bordini and Sperb 2013;
Guo 2018). Further investigation with different methodo-
logical approaches such as comparative analysis or quali-
tative study is needed to deepen understanding of the
relationship between sexual communication and adolescent
sexual behaviors. In-depth interviews with teenagers, for
example, would help us to find the complex phenomena and
cultural nuances that are embedded in sexual communica-
tion and behaviors.
Funding This study was funded by the Korea International Coopera-
tion Agency (2017-002).
Compliance with Ethical Standards
Conflict of Interest The authors declare that they have no conflict of
interest.
Ethical Approval All procedures performed in studies involving
human participants were in accordance with the ethical standards of
the University of Health Sciences (UHS) in Lao PDR and with the
1964 Helsinki declaration and its later amendments or comparable
ethical standards.
Informed Consent Informed consent was obtained from all individual
participants included in the study.
Publisher’s note Springer Nature remains neutral with regard to
jurisdictional claims in published maps and institutional affiliations.
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