Paternal Perspectives on Latino and Black Sons’ Readiness for Sex and Condom Guidance: A Mixed Methods Study

Vincent Guilamo-Ramos; Marco Thimm-Kaiser; Adam Benzekri; Anthony Balaguera; Susam Ramos Deulofeutt; Lisvel Matos

doi:10.1370/afm.3077

Article Figures & Data

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Table 1.

Sample Characteristics by Paternal Perception of Adolescent Male Readiness for Sex

Characteristic	Total (n = 191)	Father Agrees Son is Ready for Sex (n = 76)	Father Does Not Agree Son is Ready for Sex (n = 115)
Adolescents
Age, mean (SD), y	16.6 (1.3)	16.8 (1.3)	16.4 (1.3)
Race/ethnicity, No. (%)^{^a}
Latino	143 (76)	54 (72)	89 (79)
Non-Latino Black	45 (24)	21 (28)	24 (21)
Born outside the United States, No. (%)	43 (23)	17 (23)	26 (23)
Primary language at home, No. (%)
English	118 (62)	49 (65)	69 (60)
Reported sexual activity, No. (%)
Ever had sex	106 (56)	53 (72)	53 (46)
Reported paternal condom guidance, mean (SD)
Willing to provide condoms	3.8 (1.2)	4.1 (1.1)	3.6 (1.2)
Recommended new condom for each sex act	3.8 (1.3)	4.2 (1.0)	3.6 (1.4)
Demonstrated correct condom use	2.1 (1.5)	2.3 (1.6)	2.0 (1.5)
Encouraged practicing condom use	3.0 (1.5)	3.3 (1.4)	2.8 (1.5)
Fathers
Age, mean (SD), y	44.0 (12.5)	40.8 (11.3)	45.9 (12.2)
Born outside the United States, No. (%)	73 (38)	27 (36)	46 (40)
Employment status, No. (%)
Employed	114 (60)	41 (54)	73 (64)
Perception of son’s sexual activity, No. (%)
Son has had sex	59 (31)	37 (49)	22 (19)
Does not know	75 (40)	28 (37)	47 (41)
Son has not had sex	55 (29)	10 (13)	45 (39)

Note: Percentages are shown as valid percent.
↵a Family race/ethnicity based on the adolescent report.

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Table 2.

Correlations of Paternal Perception of Son’s Readiness for Sex, Adolescent Age, and Paternal Perception of Son’s Sexual Activity

Factors related to conversation about condom use	1	2	3	4
1 Paternal perception of son’s readiness for sex	1.00
2 Adolescent age	0.12	1.00
3 Paternal perception of son’s sexual activity	0.36^{^a}	0.20^{^a}	1.00
4 Adolescent report of sexual activity	0.25^{^a}	0.21^{^a}	0.61^{^a}	1.00

Note: Pearson/point-biserial correlation coefficients are shown.
↵a P <0.01 (2-tailed).

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Table 3.

Associations of Paternal Guidance for Condom Use With Paternal Perception of Son’s Readiness for Sex, Adolescent Age, and Paternal Perception of Son’s Sexual Activity

Factors related to conversation about condom use	Paternal Condom-Specific Guidance
Factors related to conversation about condom use	B (95% CI)	aB^a (95% CI)
Paternal perception of son’s readiness for sex	0.58^b (0.28 to 0.89)	0.41^c (0.07 to 0.74)
Adolescent age	0.12^c (0.00 to 0.24)	0.08 (−0.04 to 0.20)
Paternal perception of son’s sexual activity
Yes	0.77^b (0.38 to 1.15)	0.49^c (0.07 to 0.91)
Don’t know	0.18 (−0.19 to 0.54)	0.10 (−0.28 to 0.48)
No	[Ref]	[Ref]

aB = adjusted unstandardized beta coefficient; B = unstandardized beta coefficient.
a Model includes paternal perceptions of son’s readiness for sex, adolescent age, paternal perception of son’s sexual activity, race/ethnicity, adolescent social desirability tendencies, and paternal social desirability tendencies.
b P <0.01 (2-tailed)
a P <0.05 (2-tailed)

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Table 4.

Summary of Major Themes in Fathers’ Perceptions of Their Adolescent Sons’ Readiness for Sex

Readiness Theme	Example Quotes From Fathers
Life opportunity trajectory milestones
Educational success	“No, I told them, after, after they graduate from high school, they go to college, they want to start dating, by all means. But until then, I don’t want any, any [sexual activity]” (ID 104).
Being in a committed relationship with a stable romantic partner	“Having sex should be something that you should be in love with that person. That person should be in love with you and, you know, it’s a commitment thing” (ID 148). “You’re risking the possibility of diseases and possibility of, you know, getting someone pregnant. So, you have to be willing to be invested and responsible with that person [before having sex]” (ID 151).
Having achieved financial stability/independence	“You’re a teenager, you’re in high school. I mean, that means that you still live with me, you’re still living with your mother. You’re still not, you know, set. Like, you don’t have like a set job. You don’t have, like, you don’t really have financial stability […] You shouldn’t be having any, you know, condomless sex with your girlfriend” (ID 142).
Cognitive–social–emotional maturity
Making an informed decision about starting to have sex	“[He thinks] that he is ready. […] That’s kinda like shortcutting, shortcutting. I’m saying shortcutting instead of, like, not having the information. At least having information before you actually make the decision. […] In actuality, men view what are the consequences of risk and rewards that come with the decisions they make. Whether it’s having sex, protected or not, it’s still going to be choices that you have to, you know, be ready for” (ID 151).
Being able to navigate the emotional elements of a sexual relationship	“He wants to be close to her. Fine. Then he does get close to her. But one day she leaves. Is he emotionally stable enough?” (ID 142) “But I would tell him that [sex] don’t make you closer unless you try to make a commitment to be with her. […] But you, you think you’re in a serious relationship, but it’s not true ‘cause you only 15” (ID 109).
Preparedness for adult responsibilities	“Making adult decisions [about sex] as a child, I can tell you, it never works out” (ID 134). “Sex lasts a certain period of time, feeling more grown up is for life. I’ve always told them, stay a child. You don’t want to be in my shoes. You don’t want to worry about things I worry about, you know. You don’t want to worry about bills. Stay a child for as long as you can” (ID 134). “You still a boy. You know, you still have a lot of time to grow up. So, while it is true that [sex] does make you feel more like a man and more grown up, at the same time, you’re not ready to […] take that next level [and start having sex]” (ID 142). “Having sex is not being a man, but protecting yourself and your partner that’s what a man does” (ID 148).
Preparedness for safe sex to avoid negative consequences
Having a plan for protection	“Once both of you have decided to do that, then it’s time for y’all both to talk before you get to it, the part about protecting yourself. And by protecting yourself, meaning you gotta discuss, well, are you ready to have a baby right now? If you’re not ready to have a baby right now, then you have to talk about using condoms, her getting on the pill. That way you are both protecting yourself” (ID 148). “You know, [you] potentially see yourself together, or it could be that both you are like into each other in a sexual way. But if you do decide if that’s what it’s going to be, then they still got to protect yourself even more, even more so it all boils down to protecting them” (ID 148). “But for me to know how I was when I was at his age, I wanted to experiment. So, I got to talk to him, but I’m not going to deny it for him not to do it, but protected” (ID 109).
Having the requisite knowledge and skills to acquire and correctly use condoms	“They need to know. Can’t nobody say you are permitting [sex] because you supply condoms or even have conversations. That’s not permitting it, that just […] giving them the knowledge they need to know. Regardless of if they gonna do it or not, they need the knowledge. At least have the knowledge” (ID 92). “I know they, they have a program where the kids do kind of an outreach thing where within the school […] they hand out free condoms, female condoms, the lubricant, stuff like that, you know, for the kids. After, they talk about the material. But the question is… they don’t teach them how to use it…” (ID 130). “My other son is 14 years old. So, the other day we go to the store. He asked me, ‘Dad, can you buy me some Magnums?’ I said, ‘You go get them. You out there doing your thing, go provide for yourself’” (ID 109).

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Table 5.

Primary Care Strategies for Encouraging Paternal Provision of Condom Use Guidance

Topic	Challenge	Father-Focused Communication Strategy
Paternal perceptions of adolescent male sexual activity	While fathers who believe that their sons are already sexually active are more likely to provide condom-specific guidance, many fathers are unaware that their sons are having sex.	Explicitly encourage paternal condom-specific guidance as a preemptive rather than reactive strategy.
Adolescent male age	There is no strong association between adolescent male chronological age and the paternal provision of condom use guidance.	Reinforce that there is not a specific age to communicate about sex and condoms, but that it is important to provide guidance regarding correct and consistent condom use before sexual initiation.
Readiness for sex based on:
Completion of life opportunity trajectory milestones	Some fathers believe that their sons should wait to have sex until they have achieved important milestones, such as academic success (eg, high school graduation, college enrollment, etc), financial independence, or a stable long-term relationship to avoid jeopardizing their long-term life opportunities.	Emphasize that a comprehensive strategy for preventing negative academic, economic, and social consequences of sex among adolescent males includes paternal guidance regarding correct and consistent condom use.
Social–emotional–cognitive maturity	Fathers believe starting to have sex engenders responsibilities that call for a level of social–emotional–cognitive maturity that their adolescent sons do not always exhibit; as a result, some fathers prefer that their sons do not have sex during this part of their lives.	Remind fathers that providing guidance about correct and consistent condom use is not synonymous with encouraging their sons to have sex. Advise fathers to clearly communicate their expectations about waiting to have sex while also beginning to provide condom guidance in preparation for when their sons start to have sex.
Preparedness for safe sex	Fathers believe that being prepared to have sex safely, including by using condoms correctly and consistently, is an important element of their sons’ readiness for sex; however, fathers frequently wait to provide condom-specific guidance until after their sons have already started having sex.	Emphasize the important role of fathers in preparing their sons for safe sex via the correct and consistent use of condoms. Ensure that fathers (a) know how to start conversations about using a condom every time during sex, (b) can demonstrate how to use a condom correctly, (c) are willing to provide condoms to their sons, and (d) are comfortable encouraging their sons to practice using a condom.