PORTLAND, Ore. -- Asian mothers rarely educate their pubescent daughters about sex, which may contribute to making them vulnerable to contracting HIV or other sexually transmitted infections, researchers reported here

"Of the 20 women we talked to, 18 said they never talked to their mothers about sex during puberty," said BoRam Kim, RN, and a PhD student at the University of Massachusetts Boston (UMB), at the Association of Nurses in AIDS Care annual conference.

"There is a belief that Asian women living in the United States are not at great risk of HIV infection, but there are indications that those numbers are increasing," said co-author Teri Aronowitz, PhD, FNP-BC, also of UMB. "Between 2010 and 2016, there was a 35% increase in new diagnoses of HIV among Asian Americans."

Aronowitz told MedPage Today that the failure of mothers to communicate with their daughter when they are most likely to make their sexual debuts could be a contributing factor to this increase in infections.

Kim said there are multiple problems in communication including language, as first-generation Asian Americans struggle with their new language while talking with children who are speaking English; there is a problem in acculturation as well.

"While acculturated Asian Americans have adopted unsafe sexual behaviors, they maintain a strong cultural stigma to avoid open communication about sexual health topics. They refrain from discussing those topics even with their healthcare providers," Kim told MedPage Today.

Kim noted that one of the study participants told her, "In terms of sexual health, my mom never talked to me about it."

Another woman said that if she asked a question about sexual health, her mother responded, "Why are you asking that?"

The majority of the participants reported that even when they were close to their mothers, they did not talk openly about women's health issues, including puberty. Although most of the mothers did not talk to their daughters about the topic, some daughters reported that when their mothers were aware of women's health concerns, they were more likely to take their daughters to women's health providers.

Kacee Homer, RN, of CAN Community Health in Sarasota, Florida, told MedPage Today, "This is not just a problem with Asian Americans. My mother never had a talk about sexual matters with me. My grandmother told me, 'It hurts. Don't do it.' In school, our sex education consisted of a demonstration of a tampon and a jar of water."

"This lack of discussion about sexual matters is one of the reasons we still have sexual transmission of HIV and other sexual transmitted infections," Homer said.

Kim said that in the study, "most of the daughters said they did not have direct communication with mothers; however, mothers often used euphemisms when talking to their daughters about puberty and only focused on hygiene."

For example, she said, the messages were on the order of: "Be careful"; "Don't get pregnant"; "You don't know men ... be safe."

Study Details

For the study, Kim used a "convenience sample" that included friends and relatives and their contacts to discuss how their mothers talked to them about sexual matters. "Open discussion about sexual health is an extreme taboo in East Asia and Southeast Asia," she noted.

The 20 women she talked to in hour-long, semi-structured, audio-recorded conversations were ages 18 to 33, with a mean age of 23.6 years. The women were Chinese, Japanese, Korean, Taiwanese, and Vietnamese, and 60% had been born in the U.S.; 75% had lived in the U.S. for more than 10 years. About 65% of the participants were from the Boston area, while the others currently resided in California.

Kim said that most of the women she interviewed did realize that their mothers were uncomfortable with sexual communication.

Aronowitz said that the study's small numbers of participants was one of the limitations in generalizing the study.

Kim said that the study identified a problem in sexual education of young women and teens, and "future research on how acculturation and cultural values affect Asian American mother-daughter sexual communication is needed."

"This may add insight into the development of an intervention to help increase open communication between mothers and daughters at this critical life stage," she noted.