Abstract
Siblings have been shown to influence youth substance use and violent behavior. However, limited research has examined sibling-influences on sexual activity, particularly among urban Black youth. The current qualitative research was an exploratory study to describe discussions among siblings about sex and sexual health. Individual interviews were conducted with 15 Black youth (7 male, 8 female) from New York City ages 16 to 19 years. Participants were recruited from community agencies serving low income youth. Results indicated that youth had discussions about sex with their siblings. Discussions among siblings included information about sex, conversations about sexual activities and advice about sexual relationships. Some gender differences were observed. Males reported feeling pressure from their male siblings to be engaged in sexual activity. Female youth discussed hearing HIV/AIDS prevention messages from their siblings. Findings highlight the important role that siblings may play in socializing urban Black youth regarding sexuality, sexual health, and HIV/AIDS prevention.
It is well established in the literature that family and peer groups influence the sexual attitudes and behaviors of youth (DiIorio, Kelley, & Hockenberry-Eaton, 1999; Harper, Gannon, Watson, Catania, & Dolcini, 2004; Jaccard, Dodge, Dittus, 2002; Romo, Lefkowitz, Sigman, & Au, 2002; Wallace, Miller, & Forehand, 2008). They provide definitions and values about sexual activity and role-model behavior. Family and peers can also reinforce sexual attitudes and behaviors (DiIorio et al., 1999; Fasula & Miller, 2006; Guilamo-Ramos et al., 2007; Weinman, Small, Buzi, & Smith, 2008). This can be in the form of direct communication with family and peers about sex and sexuality.
Theory of Reasoned Action (TRA) (Fishbein & Ajzen, 1974) asserts that attitudes toward a behavior and perceptions of the social norms regarding a behavior determine involvement in that behavior. Previous research with ethnic minority adolescents has found that attitudes about sexual behavior predict patterns of sexual initiation and activity (Flores, Tschann, & Marin, 2002; Serovich & Green, 1997). Previous research with Black youth has found that siblings influence youth risk taking (e.g., substance use) by transmitting their positive attitudes about risk taking which in turn influences sibling involvement in those behaviors (Pomery et al., 2005). Attitude transmission about risk taking may come through various forms of communication, including direct conversations between siblings. In light of this, we posit that a young person’s sexual behavior may be influenced by direct communication with their siblings about sex and sexuality.
The results presented in this article were part of a qualitative investigation of social influences associated with sexual attitudes and behaviors among urban Black adolescents; including communication about sex with family and peers. We found information that emerged from the data revealing that siblings were involved in the sexual socialization process. Given the dearth of empirical literature regarding sibling discussions about sex, we have chosen to focus this article on those findings. A review of what has been found in the literature about sibling relationships will be followed by a discussion of how sibling relationships influence risk-taking behavior. The qualitative findings are presented with implications for sexual risk prevention and intervention development.
Siblings Relationships Are Important
Siblings are an integral part of the family system (Dunn, 1993). Siblings live together over a long period, spend a large amount of time together, and have daily interactions (Noller, 2005). In addition, they have a shared history and environment which may facilitate bonding. Research primarily with white youth has found that siblings have emotionally close relationships that remain moderately strong through adolescence and young adulthood despite the important role other peers may play in their lives (Scharf, Shulman, & Spitz, 2005; Tucker, McHale, & Crouter, 2002). Siblings learn values, knowledge, and skills from one another through discussions and direct observation (Cicirelli, 1994). Older siblings compared to younger siblings have been shown to provide more support, advice, caretaking responsibility, and authority (Ardelt & Day, 2002; Buhrmester & Furman, 1990; Tucker et al., 2002). The limited research focused on African American youth, has found similar results (McHale, Whiteman, Kim, & Crouter, 2007; Tucker, Barber, & Eccles, 1997).
Siblings Influence Youth Risk-Taking Behavior
Siblings are uniquely situated members of both the family and peer contexts. Therefore, it is not surprising that siblings have been shown to be important in the developmental trajectory of youth (Brody, 2004; Milevsky & Levitt, 2005; Whiteman, McHale, & Crouter, 2007). This includes the influence of siblings on youth risk-taking behavior, such as substance use and aggressive behavior. A longitudinal study of rural white adolescents (Slomkowski, Rende, Conger, Simons, & Conger, 2001) found that older siblings’ behavior influenced later risk-taking behavior of younger siblings. Ardelt & Day (2002) examined older sibling influences on youth risk taking among Black and white youth. Results indicated that younger siblings that engaged in risk-taking behaviors, were more likely to have older siblings involved in risk taking themselves. Similar results have been observed for substance use behaviors among white youth (Fagen & Najman, 2005). Studies have also found that sibling risk-taking behaviors were related to risk-taking behaviors among youth above and beyond the impact of parent and peer influences (Criss & Shaw, 2005; Fagen & Najman, 2005; Synder, Bank, & Burraston, 2005). There is limited research focused solely on urban Black youth. However, we identified one study of African American and Afro-Caribbean youth which found that sibling alcohol use was significantly related to youth alcohol use and initiation of alcohol before age 13 (Epstein, Williams, & Botvin, 2002).
Despite the evidence that siblings influence the aggressive and substance use behavior of youth, relatively few studies have examined the role of siblings on youth sexual behaviors. Older sibling influences on sexual initiation were examined among a multiethnic sample of adolescents (Widmer, 1997). Results indicated that older brothers’ attitudes and behaviors regarding sex were related to the sexual initiation of younger siblings. This relationship was significant for both genders, although the relationship was found to be stronger for younger brothers than for younger sisters. A longitudinal study of Black and Latino sibling dyads, found that the warmth of the sibling relationship at time two was related to fewer sexual risk behaviors at time three for younger female siblings (East & Toon Khoo, 2005).
Sibling Communication About Sex
As previously stated, prior research has found that siblings have an influence on youth sexual behaviors. The process by which these behaviors are shaped may be through direct communication (e.g., conversations, asking questions) with siblings about sex. However, there is limited research in this area. One of the few studies that focused on direct communication about sex among siblings was a quantitative study of white youth (Kowal & Blinn-Pike, 2004). Findings suggested that sibling discussions about sex occurred when the sibling relationship quality was more positive. These conversations occurred regardless of whether the older sibling had risky or conservative sexual attitudes.
Although studies have shown that sibling relationships are related to youth risk taking including sexual behavior, there is a dearth of research to describe the types of conversations that siblings have with one another about sex. Given the high risk for unintended pregnancy and STIs/HIV among Black youth (Centers for Disease Control and Prevention, 2010), research examining sibling communication about sex among this population is needed. Unfortunately, the research focused on Black youth is very limited. The present study adds to the literature by examining the following research questions (a) Do siblings have discussions with one another about sexual relationships and behaviors?, (b) What type of discussions are siblings having with one another about sexual relationships and behaviors?, (c) What are the gender differences in discussions siblings have about sexual relationships and behaviors?
For the purposes of this article, siblings are brothers and/or sisters (blood and nonblood related as defined by youth), as well as cousins. This definition of siblings is different from standard use of the term. However, it is well established in the literature that the structure of families in many Black communities is multifaceted and complex, with researchers describing up to eighty-one different combinations of family compositions and family structures within the Black community (Wilson et al., 1995). The organizational structure of Black extended families reveals a close network of relationships within and between families who may or may not be blood relatives (Nobles, Goddard, Cavil, & George, 1987). Given the important value of extended networks among Black families, a broader definition of siblings is more culturally relevant for Black populations. More importantly this broad definition of sibling kinship was derived from the descriptions youth had of their cousins and nonblood related youth as like a brother/sister and therefore mirrors their lived experiences.
Method
Participants
A total of 15 interviews (7 male, 8 female) were conducted among U.S. born ethnically diverse Black youth (7 self-identified as Black, 6 self-identified as Afro-Caribbean/African, 2 no response). The mean age for participants was 17.13 years (SD = 1.25). The responses from the demographic survey revealed that the majority of the youth had at least one sibling (13/15). Nine of the youth stated they had brothers, four stated they had sisters and several listed both (11/13). All participants self-identified as heterosexual, almost half of the youth currently had a boy/girlfriend (7/15) and approximately 50% of the sample stated that they had sexual intercourse at least once (8/15). Among those who had sexual intercourse, most (5/8) were currently sexually active (i.e., sex within past 6 months). Table 1 provides a more detailed sociodemographic summary of the participants.
Demographics of Participants (N = 15).
Only asked of those who reported having ever had sex.
Some participants did not respond to this item.
Procedure
Fifteen Black youth (7 male, 8 female) were recruited between 2006-07 from two youth related social service agencies providing a range of recreational, tutoring and health services to low income youth in New York City. The participants were recruited by soliciting youth during the agency’s regularly scheduled programming, as well as posting flyers at the agencies allowing youth to call project offices directly if interested in participation. Before enrollment, participants were screened to ensure eligibility. Participants who identified as Black (non-Hispanic) and between the ages 16 to 19 years were eligible to enroll. One hour individual face-to-face semistructured interviews were conducted by the lead author and held at the study office or in a private room at the community agency. In addition, a self-administered brief demographic and behavioral survey (e.g., sexual and dating activity) was collected from each participant directly after the interview.
Prior to data collection, the study protocol and interview guides were approved by the relevant institutional review boards. Written participant consent was obtained from all study participants, as well as parental permission for youth below the age of 18 years. After completing the interview, each participant received an HIV education packet that included information about HIV and location community resources of interest to youth (e.g., community centers, health clinics, and youth programs), a subway card (US$4), and a US$30 gift certificate.
Analysis
All interviews were conducted by the first author. Topics of the interview were influenced by previous theoretical and empirical literature. As previously mentioned, the results of the study were part of an exploratory qualitative investigation of social influences associated with sexual attitudes and behaviors among urban Black adolescents; including communication about sex with family and peers. The entire interview-guide focused on five basic topic areas: (a) neighborhood context, (b) peer networks, (c) family life, (d) racial and cultural experiences, (e) dating/sexual attitudes and behaviors. All of the interview data was reviewed for the current analysis. However, most themes that were observed came from the following interview questions; (a) Tell me about your friends, (b) Tell me about your family, (c) Tell me where you first learned about sex, (d) Tell me about the first time you had sex, who did you talk to about it, (e) Who do you talk with or discuss your sexual relationships with?
Interviews were audio-recorded and then transcribed verbatim by an independent contractor. Completeness and quality of all transcripts were checked by a graduate student research assistant by listening to the entire audio of each interview. Qualitative content analysis was based on a grounded theory approach (Glaser & Strauss, 1967), where themes for the analysis were derived directly from the data. A standard iterative process was used to develop the analysis codebook (MacQueen, McLellan, Kay, & Milstein, 1998). Multiple reviews of all transcripts by the lead and third author identified recurrent and unique concepts and themes present within the text. Using an open-coding approach, text was broken down into individual meaningful units (Goulding, 1999). Codes based on the identified themes were successfully refined through this iterative process. A final codebook was developed by the lead author based on the refined codes (MacQueen et al., 1998). The procedures used for coding were similar to those outlined by Modifi, Rozier, and King (2002) whereby one individual (graduate research assistant who was blind to the research question) completed the coding. The next phase of the analysis, axial coding, codes that share both a meaningful and authentic relationship are combined to support identification of themes and patterns (Goulding, 1999). After axial coding was completed, code frequency reports were generated (e.g., how many times codes were presented across interviews). Salient themes and patterns were then compared with participant characteristics (gender and whether sexually experienced) to facilitate additional analyses.
Results
The majority of the participants described close relationships with their siblings, stating that they could relate with one another, talk with their siblings about anything and often went to siblings for information and advice. As one male participant stated, honesty and instructional guidance about what he does is a value of the relationship he shares with his sister. When asked who he feels the closest to he responded,
Probably my older sister . . . I’m very close to her. Like I could tell her anything. You know it’s not even just that she listen(s) to me, like she also you know she be straight up with me. She tells me if what I do is wrong or if it was right, what she liked or she disliked and then she also tries to help me out (Male, 16 years, Sexually Inexperienced).
Many of the participants spoke of being able to share freely and talk about “anything” with their siblings. This female participant describes a symbiotic relationship with her sister who serves as the gatekeeper she goes to for advice and vice versa,
My sister, the one that I’m living with now I’m closest to her. . . .I see her like my best friend ’cause I tell her everything, she tells me everything. She’s about four and a half years older than me. So I talk to her about everything all my problems whether it was school or friends. I tell her everything and she tells me everything. . .thinking about what kind of decisions to make we kind of like pass it to through each other first to see what the other’s opinion is (Female, 15 years, Sexually Experienced).
Another male participant describes a peer like close relationship with his cousin.
The reason we so close is ’cause she understands a lot of what happens to me in high school. So we hang out, on weekends. And I’d go over to her—and we go chill with her friends, or she’s chillin’ with my friends sometime. . .she understands me the most, ’cause she’s, like, around my age (Male, 16 years, Sexually Experienced).
Given the high level of closeness that participants described with their siblings, it is not surprising that the majority of participants reported having discussions about sex with their siblings. Youth described, detailed and informative discussions about sex with their siblings. The siblings were often the people from whom youth first learned about sex, siblings were prime agents in their socialization about sexual behavior, and siblings were a source for receiving information about sexual health and sexual risk reduction.
The following is a description of the themes related to sibling discussions about sex which emerged during the interview. The purpose of qualitative research is to provide rich contextually driven data from the perspectives of the participants. Focus is given to the descriptive nature of the quote versus a quantitative count of the responses. However, to assist the reader a brief matrix is provided to illustrate the number of youth who mentioned sibling discussions for each theme described below (see Table 2).
Frequency of Themes Observed by Participants.
Note: Key
Siblings talk with one another about sex.
Discussion about sexual activities
Learned about sex
Siblings may influence sexual risk behavior.
Positive messages about sex
Pressure to have sex
Help Initiate sex
Siblings as sexual health educators
Provide prevention information/materials
Mention importance of safe sex
Siblings talk with one another about sex
Discussions about sexuality and sexual activity were frequent between siblings. Siblings were oftentimes the first people from whom youth learned about sex, received more details about sex, or whom reinforced information youth had heard from others about sex. As one female respondent states,
Where did I learn about sex? I think to be honest probably in school not from the teachers just things you hear from your other classmates. But I guess I didn’t really fully understand it (sex) until a bit older when I finally became confident to ask my sister about it (sex) (Female, 15 years, Sexually Inexperienced).
Conversations between siblings also included hearing about their siblings’ sexual activities or talking to siblings before or after their own sexual encounter(s). One female participant notes,
My two cousins that are visiting from X. . . . I was supposed to meet them in the park (but I was late)—they knew already (participant had first sexual experience) . . . And I just told ’em how we (participant and sexual partner) were watchin’ a movie, um, the food we ate, all kind of little stupid details. What happened, if it (sex) hurt or not. And they were just askin’ me a lot of crazy questions. And I basically just answered them all (Female, 17 years, Sexually Experienced).
One of the female respondents recalls her negative reaction when a male cousin told her about his recent sexual activity.
I stayed at my godmothers’ house a lot. So my cousin came downstairs and he was like, “Yo, I did it, I smashed her (had sex with her)!” I was like, ew! . . . that’s gross. I was probably like 15, 16 at the time (Female 19 years, Sexually Inexperienced).
Siblings influence sexual risk behavior
The interviews also suggest that siblings may be an important socializing agent in shaping sexual behavior norms. Some of the content of discussions between siblings focused on the benefits of sexual behavior and encouraged risk taking. One male participant talks about a conversation he had with his sister about sexual behavior norms. His sister communicated the dichotomy she places on “nice” girls versus “nasty” girls and her idea of how boys should behave sexually. Her attitudes towards male sexuality encourages risk taking and violation of girls/women.
My sister, what she tells me about it (sex). She says, if I was a boy I would use those girls. Not saying like the nice girls but to nasty girls, the hoes and stuff. She like, I would violate them and stuff like that (Male, 18 years, Sexually Experienced).
In other discussions about the benefits of sexual behavior, male participants often reported that their male siblings bragged about their sexual activities and put pressure on them to be involved in sexual activities.
My brother, I don’t know sometimes he kind of pressures me. ‘Cause I have a lot of (female) friends and they considered pretty so (his brother questions) why I don’t do anything (have sex) with them and stuff. He don’t understand, him and his friends, so they try to pressure me (into having sex) and stuff like that (Male, 16 years, Sexually Inexperienced).
The socialization process between siblings, in particular brothers, may not be just limited to conversations but may involve directly influencing actual behaviors.
And my brother—such an idiot. This girl liked me. And he kept tellin’ me that I should go talk to her, but I didn’t really want to talk to her ’cause I—I was real shy back then, so I was like, “Nah, I’m not gonna say nothin’ to her” (Male 18 years, Sexually Experienced).
This male participant later goes on to describe that he eventually spoke to the girl after prodding from his brother. The next day he went to the girl’s house and they had sex. This was his first sexual experience. There were a few male respondents (3/7) who stated that their brothers helped to directly initiate sexual encounters. One male respondent stated,
Being his younger brother, he would always look out for me. He used to sneak girls in the house, and then just take them in his room. It was one I was just asking him, “You know, what’s up with the girl,” but I was just playing with him, I was young. He was like, “Yo, you want to do that (have sex with the girl)?” Me being a horny little teenager, “Of course!” I was willing. So, later on that night, he called me over from my room; he was like, “Go ahead and do you (have sex with the girl).” So I slapped on the condom, I was nervous as hell (Male, 18 years, Sexually Experienced).
Siblings as sexual health educators
There were responses from youth which highlighted discussions with their siblings about abstinence, safe sex and/or HIV/AIDS prevention information. These conversations were cautionary about the dangers of sexual activity, abstaining or waiting to initiate sexual activity and/or the importance of using protection if sexually active. These types of conversations were mentioned mostly from youth who were not sexually active (e.g., virgins).
My female cousins will be like, “Don’t do that (have sex),” and my guy cousins will be like, “I’ll kill him. I’ll kill him dead.” But now that I’m older, they’re like, if you’re gonna do it (have sex), use a condom. (Female, 19 years, Sexually Inexperienced).
But another female respondent stated,
I talked to my sister and she told me about different STDs around there . . . that’s when I knew more about it (Female, 15 years, Sexually Inexperienced).
Gender Differences
There were gender differences in sibling discussions about sex (see Table 3). Although both genders were likely to have discussions with their siblings about sex, males were more likely than females to recall discussions promoting sexual activity and sexual risk taking (e.g., multiple partners). Female youth reported more conversations about abstinence, safe sex, and prevention with their siblings regardless of the gender of their sibling.
Gender Differences in Observed Themes.
Note: Key
Siblings talk with one another about sex.
Discussion about sexual activities
Learned about sex
Siblings may influence sexual risk behavior.
Positive messages about sex
Pressure to have sex
Help initiate sex
Siblings as sexual health and HIV/AIDS prevention educators
Provide prevention information/materials
Mention importance of safe sex
Discussion
Results from this qualitative study highlight that siblings directly communicate with one another about sex, there are various types of content siblings discuss about sex in their conversations and some gender differences were observed. Thus siblings may play an important role in socializing urban Black youth about sexual behavior and could play a significant role in shaping sexual attitudes.
Although much of the communication among siblings was focused on the benefits of sexual activity, youth also mentioned talking with their siblings about sexual health and safe sex practices. The majority of youth who were not sexually active (e.g., virgins) stated their siblings communicated safer sexual messages, such as promotion of abstinence. This finding is in line with results from quantitative studies of multiethnic youth which found that older sibling discussions about safe sex and abstinence were related to those behaviors among youth (Kowal & Blinn-Pike, 2004; Widmer, 1997). These findings together indicate that siblings with proper training may be effective in promoting abstinence and reducing sexual risk among youth.
In addition, there were gender differences observed in the type of content observed in direct communication among siblings. Many discussions among male siblings encouraged sexual activity. In particular, conversations between male siblings encouraged sexual activity and in some instances male youth from our sample reported feeling pressured by their brothers to have sex. In this sample, some male respondents mentioned sexual activity was initiated with the help of their male siblings.
Findings from this study highlight the benefit of considering sibling influences when examining correlates to sexual risk among urban Black youth and in particular direct communication among siblings about sex. Researchers may be missing important data to inform our understanding of sexuality, sexual behavior, and sexual risk taking among this population. Researchers should consider asking about sibling relationships and sibling direct communication about sex in studies of urban Black youth. In addition, these findings point to areas for future qualitative research specifically designed to examine sibling dyad conversations about sex and sexual health. Are siblings helping to construct the sexual scripts of youth or adjusting the scripts that have been established by parents and peers? In addition, larger quantitative studies would help identify which sibling factors (e.g., birth order, age spacing, personality characteristics, and sibling relationship quality) are related to direct communication about sex among siblings. In what ways is indirect communication (e.g., observation) similar or different from direct communication about sex among siblings? Given the important role that the extended family plays in Black households, futures studies should examine the influence of cousins and fictive kin on sexual attitudes and behaviors among urban Black youth.
There are some limitations to the study. Although the sampling achieved saturation of the themes observed in the interviews, the narrow geographic representation limits the generalizability of the study. Participants received a small paid incentive for the interview which could have resulted in bias of responses. Because of the exploratory nature of the study, it is unclear what led to the discussions among siblings about sex. Did siblings observe certain behaviors in their brothers and sisters which in turn led to them talk with their siblings or were they asked by parents to initiate conversations with their siblings? Given the interviews were conducted with individual and not sibling dyads we also have little information about the participants’ siblings (e.g., age of sibling, multiple siblings etc.). It is unknown whether siblings influenced the peer networks of youth nor do we know the risk behavior and sexual history of siblings. In spite of these limitations, this study identifies an important area for future research to be undertaken.
The findings from this study help to inform the direction of youth prevention programs designed for urban Black youth. Family-based programs have been touted as effective in decreasing sexual risk and improving sexual health practices among youth (Ball, Pelton, Forehand, Long, & Wallace, 2004). These programs are very important in that families are integral to youth development, given the shared home environment, daily interaction, and long duration for which they have an influence on the lives of youth. Siblings share these factors and are considered peers by youth. Therefore, they may be instrumental for prevention and intervention practices. For example, siblings can be included in prevention programs where both parents and older siblings can be taught how to communicate sexual risk reduction messages to younger siblings. Siblings can also be trained individually as peer educators, where they are targeted primarily to share sexual health information with their brothers and sisters.
In conclusion, finding solutions to prevent the negative health outcomes associated with sexual initiation and sexual risk such as sexually transmitted infections (STIs), including HIV/AIDS are of great importance (Santelli, DiClemente, Miller, Kirby, 1999). This is particularly true for Black youth who are at higher risk for these outcomes than youth from other racial groups (CDC, 2010). The extended family network is an important cultural value among Black populations. Siblings and other family members of similar age (e.g., cousins) may hold special prominence and influence in the lives of Black youth. Therefore, practitioners and researchers working with urban Black youth should consider sibling influences and how to incorporate sibling communication strategies in intervention programs and practice.
Footnotes
Acknowledgements
We would like to thank Sarah Johnson and Molain Saintilus for their assistance reviewing the transcriptions and coding the data. Thanks for Rebecca Eliason and Cynthia Cabral for providing assistance with formatting the manuscript. We thank the UCSF CAPS faculty for their thoughtful comments on the manuscript. We are grateful to the youth who participated in the study for sharing their experiences.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was supported by NIMH grant R25 MH067127 and NICHD grant R25 HD045810 as part of the University of California at San Francisco Collaborative HIV Prevention Research in Minority Communities Program.