Hmong American Adolescent Sexual Health and the Parents Who Care

Laurie L. Meschke, PhD, University of Tennessee at Knoxville

Parents’ conversations about sexual health with their sons and daughters help reduce adolescent sexual risk-taking by delaying sexual onset, reducing the number of sexual partners, and producing less frequent sexual activity and more consistent contraceptive and/or condom use. Parents also indirectly promote sexual health when they support comprehensive sex education.  About 80% of U.S. parents have advocated for comprehensive sex education over the past 20 years. However, we know very little about immigrant parents’ views about adolescent sexual health and sexual activity or their support (or discouragement) of comprehensive sex education. The limited studies typically reveal that traditional culture, language, and acculturation stress may challenge immigrant parents’ involvement in promoting adolescent sexual health. Indeed, such findings have been reported for Hmong American adolescents and their parents — the focus of my research.

The Hmong, traditionally agrarian people of Laos, were recruited by the United States as the CIA’s Secret Army before the U.S. declaration of war on Vietnam. The Hmong continued to serve as U.S. allies throughout the war, after which they fled to Thailand, staying mostly in refugee camps. In 1975 they began immigrating, primarily to the U.S., with the last wave of over 15,000 Hmong refugees arriving in the U.S. in 2004.   

The Hmong’s limited exposure to the U.S. and western society prior to immigration and their traditional native culture challenged their adaption. For example, in Laos the Hmong did not socially recognize the developmental period of adolescence. As such, Hmong men generally married between ages 18 and 30, and women between 14 and 18. Early marriage and childbearing were beneficial as child mortality and maternal death were not uncommon, and children were needed to support family farms and households.

Given the historical role of early family formation, researchers have reasoned that Hmong Americans endorse adolescent pregnancy. Yet the evidence to support this claim is mixed. Some parents may have endorsed early marriage to prevent their daughters' adoption of the dominant cultural ideals while others supported postponing marriage to reduce the threat to educational attainment. In addition, parents' views may not map on to actual behaviors as some Hmong American teens report marrying early to defy parents and gain independence. Thus, while traditional attitudes and behaviors may provide a starting point for understanding current attitudes and behaviors, the existence of such traditions does not necessarily mean the current generation of Hmong Americans will endorse these attitudes and behaviors as these patterns are complex and culture is ever-changing. For example, in interviews Hmong American youth shared that emotional expression is traditionally discouraged in their families and by the Hmong American community in general.  However, they went on to say that as future parents they plan on encouraging their children to be openly expressive.  Considering whether and how these attitudes may have changed over time is especially relevant to health promotion efforts.

Survey data were collected from self-identified Hmong American parents of adolescents at Hmong cultural events. The 2002 data (n=194) were collected in St. Paul, Minnesota. In November 2012 a similar survey was administered in Sacramento, California (n=251). Early results reveal that 2012 parents were much more supportive of adolescent sexual health promotion efforts than the 2002 parents.  On average the 2012 parents selected fewer benefits and many more negative consequences associated with teen pregnancy compared to 2002 parents. The 2012 parents were more likely than 2002 parents to agree with the following statements: 

·         It is important for parents to discuss marriage with their children

·         Hmong parents have a responsibility to educate their teens about sexual health

·         Hmong parents would like to educate their teens about sexual health

·         Hmong parents have the knowledge to educate their teens about sexual health

·         Hmong parents have a lot of influence in their teenagers’ lives

The 2012 parents’ ideal age of marriage for Hmong youth was older (Mmales=22.7; Mfemales=22.8) than the 2002 parents (Mmales=21.1; Mfemales=20.1). Finally, parents shared how much they supported various topics being discussed in sexuality education for youth by grade (7th-8th; 9th-10th; and 11th-12th). Topics included:  abstinence, birth control, condoms, HIV/AIDS, homosexuality, and abortion. Significant differences were revealed for almost every topic for each grade. Again, 2012 parents had higher levels of support across all topics and grades compared to 2002 parents.

The majority of parents in both years were born in Laos (82% in 2002 and 74.1% in 2012) and preferred to speak Hmong (51% in 2002; 55.4% in 2012), yet over this time, significant gains in parents’ promotion of adolescent sexual health were revealed. Perhaps the educational and economic consequences of teen pregnancy are more evident in 2012 with three or more generations of Hmong Americans. Maybe life in Thai refugee camps resulted in delayed childbearing given that large families and early childbearing were not as beneficial as earlier in Laos.

This study begins to address the lack of research about Hmong American parents’ attitudes about adolescent sexual health. Given the importance of parents in promoting healthy adolescent sexuality, including teen pregnancy prevention, the results bode well for Hmong American youth.

These findings are encouraging, yet care must be taken. First, two different Hmong American communities answered the survey so it is plausible that the differences between 2002 and 2012 do not reflect attitude change but a comparison between two specific years.  Also, Minnesota and California present different sociopolitical experiences for the two groups. Hmong Americans represent the largest Asian community in Minnesota and one of the smallest in California. Finally, the survey questions primarily assessed attitude not behavior. Parents may be attitudinally supportive of adolescent sexual education, but we cannot confirm that the parents actually contribute to the promotion of adolescent sexual health, and if so, to what degree. 

Regardless of what is influencing differences in parental attitudes about adolescent sexual health and teen pregnancy prevention, these findings offer an optimistic perspective.  Parents do make a difference in adolescent choices, and Hmong American youth are better situated to experience enhanced sexual health outcomes than previously thought.

Laurie L. Meschke is an Associate Professor of Public Health at the University of Tennessee, Knoxville. Her research interests include adolescent health promotion with a focus on sexuality, communication, and emotional and behavioral health risk. Laurie currently teaches Needs Assessment and Research Methods and has a strong affinity for community service learning. Please send her an email with your comments or questions at[email protected]

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