Adolescence is a period of life between childhood and adulthood, during which puberty occurs. The period of adolescence is a unique stage in every individual’s life [1]. It is characterized by physiological and anatomical changes such as the appearance of secondary sexual characteristics and by an acceleration of height and weight growth, and leading to the acquisition of the functions of reproduction [2].

During adolescence, the child is subordinate to his parents. Some adolescents succeed in managing this transformation whereas for others, it represents a major phase comprising stress which most often leads to risk behaviors such as irresponsible sexuality [1].

This irresponsible or hardly responsible sexuality results in unwanted pregnancies, induced abortions, early marriages and motherhood, sexually transmitted infections [3].

At a global level, one young girl out of five has already had a child at the age of 18 years [4]. Medical complications related to pregnancy and deliveries are the leading cause of death among girls from 15 to 19 years old throughout the world [5].

In eastern and southern Africa, adolescents’ fertility rates are twice as many as the world average which is 53.4 per thousand girls [6].

In Benin in general, in Parakou in particular, the prevalence of pregnancies in a school environment (SE) concerning the ten (10) state schools was estimated at 6.1% during the academic year 2010-2011 [7]. In general, adolescents need love, space and support in their everyday environment to develop their sexual identity [8].

However, parents use indirect strategies towards their child as regards sexuality implicites et non verbales afin de leur faire entendre ce qui est attendre [9]. It is necessary to understand the contribution of a series of factors both formal and informal which influence the access to adolescents’ sex education (SE) in the family structure [10].

As a matter of fact, when the adolescent is monitored by his parents within the framework of sex education of good quality, he can get away from these risks. But we have to admit that in Africa and more precisely in Benin, sex is still and continues to be a taboo in our families.

The contribution of parents to sex education deserves more and more attention for research. It is obvious that the major part of sex education begins within every family. Studies on general population are few, hence our interest for this issue in the city of Comé, south of Benin.

Framework and Approach

Our study was carried out within the framework of the urban district of Comé located at the south-east of the department of Mono, at about sixty kilometers away from the economic capital of Benin, Cotonou. It was an analytical and descriptive cross-sectional study with a prospective data collection.

The collection was performed for 8 days from 6 to 13 October 2015.

The study involved the heads of households (men and women) who gave their consent and lived in the districts of Comé in 2015 for at least one year and cared at least for an adolescent aged 10 to 19 years.

It didn’t concern the heads of households showing disabilities such as deafness or muteness or those who refused to be interviewed or the ones we couldn’t gain access to after two visits.

The sample size was determined by using Schwartz formula with p, maximum variability of the proportion of adolescents who gain access to sex education within their families in Comé set at 50 % with a risk of 5% and a cluster effect of 2.

The size of the sample per district or village was proportional to its demographic weight referring to the database of the planning department of Comé Town Hall.

In each eligible household, parents were chosen by the surveyors on the basis of a simple random sampling. The collection was performed by using a questionnaire previously tested.

Variables were:

• Sociodemographic (sex, age, educational level, marital status, type of family, and parenting style).

• Parents’socioeconomic and cultural variables (profession, monthly income, religion).

• In connection with parents’ perception as regards sex education within the family.

• Parents’ practices with respect to sex education.

The data were entered by using Epi data 3 French version software and analyzed with Epi Info 7 software.

Quantitative variables were expressed on average with their standard derivation and qualitative variables commensurate with their confidence interval.

The comparison of proportions was made by using Chi-2 test or FISHER’s exact test. Significance threshold was 5%.

During our study, 576 subjects took part in the survey.

Distribution of parents according to their sex, age, educational level and profession

Parents’ average age was 44 years ± 13 years with extremes of 23 and 90 years. About six parents out of ten (64.1%) were between 30 and 49 years old.

Women were mostly represented in this sample (67.5% versus 32.5%). The sex-ratio was 0.48 (Table 1).

Table 1: Distribution of the surveyed parents according to the sex, the age, the educational level and the profession in come in 2015

Distribution of parents according to the type of family and parenting style

Monogamous family was the most represented 373 out of 576 that is to say 64.8%. The families were polygamous, single-parent and reconstituted respectively in 27.1%, 4.9% and 3.2% of cases.

As for parenting style, the parents were authoritative, permissive and neglectful in respectively 42.2%, 54.3% and 3.5% of cases.

Distribution of parents according to religion and degree of religious practice

The surveyed parents were predominantly christians (68.2%) then animists (14.9%), muslims (2.1%) and without religion (14.8).

More than half of the surveyed parents (61.9%) were very practicing (33.6%), not very practicing and not practicing at all (4.5%).

Parents’ perception of sex education (SE)

Parents’ perception about the need for sex education in the home environment: When they are asked their opinion on the need for adolescents’ SE, around nine parents out of ten (90.8%) consider that adolescents’ sex education is necessary.

Parents’ perception about the family role in sex education: In our study, about six parents out of ten (55.0%) agree that it is their duty to provide adolescents with sex education.

Parents’ perception of teenagers as regards sex education: The analysis of the various answers mentioned by the parents as regards adolescents’ sex education enables a classification according to the five components of sex education (psychoaffective, behavioral, biological, social/cultural and moral).

On the whole, the perception of the surveyed adolescents’ parents about the concept “sex education” was more based on the psychoaffective dimension (32.6%) followed by the behavioral dimension (29.3%). Figure 1 presents the synthesis of this analysis.

Figure 1: Distribution according to the perceptions of adolescents’ parents as regards sex education referring to the different dimensions in Comé in 2015.

Parents’ practice as regards sex education

Parents’ experience in sex education: In our study, around seven parents out of ten (76.4%) had never led a discussion within their families for the purpose of sex education.

Frequency of discussion within the family as regards SE: In our study, for about five parents out of ten (49.2%) the discussion regarding sex education with adolescents within the family was circumstantial.

Discussions were regular and punctual in respectively 36.8% and 14% of cases.

Future commitment of parents to sex education within the family: Among the 440 (76.4%) parents who declared that they had never led a discussion with adolescents within their families, 50.9% would wish to do it.

Thus, around five parents out of ten (49.1%) are not prepared to be involved in a discussion about sex education with adolescents within the family soon.

Several reasons were given by the parents who did not wish to be involved in sex education to explain their point of view.

More than five parents out of ten (56.9%) mentioned the ineffectiveness of sex education. The lack of motivation in 50.0% of cases.

In 49.5% of cases, these parents mentioned the lack of skills to lead a discussion with adolescents within the family. Around four parents out of ten (44.4%) mentioned that adolescents know enough about the issue.

In addition, a large proportion of parents (31.0%) mentioned that it was not parents’ role to provide adolescents with sex education.

Another argument mentioned was the fact that the practice of sex education with adolescents within the family was contrary to their traditional values (4.6%).

The synthesis of the results is illustrated by Figure 2.

Figure 2: Main reasons given by parents who are still not prepared to be involved in a discussion about sex education soon in Comé in 2015 (N = 216).

Age for sex education: The average age of children for sex education was 12.4 years ±4.0 years.

The majority of participants declared that sex education should start before the age of 17 years old (86.2%) and 33 (5.8%) after 19 years old.

Factors related to adolescents’ sex education

Relationship between parents’ perception of the need for SE in the home environment and sociodemographic characteristics: The female sex (p=0.021), university education (0.038), permissive parenting style (0.09), christian parents (p=0.026), and the very practicing (0.022) were significantly associated with the need for sex education in the home environment.

The synthesis of the results is illustrated by Table 2.

Table 2: Relationship between parents’ perception as regards the need for SE in the home environment and sociodemographic characteristics in Comé in 2015.

Themes covered by parents within the family as regards sex education according to the gender: Among the themes covered, women are more inclined to discuss themes related to pregnancy/ contraception/adolescent’s desire (p=0.005), personal experiences (p<0,001) with adolescents rather than with men. Apart from these two themes, no more significant difference was noticed between men and women concerning the discussion regarding the other themes. Table 3 presents a synthesis of these results.

Table 3: Distribution of parents who led a discussion about sex education with adolescents in the home environment according to the gender and referring to the themes covered in Comé, in 2015

Parents’ perceptions as regards the need for SE within the family

Around nine out of ten parents (90.8%), consider that adolescents’ sex education within the family is necessary. Our results allow to have a true picture of parents’ opinion on the opportunity to provide teenagers with sex education within the family. It seems to us undeniable that the degree of parents’ involvement in sex education project can be to some extent determined by the idea they have of its opportuneness. Women are those who are more inclined to agree that sex education is necessary for adolescents.

Parents’ perceptions as regards the role of the family in sex education

Parents’ position is not definite as for their role in sex education. Among the 576 surveyed subjects, 317 parents that is to say 55.0% consider this education as part of their mission. This proportion is relatively small. This could be accounted for by the abdication of a number of parents of the city of Comé of their responsibilities as for their role in their children’s sex education.

The perception of adolescents’ parents as regards the concept of sex education

The individual perceptions of adolescents’ parents regarding the concept of sex education revolve around the five dimensions of sexuality. On the whole, the perceptions of the surveyed adolescents’ parents regarding the concept focused more on the psychoaffective dimension (32.6%). But actually, each of the dimensions of sex education only represents a part of sexuality and cannot be dealt with separately. That’s why, in the context of sex education Pelège and Picod [11] advocate that scientific information and knowledge transmitted enable youngsters to know and understand the various dimensions of sexuality. This justifies the need for sex education based on a global approach for a better prevention of the risks related to adolescents’ sexual behaviors [12]. This global approach will prevent sex education from being simply a preventive action based on mere health information. In fact, The change in the adolescent’s sexual behavior does not only depend on the knowledge he has of health risks, but rather on his ability to develop a positive self-image and that of sexuality through a harmonious integration of its different dimensions.

Parents’ experience in sex education

Sexuality remains a taboo subject within families in the city of Comé. The surveyed parents are many who have never led a discussion for the purpose of sex education within their families (76.4%). Our result corroborates what is reported by Berne and Huberman [13] in an American survey which shows that 72% of parents declare that they never talk or seldom talk about sexuality with adolescents. This shows a break with traditional African society where parents were at the forefront in their children’s sex education. We can also think that the fast growth of new sources of information (television, internet, radio, magazines…) on sex education in African countries weaken more the dialogue about sexuality between parents and adolescents. Yet, these new sources of information do not affect the place teenagers would like to give their parents. Actually, although we have no opinion of adolescents on this issue in Comé, several studies, namely in Canada, have already shown that adolescents consider their parents as precious sources of information on sexuality and that parents think it is their responsibility to discuss sexuality with their children [14]. Another Canadian survey shows that for 61% of youngsters, parents are likely to be a channel they can make use of for the purpose of adolescents’ sex education. In fact, it is desirable that parents really take part in the project from the start, since “family and community values , as well as norms and social conditions strongly influence the perception and the behavior of adolescents” [15]. It is important that parents get involved in the process of their children’s sex education by giving mutual support. Adolescents are likely to get better opportunities to fulfill themselves on a personal level. If both parties in several surveys express their desire to collaborate around the issue of sexuality, unfortunately it is not always easy for them to overcome the discomfort caused by the issue since 63.9% of our surveyed find it difficult to talk about sex within the family.

In our study, among the 440 (76.4%) parents who declare that they have never led a discussion about sex education with their adolescent children, about half of them (49.1%) have declared that they are still not prepared to be involved in such a discussion soon. It can be inferred that parents shirk their responsibilities, especially absent parents or those who never have time to talk with their offspring but who implicitly entrust their mothers with that duty, for in our study about one third of parents (36.6%) who discuss sex education with adolescents within the family are the mothers. Several reasons are given by the parents who didn’t wish to be involved in sex education. More than five parents out of ten (56.9%) mentioned the ineffectiveness of sex education, that means they did not think that sex education could succeed in changing adolescents’ sexual behaviors. Similarly, the lack of motivation was mentioned in 50.0% of cases. In 49.5% of cases, the parents mentioned the lack of skills to lead a discussion about sex education with adolescents within the family. Around four parents out of ten (44.4%) argued that adolescents know enough about the issue. Furthermore, a large proportion of the parents (31.0%) considered that it is not the role of parents to provide adolescents with sex education.

Sex education remains a taboo subject in our regions.

Even if some parents recognize their role in it, most of them do not commit themselves to achieving it especially in our developing countries where cultural values are of paramount importance in children’s education. It is undeniable that parents’ involvement remains a necessity in adolescents’ sex education.