Fear-based parent-child sexual health communication in rural southwestern Uganda: drivers and influences

Fear-based sexual and reproductive health communication remains widespread in Uganda, particularly in rural communities, where it is driven not only by religious, cultural, and political ideologies but also by internalised anxieties about parental failure. This study examines how fear functions as both a protective impulse and a disciplinary strategy in parent-adolescent communication in southwestern Uganda. Using community-based participatory research, we collected data from parents, adolescents, and community stakeholders. A thematic analysis guided by African feminist theory and Bronfenbrenner’s socio-ecological model was conducted. Findings reveal that fear-based communication, characterised by warnings, threats, and silence, is used to maintain family reputation and enforce gender norms, particularly upon girls. Mothers carried the burden of moral regulation, while fathers maintained emotional distance, leaving boys without guidance. Parental fears were shaped and legitimised by political rhetoric, religious doctrine, and technological anxieties, thereby reinforcing intergenerational mistrust and prompting adolescents to turn to peers and digital platforms for information. Study findings call for culturally grounded, gender-transformative interventions that move beyond individual awareness to address structural inequalities, emotional disconnection, and parental anxiety. Programmes should seek to reframe masculinity to accommodate care, engage fathers as emotionally present educators, and support trust-based dialogue that affirms young people’s rights and realities.