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Parent-adolescent sexual and reproductive health (SRH) communication plays an important role in reducing sexual risk behaviour and preventing HIV. We sought to enhance limited information about the unique barriers to parent-adolescent SRH communication in the Arab states. This mixed-methods study, using a two-phase sequential explorative design, was conducted in 15 public secondary schools (with grades 5 to 10 students aged 10 to 15 years) in Oman. In phase one, 15 parents participated in two single-sex focus group discussions and two in-depth individual interviews. The qualitative data were analysed using thematic analysis. In phase two, a convenience sample of 250 parents completed a paper-based self-administered questionnaire. Findings showed that parents rarely communicated with their children about SRH concerns, including HIV. Barriers to more open parent-adolescent SRH communication include the fear that such discussion might encourage early sexual debut; feelings of shyness, discomfort and shame; associated socio-cultural taboos; gender mismatch; and lack of SRH knowledge. Findings suggest the need for parental SRH education and training and school based SRH education programmes to improve adolescent SRH. Experience developing these may be helpful to other countries with similar religious beliefs and socio-cultural traditions seeking to improve parent-adolescent SRH communication. [ABSTRACT FROM AUTHOR]

School-based comprehensive sexuality education (CSE) programmes play an important role in reducing young people's sexual risk behaviour and promoting health and well-being. There is limited evidence regarding the attitudes and beliefs of parents towards the implementation of school-based CSE programmes in Islamic cultural settings, including Oman, which this mixed-method study set out to explore. A convenience sample of 250 parents, with equal numbers of mothers and fathers of children aged 12–14 years (grades 7–9) at two urban public pre-secondary schools in Saham, completed a paper-based self-administered questionnaire in Arabic. We found most parents (72.8%) supported school-based CSE programmes that conformed to Islamic requirements of pre-marital sexual abstinence, but there was some opposition. Almost all parents supported comprehensive age-appropriate CSE being taught to students aged 10–15 years, including topics perceived as controversial in Omani culture, except for birth control and safer sex. Most parents considered themselves, school teachers and school nurses to be important sources of CSE. The study findings which suggest strong parental support for CSE programmes can facilitate education policy, CSE curriculum decision-makers and school healthcare-providers in Oman, other Middle Eastern countries, and countries with Muslim immigrant populations. [ABSTRACT FROM AUTHOR]