Objectives: This study aims at examining parent-young people communication about sexual and reproductive health related topics and factors associated with it from both young people's and parents' perspectives. Methods: A cross-sectional study was conducted among 2,269 young people aged 10-24 years in Nekemte town and semi urban areas, western Ethiopia. Chi-square and multivariate logistic regression analyses were conducted using SPSS for windows version 16. The qualitative data was coded, and categorized in to emerging themes using the open code software version 3.4. Result: About a third of young people-32.5% (32.4% of females and 32.7% males) engaged in conversation about sexual and reproductive health topics with their parents/parent figures during the last six months. In logistic regression analyses, young people who were aged 15-19 years were more likely to report parent-communication compared to the other age groups (AOR = 1.57; 95% CI = 1.26-1.97). Female young people are more likely to discuss with their mothers, (AOR = 1.89, 95% CI = 1.13-3.2), sister (AOR = 2.16, 95% CI = 1.19-3.9) and female friends (AOR = 11.7, 95% CI = 7.36-18.7) while males are more likely to discuss with male friends (AOR = 17.3, 95% CI = 10-4-28.6). Educated young people were more likely to parent-communicate(AOR = 1.70, 95% CI = 1.30-2.24). Fear of parent, cultural taboos attached to sex, embarrassments, and parents' lack of knowledge related to sexual and reproductive health were found to be barriers for parent communication. Parent-communication takes place not only infrequently but also in warning, & threatening way. Conclusion: Parent-young people communication about sexual health is occurring rarely in the family and bounded by certain barriers. Programmes/policies related to young people's reproductive health should address not only individual or behavioral factors but also cultural and social factors that negatively influence parent-communication about reproductive health.
