Preventive service needs of young people perinatally infected with HIV in Uganda

Abstract

The sexual and reproductive health needs of young people perinatally infected with HIV in Uganda remain largely unaddressed by existing HIV/AIDS programs mostly because, such programs encourage young HIV-positive clients to refrain from or postpone sexual activity. This study examines the sexual expressions and experiences as well as the preventive practices of 732 adolescent boys and girls aged 15–19 years who were born with HIV with a view to identifying the preventive service needs of these young people and the implications of these needs for HIV/AIDS programs. The data come from a project on the sexuality of young people perinatally infected with HIV conducted in 2007 in four districts of Uganda, that is, Kampala, Wakiso, Masaka, and Jinja. The analysis involves both quantitative and qualitative approaches: the quantitative approach entails cross-tabulations with chi-square tests as well as significance tests of proportions while the qualitative approach involves an analysis of individual case stories, in-depth probes and focus group discussions for content. The findings show disconnect between: (1) the information the service providers give to the young people and their actual needs and desires; (2) the fears of the adolescents and their actual preventive practices; and (3) the high level of reported condom use and the frequency of use. Programs will therefore need to recognize that young people perinatally infected with HIV are sexually active or anticipate being so in future. Thus, both sexually active and non-sexually active young people require information and services on prevention of unwanted pregnancies as well as avoiding infecting their sexual partners with HIV and re-infecting themselves. Programs will need to devise ways of responding to these needs which should include emphasizing the disclosure of HIV status to the partner as well as the need to accompany such disclosure with consistent condom use.

Keywords:

• young people
• perinatally HIV-infected
• sexual experiences
• preventive service needs
• Uganda

Acknowledgements

The project that provided the data for this paper was implemented by The AIDS Support Organization (TASO) – Uganda and the Population Council. It was co-funded by the Ford Foundation and the United States Agency for International Development (USAID). The views expressed in the paper are, however, those of the authors. We also wish to acknowledge the support of various individuals from the Population Council, TASO Uganda and the Mildmay Centre as well as all HIV/AIDS treatment centres that opened their doors for the project. We are further grateful to the team of research assistants. The paper also benefitted from valuable comments from two anonymous reviewers.