“They said “be careful’”: sexual health communication sources and messages for adolescent girls living with perintally-acquired HIV infection

ABSTRACT

Due to advances in highly active antiretroviral treatment (HAART), children “who perinatally acquired HIV infection” (PHIV+) in the United States have been reaching adolescence and adulthood in large numbers. As youth PHIV + become sexually active it is important to understand their sources of sexual health information and the messages communicated by those sources to safeguard their sexual health and that of their partners. This paper explores sexual health communication for adolescent girls PHIV + in comparison to adolescent girls who were exposed but did not acquire HIV perinatally (PHIV−) to understand how HIV infection influences the sexual health communication needs of the former. A convenience sample size of 30 (20 PHIV + and 10 PHIV−, mean age 14.5) girls completed survey and participated in a 45–90 min developmentally appropriate semi-structured interview. The interviews aimed to elicit the girls’ sources of sexual health communication, the sexual health messages they receive, their comfort or discomfort with these communications, and to determine how their sexual health communication experiences differ from those of their PHIV− peers. Transcripts of the interviews were coded and analyzed for themes related to sexual health communication sources, sexual health communication messages and comfort/discomfort with sexual health communication sources. Our findings suggest that girls PHIV + do not differ significantly from Girls PHIV− in their sources of sexual health information, yet girls PHIV + are most comfortable receiving sexual health information from their health providers, whereas for girls PHIV, the comfort is higher with caregivers. However, the messages Girls PHIV + reported receiving from their providers and caregivers were vague. Both providers and caregivers of Girls PHIV + are uniquely positioned to provide information to adolescents about sexuality and responsible sex decision-making. Some caregivers and providers may need training to prepare them to provide appropriate and accurate sexual health information to girls PHIV + .

KEYWORDS:

• Perinatal HIV
• sexual health communication
• mother to child transmission
• provider-patient communication
• parent-child communication

Acknowledgements

The authors wish to thank the participants of this study, who were generous enough to share their stories. We are especially grateful to Ms. Hollie Fuhrmann, who was instrumental in getting this manuscript together. Liz Lockhart helped in editing this manuscript down to a brief report, and we are very appreciative.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Stephanie L. Marhefka http://orcid.org/0000-0001-7708-1521

Shana M. Green http://orcid.org/0000-0002-8366-9660

Additional information

Funding

During data collection, Dr Marhefka was supported by a training grant from the National Institute of Mental Health [NRSA T32 MH19139, Behavioral Sciences Research in HIV Infection; Anke A. Ehrhardt, Ph.D., Principal Investigator] and Drs Marhefka and Mellins were supported by the HIV Center for Clinical and Behavioral Studies [P30 MH43520; Anke A. Ehrhardt, Ph.D., Principal Investigator], which also provided funding for this study. Some data were collected in conjunction with a grant from the National Institute of Mental Health [R01MH069133, Mental Health and Risk in HIV+ Youth and Seroreverters; Claude Ann Mellins, Ph.D., Principal Investigator].