Living as an adolescent with HIV in Zambia – lived experiences, sexual health and reproductive needs

Abstract

HIV services in developing countries are often ill-equipped to address the specific needs of HIV-positive adolescents. Studies suggest a lack of consistent, age-appropriate support regarding sexuality, relationships and transitioning to adulthood. The aims of this study were to explore and document the informational, psychosocial, sexual and reproductive health (SRH) needs of adolescents (aged 10–19 years) living with HIV in Zambia, and identify gaps between these needs and existing services. This paper reports a qualitative explorative study. Semi-structured interviews and focus group discussions were conducted with 111 HIV-positive adolescents and 59 key informants, including health care workers (n=38) and parents/guardians (n=21). Participants were selected via a purposive sampling method. Three sites – Lusaka, Kitwe and Kalomo – were selected to ensure a broad representation of service-delivery settings in Zambia. Data were entered into NVIVO (QSR International) software, and analysed inductively to extract key themes, gather results and draw conclusions. Findings confirm that social networks have significant impact on treatment adherence and assist adolescents in coming to terms with an HIV diagnosis. The trauma of diagnosis, however, is exacerbated if poorly managed. Nevertheless, many adolescents are determined not to let HIV change their lives. They want to know SRH and HIV information, but service providers do not often adequately meet these informational needs. Where available, tailored and participatory events around HIV and SRH are greatly appreciated. Services that are welcoming, empowering and provide tailored information are highly valued. Adolescents living with HIV require effective, targeted and sustainable HIV services to navigate safely through adolescence.

Keywords:

• adolescents
• HIV
• Zambia
• sexual and reproductive health
• qualitative

Acknowledgements

We are thankful to the young people, research assistants and adults who participated; Dr Fabian Cataldo who designed the protocol; the advisory group including SAT and NZP+; and study funders: SIDA through the Africa Regional Program of the International HIV/AIDS Alliance, and DFID through the Evidence for Action Research Consortium. Also thanks to Divya Bajpai for comments on an earlier draft.