Self-reported sexual and reproductive health information/services received by adolescents and young adults with perinatally acquired HIV: what are their needs?

ABSTRACT

Adolescents and young adults (AYA) living with perinatally acquired HIV (PHIV) are now living well into young adulthood due to medical advances in the treatment and management of HIV. Research indicates that AYA with PHIV engage in developmentally expected sexual behaviors yet little is known about the type of sexual and reproductive health (SRH) information/services this cohort receives from HIV health care providers. Thirty-five AYA with PHIV engaged or formerly engaged in care at two pediatric infectious disease clinics in the southeastern United States were interviewed to assess the SRH information/services received from providers. Mean age of participants was 20.7 years (range 15–30). Most were African American (n = 27, 77.1%) and female (n = 23, 69.7%). The majority of participants were sexually active (71.4%) and used contraceptives (64.0%). The most frequently discussed SRH topics included sexually transmitted disease (STD) prevention (75.8%), condom use (72.7%) and information about STDs (72.7%). Discussions with providers about sexual risk reduction topics occurred more frequently than psychosocial aspects of SRH such as including romantic partners in medical appointments (33.3%), sexual violence (35.3%) and romantic relationships in general (45.2%). While most participants (88.6%) reported a desire to have children, only half reported childbearing discussions with HIV health care providers. Females reported receiving more SRH information/services than males, but the difference was not statistically significant. Providers initiated the overwhelming majority of SRH-related conversations. Participants expressed a preference to talk about SRH topics with members of their HIV care teams, rather than with non-clinic providers. Overall, these findings indicate the need for improved and increased SRH information/services offered to the maturing population of AYA living with PHIV within HIV care settings.

KEYWORDS:

• Adolescents and young adults
• perinatally acquired HIV
• sexual and reproductive health
• holistic care
• risk reduction

Acknowledgements

The authors express deep gratitude to the young people who shared their stories with us. Aspects of this research were presented at the at the 2013 Society of Adolescent Health and Medicine conference in Atlanta, GA.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

We would also like to thank the Elon University Faculty Research and Development Committee, the Lumen Prize, and the Elon College Fellows program for providing funding.