Adolescents living with HIV in the Copperbelt Province of Zambia: Their reproductive health needs and experiences.

Donna R Mccarraher,Sarah Mercer,Julie A Denison,Patrick Katayamoyo,Catherine Packer,Jonathan K Mwansa,Harry Banda,Randy M Stalter,Namakau Nyambe,Alexis Dennis

doi:10.1371/journal.pone.0197853

Donna R Mccarraher, Sarah Mercer + Show 8 more

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BackgroundUnderstanding and meeting the reproductive health needs of adolescents living with HIV (ALHIV) is a growing concern since advances in antiretroviral therapy mean that many ALHIV are now living into adulthood and starting to have sex.MethodsWe conducted a mixed-methods study in the Copperbelt Province of Zambia to advance our understanding of the reproductive health needs of ALHIV and to assess the extent to which these needs are being met. We conducted in-depth interviews (IDIs) with 32 ALHIV from two HIV clinics, 23 with their caregivers, and 10 with clinic staff. ALHIV were interviewed twice. We used the data from the qualitative interviews to create a cross-sectional survey that we conducted with 312 ALHIV in three HIV clinics.FindingsThe vast majority of ALHIV reported they wanted to have children in the future but lacked knowledge about preventing mother-to-child transmission. Some sexually active adolescents used condoms, although they wanted more information about and access to non-condom methods. Many ALHIV reported that their first sexual encounters were forced. Religious beliefs prevented some caregivers from discussing premarital sex and contraception with ALHIV. Clinic staff and caregivers had mixed views about integrating contraceptive counseling and method provision into HIV care and treatment services. Few sexually active ALHIV reported that they disclosed their HIV status to their sexual partners and few reported that they knew their sexual partner’s status.ConclusionsALHIV are in dire need of comprehensive sexual and reproductive health services and information including a range of contraceptive methods to prevent pregnancy, knowledge about preventing mother-to-child transmission and having a healthy pregnancy, skills related to HIV disclosure and condom negotiation to prevent horizontal transmission, and screening for sexual violence for both males and females if services are available.

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Advances in and improved access to antiretroviral therapy (ART) have resulted in HIV becoming a chronic illness with children born with HIV living into adolescence and adulthood
Interested researchers would be able to Understanding and meeting the reproductive health needs of adolescents living with HIV (ALHIV) is a growing concern since advances in antiretroviral therapy mean that many ALHIV are living into adulthood and starting to have sex
ALHIV are in dire need of comprehensive sexual and reproductive health services and information including a range of contraceptive methods to prevent pregnancy, knowledge about preventing mother-to-child transmission and having a healthy pregnancy, skills related to HIV disclosure and condom negotiation to prevent horizontal transmission, and screening for sexual violence for both males and females if services are available

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Advances in and improved access to antiretroviral therapy (ART) have resulted in HIV becoming a chronic illness with children born with HIV living into adolescence and adulthood. Meeting the needs of adolescents living with HIV (ALHIV) ages 15–19 is critical since by this age about 25% of adolescents many adolescents in sub-Saharan Africa, where most ALHIV live, have begun childbearing[2] As such, this age group needs information and access to contraceptive methods and secondary prevention strategies to prevent re-infecting themselves and transmitting the HIV virus to their children and sexual partners [3, 4]. In the DRC, providers were uncomfortable discussing sex and providing condoms to HIV-positive young people and were confused about whether it was legal to provide family planning counseling to youth under the age of 18 [11]) These articles suggest that ALHIV ages 15–19 are at risk for unintended pregnancy; transmission of the virus to their sexual partners and children; and superinfection, whereby an HIV-infected person acquires a different strain of HIV from another HIV-infected person. Understanding and meeting the reproductive health needs of adolescents living with HIV (ALHIV) is a growing concern since advances in antiretroviral therapy mean that many ALHIV are living into adulthood and starting to have sex

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