Category: OVC and HIV/AIDS

Title: Contraception in HIV-positive female adolescents

Authors: Nadia T Kancheva Landolt, Sudrak Lakhonphon, Jintanat Ananworanich

Date: 2011

Abstract:

Sexual behavior of HIV-positive youths, whether infected perinatally, through risky behavior or other ways, is not substantially different from that of HIV-uninfected peers. Because of highly active antiretroviral therapy, increasing number of children, infected perinatally, are surviving into adolescence and are becoming sexually active and need reproductive health services. The objective of this article is to review the methods of contraception appropriate for HIV-positive adolescents with a special focus on hormonal contraceptives. Delaying the start of sexual life and the use of two methods thereafter, one of which is the male condom and the other a highly effective contraceptive method such as hormonal contraception or an intrauterine device, is currently the most effective option for those who desire simultaneous protection from both pregnancy and sexually transmitted diseases. Health care providers should be aware of the possible pharmacokinetic interactions between hormonal contraception and antiretrovirals. There is an urgent need for more information regarding metabolic outcomes of hormonal contraceptives, especially the effect of injectable progestins on bone metabolism, in HIV-positive adolescent girls.

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Title: The influence of maternal HIV serostatus on mother-daughter sexual risk communication and adolescent engagement in HIV risk behaviors

Author: Julie A Cederbaum

Date: January 1, 2009

Abstract:

Objective . There is a growing body of literature that demonstrates positive parental influences on adolescents’ sexual initiation and sexual risk behaviors; little is known about how these processes operate when mom is HIV-positive. Youth of HIV-positive women are an extremely vulnerable population. They are often exposed to the same factors that placed their mothers at risk; many live in low-income, high seroprevalence inner-city areas. As these children come of age, we have the opportunity to understand parent-child sexual risk communication (PTSRC) and monitoring among HIV infected mothers, and how these behaviors may influence their child’s sexual decision-making.

Methods . Guided by a family-expansion of the Theory of Planned Behavior, this study employed a sequential mixed methods design to understand impact of maternal HIV status on maternal sexual risk communication and monitoring and in turn, how these behaviors effect daughters’ beliefs and behaviors. Phase one included 7 focus groups; this information was used to inform the development the survey instrument. Phase II was a self-administered survey completed by 110 mother-daughter dyads.

Results . Maternal HIV status was not a predictor of PTSRC or monitoring. Predictors of PTSRC included behavioral beliefs about PTSRC; relationship satisfaction was a predictor of parental monitoring. Maternal HIV status did significantly and positively influence daughters’ behavioral beliefs about the negative outcomes of sex and hedonistic beliefs about condoms. Further, maternal HIV status predicted daughters’ intentions to abstain. Child age, and normative and control beliefs also significantly predicted adolescent intention to have sex.

Conclusion . This study is one of few to explore the impact of maternal HIV status on adolescent risk behaviors. Knowledge of mother’s HIV status was predictive of behavioral beliefs; however, daughters of HIV-positive women were more likely to report ever having had sex. This shows that there is a disconnect between knowing and doing; it is this juncture that future HIV intervention must target. Important to include in future clinical and research interventions are: attention to structural factors in both physical and social community; helping families build healthy and satisfying relationships; and finding ways to create and influence community norms around abstinence and safer sex behaviors.

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Title: Growing up with HIV/AIDS: a study on adolescents with HIV/AIDS and their family caregivers

Authors: Ana Amélia Antunes Lima, Eva Néri Rubim Pedro

Date: 2008

Abstract: This is an exploratory study with a qualitative approach, which looks at the adolescent process with HIV/AIDS. The purpose is to identify how the adolescent process occurs, from the perspective of these teenagers and their family caregivers. The investigation was performed in Porto Alegre, RS between May and July 2005, and the subjects were four adolescents and three caregivers. Data were collected by means of interviews, which were subject to the content analysis technique. The study revealed that both teenagers and family caregivers did not show concern with the changes typical of the period, especially regarding sexuality questions. Yet, the underlying diagnosis and coping with HIV remain in the family core in order to protect these agents against the stigma of the disease.

 

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Title: Factors impacting on antiretroviral therapy compliance in HIV positive adolescents

Author(s): Trocomé, N, Vaudre, G, Dolfus C and G Leverger

Date: September 6, 2002

Abstract:

Is poor treatment observance frequently observed in HIV positive adolescent population, due to the adolescent developmental process, their experience of living with HIV, or lack of information on the disease or treatment?

Methods. – We interviewed the 29 HIV positive adolescents followed up in one pediatric reference center. Confidential interviews were performed according to a standard questionnaire by psychologist and research nurse.

Results. – Seventy-nine percent had stopped at least once a time their treatment who was the major barrier to their sense of freedom behind their adolescence (one-third of them decided to stop it more than one month), although 75% knew the potential consequences and had a good information about their seeks. Fifty-five percent expressed feelings of loneliness or depression, yet 75% consider they had a pleasant life because they had a normal life. In fact, the secret and silence about HIV were the price for this normality.

Conclusion. – Being dependent upon a treatment is a major constraint on the lives of HIV positive adolescents. Although they are fully informed, the deliberate interruption of treatment could attest of their expressed need for autonomy and medical prescription have to be careful with this problem.

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Title: Prevalence of parental death among young people in South Africa and risk for HIV infection

Authors: Don Operario, Audrey Pettifor, Lucie Cluver, Catherine MacPhail, Helen Rees

Date: 2007

Abstract: OBJECTIVES: This study estimated the prevalence and sociodemographic characteristics of young people in South Africa who have experienced parental death and examined associations between parental death and young people’s HIV status and sexual behaviors. DESIGN AND METHODS: Data were from a cross-sectional nationally representative household survey of 11,904 15- to 24-year-old South Africans. Surveys included items on sexual behavior and family composition, and oral fluid samples were collected to test for HIV status. RESULTS: The prevalence of parental death was 27.3% overall: 22.4% reported a father deceased, 7.9% reported a mother deceased, and 3.0% reported both parents deceased. Parental death was disproportionately associated with black ethnicity, impoverished household living conditions, lack of an adult guardian in the home, and not completing compulsory education levels. Controlling for sociodemographic factors, parental death among female participants was significantly associated with HIV-positive status (odds ratio OR = 1.25, 95% confidence interval CI: 1.08 to 1.44), ever having had oral sex (OR = 1.23, 95% CI: 1.02 to 1.49), ever having had vaginal sex (OR = 1.38, 95% CI: 1.19 to 1.60), and having more than 1 sex partner during the past year (OR = 1.33, 95% CI: 1.07 to 1.64). Among male participants, parental death was significantly associated with ever having had vaginal sex (OR = 1.19, 95% CI: 1.04 to 1.36) and having unprotected sex at the last sexual episode (OR = 1.23, 95% CI: 1.07 to 1.42). CONCLUSIONS: More than one quarter of young South Africans have experienced parental death. Death of a parent is associated with young female South Africans’ HIV status and sexual behaviors among young female and male South Africans. HIV prevention interventions are necessary to address the specific needs of young South Africans who have experienced parental death.

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Title: AIDS-Orphanhood and Caregiver HIV/AIDS Sickness Status: Effects on Psychological Symptoms in South African Youth

Authors: Lucie Cluver, Mark Orkin, Mark E Boyes, Frances Gardner, Joy Nikelo

Date: Feb, 7, 2012

Abstract: 

OBJECTIVE:

Research has established that AIDS-orphaned youth are at high risk of internalizing psychological distress. However, little is known about youth living with caregivers who are unwell with AIDS or youth simultaneously affected by AIDS-orphanhood and caregiver AIDS sickness.

METHODS:

1025 South African youth were interviewed in 2005 and followed up in 2009 (71% retention). Participants completed standardized measures of anxiety, depression, and posttraumatic stress. Comparison groups were youth who were AIDS-orphaned, other-orphaned, and nonorphaned, and those whose caregivers were sick with AIDS, sick with another disease, or healthy.

RESULTS:

Longitudinal analyses showed that both AIDS-orphanhood and caregiver AIDS sickness predicted increased depression, anxiety, and posttraumatic stress symptoms over a 4-year period, independently of sociodemographic cofactors and of each other. Caregiver sickness or death by non-AIDS causes, and having a healthy or living caregiver, did not predict youth symptomatology. Youths simultaneously affected by caregiver AIDS sickness and AIDS-orphanhood showed cumulative negative effects.

CONCLUSIONS:

Findings suggest that policy and interventions, currently focused on orphanhood, should include youth whose caregivers are unwell with AIDS.

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Title: Difference in psychosocial well-being between paternal and maternal AIDS orphans in rural China

Authors: Qun Zhao, Xiaoming Li, Xiaoyi Fang, Guoxiang Zhao, Junfeng Zhao, Xiuyun Lin, Bonita Stanton

Date: 2010

Abstract: This study compares psychosocial well-being between paternal and maternal orphans in rural China in a sample (n = 459) of children who had lost one parent to HIV and who were in family-based care. Measures included academic marks, education expectation, trusting relationships with current caregivers, self-reported health status, depression, loneliness, posttraumatic stress, and social support. No significant differences were reported between maternal and paternal orphans, except that paternal orphans reported better trusting relationships with caregivers than maternal orphans. Children with a healthy surviving parent reported significantly better scores for depression, loneliness, posttraumatic stress, and social support than children with a sick parent. Analyses showed significance with regard to orphan status on academic marks and trusting relationships with caregivers while controlling for age, gender, surviving parent’s health status, and family socioeconomic status. Results underscore the importance of psychosocial support for children whose surviving parent is living with HIV or another illness.

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