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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