Maternal and Child Health Journal

, Volume 17, Issue 5, pp 797–808

Reproductive Health Decision-Making in Perinatally HIV-Infected Adolescents and Young Adults

  • Cynthia Fair
  • Lori Wiener
  • Sima Zadeh
  • Jamie Albright
  • Claude Ann Mellins
  • Michael Mancilla
  • Vicki Tepper
  • Connie Trexler
  • Julia Purdy
  • Janet Osherow
  • Susan Lovelace
  • Suad Kapetanovic
Methodological Notes

DOI: 10.1007/s10995-012-1070-3

Cite this article as:
Fair, C., Wiener, L., Zadeh, S. et al. Matern Child Health J (2013) 17: 797. doi:10.1007/s10995-012-1070-3

Abstract

With widespread access to antiretroviral therapy in the United States, many perinatally HIV-infected (PHIV+) children are surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive decisions, better understanding of factors influencing the decision-making process is needed to help inform the development of salient treatment and prevention interventions. To begin addressing this understudied area, a “think tank” session, comprised of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD, on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged, including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration of psychosocial services with medical management, and how to design future research studies. Case examples are presented and model program components proposed.

Keywords

HIV and reproductive healthPerinatal HIVHIV-infected youthAdolescent reproductive health

Abbreviations

ART

Antiretroviral therapy

HAART

Highly active antiretroviral therapy

HIV+

HIV-infected

MTCT

Mother-to-child-transmission

PND

Perinatal depression

PHIV+

Perinatally HIV-infected

RDM

Reproductive decision making

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Cynthia Fair
    • 1
  • Lori Wiener
    • 2
  • Sima Zadeh
    • 3
  • Jamie Albright
    • 4
  • Claude Ann Mellins
    • 5
  • Michael Mancilla
    • 6
  • Vicki Tepper
    • 7
  • Connie Trexler
    • 8
  • Julia Purdy
    • 9
  • Janet Osherow
    • 10
  • Susan Lovelace
    • 11
  • Suad Kapetanovic
    • 12
  1. 1.Elon UniversityElonUSA
  2. 2.National Cancer InstituteCenter for Cancer ResearchBethesdaUSA
  3. 3.Pediatric Oncology Branch, National Cancer InstituteBethesdaUSA
  4. 4.Elon UniversityElonUSA
  5. 5.Departments of Psychiatry and Sociomedical Sciences, HIV Center for Clinical and Behavioral StudiesColumbia University and the New York State Psychiatric InstituteNew YorkUSA
  6. 6.Burgess/SIS Clinics, Children’s National Medical CenterWashingtonUSA
  7. 7.Pediatric Immunology and Rheumatology, Pediatric AIDS ProgramUniversity of Maryland School of MedicineBaltimoreUSA
  8. 8.Adolescent Clinical Research, Burgess ClinicChildren’s National Medical CenterWashingtonUSA
  9. 9.National Institutes of HealthClinical Center/CCMDBethesdaUSA
  10. 10.Pediatric Infectious Disease DepartmentGeorgetown University HospitalWashingtonUSA
  11. 11.Pediatric ImmunologyUniversity of MarylandBaltimoreUSA
  12. 12.Division of Intramural Research ProgramsNational Institute of Mental Health, National Institutes of HealthBethesdaUSA