“I Definitely Want Kids, But I Think the Risks Are Pretty High”: Fertility Desires and Perinatal HIV Transmission Knowledge Among Adolescents and Young Adults with Perinatally-Acquired HIV
Today youth with perinatally-acquired HIV (PHIV) are living into young adulthood. Relatively little is known about their reproductive intentions or knowledge of ways to prevent perinatal HIV transmission (PHT). Interviews were conducted with 35 adolescents and young adults (AYA) (mean age 20.7 years) with PHIV recruited from two pediatric infectious disease clinics in the southeast U.S. The majority of participants were African American (n = 27, 77.1 %) and female (n = 23, 65.7 %). This cross-sectional study examined fertility desires and intentions of the maturing population of individuals with perinatally-acquired HIV (PHIV) and their knowledge of PHT. Twenty-three percent (n = 8) of participants had ever experienced a pregnancy and 14.3 % (n = 5) were current parents or pregnant. Among participants, 88.6 % (n = 31) expressed a desire to have a child in the future among whom 93.5 % (n = 29) intend to have a child. Only eight participants accurately reported the risk of PHT. The mean reported risk of PHT was 32.5 %. Age and history of pregnancy were not related to knowledge. Despite errors in estimating risk, many participants knew important information about factors that could reduce the risk of PHT including “take medicine”, “be healthy”, have a C-section, avoid breastfeeding, and maintain a low viral load. Case studies highlight the complex factors that may explain high levels of fertility desires and intentions yet low levels of PHT prevention, while also providing insight into areas for intervention. Reproductive and sexual health education must include discussion of fertility desires and intentions rather than simply focusing on pregnancy and transmission prevention as a means to heighten the effectiveness of harm reduction strategies and support the health functioning of the maturing population of youth with PHIV as they enter adulthood.
KeywordsFertility desires Perinatally-acquired HIV Perinatal HIV transmission Adolescents and young adults
We would like express our deep gratitude to the young people who shared their stories with us. 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.
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