Germain Trottier

Romantic relationships and sexual activities of the first generation of youth living with HIV since birth

Abstract HIV-infected children, now maturing into adolescence and adulthood, must cope not only with adolescent developmental issues, but also with a chronic, socially stigmatised and sexually transmittable illness. Little research on this first generation of survivors has focused on romantic involvement and sexuality. This study, which employs a mixed-method embedded strategy (qualitative supported by quantitative), describes the perspectives of youth living with HIV since birth concerning: (1) romantic involvement and sexuality; and (2) risk management including the risk of HIV transmission and partner serostatus disclosure. Eighteen adolescents aged 13–22 from Montreal, Canada, participated in individual semi-structured interviews and completed self-report questionnaires. Most youths participated in non-penetrative sexual activities. Ten participants reported having had vaginal and three anal intercourses, at an average age of 14 for girls and 15 for boys. All sexually active youth reported having used a condom at least once. Of those who reported that their first sexual relationship was protected, over half had taken risks in subsequent relationships (e.g., unprotected sex, multiple partners, etc.). Interviews conducted with sexually inactive youths illustrate the interrelatedness of romantic involvement, sexual initiation and potential serostatus disclosure. Involvement in a sexual relationship would not be conceivable unless the partner was informed of their serostatus. For sexually active participants, risk management implies HIV transmission and partner disclosure. These youths have emotional issues regarding disclosure in romantic relationships and few risked potential rejection by disclosing. Condom use acts as a reminder of the infection and a barrier to intimacy. The narratives illustrate how risk perception changes and becomes relative with time and experience, especially when the viral load is undetectable and when past experience has convinced the adolescent that his/her partner might not become infected. Findings reinforce the need to prioritise sexual health issues for young people with perinatally acquired HIV.

The Importance of Meanings of Antiretroviral Treatment and Care Providers for Adherence and Transitioning to Adult Services Among Youth With Perinatally Acquired HIV Infection

The transition from pediatric to adult services for youth with perinatally acquired HIV (PaHIV) is a critical period. A successful transition is key to ensuring patient treatment adherence as adults. Eighteen youths with PaHIV, aged 13–22, participated in two individual, semistructured interviews conducted 3 years apart. Results indicate that a key factor appearing to help youth in overcoming barriers to adherence and facilitating coping strategies is the way they perceive their medication: youth with positive perceptions are more likely to overcome the barriers than are those with negative perceptions, such as emphasis on the side effects and stigma associated with the medication. Positive relationships with health professionals allowed youth to face transitioning challenges. Interventions targeting PaHIV should focus on these issues.

Transition to adult clinics in youth living with HIV since birth

Background For youth living with HIV, transition from childhood to adulthood is also a transition from child to adult HIV health care clinics. Related studies show the more youth are spending time in pediatric services the more difficult the transition is likely to be. It appears many factors can facilitate or cause difficulties in the transition process; including individual factors and environmental factors. In this study we explore the transition process from child to adult HIV health care clinics through personal experiences of young adults infected by perinatal transmission.