Comfort Lizelle, Watnick Dana, Peskin Melissa, Gutierrez Julie, Abadi Jacob, Atrio Jessica
Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA.
Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, USA.
Reprod Female Child Health. 2022 Sep;1(1):42-50. doi: 10.1002/rfc2.9. Epub 2022 Jul 7.
The aim of this study was to describe the sexual and reproductive goals of female adolescents with human immunodeficiency virus (HIV) in an urban cohort and decipher if they vary depending on the mode of HIV acquisition.
We conducted in-depth qualitative interviews with 25 Black and/or Hispanic/Latinx female adolescents living with HIV (14 perinatally, 11 behaviourally acquired) aged 17-25 years who have access to care and antiretroviral therapy at an urban public hospitals (NYC, NY). Interviews were transcribed, coded and analysed using thematic analysis.
Interviews demonstrated that access to antiretroviral therapy and HIV disclosure to a sexual partner were critical aspects of sexual health for the majority of participants. Persons with perinatal HIV defined motherhood as a source of self-validation and were confident that antiretroviral therapy prevents HIV transmission. Persons with behaviourally acquired HIV viewed their status as an insurmountable barrier that will prevent them from attaining sexual intimacy with a partner and expressed persistent concerns about HIV transmission during pregnancy despite reassurance from medical providers.
Sexual and reproductive perspectives of adolescents/young women living with HIV are multifactorial, highly stigmatized, and likely influenced by the mode of HIV acquisition. This population may benefit from patient-centred care models, including sexual health counselling that addresses sexual agency, intimacy, parenting and transmission risk reduction.
本研究旨在描述城市队列中感染人类免疫缺陷病毒(HIV)的女性青少年的性与生殖目标,并解读这些目标是否因HIV感染方式而异。
我们对25名年龄在17至25岁之间、感染HIV的黑人及/或西班牙裔/拉丁裔女性青少年进行了深入的定性访谈(14名通过母婴传播感染,11名通过行为感染),她们在纽约市的一家城市公立医院接受护理和抗逆转录病毒治疗。访谈内容经转录、编码,并采用主题分析法进行分析。
访谈表明,对于大多数参与者而言,获得抗逆转录病毒治疗以及向性伴侣披露HIV感染情况是性健康的关键方面。母婴传播感染HIV的人将母亲身份视为自我认可的来源,并确信抗逆转录病毒治疗可预防HIV传播。行为感染HIV的人认为自己的感染状况是一个无法逾越的障碍,这将阻止他们与伴侣建立亲密关系,并且尽管医疗人员给予了安慰,但她们仍持续担心怀孕期的HIV传播问题。
感染HIV的青少年/年轻女性的性与生殖观念是多因素的,受到高度污名化,并且可能受到HIV感染方式的影响。这一人群可能受益于以患者为中心的护理模式,包括提供针对性健康的咨询服务,内容涉及性自主权、亲密关系、为人父母以及降低传播风险等方面。