PLoS ONE: Adolescents living with HIV in Zambia are in dire need of comprehensive SRH information

1 January, 2019

Dear HIFA and HIFA-Zambia members,

'Adolescents living with HIV in Zambia are in dire need of comprehensive SRH information', say the authors of this study. Citation, abstract and selected extracts below. Full text here: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0197853

CITATION: McCarraher D.R et al. Adolescents living with HIV in the copperbelt province of Zambia: Their reproductive health needs and experiences. PLoS ONE. 13 (6) (no pagination), 2018.

ABSTRACT

Background: Understanding and meeting the reproductive health needs of adolescents living with HIV (ALHIV) is a growing concern since advances in antiretroviral therapy mean that many ALHIV are now living into adulthood and starting to have sex.

Methods: We conducted a mixed-methods study in the Copperbelt Province of Zambia to advance our understanding of the reproductive health needs of ALHIV and to assess the extent to which these needs are being met. We conducted in-depth interviews (IDIs) with 32 ALHIV from two HIV clinics, 23 with their caregivers, and 10 with clinic staff. ALHIV were interviewed twice. We used the data from the qualitative interviews to create a cross-sectional survey that we conducted with 312 ALHIV in three HIV clinics.

Findings: The vast majority of ALHIV reported they wanted to have children in the future but lacked knowledge about preventing mother-to-child transmission. Some sexually active adolescents used condoms, although they wanted more information about and access to non-condom methods. Many ALHIV reported that their first sexual encounters were forced. Religious beliefs prevented some caregivers from discussing premarital sex and contraception with ALHIV. Clinic staff and caregivers had mixed views about integrating contraceptive counseling and method provision into HIV care and treatment services. Few sexually active ALHIV reported that they disclosed their HIV status to their sexual partners and few reported that they knew their sexual partner’s status.

Conclusions: ALHIV are in dire need of comprehensive sexual and reproductive health services and information including a range of contraceptive methods to prevent pregnancy, knowledge about preventing mother-to-child transmission and having a healthy pregnancy, skills related to HIV disclosure and condom negotiation to prevent horizontal transmission, and screening for sexual violence for both males and females if services are available.

SLECTED EXTRACTS

Meeting the needs of adolescents living with HIV (ALHIV) ages 15–19 is critical since by this age about 25% of adolescents many adolescents in sub-Saharan Africa, where most ALHIV live, have begun childbearing[2]. As such, this age group needs information and access to contraceptive methods and secondary prevention strategies to prevent re-infecting themselves and transmitting the HIV virus to their children and sexual partners [3, 4].

Ninety-three percent of ALHIV surveyed wanted more information on how to have children without infecting their baby or their partner

More than three-quarters of adolescents reported wanting more information about having an HIV-negative baby, about how to not infect a sexual partner, and about contraception

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Best wishes, Neil

Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA: www.hifa.org

HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG /orcid.org/0000-0001-9557-1487 neil@hifa.org