Sexual and reproductive health behavior and unmet needs among a sample of adolescents living with HIV in Zambia: a cross-sectional study

Abstract

BackgroundAdolescents living with HIV face challenges, such as disclosure of HIV status, adherence to antiretroviral therapy, mental health, and sexual and reproductive health (SRH). These challenges affect their future quality of life. However, little evidence is available on their sexual behaviors and SRH needs in Zambia. This study aimed at assessing their sexual behaviors and SRH needs and identifying factors associated with marriage concerns and a desire to have children.MethodsThis cross-sectional study was conducted at the University Teaching Hospital from April to July 2014. We recruited 200 adolescents aged 15–19 years who were aware of their HIV-positive status. We collected data on their first and recent sexual behavior, concerns about marriage, and desire to have children. We used the Generalized Linear Model to identify factors associated with having concerns about marriage and desire to have children. We performed thematic analysis with open-ended data to determine their perceptions about marriage and having children in the future.ResultsOut of 175 studied adolescents, 20.6% had experienced sexual intercourse, and only 44.4% used condoms during the first intercourse. Forty-eight percent had concerns about marriage, and 87.4% desired to have children. Marriage-related concerns were high among those who desired to have children (adjusted relative risk [ARR] = 2.51, 95% CI = 1.02 to 6.14). Adolescents who had completed secondary school were more likely to desire to have children (ARR = 1.35, 95% CI = 1.07 to 1.71). Adolescents who had lost both parents were less likely to want children (ARR = 0.80, 95% CI = 0.68 to 0.95). Thematic analysis identified that major concerns about future marriage were fear of disclosing HIV status to partners and risk of infecting partners and/or children. The reasons for their willingness to have children were the desire to be a parent, having children as family assets, a human right, and a source of love and happiness.ConclusionsZambian adolescents living with HIV are at risk of engaging in risky sexual relationships and have difficulties in meeting needs of SRH. HIV care service must respond to a wide range of needs.

Sexual and reproductive health needs of young people living with HIV in low- and middle-income countries: a scoping review

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Roles and Responsibilities of Expert Clients in Adolescent HIV Service Delivery in Eswatini: A Conventional Content Analysis

“…countries (39)(40)(41). Adolescents in Eswatini are susceptible to gender-based violence, high fertility, and early sexual debut, and yet there are limited SRH and family planning services speci cally for Swazi youth (42).…”

Behavioral, Demographic, and Clinical determinants of HIV Status in Zambian Women

“…For example, Chanda-Kapata, Klinkenberg, Maddox, Ngosa, & Kapata [12] and McCarraher et al [13] found that women have higher HIV infection rates than men. Furthermore, Okawa et al [22] found that female adolescents did not understand HIV transmission methods, even though they were concerned about its effect in their future marriages. Kharsany and Karim [14] found consistent increases in HIV infection and transmission rates in Zambian women aged 18-49 years; these rates are six times higher than those of similarly aged Zambian men.…”

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