“Don't Tell Him You Have HIV Unless He's ‘The One’”: Romantic Relationships Among Adolescents and Young Adults with Perinatal HIV Infection

Abstract

Individuals with perinatally-acquired HIV (PHIV) are surviving into young adulthood. Previous literature has explored the sexual behavior of those with PHIV. However, their perspectives on navigating romantic relationships are not well understood. Semi-structured interviews were conducted with 35 young adults living with PHIV recruited from two pediatric infectious disease clinics in the southeast United States. The majority of participants were African American (n=27, 77.2%), female (n=23, 65.7%), and the mean age was 20.7 (range 15-30) years. Questions focused on experiences with dating and romantic relationships as well as relationship advice for others living with HIV. Transcribed interviews were coded for emergent themes. Qualitative analyses revealed that the majority of participants have dated and struggled with their HIV status in their intimate relationships. The majority of those who disclosed their HIV status to past partners had experienced some form of rejection. However, several participants reported receiving support upon disclosure. Some individuals had never disclosed to a romantic partner, but carefully managed intimacy by delaying dating, terminating relationships, and "taking it slow." Advice fell into two broad categories: "be safe" which referred to the physical protection of self and partners, as well as emotional protection from possible rejection. The second advice category was basic encouragement which stressed the importance for young adults living with HIV to have hope that they would find a supportive partner and to be patient. The focus of education must include not only transmission risk factors, but also developing and maintaining healthy relationships in the context of a highly stigmatized illness.

Easing the Transition of HIV-Infected Adolescents to Adult Care

“…The majority young adults with perinatally-acquired HIV participating in one recent survey have struggled with disclosure of their HIV status in intimate partner relationships. 13 Concerns about stigma and disclosure are prevalent in both perinatally and behaviorally infected youth and among their adolescent providers. This is often an important issue underlying delays in transition as pediatric/ adolescent HIV care may be perceived as more likely to afford anonymity.…”

The Reproductive Health Behaviors of HIV-Infected Young Women in the United States: A Literature Review

“…Four studies were qualitative. 8,[33][34][35] Nine studies had HIV-uninfected counterparts as part of the analytic sample to serve as a comparison group. 14,25,28,31,[36][37][38][39][40] Ten studies focused on samples of only young women, 8,9,14,19,25,28,31,33,39,41 while the remainder had samples that included both young men and women.…”

“…8,9,19,21,[25][26][27][28] Because of a recently published review article on PHIV adolescents, 7 we only included eight articles focused on just PHIV. 33,[35][36][37][38][40][41][42] Those were published since the review or were outside the scope of the review; one was included in the review, but is highlighted here from a different perspective. 41 The remaining studies 670 CARTER ET AL.…”

“…33 Another qualitative study of PHIV young adults found that they were also generally more cautious with trust and physical intimacy in their romantic relationships, and expressed optimism that they and other PHIV would find loving, supportive partners (see also ''disclosure'' below). 35 Four studies described physical, sexual, and/or emotional abuse within the past and current relationships of HIV-infected young women. In a survey of 118 BHIV young women, 89% reported childhood victimization (physical or sexual abuse, neglect, or witnessing violence as a child) and 50% reported experiencing or witnessing violence as an adult.…”

Life Experiences of Youth Who Were Born with HIV Infection in Puerto Rico: The Voices of Young Survivors

“…But this has also tended to reduce the visibility of perinatally-infected persons of all ages and the understanding that they have needs different from those of behaviorally-infected counterparts. The current effort should therefore boost advocacy for this population (Fair & Albright, 2012).…”