“Let's Talk about Sex”: A Qualitative Study of Rwandan Adolescents' Views on Sex and HIV

Nuil, Jennifer Ilo Van; Mutwa, Philippe R.; Asiimwe‐Kateera, Brenda; Kestelyn, Evelyne; Vyankandondera, Joseph; Pool, Robert; Ruhirimbura, John; Kanakuze, Chantal; Reiss, Peter; Geelen, Sibyl P. M.; Wijgert, Janneke van de; Boer, Kimberly R.

doi:10.1371/journal.pone.0102933

Cited by 11 publications

(8 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This indicates that adolescents were facing a dual pressure with rejection and infection in intimate relationships. Similar findings have been reported in Canada, the United States, and Rwanda [ 21 , 22 , 36 ]. Most adolescents in this study had learned about the risk of HIV transmission and the preventive methods, but they had limited information on the ways to develop intimate partnerships and disclose HIV status to others.…”

Section: Discussionsupporting

confidence: 89%

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

et al. 2018

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 89%

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

et al. 2018

View full text Add to dashboard Cite

show abstract

“…These findings reinforce reports from adolescent consultations and qualitative studies of there being a disparity between adolescent needs and the limited information and services they receive [18,28–30]. This requires urgent attention, given the importance of these services in preventing new infections and unwanted pregnancies.…”

Section: Discussionsupporting

confidence: 77%

HIV treatment and care services for adolescents: a situational analysis of 218 facilities in 23 sub‐Saharan African countries

Mark

Armstrong

Andrade³

et al. 2017

Journal of the International AIDS Society

View full text Add to dashboard Cite

Introduction: In 2013, an estimated 2.1 million adolescents (age 10–19 years) were living with HIV globally. The extent to which health facilities provide appropriate treatment and care was unknown. To support understanding of service availability in 2014, Paediatric‐Adolescent Treatment Africa (PATA), a non‐governmental organisation (NGO) supporting a network of health facilities across sub‐Saharan Africa, undertook a facility‐level situational analysis of adolescent HIV treatment and care services in 23 countries.Methods: Two hundred and eighteen facilities, responsible for an estimated 80,072 HIV‐infected adolescents in care, were surveyed. Sixty per cent of the sample were from PATA's network, with the remaining gathered via local NGO partners and snowball sampling. Data were analysed using descriptive statistics and coding to describe central tendencies and identify themes.Results: Respondents represented three subregions: West and Central Africa (n = 59; 27%), East Africa (n = 77, 35%) and southern Africa (n = 82, 38%). Half (50%) of the facilities were in urban areas, 17% peri‐urban and 33% rural settings. Insufficient data disaggregation and outcomes monitoring were critical issues. A quarter of facilities did not have a working definition of adolescence. Facilities reported non‐adherence as their key challenge in adolescent service provision, but had insufficient protocols for determining and managing poor adherence and loss to follow‐up. Adherence counselling focused on implications of non‐adherence rather than its drivers. Facilities recommended peer support as an effective adherence and retention intervention, yet not all offered these services. Almost two‐thirds reported attending to adolescents with adults and/or children, and half had no transitioning protocols. Of those with transitioning protocols, 21% moved pregnant adolescents into adult services earlier than their peers. There was limited sexual and reproductive health integration, with 63% of facilities offering these services within their HIV programmes and 46% catering to the special needs of HIV‐infected pregnant adolescents.Conclusions: Results indicate that providers are challenged by adolescent adherence and reflect an insufficiently targeted approach for adolescents. Guidance on standard definitions for adherence, retention and counselling approaches is needed. Peer support may create an enabling environment and sensitize personnel. Service delivery gaps should be addressed, with standardized transition and quality counselling. Integrated, comprehensive sexual reproductive health services are needed, with support for pregnant adolescents.

show abstract

“…Similarly, qualitative research conducted among women report that although they are aware of the benefits of disclosing their status to sexual partners, the fear of abandonment, violence and being blamed for bringing HIV to the family prevent them from sharing their status with their partners [49-52]. These findings are consistent for adult males and adolescents who do not disclose their HIV serostatus to sexual partners in fear of being stigmatized [48, 53-56]. …”

Section: Introductionmentioning

confidence: 91%

“…Other qualitative research suggest that adolescents with perinatally acquired HIV who are deciding whether to disclose to their partners face barriers related to lack information and skills about how to disclose their HIV serostatus to sexual partners [47, 48]. Similarly, qualitative research conducted among women report that although they are aware of the benefits of disclosing their status to sexual partners, the fear of abandonment, violence and being blamed for bringing HIV to the family prevent them from sharing their status with their partners [49-52].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Interventions Promoting HIV Serostatus Disclosure to Sexual Partners: A Systematic Review

2015

View full text Add to dashboard Cite

Disclosure of HIV serostatus to sexual partners is mandated within certain states in the United States and other countries. Despite these laws implemented and public health efforts to increase disclosure, rates of disclosure to sexual partners among people living with HIV (PLWH) remain low, suggesting the need for interventions to assist PLWH with the disclosure process. We conducted a systematic review of studies testing whether HIV serostatus disclosure interventions increase disclosure to sexual partners. We searched six electronic databases and screened 484 records. Five studies published between 2005 and 2012 met inclusion criteria and were included in this review. Results showed that three of the HIV serostatus disclosure-related intervention studies were efficacious in promoting disclosure to sexual partners. Although all three studies were conducted in the United States the intervention content and measurements of disclosure across the studies varied, so broad conclusions are not possible. The findings suggest that more rigorous HIV serostatus disclosure-related intervention trials targeting different populations in the United States and abroad are needed to facilitate disclosure to sexual partners.

show abstract

“Let's Talk about Sex”: A Qualitative Study of Rwandan Adolescents' Views on Sex and HIV

Cited by 11 publications

References 30 publications

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

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

HIV treatment and care services for adolescents: a situational analysis of 218 facilities in 23 sub‐Saharan African countries

Effectiveness of Interventions Promoting HIV Serostatus Disclosure to Sexual Partners: A Systematic Review

Contact Info

Product

Resources

About