June 10, 2011
Individuals infected with HIV as children, now reaching adolescence and adulthood, are confronted not only with the typical issues of adolescent development but also with a chronic illness that is sexually transmissible and socially stigmatized. The authors of the current study noted that little research has assessed the romantic involvement and sexuality of this first generation of HIV survivors.
The study employed a mixed-method embedded strategy (qualitative supported by quantitative). It describes the perspectives of youths living with HIV since birth concerning romantic involvement and sexuality, and risk management, including the risk of HIV transmission and partner serostatus disclosure. In Montreal, 18 youths ages 13 to 22 took part in individual semi-structured interviews and completed self-report questionnaires.
Most youths reported participating in non-penetrative sexual acts. Ten reported having had vaginal and three anal intercourse at an average age of 14 for girls and 15 for boys. Having used a condom at least once was reported by all the youths who were sexually active. Among those who reported using protection during their first sexual relationship, more than half had taken risks (e.g., unprotected sex, multiple partners, etc.) in subsequent relationships.
The responses of sexually inactive youths illustrated "the interrelatedness of romantic involvement, sexual initiation, and potential serostatus disclosure," the authors wrote. "Involvement in a sexual relationship would not be conceivable unless the partner was informed of their serostatus." Among sexually active respondents, risk management implies HIV transmission and partner disclosure. These young people "have emotional issues regarding disclosure in romantic relationships, and few risked potential rejection by disclosing."
"Condom use acts as a reminder of the infection and a barrier to intimacy," the authors concluded. "The narratives illustrate how risk perception changes and becomes relative with time and experience, especially when the viral load is undetectable and when past experience has convinced the adolescent that his/her partner might not become infected. Findings reinforce the need to prioritize sexual health issues for young people with perinatally acquired HIV."