Lowering the Risk of Secondary HIV Transmission: Insights From HIV-Positive Youth and Health Care Providers

"Both perinatally and behaviorally infected HIV-positive youth engage in sexually risky behaviors, and a better understanding of the perceptions of these youth and of health care providers regarding disclosure of HIV status and risk reduction would aid in the development of behavioral interventions for such youth," according to the authors of the current study.

In spring 2007, in-depth, semi-structured interviews were conducted with some 20 HIV-positive inner-city youths (ages 13-24) and 15 health care providers who work with HIV-infected youths. The youths were recruited at an HIV clinic, AIDS clinics, and an AIDS service organization; they had received care from participating providers. A detailed contextual and thematic analysis was conducted using interview transcriptions.

Of the 20 youths, 18 had disclosed their HIV status to another person at least once; 11 reported being sexually active, and three of these had been perinatally infected. Qualitative analysis revealed four disclosure-related sub-themes: stigma and emotions, trust issues, reasons for disclosing, and strategies for addressing disclosure. Five sub-themes were identified related to sexual risk reduction: dating challenges, attitudes concerning condom use, self-efficacy in negotiating condom use, pregnancy attitudes, and sexual risk reduction strategies. Providers reported that risk reduction counseling with HIV-positive youths could be enhanced via access to more engaging and interactive educational tools within the clinical setting.

"HIV-positive youth experience multiple challenges regarding disclosure and sexual risk reduction, and health care providers need innovative tools that can be used in clinic settings to improve adolescents' skills in reducing risky sexual behavior," the authors concluded.

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