Marseille 2007
Marseille 2007
Abstract book
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Abstract #604  -  Assessing Sexual Risk Reduction Needs of Adolescents living with HIV in a Clinical Care Setting
Session:
  6.105: Posters A (Poster) on Monday   in  Chaired by
Authors:
  Presenting Author:   PhD Christiana Noestlinger - Institute of Tropical Medicine, Belgium
 
  Additional Authors:  Dr Sabrina Bakeera-Kitaka, Dr Nicolette Nabukeera-Barungi, Dr Addy Kekitiinwa, Prof Robert Colebunders,  
Aim:
As anti-retroviral therapy becomes increasingly available, evidence shows that young people living with HIV will need tailored support to reduce sexual risk behaviour. However there is a gap in the availability of culturally appropriate and sensitive techniques for positive prevention in this age group. The aim of this Cross sectional qualitative study was to assess the sexual risk reduction needs of adolescents living with HIV regarding transmitting HIV to sexual partners, HIV-reinfection, sexually transmitted infections, unwanted pregnancy, and protection against infertility. We also assessed determinants influencing sexual risk taking.
 
Method / Issue:
Qualitative data collection was carried out at the Paediatric Infectious Disease Clinic, Mulago Hospital, Kampala, Uganda. Qualitative data were obtained using grounded theory as methodology and focus groups (FG) as data collection technique. Eight FG with same sex adolescents were done along the following dimensions: information on health risks, motivation to reduce risk taking, and behavioural skills to act accordingly. An additional FG involved health care providers working with HIV-positive adolescents in various centers around Kampala. The adolescents filled in a brief anonymous self administered questionnaire on demographic data. Informed consent was obtained. Qualitative data was analyzed inductively by constant manual comparison and using two independent raters.
 
Results / Comments:
Between October and December 2006, 75 adolescents and young people aged 11 to 21 (median=16) years were recruited, of whom 35 (46.7%) were female. Sixty four (85.6%) had presumed vertical transmission of HIV and 66 (88%) were on anti retroviral therapy. None of them was married but 17 (22.7%) reported having a sexual partner. Nineteen (25.4%) reported prior or current sexual intercourse. The focus group discussions revealed misconceptions about reproductive health, HIV transmission, contraceptive methods and condoms. Adolescents motivations to protect themselves and others included having goals in life and hope for finding a cure for HIV. Being satisfied with counseling positively influenced their motivation to adopt preventive behaviors. Adolescents had more concerns about unwanted pregnancies than STD- or HIV re-infection. Barriers to the motivation to protect themselves and others included peer pressure, poverty, stigma, lack of guidance, partners pressure, alcohol use, loss of hope for living and a desire to have children. Behavioral skills that promoted protecting themselves and others included: avoiding environments that could lead to sex, being assertive, condom use and masturbation. Disclosure of sero-status to their sexual partners was reported to be difficult because of fear of rejection and stigma. Gender- as well as developmental differences were observed in adolescents' perceptions.
 
Discussion:
Adolescents living with HIV are a potential source of infection to others. They still have knowledge gaps and are challenged by peer pressure, stigma and poverty which are a hindrance to disclosure and adoption and maintenance of sexual risk reduction. The findings of this research should inform the development of a tailored developmentally appropriate intervention to support youth living with HIV in reducing sexual risks.
 
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