Adolescent mothers affected by HIV and their children: A scoping review of evidence and experiences from sub-Saharan Africa

Abstract

While adolescents have received increasing attention in the global HIV response and international strategies and commitments, adolescent mothers and their children remain largely overlooked in research, funding and, programming for health-related outcomes. We conducted an extensive scoping review of current evidence on the experiences of adolescent mothers affected by HIV and their children in this region. We included published literature and conference abstracts, complemented by consultations with key stakeholders, and a review of documents through grey literature searching. First, we summarise the experiences of adolescent mothers and their children related to HIV and key health and development indicators. The syndemic of early motherhood and HIV in sub-Saharan Africa increases the vulnerability of adolescent mothers and their children. We then highlight lessons from a series of promising programmes focused on supporting adolescent mothers through novel approaches. In sub-Saharan Africa, supporting adolescent mothers living in high HIV-risk communities is critical not only to eliminate HIV/AIDS, but also to attain the Sustainable Development Goals. While research on and programming for adolescent mothers and their children is growing, the complex needs for this vulnerable group remain unmet. We conclude with evidence gaps and programming priorities for adolescent mothers affected by HIV and their children.

Reproductive aspirations, contraception use and dual protection among adolescent girls and young women: the effect of motherhood and HIV status

“…Safe conception considerationsplanned pregnancies that coincide with viral suppression, but also socio-emotional readinessmust be integrated in HIV and SRH service provision for adolescent girls and young women living with HIV. It is also critical to shift away from a risk-centred narrative, promoting more nuanced evidence on young women's sexual and reproductive health needs and practices, especially among ALHIV [15,30,41]. Additional research is needed to understand which factors support adolescent girls and young women to use dual protection and have well-timed, supported pregnancies, particularly in the context of HIV.…”

“…All the rates reported below are adjusted predicted probabilities of each outcome being reported, holding age, informal housing and poverty at their mean values. Independent of HIV status, adolescent mothers were less likely to report wanting >2 children (aOR 0.57, CI 0.43 to 0.75), possibly due to the challenges already experienced [30]. Predicted probabilitiesadjusted to take into account age, informal housing and povertyshowed that aspirations for two or more children were lowest among AMLHIV (62.9%) and highest among nulliparous controls (77.4%).…”

“…First, it is the first and largest quantitative analyses of reproductive aspirations and practices of adolescent girls and young mothers living in HIV-endemic communities. Second, given the high levels of stigmatization reported by ALHIV [39,40] and adolescent mothers [30], conventional recruitment techniques for this sample would have resulted in a biased sample. The research team designed a systematic sampling approach prioritizing non-stigmatization and use of community and peer networks to increase reach and uptake among this group.…”

Understanding Mental Health in the Context of Adolescent Pregnancy and HIV in Sub-Saharan Africa: A Systematic Review Identifying a Critical Evidence Gap

“…Hence, for pregnant adolescents living with HIV, additional considerations may arise; poor mental health may have impacts on service engagement (HIV, sexual and reproductive health, antenatal) and onwards HIV transmission (i.e. prevention of mother to child transmission)-concerns critical to both adolescent and child wellbeing [89]. Adolescents living with HIV (both mothers and fathers) and their children may have specific needs, and therefore, further investigations into the mental health needs of this group are required to bolster positive outcomes for this group.…”

Adolescent, Pregnant, and HIV-Infected: Risk of Adverse Pregnancy and Perinatal Outcomes in Young Women from Southern Mozambique

“…Nevertheless, there is limited information about the interactions of the three conditions and their concomitant impact on maternal health [ 11 , 21 ]. Of note, a recent scoping review about the experiences of adolescent mothers living with HIV in SSA, concluded that information about pregnancy and perinatal outcomes of this population group was almost non-existent [ 22 ].…”