Parenting Among Adolescents and Young Adults with Human Immunodeficiency Virus Infection in the United States: Challenges, Unmet Needs, and Opportunities

Abstract

Given the realistic expectations of HIV-infected adolescents and young adults (AYA) to have children and start families, steps must be taken to ensure that youth are prepared to deal with the challenges associated with their HIV and parenting. Literature reviews were conducted to identify published research and practice guidelines addressing parenting or becoming parents among HIV-infected AYA in the United States. Research articles or practice guidelines on this topic were not identified. Given the paucity of information available on this topic, this article provides a framework for the development of appropriate interventions and guidelines for use in clinical and community-based settings. First, the social, economic, and sexual and reproductive health challenges facing HIV-infected AYA in the United States are summarized. Next, family planning considerations, including age-appropriate disclosure of HIV status to those who are perinatally infected, and contraceptive and preconception counseling are described. The impact of early childbearing on young parents is discussed and considerations are outlined during the preconception, antenatal, and postnatal periods with regard to antiretroviral medications and clinical care guidelines. The importance of transitioning AYA from pediatric or adolescent to adult-centered medical care is highlighted. Finally, a comprehensive approach is suggested that addresses not only medical needs but also emphasizes ways to mitigate the impact of social and economic factors on the health and well-being of these young parents and their children.

Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States

“…Interventions could work with youth and providers to frame care in a holistic way that ensures youth feel comfortable coming to the clinic for services such as housing, education, reproductive health, and mental health. 32 Accessing these other services will, in turn, increase youths' connectedness to the clinic and support HCT.…”

Reproductive health perspectives of young women with perinatally and behaviourally acquired HIV: A qualitative study

“…In the United States, 1.2 million people are living with HIV, 2 and over 9500 were perinatally acquired 3 . With improved antiretroviral therapy, individuals with perinatally acquired HIV are now of reproductive age and face unique challenges as they navigate sexual relationships, fertility and pregnancies 4,5 . They have often contended with repeated hospitalizations, the stigma of HIV and the anxiety associated with the possibility of transmission to others 6,7 .…”

“…3 With improved antiretroviral therapy, individuals with perinatally acquired HIV are now of reproductive age and face unique challenges as they navigate sexual relationships, fertility and pregnancies. 4 , 5 They have often contended with repeated hospitalizations, the stigma of HIV and the anxiety associated with the possibility of transmission to others. 6 , 7 Despite concerns about transmission, the majority of persons with perinatally acquired HIV want to have children.…”