The Reproductive Health Behaviors of HIV-Infected Young Women in the United States: A Literature Review

Abstract

HIV-infected young women in the United States have important reproductive health needs that are made more complex by their HIV status. We searched Pubmed and relevant bibliographies to identify 32 articles published from 2001 to July 2012 that described the prevalence, correlates, and characteristics of the sexual activity, relationships, pregnancy intentions, HIV status disclosure, and contraceptive and condom use among US HIV-infected adolescents and young women. Our synthesis of those articles found that, like youth not infected with HIV, substantial proportions of HIV-infected youth were sexually active, and most sought romantic or sexual relationships, though their serostatus may have affected the pace of physical and emotional intimacy. Disclosure was difficult, and large proportions of HIV-infected youth had not disclosed their serostatus to recent partners. A few studies suggest that most HIV-infected young women hoped to have children in the future, but many wanted to avoid pregnancy until later. Only one study described contraceptive use among this population in detail and found that condoms were a primary method of contraception. The results point to substantial gaps in published research, particularly in the areas of pregnancy intentions and contraceptive use. Much more needs to be done in research and health services to better understand and meet the complex health needs of HIV-infected young women.

Sexuality and childbearing as it is experienced by women living with HIV in Sweden: a lifeworld phenomenological study

“…Although there has been increased access to ART, studies examining sexuality and reproduction for women living with HIV still show that HIV impacts sexuality and reproduction negatively (Carter et al, 2017a; Greene, Ion, Kwaramba, Smith, & Loutfy, 2015; Rahangdale et al, 2014). Women with HIV therefore face unique challenges, such as in partner relationships, sexual satisfaction and childbearing (Bharat & Mahendra, 2007; Carter et al, 2013; Florence et al, 2004). Many women living with HIV have a desire to give birth to a child (Carter et al, 2017b; Wessman et al, 2015), a desire which can further increase feelings of stigmatization, shame and fear (Sandelowski & Barroso, 2003; Sanders, 2008).…”

Examining the Traits-Desires-Intentions-Behavior (TDIB) Model for Fertility Planning in Women Living with HIV in Ontario, Canada

“…2 Additionally, in a sample of adolescent females living with HIV, 70-80% report a desire to have a child now or some time in the future. 6 Pregnancy desires and childbearing motivations among young women living with HIV are comparable to women who are not HIV positive. 7 Finger et al 8 found that history of victimization as a child, having fewer living children, decreased disclosure of HIV status, increased likelihood of sexual intercourse and oral sex, and decreased condom use are correlated with desire for pregnancy in sample of young women living with HIV.…”

HIV-Positive Men's Experiences with Integrated Family Planning and HIV Services in Western Kenya: Integration Fosters Male Involvement

“…3 The need and desire for FP services is substantial among HIV-positive persons in both resource-limited [4][5][6][7][8][9][10] and resource-rich [11][12][13][14] settings. The unmet need for FP services is particularly high in Kenya; one study found that nearly 70% of HIV-positive women in western Kenya indicate wishing to delay their fertility for another 2 years or not have any further children.…”