Sexual behaviors and procreational intentions of adolescents and young adults with perinatally acquired human immunodeficiency virus infection: experience of an urban tertiary center.

Purpose: To assess sexual knowledge, behaviors, and procreational intentions of adolescents and young adults with perinatally acquired human immunodeficiency virus (PNA HIV) infection. Increasingly, children with PNA HIV infection survive to adolescence and become sexually active. Understanding their procreational intentions could aid in designing reproductive health and secondary prevention programs.

Methods: A cross-sectional survey of adolescents and young adults with PNA HIV infection at an urban tertiary center was conducted. From June 2003 through September 2004, participants completed a questionnaire that inquired about their sexual knowledge and behaviors. Participants aware of their diagnoses also completed items regarding procreational intentions.

Results: Seventy-four percent (57/77) of eligible participants completed the survey. Thirty-three percent (19/57) of participants reported having had penile-vaginal intercourse, 89.4% of them after learning of their HIV status. Fifty percent (5/10) of sexually active female participants had been pregnant. Among the 50 participants who were aware of their diagnosis, 70% (n = 35) expressed intent to have children. A majority of those aware of the risk of maternal-to-child transmission (MTCT) (71.1%) expressed intent to procreate. Participants who perceived MTCT as low were more likely to express intent to procreate than those who perceived the risk of MTCT as high.

Conclusions: Adolescents with PNA HIV infection are becoming sexually active and express intent to have children. This has important implications for secondary prevention of HIV infection. These adolescents need innovative intervention programs offering reproductive health education including procreational choices and considerations.