Factors that Influence Sexual and Reproductive Health Information Offered to Adolescents with Perinatally Acquired HIV: An Ecological Analysis of Provider Perspectives.

The goal of our project was to examine health and social service provider views of factors that influence the nature and timing of sexual and reproductive health (SRH) information shared with adolescents with perinatally acquired HIV (PHIV). Health care (n = 6) and social service (n = 7) providers (11.6 mean years caring for adolescents with PHIV) completed audio-recorded interviews that were transcribed, and coded for emerging themes. Analyses revealed multiple levels of influence best understood in the context of the ecological model. Adolescent factors included cognitive development, comfort level with sexuality talk, and disclosure status. Guardian/parent hesitancy, values, and concerns regarding disclosure comprised the microsystem. Exosystem-level factors included disclosure as a prerequisite to SRH education, provider comfort, and relationship with the adolescent. Finally, broader structural aspects of the macrosystem included mandatory disclosure laws and quality of school-based SRH education. Across systems, findings underscored the central importance of disclosure in the provision of SRH information.