Knowledge, sexual behaviors, pregnancy experiences and HIV prevention among adolescents living with HIV from early childhood in Dar es salaam, Tanzania

Abstract

Background: Due to the widespread use of antiretroviral therapy, most children who have been living with HIV/AIDS from a young age are healthy and reach their adolescence and early adulthood. While most of these adolescents have started exploring their sexuality, their preventive practices are reported to be inadequate thus increasing the risk for onward transmission of the infection. In Tanzania not much has been done on this subject and hence there is no enough data to inform the intervention programmes targeting this population. Objective: This study aimed at assessing knowledge, sexual behaviours, pregnancy experiences and HIV preventive practices of adolescents who have been living with HIV from early childhood. The results that have been obtained will be chanelled to programmes providing care to these adolescents inorder to institute appropriate interventions. Methodology: This was a cross sectional study which was carried out at five Care and Treatment Centres (CTC) led by the Management and Development for Health (MDH) programme for a period of 9 months. The study population included adolescents of 10-19 years of age who have been living with HIV from early childhood. The study used both quantitative and qualitative methods. Quantitative data was collected using structured questionnaires while qualitative data was gathered through indepth interviews. Analysis of quantitative data was done using SPSS while that for qualitative data was done through content analysis.

Results: The study enrolled 300 adolesents. Over 80% of them could correctly identify the means through which HIV can be transmitted and prevented. Thirty nine percent of these adolesecents had had penetrative sex and 22% reported to have had unprotected sex at least once. The only significant risk factor for unprotected sex was having lost a mother. About 10 % of the female adolescents reported to have ever been pregnant with about a third of these having living children. The main findings from the qualitative data were that the poor preventive practices were a consequence of fear of disclosure of HIV status to sexual partners, fear of rejection by the partners and sense of powerlessness shown by the women in negotiating safer sex.

Conclusion: Adolescents who have been living with HIV from early childhood have good knowledge on HIV transmission and prevention. Penetrative sex among them is common however their preventive practices are poor thus posing a risk for secondary transmission of HIV. Recommendation: There is a need for programmes dealing with HIV infected adolescents to concentrate their care on the issues regarding sexual and reproductive health especially on promotion of safer sex, disclosure of HIV status to sexual partners and women empowerment in order to prevent secondary transmission of HIV/AIDS.