HIV Prevention and Family Planning Use Among Adolescents on ART: Preliminary Results from the Qualitative Phase

A qualitative study conducted from 2011 to 2012 at Arthur Davidson Children's Hospital and Ndola Central Hospital aimed to understand the experiences of adolescents, their parent/guardians, and clinic staff in managing ART and address the sexual and reproductive health needs of adolescents. The study involved in-depth interviews with 32 adolescents, 23 of their parent/guardians, and 10 clinic staff members. The adolescents were aged 15-18 and were on ART. The interviews were conducted in two phases, with the first phase focusing on learning HIV status, starting ART, and factors that facilitate or hinder daily ART adherence. The second phase explored sexual and reproductive health experiences and the views of parent/guardians and clinic staff. Preliminary findings indicate that family support plays a crucial role in ART adherence. Adolescents reported that their family members often remind and encourage them to take their ART, and some parent/guardians even administer the medication to them. Clinic staff also emphasized the importance of family and friends' involvement in improving adolescent ART adherence. However, several barriers to ART adherence were identified, including arriving home late or being away from home, fear of disclosure, and lack of understanding of the importance of ART. Some adolescents and parent/guardians also reported that youth forget to take their ART due to lack of reminders or forgetfulness. Regarding sexual and reproductive health, about one-third of adolescents discussed having ever had sex, with most reporting consensual sex. However, disclosure of HIV status to sex partners was rare, with only one female youth discussing disclosure. The few sexually active adolescents reported using condoms or abstinence to prevent pregnancy and prevent infecting their partners. Misconceptions about HIV prevention and family planning methods were also prevalent among the adolescents. Some adolescents discussed ineffective methods of preventing pregnancy, such as combining Coca Cola and pain medication. Clinic staff emphasized the need for adolescents to learn about and have access to condoms to prevent unintended pregnancies and HIV transmission or re-infection. Most adolescents expressed a desire to have children in the future, with a common concern being how to have a healthy baby without infecting their partner. Clinic staff also highlighted the need for adolescents to learn about and have access to family planning counseling and services to prevent unintended pregnancies and HIV transmission or re-infection. The study team will continue to analyze the qualitative data and write up the results. In the next phase, the study team will conduct a quantitative survey to assess ART adherence and sexual and reproductive health needs among adolescents on ART. The results will inform the development of recommendations and strategies to support HIV prevention and family planning among adolescents on ART.