Maternal HIV status, mother-daughter sexual risk communication, and adolescent behavioral beliefs

Background: Youth with an HIV-positive mother are an extremely vulnerable population; they are often exposed to the same environments which placed their mothers at risk for HIV. What is unknown is how mother-daughter sexual risk communication operates in HIV-affected families. The objective of this study was to gain a broader understanding of maternal HIV status and its influence on sexual risk communication and behavioral beliefs. Methods: Eight focus groups, 4 with HIV-positive African American women and 4 with their HIV-negative daughters' ages 14-18 years (conducted separately but simultaneously) were undertaken. Transcript-based analyses using an inductive method to identify themes and threads were conducted. Results: Mothers articulated great concern for their daughters' HIV risk. Most had spoken to their daughters about abstinence and safer sex yet many expressed concerns about whether they were the most relevant or skilled person to provide the information. Daughters' expressed that compared to their peers with HIV-negative mothers they experienced more frequent sexual risk communication and had greater comfort with communication. Further, they expressed greater fear about contracting HIV which triggered choices about abstinence and safer sex. Conclusions: Daughters of HIV-positive mothers expressed greater sexual health knowledge and risk reduction skills compared to peers as a result of mothers' serostatus and communication. Further, fear about future HIV infection triggered safer sex beliefs. Standardized HIV prevention curriculum does not take serostatus in families into account. These findings suggest that serostatus may have implications for girls' choices about sexual engagement and should be considered in future interventions.