Reproductive health decision making among HIV-infected and at-risk adolescent females: Predictors of pregnancy and contraceptive use

Purpose: This study seeks to determine factors that influence the decisions of HIV+ and HIV- adolescent females regarding pregnancy and contraception.

Methods: Forty-four adolescent females, [14 HIV+ and 30 HIV-], attending an urban primary health care facility, exclusively serving adolescents aged 12-24, were interviewed about their attitudes regarding sexual activity, contraception, and pregnancy. An additional interview was conducted with 27 participants (10 HIV+ and 17 HIV-) reporting previous or current pregnancy. Statistical group comparisons were made, using appropriate parametric and non-parametric methods.

Results: Significantly fewer HIV+ adolescent females reported currently being in school, or having finished high school (35.7%) than their HIV- peers (73.3% p=.017). HIV+ participants reported significantly higher risk-taking behavior in several categories. HIV+ respondents reported a mean of 27.7 lifetime sexual partners while their HIV- peers reported a mean of 7.2 partners (p=.005). HIV+ participants reported believing they would have trouble becoming pregnant at higher rates than their HIV- peers (71.4% and 37.9% respectively, p=.041). All HIV+ adolescent women agreed that breastfeeding represented a risk for vertical HIV transmission (100%) when compared to their HIV- peers (64%, p=.038).

Conclusion: HIV+ adolescent women report having interrupted or incomplete education at higher rates than their HIV- peers. They also report having a greater knowledge of HIV transmission risk factors, while also reporting greater engagement in high-risk behavior affecting their health such as, multiple sexual partners, drug use, and lack of hormonal contraceptive use. Supported in part by USPHS Health Disparities Program MD00532 and RO1 HD37785.