“Someone needs to carry on the legacy of my family”: Perceptions of Childbearing and Parenting among Young Adults with Perinatally-Acquired HIV

Background: Individuals with perinatally-acquired HIV are reaching reproductive age, many of whom will eventually have children. To date most public health efforts have focused on pregnancy and secondary transmission prevention. The perspectives of young adults with perinatally-acquired HIV (YPHIV) on parenthood are not well understood. This project explored the perceptions of YPHIV regarding their childbearing motivations as well as potential rewards/challenges of parenting.

Methods: In-depth interviews were conducted with a cross-sectional sample of 33 YPHIV recruited from two pediatric infectious disease clinics in the southeast U.S. The mean age of participants was 20.5 (range 15-30 years). The majority of participants were African-American (n=29, 87.8%) and female (n=23, 69.7%). Beliefs regarding childbearing and parenting were explored. Interviews were transcribed and coded for emergent themes.

Results: The primary childbearing motivations included the desire to experience parenthood, a wish to leave a legacy, and the chance to offer and receive unconditional love from a child. Several participants indicated that parental loss intensified their desire to have children, but it also further complicated their feelings. Challenges included concerns over the cost of raising a child and future disclosure of their HIV status to a child.

Conclusions: YPHIV have a unique set of stressors related to their disease status and family of origin which influence their childbearing motivations and views on parenting. A primary task of young adulthood is establishing intimate relationships and creating a family. Specific interventions are needed to promote healthy development across the lifespan among the third generation of HIV-affected families.