I definitely want grandbabies”: Guardians of adolescents with perinatally-acquired HIV reflect on dating and childbearing

background: Parents of typically developing teens are often a source of information about sexual health and relationships.  However, little is known about the information offered to adolescents with perinatally-acquired HIV (APHIV) by guardians who may provide support and guidance to their teen as they explore sexuality and childbearing. 

methods: This qualitative exploratory study involved the in-depth interviews of 18 guardians (17 females) including biological mothers (9), relatives (5) and adoptive/foster mothers (4) who care for APHIV.  Interviews explored views regarding their adolescent’s engagement in romantic relationships, sexual behaviors, and childbearing.  The guardian’s knowledge of mother-to-child-transmission (MTCT) was also assessed for accuracy.  Transcribed interviews were coded for emergent themes. 

results:  Results indicated that the majority of guardians discussed sexual health and dating with their adolescent.  However, guidance regarding disclosure to partners of the adolescent’s HIV status varied.  Biological mothers and relatives cautioned against disclosure, contrary to foster/adoptive mothers.  Most guardians wanted their adolescent to experience parenthood.  Reasons affirming childbearing included the belief their child would be a good parent, their child desired to be a parent, childbearing as a normative experience, and decreased HIV-related stigma.  Biological mothers and most relatives did not know the risk of MTCT, as opposed to all foster/adoptive mothers who accurately stated the risk was 1-2%. 

conclusions:  The type of guardian influenced the nature of shared information related to disclosure and risk of MTCT.  Sexual and reproductive health education should be provided to guardians because they could be an important source of information for APHIV.