Abstract
With widespread access to antiretroviral therapy in the United States, many perinatally HIV-infected (PHIV+) children are
surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The
literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard
for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish
reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive
decisions, better understanding of factors influencing the decision-making process is needed to help inform the development
of salient treatment and prevention interventions. To begin addressing this understudied area, a “think tank” session, comprised
of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD,
on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making
of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention
for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative
studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged,
including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration
of psychosocial services with medical management, and how to design future research studies. Case examples are presented and
model program components proposed.
surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The
literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard
for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish
reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive
decisions, better understanding of factors influencing the decision-making process is needed to help inform the development
of salient treatment and prevention interventions. To begin addressing this understudied area, a “think tank” session, comprised
of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD,
on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making
of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention
for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative
studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged,
including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration
of psychosocial services with medical management, and how to design future research studies. Case examples are presented and
model program components proposed.
- Content Type Journal Article
- Category Methodological Notes
- Pages 1-12
- DOI 10.1007/s10995-012-1070-3
- Authors
- Cynthia Fair, Elon University, CB 2338, Elon, NC 27244, USA
- Lori Wiener, National Cancer Institute, Center for Cancer Research, 9000 Rockville Pike, Building 10, Pediatric Clinic I-SE, Room 1-6466, Bethesda, MD 20892, USA
- Sima Zadeh, Pediatric Oncology Branch, National Cancer Institute, 10 Center Drive, Building 10, Room 1-5460, Bethesda, MD 20892, USA
- Jamie Albright, Elon University, CB 3362, Elon, NC 27244, USA
- Claude Ann Mellins, Departments of Psychiatry and Sociomedical Sciences, HIV Center for Clinical and Behavioral Studies, Columbia University and the New York State Psychiatric Institute, New York, NY 10032, USA
- Michael Mancilla, Burgess/SIS Clinics, Children’s National Medical Center, 111 Michigan Ave NW # 3600, Washington, DC 20010, USA
- Vicki Tepper, Pediatric Immunology and Rheumatology, Pediatric AIDS Program, University of Maryland School of Medicine, 737 W. Lombard Street, Room 244, Baltimore, MD 21201, USA
- Connie Trexler, Adolescent Clinical Research, Burgess Clinic, Children’s National Medical Center, 111 Michigan Ave., NW, Washington, DC 20010, USA
- Julia Purdy, National Institutes of Health, Clinical Center/CCMD, Bldng. 10, Room 2C145, MSC 1662, Bethesda, MD 20892, USA
- Janet Osherow, Pediatric Infectious Disease Department, Georgetown University Hospital, 3800 Reservoir Rd. NW, 2nd Floor, PHC, Washington, DC 20007, USA
- Susan Lovelace, Pediatric Immunology, University of Maryland, 737 W. Lombard Street, Rm 240, Baltimore, MD 21201, USA
- Suad Kapetanovic, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, 10-CRC, Room 6-5340, 10 Center Drive, MSC 1276, Bethesda, MD 20892-1276, USA
- Journal Maternal and Child Health Journal
- Online ISSN 1573-6628
- Print ISSN 1092-7875