Contraceptive needs of human immunodeficiency virus-infected adolescent women: a qualitative analysis.

INTRODUCTION: Adolescents and young adults represent approximately 40% of new human immunodeficiency virus (HIV) infections in the United States. Although knowledge and attitudes regarding family planning methods and use have been described in adult women living with HIV limited work has focused on adolescents and young adults. METHODS: We conducted semistructured interviews with 10 HIV-positive women aged 13-21 years. The interviews addressed contraceptive knowledge preferences experiences and pregnancy intentions. Qualitative analysis of the interviews was performed using a grounded theory approach. RESULTS: The majority (n=9) of interview participants were perinatally infected with HIV. Five respondents reported ever having been sexually active with three reporting use of hormonal contraception (all used injectable progestin). Only three women were aware of the intrauterine device and one was aware of the implant as contraceptive options. All expressed a desire for future fertility and none wanted to conceive right now. Major themes included concerns regarding hormonal contraceptive side effects the importance of avoiding HIV transmission to a partner or child and the desire to delay childbearing. Participants frequently identified their HIV care provider as their preferred source of information regarding contraception. CONCLUSIONS: This research demonstrates that young women with HIV have unmet needs for family planning services and they rely on their HIV care providers for these services. Clinicians specializing in HIV management need to be comfortable providing contraceptive counseling for highly effective methods. Collaboration between HIV care providers and adolescent-friendly family planning service providers is important to prevent unintended pregnancy in this vulnerable group of youth.