“Adolescents are often very in tune to subtle cues, so if the person speaking to them is nervous or uncomfortable, they will likely know,” said Dr. Stephanie Marhefka, professor in the University of South Florida College of Public Health’s department of community and family health.
Dr. Marhefka explored sexual health communication for adolescent girls with perinatally-acquired HIV infection (PHIV+) in comparison to girls who did not acquire infection despite the fact that their mothers were living with HIV and could have passed HIV to them (PHIV-).
The resulting article, “They said “be careful’”: sexual health communication sources and messages for adolescent girls living with perintally-acquired HIV infection,” was published in AIDS Care, and examines how HIV infection influences sexual health communication among PHIV+.
Using a sample of 30 girls living in New York city, 20 PHIV+ and 10 PHIV-, she conducted semi-structured interviews and surveys to discover with whom the girls experienced sexual health communication, their comfort levels with the communication and how that communication differed based on HIV status.
She found that girls PHIV+ were more comfortable receiving their sexual health information from their health providers, whereas PHIV- girls were more comfortable receiving that information from their caregivers.
“I suspect it could be that girls who are living with perinatally-acquired HIV have a longstanding relationship with their healthcare provider, who may, given the nature or his or her work, be inquisitive about the girls’ sexual development and activity, and be skilled in talking about it in a non-judgmental, caring manner,” Dr. Marhefka said. “Their mothers may be less comfortable talking about sex with their daughters, especially because they may be concerned about their daughters passing HIV to a sexual partner and yet may not know how to communicate that without seeming judgmental — particularly if they have guilt about passing HIV onto their daughter.”
Dr. Marhefka said girls PHIV- may visit their health care providers less frequently, thus resulting in lower trust and comfort in speaking with them on the topic.
“Caregivers may have been more proactive in talking with their girls PHIV- about sex, as they were particularly keen to prevent their daughters from acquiring HIV,” she said. “These girls had already learned that their mothers were living with HIV and their mothers may have even told the girls in the context of providing sexual health education. Because their mothers shared their own vulnerability, these girls may have been more comfortable talking with their mothers about sex than other sources.”