What This Means
This research explored the sexual and reproductive health (SRH) experiences of 16 young South Africans aged 18 to 24 who were born with HIV (vertically acquired, meaning they got it from their mothers). Because HIV treatment has improved so dramatically, many children born with HIV are now surviving into adulthood, creating a generation of young people navigating relationships, sexuality, and healthcare with a lifelong condition. Researchers conducted in-depth interviews with participants at three healthcare clinics in Gauteng province, South Africa, and analyzed the conversations for common themes.
The study found three major challenges facing these young people. First, they felt uncomfortable with dating and were afraid to tell potential partners about their HIV status, fearing rejection. Second, while their families provided emotional support, parents and relatives rarely talked with them specifically about sexual health, leaving important questions unanswered. Third, despite regularly visiting healthcare facilities for HIV treatment, their individual sexual health concerns were often not addressed by healthcare workers, meaning the clinical contact that could be used to provide guidance was frequently a missed opportunity.
This research suggests that simply being in regular medical care is not enough to meet the SRH needs of young people with vertically acquired HIV. Both families and healthcare providers need to create more open, individualized conversations about sexual health with this population. Without these conversations, young people are left to navigate complex decisions — such as when and how to disclose their status to partners — largely on their own, which could have consequences for their wellbeing and for HIV prevention efforts more broadly.