Young people with perinatal HIV infection face unique sexual and reproductive health challenges requiring tailored, inclusive, evidence-based interventions integrated within holistic HIV care.
Key Findings
Background
Young people with perinatal HIV infection are born into multigenerational families living with HIV, creating unique disclosure challenges where personal HIV disclosure risks exposing family members' status.
Perinatal HIV is described as a 'stigmatizing sexually transmissible infection'
Adolescents must navigate disclosure in a context where revealing their own status could simultaneously disclose the HIV status of parents or siblings
The paper identifies this multigenerational family dynamic as a distinguishing feature of perinatal versus behaviorally acquired HIV
Results
Rates of sexually transmitted infections in young people with perinatal HIV are broadly comparable to their peers, but rates of human papillomavirus (HPV) infection and persistence are higher.
Higher rates of HPV infection and persistence were specifically identified as a concern compared to age-matched peers
The elevated HPV burden highlights the importance of early prevention strategies including vaccination and screening
Gaps exist in the optimal vaccine schedule and age of screening onset for this population
Results
Rates of intimate partner violence and unplanned pregnancy in adolescence are high among young people with perinatal HIV.
Adverse maternal and neonatal outcomes were identified, including higher rates of preterm birth and low birth weight infants compared to age-matched peers
Unplanned pregnancy rates in adolescence were specifically flagged as elevated in this population
Intimate partner violence was identified as a significant co-occurring issue
Results
Vertical (mother-to-child) HIV transmission rates among young people with perinatal HIV who become pregnant are reassuringly low, but maternal health outcomes are of growing concern.
Maternal health concerns are driven by prolonged HIV infection and its long-term complications
Comorbidities negatively impacting pregnancy include hypertension, diabetes, and renal disease
The paper describes maternal outcomes as 'of growing concern' despite low vertical transmission rates
Discussion
Significant research gaps persist regarding fertility, contraception, pregnancy, and outcomes for HIV-exposed uninfected infants born to mothers with perinatal HIV.
The paper identifies fertility, contraception, pregnancy, and HIV-exposed uninfected infant outcomes as areas with insufficient evidence
HIV-exposed uninfected infants represent a distinct population whose outcomes have not been adequately studied in the context of perinatal HIV mothers
These gaps are identified as priorities for future research
Conclusions
Tailored sexual and reproductive health education addressing HIV stigma, contraception access, and disclosure support is needed for young people with perinatal HIV.
The paper emphasizes interventions must be 'inclusive, nonjudgemental, accessible, evidence-based'
Services should be 'integrated within holistic HIV care' and 'tailored to their needs and voiced by them'
Addressing the disclosure process is highlighted as a specific support need distinct from the general adolescent population
What This Means
This research summarizes the unique sexual and reproductive health challenges faced by young people who were born with HIV (perinatal HIV). Unlike people who acquire HIV later in life, these individuals grow up in families where multiple members may be living with HIV, making decisions about disclosing their own HIV status complicated — telling someone they have HIV could inadvertently reveal a parent's or sibling's status as well. The paper finds that while their rates of most sexually transmitted infections are similar to peers their age, they have notably higher rates of HPV infection that persists longer, raising concerns about cancer risk. They also experience high rates of intimate partner violence and unplanned teenage pregnancy, and when they do become pregnant, their babies are more likely to be born premature or underweight compared to babies of HIV-negative mothers the same age.
This research suggests that as the first generation born with HIV grows into adulthood, new health challenges are emerging. Although the risk of passing HIV to their own babies is low, the mothers themselves face increasing health complications from decades of living with HIV — including high blood pressure, diabetes, and kidney disease — all of which can complicate pregnancy. The paper also points out major gaps in scientific knowledge about how HIV and its treatments affect fertility, contraception choices, and the health of babies born to these mothers.
The paper calls for health services specifically designed for this group that are non-judgmental, easy to access, and built around what young people with perinatal HIV actually say they need. This matters because this population is growing globally as HIV treatment allows people born with the virus to survive into adulthood, and healthcare systems have not fully adapted to meet their distinct reproductive health needs.
Foster C. (2026). Sexual and reproductive health issues facing young people with perinatal HIV infection.. AIDS (London, England). https://doi.org/10.1097/QAD.0000000000004274