Sexual Health

Sexual health indicators among young adults living with perinatally-acquired HIV in france, a gender-stratified comparison with their peers in the general population.

TL;DR

Young adults living with perinatally-acquired HIV showed similar results regarding most sexual health outcomes compared to their peers in the general population, however PHIV women reported less sex life satisfaction and more voluntary abortion.

Key Findings

PHIV participants showed similar rates to the general population for most sexual health indicators including current romantic relationship, previous sexual experiences, same-sex sexual partners, age at first intercourse, and condom use at first sexual intercourse.

  • Data drawn from 284 PHIV participants in the ANRS-COVERTE-CO19 cohort enrolled from 2010 to 2015
  • Compared against Baromètre Santé surveys: BS10 N=2,899 and BS16 N=1,633, described as nationally representative cross-sectional surveys
  • Participants were aged 18 to 25 years
  • Analyses were carried out separately by gender

PHIV women were less likely to report a satisfactory sex life compared to their peers in the general population.

  • 86% of PHIV women reported satisfactory sex life versus 94% in the general population
  • This difference was statistically notable enough to prompt logistic regression analysis
  • HIV disclosure was associated with higher likelihood of reporting satisfactory sex life in men (aOR 4.68 [1.29–17.04])
  • Gender-stratified analysis was used throughout

PHIV women were more likely to report voluntary abortion compared to their peers in the general population.

  • 16% of PHIV women reported voluntary abortion versus 12% in the general population
  • Prevalence of use of means to avoid pregnancy was lower among PHIV participants of both genders
  • The combination of lower contraceptive use and higher voluntary abortion rates was specific to PHIV women

Prevalence of use of means to avoid pregnancy was lower among PHIV participants of both genders compared to the general population.

  • This finding applied to both male and female PHIV participants
  • The lower use of pregnancy-avoidance methods may be related to HIV-specific concerns or counseling practices
  • This finding was identified via standardized rate comparisons between PHIV participants and pooled weighted rates from the general population

HIV disclosure was associated with a higher likelihood of reporting a current romantic relationship in PHIV women.

  • Adjusted odds ratio for current romantic relationship associated with HIV disclosure in women: aOR 4.40 [95% CI: 1.94–9.95]
  • Logistic regression was performed to assess associations between differing indicators and three HIV-specific variables
  • HIV disclosure was one of three HIV-specific variables examined

HIV disclosure was associated with a higher likelihood of reporting a satisfactory sex life in PHIV men.

  • Adjusted odds ratio for satisfactory sex life associated with HIV disclosure in men: aOR 4.68 [95% CI: 1.29–17.04]
  • Logistic regression was performed only where indicators differed between PHIV and general population
  • This association was found specifically in men, while the satisfactory sex life deficit was observed in women

The study used a gender-stratified comparison design drawing on two data sources: a prospective PHIV cohort and nationally representative general population surveys.

  • PHIV data came from baseline questionnaires of the ANRS-COVERTE-CO19 cohort, enrolled 2010–2015, N=284
  • General population data came from pooled Baromètre Santé surveys conducted in 2010 (N=2,899) and 2016 (N=1,633)
  • Standardized rates among PHIV participants were compared with pooled weighted rates from the general population
  • The COVERTE study received approval from CPP III (n°2738); BS surveys approved by CNIL (n°915589)

What This Means

This research examined the sexual health of young adults (ages 18–25) who were born with HIV (perinatally-acquired HIV, or PHIV) in France, comparing them to their peers in the general population. The researchers used data from 284 young people living with HIV enrolled in a French cohort study and compared them to thousands of respondents from two large national health surveys. They looked at indicators such as whether participants were in a romantic relationship, their sexual experiences, use of contraception, satisfaction with their sex life, and history of abortion. The study found that, contrary to what some might expect, young adults living with perinatally-acquired HIV were broadly similar to their peers on most sexual health measures. They were equally as likely to be in relationships, to have had sexual experiences, and to use condoms at first sex. However, some differences did emerge: PHIV women were less likely to report being satisfied with their sex life (86% vs. 94%) and more likely to have had a voluntary abortion (16% vs. 12%). Both PHIV men and women were less likely to use contraception to avoid pregnancy. Additionally, having disclosed their HIV status to others was strongly linked to being in a romantic relationship for women and to reporting a satisfying sex life for men. This research suggests that young people living with perinatally-acquired HIV face some specific sexual health challenges, particularly women, who may need additional support around sexual satisfaction and reproductive decision-making. The finding that HIV disclosure is associated with better relationship and sexual outcomes highlights the potential importance of support around disclosure decisions for this population. Healthcare providers working with PHIV young adults may want to address these areas as part of routine care.

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Citation

Ibrahim N, Bouyer J, Dollfus C, Viard J, Faye A, Reliquet V, et al.. (2025). Sexual health indicators among young adults living with perinatally-acquired HIV in france, a gender-stratified comparison with their peers in the general population.. BMC public health. https://doi.org/10.1186/s12889-025-24542-x