Sexual and reproductive health issues among HIV positive adolescents in Gweru rural district
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The Sexual and Reproductive Health (SRH) needs of adolescents have been largely ignored to date by existing reproductive health services. Adolescents Living with HIV (ALHIV) face twin challenges of adolescence in general and being perinatally infected with HIV. This study sought to investigate the SRH issues for ALHIV in Gweru rural district in Zimbabwe. The study used a mixed method research design, qualitative and quantitative methods. The study administered 112 questionnaires to ALHIV, conducted four focus group discussions with ALHIV in Gweru rural district and six key informant interviews at district and national levels. The majority of ALHIV were not in relationships and lacked general understanding of relationships. All respondents reported that they were not sexually active, although the majority intend to have sex in future. Only a fifth of the respondents had comprehensive knowledge of HIV transmission. Respondents were aware of few modern contraception methods namely female condoms, male condoms and the pill. Adolescents Living with HIV mainly access HIV related services in Gweru rural district. There is limited access to SRH services besides HIV treatment as less than half of ALHIV reported talking to a health service provider about SRH issues such as sexuality, family planning, condoms, sexually transmitted infections, pregnancy and child bearing. The key SRH issues facing ALHIV include lack of comprehensive knowledge on SRH issues, such as sexuality, relationships, prevention of HIV reinfection, pregnancy and child bearing and family planning. There is also limited access to SRH services. This is despite strong future intentions to have sex and families. Adolescents living with HIV in Gweru rural district face barriers to accessing SRH services at policy, programmatic, community, family and individual levels. These barriers include national policies that are unclear on access to SRH services by adolescents. Culture does not support open discussion of ASRH issues, worse still for ALHIV as community does not expect them to have sex. The study recommends finalization of an evidence informed clear policy on access to SRH services for adolescents in general, incorporating specific sections on unique SRH needs of ALHIV and implementation of multi-sectoral awareness interventions on SRH issues and services for adolescents in general with a component on ALHIV.