title: "Let's talk about sex": a qualitative study of Rwandan adolescents' views on sex and HIV.
abstract: OBJECTIVE
  This qualitative study explored the views and experiences of adolescents with perinatally acquired HIV in Kigali, Rwanda, regarding sex, love, marriage, children and hope for the future.
  
  
  METHODS
  The study enrolled 42 adolescents who had received combination antiretroviral therapy for at least 12 months, and a selection of their primary caregivers. Study methods included 3 multiple day workshops consisting of role-playing and focus group discussions (FGDs) with adolescents, 8 in-depth interviews with adolescents, and one FGD with caregivers.
  
  
  RESULTS
  The adolescents reported experiencing similar sexual needs and dilemmas as most other adolescents, but with an added layer of complexity due to fears related to HIV transmission and/or rejection by partners. They desired more advice from their parents/caregivers on these topics. Although they struggled with aspects of sex, love, marriage and having children, most agreed that they would find love, be married and have children in the future. The two most discussed HIV-related anxieties were how and when to disclose to a (potential) sex/marriage partner and whether to have children. However, most adolescents felt that they had a right to love and be loved, and were aware of prevention-of-mother-to-child-transmission (PMTCT) options in Rwanda. Adolescents generally spoke about their future role in society in a positive manner.
  
  
  CONCLUSIONS
  Strengthening the life skills of HIV-positive adolescents, especially around HIV disclosure and reduction of HIV transmission, as well as the support skills of parents/caregivers, may not only reduce onward HIV transmission but also improve quality of life by reducing anxiety.
authors.affiliation: Rinda Ubuzima, Kigali, Rwanda.
authors.forename: Jennifer Ilo
authors.initials: JI
authors.lastname: Van Nuil
authors.affiliation: Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands; Department of Pediatrics, Kigali University Teaching Hospital, Kigali, Rwanda.
authors.forename: Philippe
authors.initials: P
authors.lastname: Mutwa
authors.affiliation: Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Brenda
authors.initials: B
authors.lastname: Asiimwe-Kateera
authors.affiliation: Rinda Ubuzima, Kigali, Rwanda; Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Evelyne
authors.initials: E
authors.lastname: Kestelyn
authors.affiliation: Rinda Ubuzima, Kigali, Rwanda; Department of Obstetrics and Gynecology, King Faisal Hospital, Kigali, Rwanda.
authors.forename: Joseph
authors.initials: J
authors.lastname: Vyankandondera
authors.affiliation: Center for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Pool
authors.affiliation: Treatment and Research on HIV/AIDS Center, Kigali, Rwanda.
authors.forename: John
authors.initials: J
authors.lastname: Ruhirimbura
authors.affiliation: Treatment and Research on HIV/AIDS Center, Kigali, Rwanda.
authors.forename: Chantal
authors.initials: C
authors.lastname: Kanakuze
authors.affiliation: Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Reiss
authors.affiliation: Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands; Utrecht University Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Sibyl P M
authors.initials: SP
authors.lastname: Geelen
authors.affiliation: Rinda Ubuzima, Kigali, Rwanda; Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Janneke H
authors.initials: JH
authors.lastname: van de Wijgert
authors.affiliation: Department of Global Health and Amsterdam Institute for Global Health and Development, Academic Medical Center, Amsterdam, The Netherlands; Utrecht University Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands; Biomedical Research, Epidemiology Unit, Royal Tropical Institute, Amsterdam, The Netherlands.
authors.forename: Kimberly R
authors.initials: KR
authors.lastname: Boer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology; D017028:Caregivers / Q000523:psychology; D002648:Child; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology* / Q000635:transmission; D006679:HIV Seropositivity / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D010465:Perception; D012432:Rwanda / Q000453:epidemiology; D012650:Self Disclosure; D012725:Sexual Behavior / Q000523:psychology*; D012944:Social Support; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
references.citation: J Adolesc Health. 2009 Feb;44(2):184-187
references.pmid: 19167668
references.citation: AIDS Care. 2011 Apr;23(4):393-400
references.pmid: 21271400
references.citation: Afr J Reprod Health. 2011 Dec;15(4):120-9
references.pmid: 22571114
references.citation: AIDS Care. 2012;24(7):936-42
references.pmid: 22292484
references.citation: AIDS Behav. 2010 Oct;14(5):1083-94
references.pmid: 19763811
references.citation: BMC Pediatr. 2007 Mar 17;7:13
references.pmid: 17367540
references.citation: J Adolesc Health. 2002 Mar;30(3):161-8
references.pmid: 11869922
references.citation: Lancet. 2006 Apr 22;367(9519):1367-9
references.pmid: 16631916
references.citation: Afr Health Sci. 2011 Jun;11(2):211-8
references.pmid: 21857852
references.citation: PLoS One. 2013 Jul 23;8(7):e70254
references.pmid: 23894625
references.citation: J Adolesc Health. 2006 Mar;38(3):307-9
references.pmid: 16488835
references.citation: PLoS Med. 2011 Jun;8(6):e1001044
references.pmid: 21695087
references.citation: J Int Assoc Physicians AIDS Care (Chic). 2010 Mar-Apr;9(2):113-5
references.pmid: 20133498
references.citation: AIDS Care. 2013;25(4):447-50
references.pmid: 22909272
references.citation: Reprod Health. 2011 Sep 24;8:25
references.pmid: 21943095
references.citation: J Adolesc Health. 2006 Jun;38(6):719-25
references.pmid: 16730601
references.citation: AIDS Res Hum Retroviruses. 2013 Jun;29(6):892-900
references.pmid: 23373540
references.citation: Arch Pediatr. 2011 Jul;18(7):797-805
references.pmid: 21652188
references.citation: Eur J Contracept Reprod Health Care. 2009 Apr;14(2):111-9
references.pmid: 19340706
references.citation: Reprod Health Matters. 2013 May;21(41):176-85
references.pmid: 23684200
references.citation: BMC Pediatr. 2013 Mar 27;13:42
references.pmid: 23536976
references.citation: AIDS Care. 2009 Jun;21(6):725-31
references.pmid: 19806488
references.citation: PLoS One. 2013;8(4):e60073
references.pmid: 23573232
references.citation: Pediatrics. 2012 Sep;130(3):e591-9
references.pmid: 22891234
references.citation: Popul Stud (Camb). 2010 Mar;64(1):97-104
references.pmid: 20087816
references.citation: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013 Feb;56(2):250-5
references.pmid: 23361210
references.citation: Arch Dis Child. 2010 Jun;95(6):414-21
references.pmid: 19880392
references.citation: AIDS Care. 2008 Apr;20(4):426-33
references.pmid: 18449819
references.citation: AIDS Patient Care STDS. 2012 Dec;26(12):746-54
references.pmid: 23199192
references.citation: Scand J Public Health. 2009 Jun;37 Suppl 2:65-74
references.pmid: 19493983
references.citation: AIDS Behav. 2009 Jun;13 Suppl 1:82-91
references.pmid: 19301113