title: Intimate relationships in young adults with perinatally acquired HIV: a qualitative study of strategies used to manage HIV disclosure.
abstract: An increasing number of children born with perinatally acquired HIV (PAH) are surviving into late adolescence and early adulthood. At this developmental stage, forming and sustaining intimate relationships is important. Young adults with PAH face both normative challenges and additional, HIV-related, relationship stressors. One key issue is the decision about whether and how to share their HIV status with others. Being able to disclose one's HIV status to sexual partners may reduce the risk of onward HIV transmission but is associated with the fear of rejection. There has been little research on how young people with PAH manage such disclosure-related stressors in intimate relationships. This study examined how disclosure challenges are managed by young adults with PAH in the UK within their intimate relationships. Seven participants (five females and two males) currently or previously in an intimate relationship, aged 18-23 years, were recruited from a UK hospital clinic. The majority of participants were of sub-Saharan African origins. They took part in in-depth interviews, with data analysed according to the principles of interpretative phenomenological analysis. Four themes were elicited: (1) decisions about starting, continuing or resuming relationships shaped by disclosure, (2) disclosing early to avoid the pain of future rejection, (3) using condoms to avoid disclosure and (4) testing likely partner reactions to disclosure. The study revealed the significant extent to which HIV disclosure affected the experience of relationships in this population. Interventions to support adolescents and young adults with PAH to disclose to their partners should be developed alongside guidance for professionals. Future research should include older samples of adults with PAH and studies in sub-Saharan African settings.
authors.affiliation: a Department of Clinical Psychology, Royal Holloway , University of London , Surrey , UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Greenhalgh
authors.affiliation: a Department of Clinical Psychology, Royal Holloway , University of London , Surrey , UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Evangeli
authors.affiliation: b The 900 Clinic , Imperial College Healthcare NHS Trust, St. Mary's Hospital , London , UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Frize
authors.affiliation: b The 900 Clinic , Imperial College Healthcare NHS Trust, St. Mary's Hospital , London , UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Foster
authors.affiliation: b The 900 Clinic , Imperial College Healthcare NHS Trust, St. Mary's Hospital , London , UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Fidler
mesh_terms: D000293:Adolescent; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000635:transmission; D006679:HIV Seropositivity / Q000523:psychology* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008131:London / Q000453:epidemiology; D008297:Male; D036301:Qualitative Research; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners; D014342:Truth Disclosure; D055815:Young Adult
keywords: HIV; disclosure; perinatally acquired; young adults