title: Parenting Among Adolescents and Young Adults with Human Immunodeficiency Virus Infection in the United States: Challenges, Unmet Needs, and Opportunities.
abstract: Given the realistic expectations of HIV-infected adolescents and young adults (AYA) to have children and start families, steps must be taken to ensure that youth are prepared to deal with the challenges associated with their HIV and parenting. Literature reviews were conducted to identify published research and practice guidelines addressing parenting or becoming parents among HIV-infected AYA in the United States. Research articles or practice guidelines on this topic were not identified. Given the paucity of information available on this topic, this article provides a framework for the development of appropriate interventions and guidelines for use in clinical and community-based settings. First, the social, economic, and sexual and reproductive health challenges facing HIV-infected AYA in the United States are summarized. Next, family planning considerations, including age-appropriate disclosure of HIV status to those who are perinatally infected, and contraceptive and preconception counseling are described. The impact of early childbearing on young parents is discussed and considerations are outlined during the preconception, antenatal, and postnatal periods with regard to antiretroviral medications and clinical care guidelines. The importance of transitioning AYA from pediatric or adolescent to adult-centered medical care is highlighted. Finally, a comprehensive approach is suggested that addresses not only medical needs but also emphasizes ways to mitigate the impact of social and economic factors on the health and well-being of these young parents and their children.
authors.affiliation: 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Kendra
authors.initials: K
authors.lastname: Hatfield-Timajchy
authors.affiliation: 2 Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine , Cincinnati, Ohio.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Brown
authors.affiliation: 3 Department of Gynecology and Obstetrics, Emory University School of Medicine , Atlanta, Georgia .
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Haddad
authors.affiliation: 4 Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia .
authors.forename: Rana
authors.initials: R
authors.lastname: Chakraborty
authors.affiliation: 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Athena P
authors.initials: AP
authors.lastname: Kourtis
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003376:Counseling; D005193:Family Planning Services; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D020380:Needs Assessment; D016487:Parenting / Q000523:psychology*; D010290:Parents; D012098:Reproduction; D060728:Reproductive Health; D012736:Sex Education; D012725:Sexual Behavior; D014481:United States; D055815:Young Adult