Sexual behaviour and reproductive intentions of adolescents living with HIV seeking care at Moi Teaching and Referral Hospital, Eldoret Kenya

Abstract

Background: Adolescence is an explorative phase where romantic relationships and sexual interests develop. Adolescents living with HIV (ALHIV) face challenges related to sexual reproductive health (SRH). This study seeks to describe the sexual behavior (SB) and reproductive intentions (RI) of ALHIV seeking care at Moi Teaching and Referral Hospital (MTRH). Objectives: To describe the SB and RI of ALHIV and to determine the factors that influence their SB and R1 Methods: A Cross sectional, mixed methods study was conducted at Rafiki Centre of Excellence in Adolescent Health in MTRH. We sampled every alternate adolescent from a total of 450 to a sample size of 272. Socio-demographic data, SB and RI of the adolescents were collected using an interviewer administered questionnaire. Focused group discussions were held to identify factors influencing SB and RI. Descriptive statistics were used for continuous variables and frequency listings for categorical data. Pearson’s Chi square test was used to test for statistical significance of the factors that influence and a P value less than 0.05 was statistically significant. Qualitative data was transcribed, coded and categorised using N-vivo version 12. Results: The ratio of male to females was 1:1. A total of 200/272 (73.5%) of ALHIV were in high school; 111/272(55%) were either total or partial orphans. Twenty nine percent of the ALHIV had ever been in a romantic relationship, of whom 40/79 (50.6%) had multiple partners. Those who had ever experienced sexual intercourse were 56 /272(20.6%); mean age of sexual debut at 15.6 years (Standard deviation 2.05). Among the ALHIV who were sexually active, 56.7% (17/30) had not disclosed their HIV status to their partners. Condom use among those sexually active was at 13 (43.3%). RI was at 238/272 (87.5%) although 126/238 (52.9 %) had fears of infecting their children. Up to 218/272 (80%) had no preference of the HIV status of a romantic partner in future. The factor that influenced SB was going to discotheques AOR- 4.786, (CI 1.680 – 13.630). From the FGDs, idleness, biological changes on their bodies, drug abuse and alcohol influenced SB negatively, while going to school and family structure influenced SB positively. Fear of infecting their children and hard economic times influenced the RI. Conclusions: ALHIV are engaging in romantic relationships, exploring their sexuality as well as harboring intentions of having children in future. They have a lot of unmet needs for making their SRH safe and healthy. Recommendations: SRH education addressing risky sexual behaviours and methods of prevention of mother to child transmission of HIV to be introduced early among ALHIV.