Teenagers, HIV, and AIDS: Insights from Youths Living with the Virus (Sex, Love, and Psychology)

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Regular screening of youth with HIV for spiritual or religious needs and identifying sources of religious or spiritual support should be a routine part of care, consistent with JACHO and palliative care guidelines Puchalski et al. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.

We thank our families for their participation. This trial has been registered at www. The authors have no financial relationships relevant to this article to disclose. Lyon's research and interests focus on the study of adolescence, including supporting adolescents with serious medical conditions. Lyon has an adult private practice in Alexandria, Virginia. Now What Do I Do? National Center for Biotechnology Information , U. Author manuscript; available in PMC Jun 1.

Patricia Garvie 2 St. Collaboration on this project is continued as a voluntary consultant. The publisher's final edited version of this article is available at J Relig Health. See other articles in PMC that cite the published article. Introduction Religion plays an integral part in the lives of adolescent patients in the United States Lippman Statistical Analysis Data were analyzed using Stata Results Participants Baseline adolescent and family characteristics are presented in Table I.

Open in a separate window. Spiritual Wellbeing among HIV-Infected Adolescents and their Families There were statistically significantly higher levels of spirituality in family members than in adolescents at baseline and these differences persisted at the 3 month assessment. Responses were clustered from a 5-point Likert scale to a 3-point Likert scale for this analysis, because of empty cells due to the high proportion of families who scored in the highly spiritual range, creating ceiling effects. Discussion This is the first study to examine congruence in spiritual beliefs between adolescents with HIV and their families.

Conclusion The Centers for Disease Control and Prevention CDC have recognized the importance of partnering with communities of faith in addressing the HIV epidemic, as religious institutions may be in a unique position to intervene with youth on an individual and community level CDC Footnotes This trial has been registered at www.

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Spiritual Wellbeing among HIV-Infected Adolescents and their Families

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Religious change and adolescent family dynamics. Issues in Comprehensive Pediatric Nursing. But I still stuck by him regardless. She had not disclosed it to any of her family members or friends. Another year-old Black female participant , diagnosed at age 19, was pregnant at the time of her interview. She had had a childhood rife with parental neglect.

She felt abandoned by her parents who were no longer together and had gone onto have other children who became their focus. She got other kids, so really her attention is on her other kids. Do for my own and all that stuff so. She had felt unwanted by her grandmother and believed she regarded the participant as a financial burden.

When young, the participant was also sometimes physically abused by her grandmother. You know like just for a stupid thing I used to get beat for. By the beginning of high school, she was already smoking marijuana and having sex. Although she did poorly the first couple of years of high school, she managed to graduate, but afterwards continued smoking, drinking and getting into fights. Soon afterwards she heard a rumor that he had HIV, but when she confronted him about it, he denied it. She believed him, tested negative for HIV, and they continued to have unprotected sex.

However, a few months later when she registered for a federal program, the mandatory HIV test came back positive. She felt certain that her partner had known he was positive, but had lied. When she was diagnosed, they were no longer together and she did not confront him about his HIV status or reveal to him her serostatus. She had not told her grandmother about her disease, or her father, with whom she had had little communication. The family members she had disclosed to were not supportive. She [her mother] felt a little sad but then she also told me something that she have which is herpes.

Early Life Circumstances as Contributors to HIV Infection

So in a way I felt a little connection and a little bit better. She felt that her female cousins, who she felt close to before her diagnosis, blamed her for her situation. These friends, the participant felt, subsequently distanced themselves from her and this amplified her social isolation. She had told a previous partner, a year-old man, about her HIV infection who she felt also had begun to take her for granted. One of the ways she felt he was using her was to stay at her apartment, which she had because of her HIV housing benefits.

She added that she believed that many older men took advantage of younger girls, especially once the girls were HIV-infected. At the time of the interview, she was pregnant by a current partner, a year-old man. Although he had advised her not to have the baby because her feared for its health and her not living to raise it, he was still present and made it a point to remind her to take her antiviral medications and to keep her doctor appointments.

However, she expected him to eventually abandon her: An indicator of the profound bitterness she still felt toward her mother was when she explained that after her daughter was born if she became unable to care for her, she would rather put the child in foster care than have family members or her mother raise her. Or you know needing something; I get turned down and stuff, so I just learned growing up to just deal with it and just forget about it. These cases illustrate the early adversities or disadvantages in the family domain that many of the young HIV-infected women in this study shared and that typically co-occurred rather than exist in isolation.

The constellation of these early family life experiences caused them to feel unloved and unwanted, betrayed by parents and family, and anxiously insecure about the permanence of relationships. In many cases, one or both parents were physically absent due to divorce, separation, abandonment or death. When their parents were divorced or separated, the participants often had sporadic or no contact with the non-custodial parent and this severely restricted the opportunity to build a meaningful parent-child relationship.

Participants often felt abandoned or rejected by that parent. Many of the female participants who grew up without a father seemed to assign considerable significance to being deprived of their guidance, care, and protection from exploitive men. Some seemed to engage in sex in an effort to achieve emotional closeness with a man who cared for them.

Not surprisingly, several became sexually involved in their teens with men many years their senior who clearly served as a substitute father figure. Even when parents had been physically present while participants were growing up, they often were emotionally and practically unavailable.

As a result, they were unable to provide love, consistent caregiving, guidance, protection and the sense of security so important to healthy development. This left them feeling rejected and devalued and possibly more accepting of abuse or mistreatment by others. Many participants were sent to live for periods ranging from months to years with relatives who were often reluctant or resentful custodians. When relatives were unavailable, they ended up in foster care or group homes.

The constant relocations they experienced also contributed to their feeling insecure and anxious about investing in relationships, which were usually hurtful and impermanent. Most seemed never to have forged a secure attachment to a parent or parent surrogate who they felt was a reliable source of love and emotional support.

Teenagers, HIV, and AIDS: Insights from Youths Living with the Virus - Google Книги

With little parental control or supervision many participants became easy targets for sexual exploitation and emotional manipulation. As participants were often quite young when their sexual abuse began, they were traumatized or psychologically overwhelmed by the experience. Some coped by denying, repressing or dissociating from their feelings. Those with the courage to reveal the abuse to an adult, were usually not believed, and in some cases even punished for supposedly fabricating a story. Understandably, these young women felt deeply betrayed and discredited by the adults who had failed in their role of protecting their physical and emotional well-being.

Many responded to their abuse by becoming sexually promiscuous, since their experience had revealed to them that at least as sexual beings, they were wanted. The profound need many participants had to believe that their partners truly cared for them and would not expose them to danger trapped them in unhealthy relationships. Some were so desperate for love and acceptance by others that they denied the harm posed by their predatory and abusive sexual partners. Many of the participants constructed and maintained the vital lie that their sexual partners offered them the true love and attention they had been deprived of by their parents and families.

Unfortunately, the outcome of preserving this lie was acquiring HIV. Clearly efforts must be made to identify chaotic and dysfunctional family settings when children are still young, so interventions can aim at primary prevention. One way to identify such families is to institute an annual assessment of the family situation of all children enrolled in elementary and middle school, prior to dropping out of high school.

Families with risk factors could then be referred to appropriate services. Targeting vulnerable families and providing parents with guidance and support to promote more effective monitoring and parenting of their children is definitely one component of HIV prevention efforts. However, many children growing up in chaotic or dysfunctional families sustain psychological insults and forms of abuse that leave them psychologically damaged, anxious, angry, depressed, and with no self-esteem.

They require therapeutic interventions to deal with underlying anxiety and depression and attain a sense of self-worth.

Introduction

In the absence of parents or other adult family members who can serve as positive role models, many of the adolescents in this study might have benefitted from programs that linked them to an adult mentor e. Community or religious organizations might also offer such programs to neighborhood children. Clearly many of these young women had little sense of any self-worth primarily because of their feeling that they were unlovable and devalued by adults. Many felt invisible in their own families. Several concluded that the only thing they had to offer to get attention and become visible was their bodies and sexual favors.

While some might regard this as encouraging distrust of partners in relationships, it seems prudent to at least raise the consciousness of female adolescents about the possibility that they are being taken advantage of by partners who are selfish or manipulative. Indeed, for many of the young women in our sample, being diagnosed with HIV, a stigmatizing disease with the potential to taint their identity, further diminished their low sense of self-worth.

It is important that even after being diagnosed and believing that their boyfriend had betrayed them by knowingly exposing them to HIV, they often did not confront him, but rather clung to the relationship, most likely because for the first time in their lives, they felt noticed and emotionally connected to another person.

They probably also questioned whether any other man would want them now in light of their HIV-positive status. Interventions must be developed to support at-risk and HIV-positive young women in constructing a firm and positive sense of self independent of being part of a couple. This task, unfortunately, becomes very challenging in families where the parents are substance users, mentally ill, incarcerated or physically and emotionally unavailable.

Finally, the factors that placed the young women in this study at risk for HIV also place them at risk for intimate partner violence, coercive sex or rape, and unintended pregnancy. When young women enter relationships with older men rather than age peers, the gender power differentials become even more pronounced. This in turn may enhance the risks of engaging in higher risk sexual behavior Raiford et al. Programs developed to address these problems have a longer history than HIV, and therefore, HIV prevention programs need to be integrated in existing programs to maximize the opportunity to empower young women.

Although the relationships between inadequate parent monitoring, sexual abuse, unstable housing and risky behaviors, including sexual behavior, have been well established statistically, there have been relatively few qualitative investigations. To our knowledge this is the first report in which these relationships are looked at in HIV-infected adolescents and young adults and interpreted through their accounts of early life experiences.

This analysis provided valuable and novel insights into the meanings behind the sexual behaviors and the unmet emotional needs sexual relationships played in the lives of the young women in our study. As Crockett, Raffaelli and Moilanen have noted, the research literature on adolescent sexuality has focused primarily on behaviors.

We believe the findings reported here make an important contribution redressing this limitation of the extant literature and arguably strongly support their position that understanding meaning is critical to designing efficacious interventions. This manuscript demonstrates that the relationships these young women establish with their male partners, even exploitive ones, often meet powerful and very fundamental needs for love, attachment and safety. Being in a sexual partnership, for these young women, meant that they were lovable, valuable and worthy of protection.

Their unquenched thirst for feeling loved and cared for was deeply rooted in their neglectful or even abusive upbringing. It is imperative that interventions provide insight into how short-sighted and self-destructive their unsafe sexual behavior is and support in finding healthier more adaptive ways to meet the fundamental needs of love and emotional closeness.

Сведения о продавце

Three important limitations of the study must be noted. First, the findings are based on a convenience sample of HIV-infected adolescents and young adults. While qualitative research is well suited for generating novel insights and providing rich description of phenomena it is not a firm basis for statistical generalization. Thus while the findings provide new and important insights into the ways certain early life adversities can place females on a pathway to HIV infection they need to be confirmed by a larger more representative sample.

Another limitation of the sample is that all of the participants were receiving care in HIV clinics and therefore were engaged in the care system and had access to supportive services alongside medical care. The third limitation is associated with the focus of the study being on adjustment to living with HIV as an adolescent and young adult and not on how early experiences might have set participants on a pathway to HIV infection. Therefore, the data presented in this manuscript emerged largely spontaneously in the stories adolescents told when we asked about their relationship with parents and the circumstances surrounding their diagnosis.

We were struck by the strong similarities we saw in the adversities many have faced in early childhood and adolescence prior to becoming infected. Given that we could not find a similar report in the literature. We hope this report will motivate other investigators to further address these early life adversities and how they contribute to becoming HIV-infected. VanDevanter [PI] and K. National Center for Biotechnology Information , U. Soc Work Health Care. Author manuscript; available in PMC Jan Abstract Adolescents may come from family settings that heighten their vulnerability to early sexual initiation, promiscuity and sexual exploitation.

Childhood sexual abuse The relationship of childhood sexual abuse CSA to a host of subsequent adverse outcomes has received a great deal of attention by researchers and clinicians alike. Methods Study Design and Participants To be eligible for participation in the study, individuals had to: Recruitment and Procedures Study participants were recruited from five New York City adolescent HIV clinics that provided comprehensive specialty medical and supportive ancillary social services to adolescents and young adults with HIV.

Data Collection After obtaining informed consent, each participant completed a brief survey using audio computer-assisted self-interviews ACASI that elicited demographic and behavioral data and also a small battery of psychosocial measures. Data Analysis An inductive approach was used in the analysis of the data. When describing her relationship with this older man, she referred to the loss of her father and to her search for a relationship with a loving adult male figure: Throughout the interview, the participant expressed ambivalence about breaking up with him and the hope that they could re-establish a relationship even as friends, since they had stopped being sexually active: Now more mature she realized how inappropriate his behavior had been, given her youth and their age difference: While growing up, she experienced a history of intense, chronic conflict with her mother, who the participant saw as an excessively restrictive and punitive parent: She had conflicted feelings for her boyfriend, including anger, love, resentment and forgiveness: Despite recognizing that she has been victimized by this boyfriend, her need to feel desired and loved drives her to convince herself that this relationship fulfills her needs as well: The relationships among childhood maltreatment, emotion regulation, and sexual risk taking in men from urban STD clinics.

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