The perceptions of the future of HIV-positive teens and young adults are challenged by what they believe their life course will be, what they know about those family members who are affected or who have died of HIV and the reality of their medical situation. In the United States, in addition to the realistic facts of their own situation (minority ethnic groups and socioeconomically disadvantaged groups are affected disproportionately by HIV/AIDS), teens and young adults must live in a society that infrequently embraces those who are HIV-positive. The honesty with which a teen or young adult approaches relationships with others will be influenced by a myriad of circumstances, often based on the individual’s past experiences. The experience of their own HIV status, how they perceive that their HIV-positive family members have been treated, the outcomes of each family member’s illness and what their family relationships have been like will all influence their actions on facing their first and subsequent physical and emotional relationships.
This particular group of children and young people have lived during two very different times. Initially there was a sentiment that children should not know their diagnosis. This was because society had not made peace with the idea of children diagnosed with a condition that was both potentially infectious and life-threatening. Currently there is more of a focus on informing children of their diagnosis and research suggests the benefits to the child and family of disclosing the information to others. Disclosure, however, remains a complicated issue as it impacts on the child’s experience in school and in the community. There is still a pervasive stigma surrounding the diagnosis. Once children who are HIV-positive come to understand their HIV status, the issues then include how they involve others with information about their diagnosis and treatment. The decisions they make, who they make them with and the dialogues they engage in are all part of this uncharted journey in which these children, not always with the strongest of social supports and resources, are forging ahead. It is a challenge for the professionals from whom these youth receive their care to join them on their journey and to try to help them make sense of it along the way. A recent study of HIV-positive adolescents noted that the majority were sexually active and almost half of the cohort reported unprotected sex at last intercourse. Higher levels of depression were associated with unprotected sex and alcohol use.