Exploring the Meaning of Sexual Health Through the Voices of Black Adolescents With HIV-Positive Mothers: An Interpretative Phenomenological Analysis

Background: Youth who have a parent living with HIV represent a population that may experience negative sexual health outcomes particularly if they reside within social and cultural contexts (e.g., families, communities, schools) that contribute community-level risks associated with HIV infection. Objective: This study sought to understand how adolescents with HIV-positive mothers engage in parent–child communication about sex and give meaning to their sexual health attitudes, beliefs, and experiences. Methods: An interpretative phenomenological analysis (IPA) approach was used to collect focus group and individual interview data from fourteen Black adolescents residing in an urban U.S. city that is characterized to have a generalized HIV epidemic. NVivo supported qualitative data analysis, which was guided by a six-step heuristic framework. Findings: Three themes were associated with HIV-affected adolescents’ meaning-making around sexual health—Being Ambivalent about Sex, Making Decisions about Sex, and Reflecting on Sexual Health. These themes describe participants’ perspectives of informal parent–child communication about sex and offer an interpretation of their sexual health attitudes, beliefs, decisionmaking, and risk-taking behaviors. Conclusion: Despite informally engaging in parent–child communication about sex with their mothers, many participants did not articulate comprehensive sexual health knowledge and furthermore sought opportunities for increased dialogue around decision-making concerning their sexual health.