Les adolescents infectés par le VIH à la naissance : sexualité et procréation ; mise en perspective avec la maladie du cancer

Les enjeux de la transition de la pédiatrie vers la médecine d’adultes

THE ISSUES IN THE TRANSITION FROM PAEDIATRICS TO ADULT MEDICINE

The transfer or transition from paediatric care to adult medicine is, for a large number of adolescents and young adults being monitored for a rare and/or chronic pathology, as well as for the care teams, a critical period in their medical journey and in their life. It is both an individual and a public health issue, with medical-economic consequences. At the hôpital Necker-Enfants malades in Paris, a specific programme has been implemented aimed at the patients and carers.

[The sexuality of HIV-infected-adolescents: literature review and thinking on the unthinkables of sexuality]

The objective of this review was to analyze the scientific literature on the sexuality of HIV-positive adolescents. The first point was to identify how sexuality is addressed and secondly the impact of HIV infection on HIV-positive adolescents. Fifty-four articles were selected for this review. The review demonstrates that sexuality is mainly considered under the angle of sexual and reproductive behavior and preventive practices (condom use and contraception), based on questionnaire studies. Some studies investigated the physiological impact of HIV and its treatment, especially in relation to puberty. On the other hand, the subjective experience of an HIV-positive status among adolescents was rarely studied. Overall, HIV has a negative impact on the sexual life of HIV-positive adolescents. The vast majority of them practice sexual abstinence, notably adolescents infected through mother-to-child contamination, for whom the access to sexuality seems to be delayed. Among those who are sexually active, nearly one-half continue having unprotected sex. The problems related to living with HIV induce a climate of anxiety and dissatisfaction that affects behaviors and sexual practices, and disrupts the quality of sexual life. Some results suggest that the type and mode of contamination has an effect on the general sexual experience of being an HIV-positive adolescent. More research should be developed to study the subjective experience of HIV-positive adolescent sexuality and its impact on sexual experience according to the type of contamination in this population.