Perceived barriers and facilitators to accessing sexual and reproductive health services among adolescents living with HIV: A qualitative thematic analysis

Objective: This study aims to explore the perceived barriers and facilitators to accessing sexual and reproductive health services among adolescents living with HIV. Background: Sexual and reproductive health is essential for adolescents' physical, emotional, and social wellbeing; enabling them to make informed health decisions. Nurses, as frontline healthcare providers, play a vital role in delivering sexual reproductive healthcare through counselling, contraception, and prevention of sexually transmitted infection. Despite the global prioritisation of sexual and reproductive health, research addressing factors influencing sexual and reproductive health services access among adolescents living with HIV remains scarce, particularly in Nigeria. Study design and methods: A qualitative descriptive research method was employed in this study. Fifteen adolescents living with HIV (aged 15-19 years) and five nurses from the Nigerian Institute of Medical Research paediatric HIV clinic were recruited. In-depth interviews were conducted with participants using an interview guide to gather information. The data was analysed using a thematic approach. Results: Three themes emerged from the nurses' responses: interpersonal dynamics and attitudes, stigma and discrimination, and support systems for SRH access. Similarly, four themes were identified from the responses of adolescents living with HIV: perception and misconception, cultural norms, empowerment through education and advocacy, and adolescent-friendly services. These themes were categorised as 'barriers' and 'facilitators' to accessing sexual and reproductive health services faced by adolescents living with HIV. Discussion: The study identifies stigma, labelling, stereotyping, and gender roles as significant barriers to accessing sexual and reproductive health services for adolescents living with HIV. It emphasises the importance of integrating adolescent-friendly sexual and reproductive health services that are confidential and non-judgmental. The study also highlights the role of social media and peer influencers in promoting the sexual and reproductive health, and wellbeing of adolescents living with HIV, ensuring they are equipped with the knowledge and skills needed to make informed decisions about their health.