Peer-reviewed article
Caregiver attitudes towards HIV testing and contraceptive services for adolescents in Tanzania.
Alexander K, Gitagno D, Mtei RJ, Minja A, Lema I et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study explores how parents and guardians in Tanzania view adolescent access to HIV testing and contraceptive services without parental consent. The researchers conducted interviews with 42 caregivers of adolescents participating in a school-clinic health program. Many caregivers were hesitant about adolescents using these services independently, worried about losing control over their children's behavior and concerned about cultural norms around adolescent sexuality. While parents were more supportive of HIV testing, they feared adolescents might receive positive results without emotional support.
Key points
- 74% of interviewed caregivers were women; many expressed hesitancy about adolescents accessing sexual and reproductive health services independently
- Caregivers feared that contraceptive access would decrease their behavioral control over adolescents and conflict with community norms about adolescent sexuality
- Most caregivers endorsed positive attitudes towards HIV testing and counseling, but worried adolescents would receive positive results alone
- Parent and guardian attitudes directly shape whether adolescents seek out health services
- The study suggests tailored communication interventions could help caregivers support adolescent access to these services
Limitations
This is a qualitative study based on caregiver attitudes only; it does not measure actual adolescent health outcomes, service uptake rates, or the long-term effects of parental support or opposition on adolescent health-seeking behavior. The findings reflect attitudes at one point in time and may not represent all Tanzanian communities.
Abstract
Adolescents are disproportionately vulnerable to unintended pregnancies and delayed HIV treatment in low-resource settings. Tanzanian policies support adolescent access to contraception and HIV testing and counseling (HTC) without parental consent if needed; however, parent/guardian disapproval could lead to unmet service needs. This qualitative study explores factors that influence caregivers' attitudes towards adolescents accessing these services independently. VITAA is a cluster RCT testing a school-clinic partnership to provide adolescent health check-ups in Tanzania. Semi-structured interviews (n = 42) were conducted with a purposeful sample of parents/guardians (74% women) of VITAA participants. The extended theory of planned behavior for parent-for-child health behaviors informed thematic analysis. Many parents/guardians expressed hesitancy about adolescents accessing services independently. Contraception concerns included community norms about adolescents being too young for sex and fears that access to contraception decreases parents' behavioral control over adolescents. Conversely, many caregivers endorsed positive attitudes towards HTC, but they had worries about adolescents receiving positive test results alone. Parent/guardian attitudes shape adolescents' health-seeking behaviors and Tanzanian parents and guardians are hesitant about adolescents' independent service use for diverse reasons, including its potential relationship with sexual debut. Tailored communication interventions could encourage caregivers' support for adolescent service access to meet community goals for healthy adolescents.Trial registration: ClinicalTrials.gov identifier: NCT05306938..