Table of Contents
- Physical Changes
- Mental Development
- Social and Emotional Growth
- Support for the Teen Living with HIV
The teen years bring a variety of physical, mental, and emotional changes that can be both exciting and challenging. As a teen living with HIV, the transition into adulthood can be even more challenging because you have to live and cope daily with a chronic medical condition. Life may seem overwhelming at times. However, learning about teen development and how these changes affect your feelings and behavior can help make things a little easier.
If you would like to find out more about teens’ risk of acquiring HIV, see our fact sheet on What Parents and Providers Need to Know about HIV Risk and Teens.
A teen's body grows faster than at any time since infancy. During a "growth spurt," a teen assigned male sex at birth (such as a cisgender or cis boy, or transgender girl) can grow four inches taller, and someone assigned female at birth (cis girl, transgender or trans boy, etc.) may grow three inches taller. Body weight increases, too, and while this includes both muscle and fat, cis boys usually add more muscle and cis girls more fat compared to overall weight gain. During puberty, hormonal changes in cis boys can cause a deeper voice and hair growth in the face, under the arms, in the pubic area, and other places on the body. Cis girls begin to develop breasts, get fuller hips, start to have a menstrual period, and grow underarm and pubic hair. Even your brain is growing and maturing.
It is common for teens to feel self-conscious about these changes, especially if they grow at a faster or slower rate than others at the same age. Teens living with HIV may have additional physical issues. If you are starting new HIV drugs, you may have some uncomfortable side effects, such as nausea, diarrhea, dizziness, muscle pain, or fatigue. Usually these go away after the first two or three weeks as your body adjusts to the new drugs.
Sometimes HIV drugs can cause a body change called lipodystrophy. This means you gain weight in the central part of your body, such as your stomach, chest, shoulders, and waist. Lipodystrophy can also include losing fat in the face, arms, legs, hips, and buttocks ("butt"). The good news is that newer HIV drugs do not cause lipodystrophy nearly as often as older HIV drugs did.
If these body changes happen to you, they may also make you feel self-conscious about your appearance. Some teens develop a poor self-image and low self-esteem. Some young people may want to stop taking their HIV drugs. Talk to your health care provider if you feel this way so that you can take the necessary steps to support your mental health.
While it is important for all teens to eat a healthy diet and get enough exercise, it is especially important for teens living with HIV. You may need to make a special effort to eat a balanced diet, get enough rest, and exercise regularly to help protect your immune system. Ask your health care provider about taking supplements if you think you are not getting enough vitamins and minerals from food to support your growing body.
In addition to physical growth, your mental processes -- especially perception, memory, and judgment -- develop during the teen years, as do your emotional control and ability to make decisions. Even adults living with HIV find that taking HIV drugs every day can be annoying, hard to remember, and may be difficult to hide from others. HIV drugs can be a constant reminder of your condition. In addition, you may be embarrassed about regular school absences for visiting your health care provider. All of this may make you feel more self-conscious and sensitive to what others may think of you.
Low self-esteem is common among teens, and living with HIV can make that feeling worse. Teens who do not feel good about themselves are more likely to make poor decisions about their health. They may seek the approval of friends, peers, or others to make up for not having a positive view of themselves.
As a result, they may be more tempted to use street drugs or alcohol, or to engage in unsafe sexual activity. Those with self-esteem concerns may also experience problems with depression, or have suicidal thoughts. If this is true for you, it is very important that you talk to your health care provider or another trusted adult. There are many ways to get help with your mental and emotional health, including your self-esteem. Getting help can lead to feeling better about yourself and making more empowering decisions.
Important: If you are thinking of hurting or killing yourself, call the National Suicide Prevention Lifeline at any time in the US at 1-800-273-8255. If you are not in the US, click here to find crisis centers with help near you.
Teens may deal with several social and emotional issues, especially with understanding their identity. Asking "who am I?" and "how do I fit in the world?" are normal questions. Some teens find it difficult to fit in and make friends. This feeling of isolation and like "no one gets you" can be common.
Many teens experiment with smoking, street drugs, alcohol, sex, and sexuality. However, if you are drunk or high, you are more likely to not take your HIV medication and to have sex without condoms or other barriers. These activities can expose your partner to HIV (unless your viral load is undetectable – then the chance of transmitting HIV during sex is zero). They may also expose you to other sexually transmitted infections or diseases (STIs or STDs) such as herpes, hepatitis B or C, or genital warts. STI treatment can interfere with your HIV drugs.
If you have sex without barriers with a partner who also lives with HIV and has a detectable viral load, there is also the possibility of getting another strain of HIV. This can cause additional damage to your immune system. In addition, if one partner has a penis and the other has a vagina, sex without condoms can put you or your partner at risk of getting pregnant.
It is important to know that in some places, there are unfair, stigma-based laws that make it illegal to not tell your partner that you are living with HIV before having sex. If you are drunk or high, you may forget to tell a sexual partner about your HIV status and may be vulnerable to brutal legal consequences – even if you take the responsible step of practicing safer sex. If you want to learn more about ways to protect yourself from the harm of these laws, please see our fact sheet on HIV criminalization.
Even though living with HIV may be isolating at times, it is important to have open, honest, and supportive friendships. Many teens living with HIV are afraid to tell their friends that they are living with HIV because they are afraid that they may be rejected or treated badly. In fact, telling others can be one of the hardest decisions that a teen living with HIV can make. While telling someone that you are living with HIV may be a stressful process, it can also be liberating and open you up to love, acceptance, and support from friends and others.
Some things to consider before disclosing your HIV status:
- Why do I want to tell this person about my HIV status?
- Will he or she keep my confidence?
- What happens if he or she tells other people?
- What will happen if the relationship is changed by my disclosure?
If you want or need support in disclosing your status, you can get help from your health care provider, a parent, a trusted relative, an HIV peer educator, or a friend.
Lastly, the teen years are all about preparing yourself for adulthood and your future. Questions like "Will I find love?", "Will I be able to have children?", or "Will I ever have a normal life?" may arise. With the treatments now available, people with HIV can live very healthy, long lives, find love, start families, and fulfill their dreams. To read about the experiences of young adults who were born with HIV, please see our fact sheet on women with early acquired HIV.
Where can you find help and support? Trusted family members, friends, teachers, counselors, clergy, and health care providers can be a valuable support system. Many communities have local HIV support groups, too — try looking in the POZ directory for some places near you (in the US). Some support groups are specifically for teens and/or young adults. In a support group, you can talk openly, safely, and confidentially with others who are in similar situations and have similar concerns.
You can also find support through trusted online groups and blogs (please visit A Girl Like Me to learn more – several of our bloggers have experienced living with HIV as teens). If you choose to participate in an online group or blog, it is important to be careful not to share information about yourself that you do not want publicly available. Once information such as your name, address, school, or workplace is out there (on the Internet), there is no way to get it back or erase it. If you join an online group or blog, you may want to use a pseudonym (made-up name) or "handle" instead of your real name to preserve your privacy.
There are also some important things that your parents or guardians can do to help you:
- Answer questions about sex honestly and accurately
- Encourage and model a healthy lifestyle, such as good eating habits and physical activity
- Respect your privacy
- Allow you to handle as much of your care as possible, including setting medical appointments and taking HIV drugs; and encourage you to understand and be a part of medical decisions
- Help you set both short-term and long-term goals that are realistic and achievable
- Provide lots of love, compassion, and patience!
If your parents or guardians are not already doing these things, it is probably because they are also learning how to live well with your HIV, just like you. Showing them this article may help them.