ArticleJournal of the International AIDS Society2022
Predictors and consequences of HIV status disclosure to adolescents living with HIV in Eastern Cape, South Africa: a prospective cohort study.
Article in Journal of the International AIDS Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Characterizing the HIV care continuum among children and adolescents with HIV in eastern and southern Africa in the era of "Universal Test and Treat": A systematic review and meta-analysis.Journal of the International AIDS Society · 2025Pooled it
- Pooled it
- Disclosure of HIV status and its association with quality of life and depressive symptoms among children with HIV in North-Eastern Tanzania.AIDS research and therapy · 2026Article
- ART adherence care strategies among adolescents living with HIV in Ghana's Ashanti Region: a qualitative study.Frontiers in public health · 2026Article
- The correlates and experiences of HIV-related intersectional stigma among caregivers of adolescents living with HIV during COVID-19 in KwaZulu-Natal, South Africa: Results from a mixed method study.PLOS global public health · 2026Article
- Economic evaluation of digital health interventions to improve quality-adjusted life years in adolescents living with HIV in Ethiopia.Frontiers in public health · 2026Article
- Mental health challenges and HIV status disclosure among children and adolescents living with HIV in Eastern Uganda.Scientific reports · 2025Article
- Article
- Determinants Associated With CD4 Cell Count and Disclosure Status Among First-Line Antiretroviral Therapy Patients Treated at Felege Hiwot Comprehensive Specialized Hospital, Ethiopia.Journal of tropical medicine · 2025Article
- "I am still human and worth a life:" a qualitative study of the impacts of a community based, peer-led, treatment support model for young adults living with HIV in Zimbabwe.Frontiers in public health · 2024Article
- Qualitative Study on the Voices of Adolescents Living with Perinatally Acquired HIV in Selected Clinics in the Limpopo Province of South Africa.Children (Basel, Switzerland) · 2023Article
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7 authors.
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Abstract
introductionThe World Health Organization recommends full disclosure of HIV-positive status to adolescents who acquired HIV perinatally (APHIV) by age 12. However, even among adolescents (aged 10-19) already on antiretroviral therapy (ART), disclosure rates are low. Caregivers often report the child being too young and fear of disclosure worsening adolescents' mental health as reasons for non-disclosure. We aimed to identify the predictors of disclosure and the association of disclosure with adherence, viral suppression and mental health outcomes among adolescents in sub-Saharan Africa.
methodsAnalyses included three rounds (2014-2018) of data collected among a closed cohort of adolescents living with HIV in Eastern Cape, South Africa. We used logistic regression with respondent random-effects to identify factors associated with disclosure, and assess differences in ART adherence, viral suppression and mental health symptoms between adolescents by disclosure status. We also explored differences in the change in mental health symptoms and adherence between study rounds and disclosure groups with logistic regression.
resultsEight hundred and thirteen APHIV were interviewed at baseline, of whom 769 (94.6%) and 729 (89.7%) were interviewed at the second and third rounds, respectively. The proportion aware of their HIV-positive status increased from 63.1% at the first round to 85.5% by the third round. Older age (adjusted odds ratio [aOR]: 1.27; 1.08-1.48) and living in an urban location (aOR: 2.85; 1.72-4.73) were associated with disclosure between interviews. There was no association between awareness of HIV-positive status and ART adherence, viral suppression or mental health symptoms among all APHIV interviewed. However, among APHIV not aware of their status at baseline, adherence decreased at the second round among those who were disclosed to (N = 131) and increased among those not disclosed to (N = 151) (interaction aOR: 0.39; 0.19-0.80). There was no significant difference in the change in mental health symptoms between study rounds and disclosure groups.
conclusionsAwareness of HIV-positive status was not associated with higher rates of mental health symptoms, or lower rates of viral suppression among adolescents. Disclosure was not associated with worse mental health. These findings support the recommendation for timely disclosure to APHIV; however, adherence support post-disclosure is important.
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