Navigating HIV Disclosure: Voices of Young Women with Perinatally Acquired HIV

Human Immunodeficiency Virus (HIV) self-disclosure plays a crucial role in enhancing adherence to Antiretroviral Therapy (ART) and preventing secondary HIV transmission. Young women with perinatally acquired HIV face health and psychosocial challenges, including poor adherence and retention to treatment, poor viral load suppression, constraints in disclosing their HIV status to others, and acceptance by family members, peers, and intimate partners after disclosure. The objective of this study was to explore and understand the experiences of young women with perinatally acquired HIV in self-disclosure, providing insights to guide the development of strategies for professional nurses that support the disclosure process, empowering young women to make informed decisions about when and to whom they disclose.

A qualitative, exploratory, descriptive, and contextual research design employing a phenomenological method was used. The purposive sample included 18 young women with Perinatally Acquired HIV (PAH), aged 18-22, recruited from the Intermediate Hospital Katutura ART Clinic. Data were collected through in-depth, face-to-face, individual phenomenological interviews, transcribed verbatim and thematically analysed using the Braun and Clarke method. Themes and categories were generated from collected data by the researcher and an independent coder.

Four themes emerged from the data that contributed to the experiences of HIV self-disclosure among young women living with perinatally acquired HIV. (1) a lack of awareness of their HIV status and had taken ART medication without comprehension of the infection, (2) demonstrated resilience and acceptance of their HIV status despite facing various challenges, (3) hesitance to disclose their condition due to fear of stigma and discrimination, (4) need for support and guidance on how to disclose their HIV status.

Participants exercised considerable caution in disclosing their HIV status, confiding only in a limited and trusted few, primarily due to experiences of both enacted and anticipated stigma and lack of trust in others. They further expressed a critical need for support in the disclosure process, highlighting the essential roles of nurses and teachers in reducing HIV-related stigma, while also pointing to the limited community awareness regarding fundamental HIV knowledge. This study is the first of its kind conducted in Namibia, and its findings will contribute to the review of guidelines for adolescents and young people with PAH, promoting self-disclosure and enhancing both their mental and physical health outcomes.

The results revealed the complex challenges faced by young women with PAH regarding self-disclosure, underscoring the need for support and guidance on how and when to disclose their status to significant others. The findings of the study provide meaningful insights into the lives of young women with PAH. Future studies and policies should focus on the development of strategies to support HIV self-disclosure among young people living with HIV.