Disclosure of positive HIV status to sexual partners among young people receiving treatment at an urban clinic, Kampala, Uganda

Abstract Background HIV/AIDS remains a public health threat globally. The disclosure rates of positive HIV status by young people living with HIV (YPLHIV) to their sexual partners vary and have been reported as low as 31%, despite the consequences of non-disclosure. Little is known about disclosure...

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Main Authors: Moses Mugerwa, Juliana Namutundu, Joanita Nangendo, Victoria Babirye Tumusiime, Denis Ndekezi, Collins G. K. Atuheire, Kelvin Bwambale, Suzanne N. Kiwanuka, David Kyaddondo
Format: Article
Language:English
Published: BMC 2025-04-01
Series:AIDS Research and Therapy
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Online Access:https://doi.org/10.1186/s12981-025-00727-7
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author Moses Mugerwa
Juliana Namutundu
Joanita Nangendo
Victoria Babirye Tumusiime
Denis Ndekezi
Collins G. K. Atuheire
Kelvin Bwambale
Suzanne N. Kiwanuka
David Kyaddondo
author_facet Moses Mugerwa
Juliana Namutundu
Joanita Nangendo
Victoria Babirye Tumusiime
Denis Ndekezi
Collins G. K. Atuheire
Kelvin Bwambale
Suzanne N. Kiwanuka
David Kyaddondo
author_sort Moses Mugerwa
collection DOAJ
description Abstract Background HIV/AIDS remains a public health threat globally. The disclosure rates of positive HIV status by young people living with HIV (YPLHIV) to their sexual partners vary and have been reported as low as 31%, despite the consequences of non-disclosure. Little is known about disclosure to sexual partners among YPLHIV in most of Sub-Saharan Africa, including Uganda. We assessed the prevalence, determinants, barriers and facilitators of HIV status disclosure to sexual partners among YPLHIV in care at an urban HIV clinic in Uganda. Methods The study utilized a cross sectional design using a parallel-convergent mixed method approach. We conducted 281 structured interviews through random sampling and 16 purposively sampled in-depth interviews (IDIs) among YPLHIV (18 to 24 years). Descriptive analysis was done to obtain the frequency and percentage of HIV status disclosure to sexual partners of YPLHIV. Modified Poisson regression was used to determine associated factors at multivariate analysis and adjusted prevalence ratios, 95% CI and p values were obtained using STATA version 14. Verbatim transcription and thematic analysis using NVIVO version 12 was used to explore the barriers and facilitators of HIV status disclosure to sexual partners using the health belief model. Results The prevalence of HIV status disclosure to sexual partners was 45.2%. Having a known HIV free partner (aPR = 0.6, P < 0.001), being a partial or complete orphan (aPR = 1.4, P = 0.022), knowing one’s HIV status for > 1 year (aPR = 0.7, P < 0.001), and having 2 rather than 3 sexual partners (aPR = 1.7, P = 0.013) were among the determinants of HIV status disclosure. Facilitators of disclosure included; health worker/peer support, nature of relationship, protecting partners against HIV, need for social/financial support. Barriers to disclosure included; lack of confidence to disclose, fear of sexual partners’ reaction, awareness of undetectable HIV viral load equated to none HIV transmission, influence by parents among others. Conclusion This study revealed a low HIV status disclosure prevalence to sexual partners among YPLHIV. Addressing potential barriers through comprehensive health education including the role of viral load in HIV transmission, and creating supportive environments to enhance their confidence, will improve disclosure rates among YPLHIV to their sexual partners.
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spelling doaj-art-e5c6c61b37b2445eb110e76402576b952025-08-20T01:54:22ZengBMCAIDS Research and Therapy1742-64052025-04-0122111210.1186/s12981-025-00727-7Disclosure of positive HIV status to sexual partners among young people receiving treatment at an urban clinic, Kampala, UgandaMoses Mugerwa0Juliana Namutundu1Joanita Nangendo2Victoria Babirye Tumusiime3Denis Ndekezi4Collins G. K. Atuheire5Kelvin Bwambale6Suzanne N. Kiwanuka7David Kyaddondo8Baylor FoundationDepartment of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere UniversityClinical Epidemiology Unit, College of Health Sciences, Makerere UniversitySchool of Public Health, College of Health Sciences, Makerere UniversityMRC/UVRI/LSHTM Uganda Research UnitDepartment of Biosecurity, Ecosystems and Veterinary Public Health, College of Veterinary Medicine, Animal Resources and Bioaffiliationersity, Makerere UniversityDepartment of Biosecurity, Ecosystems and Veterinary Public Health, College of Veterinary Medicine, Animal Resources and Bioaffiliationersity, Makerere UniversityDepartment of Health Policy Planning and Management, School of Public Health, Makerere UniversityChild Health Development Center (CHDC), Makerere UniversityAbstract Background HIV/AIDS remains a public health threat globally. The disclosure rates of positive HIV status by young people living with HIV (YPLHIV) to their sexual partners vary and have been reported as low as 31%, despite the consequences of non-disclosure. Little is known about disclosure to sexual partners among YPLHIV in most of Sub-Saharan Africa, including Uganda. We assessed the prevalence, determinants, barriers and facilitators of HIV status disclosure to sexual partners among YPLHIV in care at an urban HIV clinic in Uganda. Methods The study utilized a cross sectional design using a parallel-convergent mixed method approach. We conducted 281 structured interviews through random sampling and 16 purposively sampled in-depth interviews (IDIs) among YPLHIV (18 to 24 years). Descriptive analysis was done to obtain the frequency and percentage of HIV status disclosure to sexual partners of YPLHIV. Modified Poisson regression was used to determine associated factors at multivariate analysis and adjusted prevalence ratios, 95% CI and p values were obtained using STATA version 14. Verbatim transcription and thematic analysis using NVIVO version 12 was used to explore the barriers and facilitators of HIV status disclosure to sexual partners using the health belief model. Results The prevalence of HIV status disclosure to sexual partners was 45.2%. Having a known HIV free partner (aPR = 0.6, P < 0.001), being a partial or complete orphan (aPR = 1.4, P = 0.022), knowing one’s HIV status for > 1 year (aPR = 0.7, P < 0.001), and having 2 rather than 3 sexual partners (aPR = 1.7, P = 0.013) were among the determinants of HIV status disclosure. Facilitators of disclosure included; health worker/peer support, nature of relationship, protecting partners against HIV, need for social/financial support. Barriers to disclosure included; lack of confidence to disclose, fear of sexual partners’ reaction, awareness of undetectable HIV viral load equated to none HIV transmission, influence by parents among others. Conclusion This study revealed a low HIV status disclosure prevalence to sexual partners among YPLHIV. Addressing potential barriers through comprehensive health education including the role of viral load in HIV transmission, and creating supportive environments to enhance their confidence, will improve disclosure rates among YPLHIV to their sexual partners.https://doi.org/10.1186/s12981-025-00727-7HIVDisclosureSexual partnersAntiretroviral therapyYoung people living with HIV
spellingShingle Moses Mugerwa
Juliana Namutundu
Joanita Nangendo
Victoria Babirye Tumusiime
Denis Ndekezi
Collins G. K. Atuheire
Kelvin Bwambale
Suzanne N. Kiwanuka
David Kyaddondo
Disclosure of positive HIV status to sexual partners among young people receiving treatment at an urban clinic, Kampala, Uganda
AIDS Research and Therapy
HIV
Disclosure
Sexual partners
Antiretroviral therapy
Young people living with HIV
title Disclosure of positive HIV status to sexual partners among young people receiving treatment at an urban clinic, Kampala, Uganda
title_full Disclosure of positive HIV status to sexual partners among young people receiving treatment at an urban clinic, Kampala, Uganda
title_fullStr Disclosure of positive HIV status to sexual partners among young people receiving treatment at an urban clinic, Kampala, Uganda
title_full_unstemmed Disclosure of positive HIV status to sexual partners among young people receiving treatment at an urban clinic, Kampala, Uganda
title_short Disclosure of positive HIV status to sexual partners among young people receiving treatment at an urban clinic, Kampala, Uganda
title_sort disclosure of positive hiv status to sexual partners among young people receiving treatment at an urban clinic kampala uganda
topic HIV
Disclosure
Sexual partners
Antiretroviral therapy
Young people living with HIV
url https://doi.org/10.1186/s12981-025-00727-7
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