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"He can run away, life goes on;" Factors in Partner Disclosure among HIV Positive Adolescents in Cape Town, South Africa


Background: Home to around 7.7 million HIV positive individuals, South Africa holds 20% of the global HIV population. HIV presents many challenges, such as stigmatization, disclosure, and HIV transmission. However, adolescents living with HIV must also navigate sexual debut, peer pressure, and puberty, emphasizing the need for tailored interventions to support their sexual and reproductive health. In an effort to determine appropriate prevention and treatment methods, this qualitative study investigated HIV-serostatus partner disclosure among adolescents living with HIV in Cape Town. Disclosure rates are currently low, despite research indicating the many benefits of sharing one’s status. Objectives: A mixed methods study design was used as a way to better inform development of interventions for HIV positive adolescents, and specifically, clinical methods of improving disclosure rates. The qualitative data reported within this abstract is organized as such; 1) Facilitators of partner disclosure, 2) Barriers to partner disclosure, 3) Habitual, emotional, and concrete outcomes of partner disclosure, and 4) Clinical support and reported intervention strategies. Methods: Qualitative data was extracted from in-depth interviews with individuals recruited from clinics in Cape Town, South Africa. Data is drawn from 20 interviews with adolescents living with HIV, aged 16-19, as well as 15 clinicians. Data was coded and analyzed using the NVivo 12 program, to better understand the motivations for adolescent’s disclosure or non-disclosure to sexual partners. Results: Several major themes related to HIV-serostatus disclosure arose from analysis of the data. These include: 1) negative social backlash such as abandonment or peer gossip are perceived primary barriers, 2) facilitators of adolescent partner disclosure primarily revolve around respect for one’s partner or feelings of self-confidence despite the social stigmatization of HIV, 3) adolescents that disclose report overall positive experiences, though concrete positive results vary, and 4) clinical guidance may be helpful in improving partner disclosure rates. Conclusion: Adolescents are especially reluctant to disclose their HIV status to partners due to fears of social backlash, particularly the negative rumors that may result even from sharing one’s status in confidence with a partner. Partner communication about HIV serostatus is infrequent for sexually active adolescents, but almost all adolescents appear to understand the benefits of disclosure, especially the large portion of these adolescents who had not yet engaged in sex. Finally, it is clear that therapeutic clinical interventions to reduce the barriers to effective communication are necessary, especially due to reports about the perceived trustworthiness of clinicians and medical advice. These data offer insights into programs that would best support adolescents seeking strategies to navigate the challenges of HIV-serostatus disclosure.
Senior thesis (AB)--Brown University, 2020
Concentration: Health and Human Biology

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Belsky, Mikaela S., "'He can run away, life goes on;' Factors in Partner Disclosure among HIV Positive Adolescents in Cape Town, South Africa" (2020). Biology and Medicine Theses and Dissertations. Brown Digital Repository. Brown University Library.