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. 2025 Apr 1;22(1):40.
doi: 10.1186/s12981-025-00727-7.

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

Moses Mugerwa  1   2 , Juliana Namutundu  3 , Joanita Nangendo  4   5 , Victoria Babirye Tumusiime  6   7 , Denis Ndekezi  7 , Collins G K Atuheire  8 , Kelvin Bwambale  8 , Suzanne N Kiwanuka  9 , David Kyaddondo  10
Affiliations

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

Moses Mugerwa et al. AIDS Res Ther. .

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.

Keywords: Antiretroviral therapy; Disclosure; HIV; Sexual partners; Young people living with HIV.

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Conflict of interest statement

Declarations. Ethical approval: The Research and Ethics Committee of Makerere University School of Public Health (Mak-SPH-REC) gave approval for this research, protocol number 124 in 2022. Permission was sought from research directorate of Baylor Uganda to conduct the study at their site. Informed consent was sought from participants and unique identifiers were used during data collection for confidentiality. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Illustration of the health belief model [23], adopted from the Handbook for Designing and Conducting Clinical and Translational Research, 2023
See this image and copyright information in PMC

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