A self-disclosure model for adolescents with perinatally acquired HIV in Eswatini.

Abstract

Background:  Adolescents living with HIV (ALHIV) are faced with the hard decision of how to disclose their HIV status to others. Despite this obvious challenge, few HIV self-disclosure models exist.

Objectives:  This study was aimed at developing a self-disclosure model that would assist adolescents with perinatally acquired HIV in Eswatini to share their HIV status with others.

Method:  The explanatory sequential mixed method design was used; therefore, quantitative data were collected first from 361 ALHIV aged 15-19 years using questionnaires and analysed. Qualitative data were collected from 23 ALHIV, 24 nurses and 4 policymakers using 3 focus group discussions and in-depth individual interviews. For quantitative data, statistical analysis was utilised, and grounded theory guided the analysis of qualitative data and the development of the model.

Results:  HIV self-disclosure is the central concept for this model, and it is supported by four major concepts: (1) national HIV strategic framework, (2) enablers, (3) adolescent empowerment and (4) model outcomes. The description of the model was conducted using Chinn and Kramer's stages of model development.

Conclusion:  HIV education and social support are important in reducing stigma and discrimination in communities where adolescents reside. Prioritising the training of nurses and developing self-disclosure guidelines would lead to a remarkably increased level of adolescent HIV self-disclosure. Contribution: The contribution of this study is that it is the first of its kind to develop an adolescent HIV self-disclosure model in Eswatini.