The association between disclosure and adherence to Antiretroviral Therapy among adolescents living with HIV in Windhoek, Khomas region, Namibia
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Date
2024
Authors
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Journal ISSN
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Publisher
University of Namibia
Abstract
The study was conducted in Windhoek, Khomas region, Namibia, focusing on adolescents
living with HIV aged 10-19 who had been receiving antiretroviral therapy (ART) care for at
least six months between 2010 and 2021. It also included healthcare workers who had worked
in the ART department for at least six months during the data collection period. The primary
objective was to assess the association between disclosure (the process of revealing one's
HIV-positive status) and adherence to ART among adolescents living with HIV. A mixed method approach with an explanatory sequential design was employed. The quantitative
component used an unmatched case-control design with a 1:1 ratio, while the qualitative
component utilized an exploratory design to complement the quantitative analysis. The study
participants included 20 healthcare workers and 37 adolescents living with HIV who were on
ART care. Findings revealed that among adolescents with good adherence (≥90%), 76% had
been fully disclosed about their HIV-positive status, while 20% were partially disclosed. In
contrast, among adolescents with poor adherence (<90%), 92% had not been disclosed about
their HIV-positive status. Some adolescents who were fully disclosed learned about their
status accidentally. Caregivers of the adolescents and healthcare workers were the key
informants in disclosure and adherence aspect. The study recommends strengthening
disclosure programs through enhanced efforts by the Ministry of Health and Social Services.
This includes training healthcare providers involved in the disclosure process, educating
parents/caregivers or guardians about the disclosure process and the skills required to conduct
it at home, ensuring equitable distribution of disclosure tools and equipment among health
facilities, and implementing standardized disclosure processes through Standard Operating
Procedures (SOPs) and guidelines consistently across all health facilities nationwide. Future
research should explore factors that enable adolescents to accept their HIV-positive status
with reduced distress and examine their experiences during and after disclosure sessions,
including their psychosocial support needs. In summary, this study aimed to understand the
relationship between disclosure and adherence to ART among adolescents living with HIV in
Namibia and provided recommendations to improve the disclosure process and support for
these adolescents
Description
A thesis submitted in partial fulfillment of the requirements for the degree of Master of Public Health
Keywords
Adolescents, Adherence, disclosure, Anti-retro viral therapy (ART), Health care workers, University of Namibia, Namibia