Abstract
HIV self-disclosure plays an important role in preventing secondary HIV transmission and
enhancing adherence to antiretroviral therapy (ART). Young women living with perinatally
acquired HIV (PAH) face numerous health and psychosocial challenges, including poor viral
load suppression and poor adherence and retention to treatment. They also face constraints
in disclosing their HIV status to others and acceptance by family members, peers, and intimate
partners after disclosure. Professional nurses are strategically positioned to support
disclosure, yet patient-centred and evidence-based strategies to guide their facilitation of the
process are limited.
The purpose of this study was to develop strategies for professional nurses to facilitate HIV
serostatus disclosure among young women living with perinatally acquired HIV, enabling them
to make informed decisions about when and to whom to disclose. The objectives of the study
were to explore young women living with PAH’s experiences of HIV self-disclosure to family
members, peers and sexual partners; develop and describe a conceptual framework for
professional nurses to facilitate HIV serostatus disclosure among young women living with
PAH; develop and describe strategies for professional nurses to facilitate self-disclosure
among young women living with PAH; and identify experts in the field of HIV and women,
strategy development, public health and primary healthcare to evaluate the strategies
developed for professional nurses to facilitate self-disclosure among young women living with
PAH.
The study was conducted over four phases. In phase one, a phenomenological exploration
and description of the lived experiences of young women living with PAH was conducted
through a qualitative, exploratory, descriptive, and contextual research design. The purposive
sample included 18 young women living with PAH aged 18-22; they were recruited from the
Intermediate Hospital Katutura ART clinic. Data were collected through in-depth, face-to-face,
individual phenomenological interviews. Thereafter, the interviews were transcribed verbatim
and thematically analysed using Braun and Clarke’s method. Five themes emerged from the
analysed data, namely a lack of awareness of their HIV status, resilience and acceptance of
their HIV status despite facing various challenges, a lack of trust and hesitance to disclose
due to fear of stigma and discrimination, a need for guidance on how to disclose their status
to others, and identified knowledge gaps related to HIV in the school curriculum and the
community...