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Self-disclosure of HIV infection: experiences and wellbeing reported by youth in Kinshasa, Democratic Republic of the Congo (DRC)
E. Taylor1, S. Duvall1, A. Pettifor1, B. Mupenda2, M. Kashosi2, C. Holub3, S. Rennie4, F. Behets1
1UNC Gillings School of Global Public Health, Epidemiology, Chapel Hill, United States, 2School of Public Health University of Kinshasa, Kinshasa, Congo, the Democratic Republic of the, 3UNC Gillings School of Global Public Health, Health Behavior and Health Education, Chapel Hill, United States, 4University of North Carolina -Chapel Hill, Dental Ecology, Chapel Hill, United States
Background: Information on self-disclosure of HIV infection by youth, particularly in sub-Saharan Africa, is scarce despite prevention and social support needs. To inform support strategies we aimed to document disclosure experiences.
Methods: Youth, aged 14-24 receiving HIV care/support services in Kinshasa were evaluated using structured questionnaires and in-depth interviews. Using age-adjusted linear models we evaluated associations between reported self-disclosure and wellbeing (measured using established multidimensional scales).
Results: Of 151 HIV+ youth who knew they had HIV, 84% were aged 18-24, 80% were female, and 30% were attending school. 58% of youth had lost one parent and 23% had lost both parents. 54% of youth had talked to at least one person about their HIV infection. Youth were most likely to discuss their HIV infection with siblings (40%) or close friends (33%). Youth expressed fear and concern about reactions to HIV disclosure and were more likely to report bad or mixed experiences than good experiences. Approximately 25% of individuals informed of youth's HIV infection were informed without the youth's consent, and youth were more likely to regret these individuals knowing their status. A negative impact on at least one relationship was reported by 57% of youth. Signs of major depression were more common among youth who had self-disclosed than among those who had not (61% vs. 54%). 65% of youth rated their quality of life as good or very good compared to life before diagnosis. Instrumental social support and emotional support were strongly associated with HIV self-disclosure.
Conclusions: Youth who discussed their HIV infection with others reported improved social support but also expressed fears and reported negative experiences following disclosure. More research is needed to better understand the benefits and challenges to self-disclosure by HIV+ youth and enable the development of improved care and support strategies.
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