Research Article
Perceptions and Experiences about Self-Disclosure of
HIV Status among Adolescents with Perinatal Acquired HIV in
Poor-Resourced Communities in South Africa
Sphiwe Madiba
1
and Mathildah Mokgatle
2
1
School of Public Health, Department of Environmental and Occupational Heath, Sefako Makgatho Health Sciences University,
Pretoria, South Africa
2
School of Public Health, Department of Biostatistics, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Correspondence should be addressed to Sphiwe Madiba; sphiwe madiba@embanet.com
Received 31 May 2016; Accepted 11 August 2016
Academic Editor: David Katzenstein
Copyright © 2016 S. Madiba and M. Mokgatle. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Background. Tere is limited research on the disclosure experiences of adolescents with perinatal acquired HIV (PAH). Te
study explores how adolescents with PAH experience living with HIV and examined their perceptions and experiences regarding
disclosure and onward self-disclosure to friends and sexual partners. Methods. Tematic analysis was used to analyze in-depth
interviews conducted with 37 adolescents. Findings. Adolescents received disclosure about their status at mean age of 12 years.
Tey perceived disclosure as necessary and appreciated the truthful communication they received. Adolescents have learned to
accept and live with HIV, and they desired to be healthy and normal like other people. Afer receiving disclosure, they found their
treatment meaningful, and they adhered to medication. However, they also expressed a strong message that their HIV status was
truly their secret and that self-disclosure to others will take the feeling of being normal away from them because they will be treated
diferently. Conclusion. Adolescents maintained secrecy in order to be accepted by their peers but also to protect themselves from
stigma and isolation. Given that adolescents want to be informed of their HIV status but desire controlling self-disclosure of their
HIV status, these should form the basis for development of disclosure interventions.
1. Introduction
Te increasing availability and provision of free antiretroviral
treatment (ART) have resulted in a signifcant reduction in
mortality of HIV-infected children, surviving through child-
hood into adolescence in low income countries [1, 2]. Te
increased survival of children and adolescents with perina-
tally acquired HIV (PAH) has been accompanied by unique
needs and specialized management [3]. Teir needs are more
sensitive and varied than those of adults; they must simulta-
neously deal with adult issues, such as disclosure, stigma, and
practicing safe sex [4]. However, adolescents with PAH can
deal with all of these issues only if they are informed about
their HIV diagnosis. Yet, the World Health Organization
(WHO) maintains that most of the estimated 2 million ado-
lescents with PAH worldwide are unaware of their HIV status
[5]. Te levels of disclosure of the HIV status to adolescents
are low even though limited research shows that adolescents
prefer to be informed about their HIV status [6–8].
While adolescents and children with PAH prefer to be
informed about their HIV diagnosis, data from studies that
examine self-disclosure by adolescents suggest that disclosure
to sexual partners and friends remains low, particularly in
developing countries [9–11]. Self-disclosure to sexual part-
ners is considered an important process in preventing HIV
transmission. It is for these reasons that the disclosure focus is
shifing from caregivers’ disclosure to HIV-infected children
to decisions concerning self-disclosure among adolescents
with PAH. Te importance of self-disclosure increases as
children with PAH progress into adolescence, and concerns
regarding HIV transmission intensify [12]. Self-disclosure
among adolescents with PAH increases condom negotia-
tion and use, improves ART adherence, and reduces levels
of unprotected sexual activities [13]. Toth and colleagues
Hindawi Publishing Corporation
AIDS Research and Treatment
Volume 2016, Article ID 2607249, 10 pages
http://dx.doi.org/10.1155/2016/2607249