Pathways of onward HIV disclosure in relationships among young people living with vertically acquired HIV receiving antiretroviral therapy: A qualitative analysis from the BREATHER Plus trial, South Africa
Year: 2026
Type: article
Abstract: For young people living with HIV (YPLHIV) navigating their status since birth, managing onward disclosure of a potentially stigmatising condition in relationships is challenging, and may or may not lead to social support, with implications for wellbeing. In a clinical trial setting in KwaZulu-Natal, South Africa, we investigate how young people living with vertically acquired HIV navigate onward disclosure. Data were from the qualitative component of the BREATHER Plus randomised controlled trial evaluating the efficacy, safety and acceptability of short-cycle dolutegravir/tenofovir-based triple antiretroviral therapy (ART) in young people aged 12-19 years. We analyse data on 35 participants receiving ART engaged in clinical trials at the research site: 29 in longitudinal in-depth interviews (IDIs) and 12 across three focus group discussions (FGDs), including 6 in IDIs and FGDs. The Disclosure Processes Model was applied in the thematic analysis. Pre-disclosure was characterised by social assessments of potential confidants. During disclosure, reciprocal vulnerability and partial information-sharing were employed. Post-disclosure processes entailed linear and non-linear feedback trajectories, impacting future disclosures. The findings show that the study cohort of young people receiving ART navigated many bidirectional disclosure pathways to maintain social connections in relationships, and counselling guidelines need to be responsive to this.
Source: Global Public Health
Institutions: Centre for the AIDS Programme of Research in South Africa, Africa Health Research Institute, University of KwaZulu-Natal, London School of Hygiene & Tropical Medicine, MRC/UVRI & LSHTM Uganda Research Unit, The University of Sydney, MRC Clinical Trials Unit at UCL, University College London, Medical Research Council, Joint Clinical Research Centre, Baylor College of Medicine Children’s Foundation, University of Oxford
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,650
Awards: BREATHER Plus: A randomised open-label 3-arm, 96-week trial evaluating the efficacy, safety and acceptability of weekends off dolutegravir-based antiretroviral therapy (ART) and monthly long-acting injectable ART compared to daily dolutegravir-based ART in virologically suppressed HIV-infected children and adolescents in sub-Saharan Africa, G2347075150, G3982095159, G4438663976, G4926557987, Paediatric and adolescent infections, Blood borne viruses, G565924057, G7063735130
OpenAlex ID: W7203821367