Factors Influencing HIV Testing and Status Disclosure Among Young Women and Men in Kafue and Lusaka Districts

Abstract : Adolescent HIV testing and status disclosure rates remain low in Zambia with many people unaware of their status. HIV testing rates for adolescents and young people are about 61 percent for females and 49 percent for males while HIV disclosure is about 83 percent for females and 77 percent for males. This study explored the factors influencing HIV testing and status disclosure among male and female young people in Kafue and Lusaka Districts. The study specifically intended to identify factors that influence HIV testing and status disclosure among young people, explore experiences and attitudes towards HIV Testing and status disclosure among young males and young females living with HIV and determine facilitators and barriers for HIV Testing and status disclosure among the male and female participants. The study adopted a cross-sectional design and was anchored in a mixed method approach. It was conducted in Lusaka and Kafue districts of Zambia. The study applied both qualitative and quantitative data collection and analysis techniques. The study utilized both primary and secondary data. Primary data was obtained from young people, while secondary data was sourced from relevant national and international reports and policy documents as well as peer reviewed journals. The sample comprised of 359 male and female young people (i.e.180 females and 179 males. Out of this total, 83 males and 101 females were from Kafue district while 96 males and 79 females were from Lusaka district) attending youth friendly corners and the ART clinics. The participants were randomly selected. Results showed that HIV testing awareness and knowledge were prevalent among Adolescents and Young People (AYP), with educational platforms and friends being significant sources of information. It was also found that many factors influenced HIV status disclosure among adolescents and young people (AYP) in Kafue and Lusaka. These included strong support networks, comprehensive sexuality education (CSE), youth-friendly health services, anti-stigma campaigns and the influence of role models, family members, high rates of disclosure to sexual partners, healthcare providers and school counsellors or teachers. Barriers to disclosure included fear of stigmatization and discrimination, concerns about confidentiality, negative family reactions and the impact on romantic relationships. Further, respondents experienced significant hardships following the disclosure of their HIV status, with girls often suffering from increased judgment and social isolation, while boys faced stigma and a pressure to appear unaffected. In coping with these challenges, they developed various strategies: finding solidarity in support groups, drawing strength from family support, seeking professional counselling, engaging in education and advocacy, expressing themselves artistically, and maintaining a healthy lifestyle. Therefore, it was recommended that there must be the development of gender-sensitive programs, community engagement with a focus on gender roles, and the creation of accessible services with consideration for gender dynamics. Additionally, urban youth engagement needed to incorporate gender-specific messaging, and educational efforts to emphasize gender equality. Support networks and safe spaces needed to account for gender differences. In addition, the policies ought to advocate for gender equity, addressing legal and social challenges specific to young men and women in the context of HIV testing and disclosure.