Late disclosure of HIV diagnosis in adolescents: psychosocial implications from the perspective of caregivers and healthcare providers in Maputo Province, Mozambique

HIV infection in children and adolescents carries significant psychosocial implications. In Mozambique, disclosure is frequently delayed, yet the consequences remain understudied. This qualitative study analyzed the psychosocial implications of late HIV disclosure among adolescents aged 10–14 years receiving antiretroviral therapy (ART) from the perspectives of 15 caregivers and two healthcare workersat Namaacha Healthcare Center, Maputo Province, in January 2026. Data were analyzed using thematic content and descriptive frequency analyses. Disclosure was most commonly performed by parents (46.7%), followed by family members (26.7%), healthcare providers (20.0%), and friends (6.7%). Sadness (60.0%) and confusion (26.7%) were the dominant initial reactions. Moderate anxiety (66.7%) and sadness (66.7%) persisted long-term. Most adolescents coped through sports (46.7%) and artistic activities (26.7%). Professional counseling was the most valued support mechanism (73.3%). Diagnosis acceptance emerged as the primary long-term challenge (53.3%). Fear of stigma, caregiver guilt, and insufficient professional preparation heavily drive delayed disclosure. Structured disclosure protocols and dedicated caregiver support are critical health system requirements. It is insufficient to merely advise early disclosure; caregivers must be equipped and supported to disclose safely.​IMPACT STATEMENTWhat does this paper add? This study provides novel, context-specific evidence on the psychosocial consequences of late HIV diagnosis disclosure for adolescents aged 10–14 years in Mozambique. It demonstrates that sadness, confusion, and diagnosis acceptance difficulties are the dominant responses following late disclosure, while structured psychosocial counseling significantly mitigates these effects. The findings are the first from a peri-urban Mozambican setting to center caregiver and healthcare provider perspectives on disclosure, and directly inform national guidelines, clinical practice, and health system investment in pediatric HIV psychosocial services in low- and middle-income country contexts.