Self-Disclosure of HIV Status and the Relationship to Mental Health Among Adolescents Living With HIV in Uganda: A Cross-Sectional Secondary Analysis of a Longitudinal Cohort

ABSTRACT: Research on self-disclosure of HIV status by adolescents living with HIV (ALHIV) is scarce, despite its growing recognition as a determining factor of psychosocial outcomes and HIV treatment adherence, warranting examination of its mental health implications. A secondary analysis of longitudinal data of ALHIV in Uganda was conducted to assess patterns of self-disclosure and associations between sociodemographic factors, disclosure choices, and mental health symptoms. ALHIV disclosed to at least one person, most commonly a nuclear family member, with no significant associations except for disclosure to one's brother (i.e., lower depression symptoms). ALHIV who self-disclosed generally reported lower depression and anxiety symptoms, with a significant association observed for depression. The likelihood of ALHIV to disclose to family members highlights the importance of engaging these individuals in psychosocial interventions. Further research should clarify directionality and causality and examine the factors shaping ALHIV disclosure preferences to inform tailored care.