Open AccessDisclosure, Social Support, and Mental Health are Modifiable Factors Affecting Engagement in Care of Perinatally-HIV Infected Adolescents: A Qualitative Dyadic Analysis
Author(s) -
Brian C. Zai,
Moherndran Archary,
Tamarra Subramony,
Thobekile Sibaya,
Christina Psaros,
Jessica Haberer
Publication year - 2020
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-020-02968-1
Subject(s) - health psychology , denial , mental health , qualitative research , social support , psychology , psychological resilience , public health , medicine , clinical psychology , psychiatry , nursing , social psychology , psychotherapist , social science , sociology
Adolescents living with perinatally acquired HIV in South Africa face significant barriers to successful transition from pediatric to adult care. We performed in-depth qualitative interviews with 41 adolescents living with HIV and 18 of their caregivers to investigate modifiable factors to improve engagement in care prior to transition to adult care. Based on dyadic, inductive content analysis, findings suggest that HIV status disclosure, social support, and mental health are targets for improvement in engagement in care. Early disclosure and a sense of belonging facilitated engagement in care, while barriers included delayed or inadequate disclosure, denial, and lack of disclosure to others. Adherence support improved by having a biological mother as a direct supervisor. Barriers to care included changing caregivers, abandonment, undiagnosed mental health problems and learning difficulties. Despite these factors, the majority of adolescents showed resilience and remained engaged in care despite difficult circumstances.