Navigating Disclosure Obstacles Encountered by Individuals with HIV at Kakomo Healing Centre IV in Kabale District

Ahimbisibwe Godfrey

Faculty of Clinical Medicine and Dentistry Kampala International University Western Campus Uganda


HIV/AIDS remains a pressing global health concern, particularly impacting socio-economic development in various African nations, Uganda included. Revealing one’s HIV-positive status to a family member or relative is crucial for adherence to effective antiretroviral therapy, which significantly enhances the survival and well-being of those living with HIV. To evaluate the hurdles faced by individuals with HIV at Kakomo HC IV in Kabale District regarding disclosure and to curtail new infections in this community, a descriptive cross-sectional study was conducted. The study sampled individuals living with HIV at Kakomo HC IV randomly, utilizing a pretested questionnaire as the data collection instrument. The gathered data underwent coding, sorting, entry, and analysis through statistical software (SPSS), presented via tables and charts. Findings revealed that only 40 (50.6%) were adequately prepared before disclosing their status, while 30 (37.0%) neither prepared nor disclosed to anyone. 61 (63.5%) received education on the importance of disclosure during clinic visits, but 26 (46.4%) neither disclosed nor received such education. Barriers to disclosure primarily stemmed from anxiety about blame, stigma, fear of losing a partner, and violence among 18 (54.5%), 19 (52.8%), 30 (39.0%), and 2 (18.2%) individuals, respectively. Despite 62 (43.4%) intending to disclose to someone, 88 (98.9%) faced barriers to disclosing their status. Misconceptions in 51 (31.9%) communities and potential discrimination by families in the same proportion highlighted the challenges. Consequently, 123 (76.9%) still fear others spreading word of their HIV-positive status. Understanding disclosure motivations is crucial, requiring tailored strategies for decision-making based on the discloser’s needs and their intended audience. The significance of support, proximity, and relational dynamics between the discloser and the recipient emphasizes the necessity for a secure environment during disclosure.

Keywords: HIV/AIDS, Antiretroviral therapy, HIV-positive, HIV status, Stigma.


HIV is referred to as Human Immunodeficiency Virus (HIV), which is the most dangerous virus and is the major cause of AIDS in human life[1, 2]. It continues to spread worldwide and is one of the serious health challenges. Although much of the news on AIDS is encouraging, the challenges have continued [3] Disclosure is defined as the willingness of people living with HIV/AIDS (PLWHA) to reveal their seropositive status to another person [4]. An individual who has accepted the diagnosis may be likely to disclose his/her status as a coping action to regain control over his/her life. Disclosing one’s HIV seropositive status has been described as a complex issue and a ‘double-edged sword’, which could either have a positive or negative outcome, or both.

Globally, there were 36.7 million people living with HIV in 2023[2, 5–7]. This was a high of 33.3 million in 2010. These increments in the number of patients resulted from continuing new infections, people living longer with HIV, and general population growth [8]. 1.1 million people died of AIDS in 2015. There were about 2.1 million new infections in 2015, or about 5700 new infections per day. In developed countries, an average of 79% of HIV-positive patients disclosed their HIV status to other people [9]. Whereas in developing countries, the rates of disclosure of HIV serostatus were very low compared to developed countries.

Sub-Saharan Africa, the hardest-hit region, is home to nearly 70% of people living with HIV but only about 13% of the world’s population [1, 10]. The rates of HIV-positive disclosure serostatus ranged from 16.7% to 86%, with an average of 49%, as almost half of the HIV-positive patients do not expose their serostatus to other people, including their sexual partners [11].

In Africa, the situation is even worse, with Ethiopia having a large and very vulnerable population with more than half a million (671,941) HIV-positive population, 14,405 new HIV infections, and 24,813 deaths in 2016, with a very low percentage of HIV-positive patients disclosing their serostatus to other people, including their sexual partners [12]. In Tanzania, 41% of HIV-positive women living with the infection had disclosed to their partners, and the most common reasons for disclosure status were age, level of education, and financial independence, particularly for women, to be important factors in predicting HIV serostatus disclosure [13].

HIV status disclosure has been reported to benefit PLWHA in several ways, including psychological, emotional, and material support from family and other community members and freedom to use ARV medications [4, 14]. In Uganda, an estimated 1.3 million people were living with HIV in 2017, and an estimated 26,000 Ugandans died of AIDS-related illnesses (UNAIDS, 2018). Men were disproportionately affected, with only 8.8% of adult women living with HIV disclosing their HIV-positive serostatus to their partners compared to 4.3% of men. Disclosure of Human Immunodeficiency Virus (HIV) positive status has a key role in the prevention and control of HIV/AIDS. The failure of people infected with HIV to disclose their positive status can expose their sexual partners and other relatives who have close contact with them to the virus. There are different factors that affect the disclosure of their HIV status; such as marital status, knowledge of partner HIV status, fear of negative outcomes of disclosure, communication skills, initiation of antiretroviral, receiving ongoing counseling, and duration of HIV-related care follow-up are some of the identified reasons [15].

Similarly, a growing body of research has explored the disclosure experiences of people living with HIV and AIDS in Kabale District. Results suggested that most people, particularly men living with HIV, do not disclose knowledge of their seropositive status to their partners [16]. The decision to disclose seropositive status among men is a complex process influenced by multiple factors such as knowledge of the partner’s HIV status, anticipated support, and being the head of the household. The current study, therefore, seeks to assess disclosure challenges faced by people living with HIV/AIDS at Kakomo Health Centre IV located in Ndorwa West in Kabale District, western Uganda. HIV/AIDS remains a global public health issue with devastating effects, especially on the socio-economic development in several African countries, including Uganda [17, 18]. Disclosure of HIV-positive status to at least one family member or relative is paramount for adherence to highly active antiretroviral therapy (HAART), which increases the survival and quality of life of people living with HIV [19–22]. The Government of Uganda has deployed qualified health workers and provided HIV prevention and testing materials in various hospitals recently to promote, among other things, HIV seropositive disclosure to family members or relatives through multi-sectoral collaborative efforts together with other key stakeholders such as peer educators, social workers, opinion leaders, community members, and the PLWHA themselves. Despite the above efforts in place and the importance of HIV seropositive status disclosure, still, most PLHIV conceal their seropositive status from their family/relatives. In Kakomo Health Centre IV, a recent Health Management Information System (tool 105) report indicated that, of 100% of PLHIV, only an estimated 55% disclosed their HIV seropositive status, although health workers working in the ART clinic provide routine health education talks on the importance of HIV seropositive status disclosure to PLHIV on every ART clinic day (HMIS, August 2018). This has resulted in 30% of new HIV infections occurring yearly, poor retention, and an increased number of unsuppressed viral load clients on care due to non-adherence to ART. No clear documentation exists on what exactly influences non-disclosure of HIV seropositive status among PLHIV, and this has motivated the researcher to assess disclosure challenges faced by PLWHA at Kokomo HC IV in Kabale District to make some relevant recommendations to the stakeholders for implementation.


The findings suggest that the reasons for disclosure may differ by the target of disclosure or nondisclosure, highlighting the need for tailoring interventions and strategies for improving disclosure decision-making according to the specific needs of the disclosers and who they are disclosing. The prominence of support, closeness, and social distance between the discloser and the disclosure target highlights the need for people to feel safe when disclosing.


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CITE AS: Ahimbisibwe Godfrey (2023). Navigating Disclosure Obstacles Encountered by Individuals with HIV at Kakomo Healing Centre IV in Kabale District. IDOSR JOURNAL OF BIOCHEMISTRY, BIOTECHNOLOGY AND ALLIED FIELDS 8(3): 23-37.