Anti-retroviral therapy adherence and HIV status disclosure among women aged 18 to 35 years in selected health facilities in Kampala District

Abstract

This study examined the association between HIV status disclosure and antiretroviral therapy (ART) adherence among 369 women aged 18–35 receiving HIV care in Kampala, Uganda, using secondary data from the 24-month BONE: CARE prospective cohort study. Although ART adherence improved over time, peaking at 83.6% at month 21 and 81.8% at month 24 HIV status disclosure remained low. At baseline, only 32.5% of participants had disclosed their status, and just 5% of initial non-disclosers disclosed by study end. Multivariable analysis showed that women aged 25–35 years (aPR = 1.10, p = 0.048) and employed women (aPR = 0.92, p = 0.033) were more likely not to disclose their HIV status. The findings highlight persistent psychosocial and economic barriers to disclosure despite improved adherence. Comprehensive interventions focusing on stigma reduction, empowerment, and targeted support services are needed to promote both HIV status disclosure and sustained ART adherence among young women living with HIV.