We examined patterns of disclosure among youth living with HIV (YLHIV) in Kenya, and the association between self-disclosure and antiretroviral therapy adherence, stigma, depression, resilience, and social support. Of 96 YLHIV, 78% were female, 33% were ages 14–18, and 40% acquired HIV perinatally. Sixty-three (66%) YLHIV had self-disclosed their HIV status; 67% to family and 43% to non-family members. Older YLHIV were 75% more likely to have self-disclosed than those 14–18 years. Of the 68 either married or ever sexually active, 45 (66%) did not disclose to their partners. Those who had self-disclosed were more likely to report internalized stigma (50% vs. 21%, prevalence ratio [PR] 2.3, 1.1–4.6), experienced stigma (26% vs. 3%, PR 11.0, 1.4–86), and elevated depressive symptoms (57% vs. 30%, PR 1.8, 1.0–3.1). The association with stigma was stronger with self-disclosure to family than non-family. Support should be provided to YLHIV during self-disclosure to mitigate psychosocial harms.

我们研究了肯尼亚青少年艾滋病毒感染者 (YLHIV) 的披露模式，以及自我披露与抗逆转录病毒治疗依从性、耻辱、抑郁、复原力和社会支持之间的关联。在 96 名 YLHIV 患者中，78% 是女性，33% 年龄在 14-18 岁，40% 是在围产期感染艾滋病毒。六十三名 (66%) YLHIV 已自我披露其 HIV 状况；67% 为家庭成员，43% 为非家庭成员。年龄较大的 YLHIV 自我暴露的可能性比 14-18 岁的人高出 75%。在 68 名已婚或性活跃的人中，45 人 (66%) 没有向伴侣透露这一情况。那些自我暴露的人更有可能报告内在的耻辱（50% vs. 21%，患病率 [ PR ] 2.3, 1.1–4.6），经历耻辱（26% vs. 3%，PR 11.0, 1.4–86） ，以及抑郁症状加重（57% vs. 30%，PR 1.8、1.0–3.1）。与非家庭成员相比，向家人进行自我披露与耻辱感的关联性更强。在自我表露期间应向 YLHIV 提供支持，以减轻社会心理伤害。