Dilemma of HIV status disclosure among sexually active 14-19-year-old adolescent boys and its effects on viral load suppression in Siaya County, Kenya

Background: Stigma related to HIV status disclosure creates a great dilemma among AIDS patients and is associated with ART non-adherence and mortality particularly in the developing world. Worldwide, adolescents aged 14-19 constituted 69% of HIV-related deaths, with boys on ART making up 68% of such deaths in areas such as Siaya County of Kenya in 2020. While non-suppression of VL is associated with HIV-related deaths among others, a dearth of literature however exists on whether adolescent boys are more prone to stigma related to HIV status disclosure. This paper sought to investigate how stigma-related to HIV status disclosure among sexually active 14-19-year-old adolescent boys in Siaya County, Kenya. Methods: This cross-sectional study used questionnaire to collect quantitative data from 263 adolescent boys on ART. Qualitative data was also collected from a section of the boys using focus group discussion guide and in-depth interviews, alongside seven comprehensive care-in charge (CCC), the county AIDS/HIV and STI coordinator (CASCO), sub county AIDS coordinators (SCACOs), and public benefit organizations (PBO) officials. Results: The correlation between disclosure to partners and VL suppression (r=0.072; p=0.122) and multiple sexual partners and VL suppression (r=0.023; p=0.353) were found not to be significant, while that of disclosure to partners and multiple sexual partners (r=0.391; p=0.000) was significant. Conclusions: The study concluded that stigma-related to HIV status disclosure to partners has a direct and significant effect on multiple-sexual behaviour, a risk factor to VL suppression endeavour. Targeted interventions should aim at addressing HIV status disclosure among the adolescent boys.