Adolescents living with HIV in sub-Saharan Africa face significant mental health challenges, often worsened by non-disclosure of their status. While family-centred disclosure is recommended, robust methodological frameworks for evaluating its impact on adolescent mental health are scarce. This methodology article details the protocol for a study assessing the effectiveness of a family-centred disclosure intervention on mental health outcomes for adolescents living with HIV in Iringa, Tanzania. Its primary objective is to describe the mixed-methods design for evaluating changes in depression and anxiety symptoms. The study employs a pre-post intervention design with a nested qualitative component. Adolescents aged 10-19, who are unaware of their HIV status, and their caregivers are recruited from public health facilities. The structured intervention involves preparatory counselling sessions for caregivers and adolescents, followed by a facilitated disclosure event. Quantitative data on depression and anxiety are collected using validated tools at baseline, immediately post-disclosure, and at a three-month follow-up. Concurrent in-depth interviews explore the lived experiences of a purposively selected sub-sample. As a protocol paper, this article presents no empirical results. The anticipated primary finding is a measurable reduction in symptoms of depression and anxiety among adolescents post-disclosure. Qualitative analysis is expected to yield themes relating to improved family communication and reduced internalised stigma. This protocol provides a rigorous, culturally adapted methodological framework for evaluating a critical intervention in adolescent HIV care. It underscores the importance of family involvement in the disclosure process. Future research should employ similar mixed-methods designs to capture the nuanced effects of disclosure. Programme implementers should consider integrating mental health assessment and support as a core component of disclosure protocols. HIV disclosure, adolescents, mental health, family-centred care, Tanzania, mixed-methods, protocol This article contributes a detailed methodological protocol for assessing mental health outcomes within a family-centred HIV disclosure intervention, addressing a gap in evaluation frameworks for this key aspect of adolescent care.
Mboya et al. (Tue,) studied this question.