Nurses and policymakers role in preparing adolescents with HIV for self-disclosure in Eswatini

Background: Nurses in Eswatini are best positioned to assist adolescents living with HIV to disclose their status to others. Nonetheless, it is evident that many nurses are not actively involved in the disclosure process. Aim: The aim of this study was to explore the process of nurses in preparing adolescents for self-disclosure and describe the role of policymakers in enabling adolescents to disclose their HIV status to others. Setting: The study was conducted in four facilities, one from each of the four regions of the country, after getting ethical clearance from a Public University Higher Degrees Ethics Committee and the Eswatini Health and Human Research Review Board. Methods: In-depth interviews were conducted on 28 participants: 24 nurses and 4 policymakers. The three steps of open, axial and selective coding were used to analyse data until theoretical saturation was achieved. Results: Adolescents were assisted to disclose by providing them with HIV information to empower them, encouraged to enrol in teen club because it created a conducive environment for peer-to-peer support, and they were given ongoing psychosocial support to prepare them for self-disclosure. Adolescent HIV management workshops were not routinely done because such training relied on funders. Conclusion: Nurses are not preparing adolescents satisfactorily to disclose. Prioritising the training of nurses would lead to a remarkable increase in the rate of HIV self-disclosure by Swati adolescents. Contribution: This study is the first of its kind in Eswatini, and the results will contribute to the review of HIV management guidelines and promote adolescent self-disclosure.