Health System Support Mechanisms for HIV Status Disclosure Among People Living with HIV/AIDS in Mukono District, Uganda
Background Health systems play a crucial role in supporting HIV status disclosure, which is essential for HIV prevention, treatment adherence, and psychosocial support. Understanding how health systems support disclosure is vital for improving HIV care outcomes. Methods A descriptive cross-sectional study was conducted in 10 health facilities offering comprehensive HIV/AIDS care in Mukono district, Uganda. Data was collected from 317 clients through interview-guided questionnaires, 55 health workers through self-administered questionnaires, and 10 health managers through interviews. Data was analyzed using SPSS version 16. Results The health system in Mukono district supported HIV status disclosure through multiple mechanisms: pre-test counseling (reported by 94.5% of health workers), post-test counseling (98.2%), ongoing counseling (89.1%), care and support services (85.5%), and referral systems (76.4%). Clients reported receiving disclosure support primarily through counseling services (92.7%), with health workers emphasizing benefits of disclosure during these sessions. Health facilities provided private counseling spaces, trained counselors, and peer support groups to facilitate disclosure. The Ministry of Health, District Health Office, and partner NGOs contributed to disclosure support through policy guidance, supervision, training, and resource provision. Conclusions The health system in Mukono district has established several mechanisms to support HIV status disclosure, with counseling services being the primary approach. However, gaps remain in infrastructure, human resources, and policy implementation. Strengthening these support mechanisms through increased resource allocation, improved training, and enhanced coordination between stakeholders could further improve disclosure outcomes.