Document is current

Article History

Received: 23 November 2025

Accepted: 13 April 2026

First Online: 19 April 2026

Declarations

:

: The authors declare no competing interests.

: for this study, protocol number WDU/IRB001, was obtained from the Ethical Review Committee of Woldia University, College of Health Sciences. An official cooperation letter was issued to each study facility, and written informed consent was obtained from all study participants. For participants who were unable to read or write, the consent form was read aloud in Amharic in the presence of an impartial witness. Participants provided informed consent using a thumbprint, and the witness co-signed the form to document voluntary participation. No legally authorized representatives were involved unless required for individuals lacking decision-making capacity. Participants were informed about the study’s purpose, procedures, potential risks, and benefits. Given the sensitive nature of HIV status, special attention was paid to privacy and confidentiality in ART clinics. Data collection was conducted in designated private areas within the clinics to ensure that conversations could not be overheard by other patients or staff not involved in the study. Questionnaires were completed in a manner that minimized visibility to others in the clinic environment. Interviews were conducted in private settings, and no personal identifiers were recorded. Each participant was assigned a unique study code, and all data were stored in password-protected electronic files accessible only to the research team. For participants requiring assistance, trained data collectors ensured confidentiality during interviewer-assisted questionnaire completion. Measures were taken to minimize potential stigma and to protect participants’ autonomy and dignity. All methods were performed according to the Declaration of Helsinki.