HIV disclosure in Ugandan schools
A qualitative study of how educators navigate the institutional ecology of information, HIV stigma, and care.
Bibliographic Data
| ID | 24019076 |
|---|---|
| Authors | Massy Mutumba (0000-0002-0636-891X, Washington University in St. Louis, corresponding author), Jennifer Nattabi (0000-0002-8300-1791, Washington University in St. Louis), Proscovia Nabunya (0000-0002-9088-5839, John Brown University), Francis Matovu (0000-0002-9241-6761, Child Development Center), Fred M Ssewamala (0000-0002-4849-5650, New York University) |
| Year | 2026 |
| Volume | 407 |
| Pages | 119664 |
| Publication date | 2026-08-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Social Science & Medicine (JOURNAL) |
| Journal identifiers | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2026.119664 |
| PMID | 42603465 |
| OpenAlex | W7172385927 |
| Language | EN |
| References cited | 29 |
Adolescents living with HIV (ALHIV) spend much of their daily lives in school environments, yet little research has examined how HIV-related disclosure unfolds within educational institutions. Most studies focus on disclosure decisions within families or clinical settings, leaving limited understanding of how schools encounter and manage knowledge of students' HIV status. This study examines how educators learn about and respond to the presence of students living with HIV within school communities. The analysis draws on 19 qualitative interviews with educators participating in a school-based HIV stigma reduction trial in southwestern Uganda. Interviews, analyzed using iterative thematic analysis, explored how educators became aware of students' HIV status, how disclosure was managed within school settings, and how schools responded to the needs of students living with HIV. Findings show that HIV disclosure within schools rarely occurs as a singular event in which caregivers formally inform school authorities. Instead, awareness of students' HIV status often emerges through indirect observation, selective disclosure, peer interactions, and the circulation of information across school and community networks. Educators frequently played informal roles in supporting treatment adherence, monitoring medication routines, and coordinating with caregivers while attempting to maintain confidentiality. To conceptualize these dynamics, the study introduces the concept of an institutional ecology of disclosure, highlighting how knowledge of adolescents' HIV status emerges through interconnected relationships among caregivers, educators, peers, and community actors. Strengthening institutional protocols, educator training, and coordination between schools and health services may help support adolescents living with HIV while minimizing stigma and unintended disclosure.
Human immunodeficiency virus (HIV) · Institutional theory · Population · Public health · Qualitative property · Qualitative research · Adolescent Sexual and Reproductive Health · HIV/AIDS Impact and Responses · Poverty, Education, and Child Welfare
From Conceptualizing to Measuring HIV Stigma
Disclosure of HIV status to children in resource‐limited settings
Navigating antiretroviral adherence in boarding secondary schools in Nairobi, Kenya
Views of adolescents living with perinatally acquired HIV on HIV status disclosure in Eswatini
HIV serostatus disclosure and lived experiences of adolescents at the Transition Clinic of the Infectious Diseases Clinic in Kampala, Uganda
Factors Associated With HIV Disclosure and HIV-Related Stigma Among Adolescents Living With HIV in Southwestern Uganda
Care and support for youth living with HIV/Aids in secondary schools
HIV Stigma Mechanisms and Well-Being Among PLWH
Using thematic analysis in psychology
Demonstrating Rigor Using Thematic Analysis
Conceptualizing Stigma
Youth living with HIV/Aids in secondary schools
| Citation velocity | historical |
|---|---|
| Highly cited | No |