HIV disclosure in Ugandan schools

A qualitative study of how educators navigate the institutional ecology of information, HIV stigma, and care.

Datos Bibliográficos

ID24019076
AutoresMassy Mutumba (0000-0002-0636-891X, Washington University in St. Louis, autor de correspondencia), 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)
Año2026
Volumen407
Páginas119664
Fecha de publicación2026-08-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaSocial Science & Medicine (JOURNAL)
Identificadores de la revistaISSN: 0277-9536 • E-ISSN: 1873-5347
EditorialElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2026.119664
PMID42603465
OpenAlexW7172385927
IdiomaEN
Referencias citadas29

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