Social Science and Medicine
Authors: Massy Mutumba, Jennifer Nattabi, Proscovia Nabunya, Francis Matovu & Fred M. Ssewamala
This qualitative study, published in Social Science & Medicine (Volume 407, October 2026) by Mutumba and colleagues, examines how educators in Uganda learn about and respond to students living with HIV. School is a key setting for adolescents’ treatment adherence and exposure to stigma, but little is known about how school staff come to know a student’s HIV status or what they do with that knowledge.
The analysis draws on 19 interviews with educators in a school-based HIV stigma reduction trial in southwestern Uganda. The interviews explored how educators became aware of students’ status, how disclosure was managed in school, and how schools responded to these students’ needs. Responses were analysed with iterative thematic analysis.
Educators typically learned of a student’s status through informal routes: indirect observation, selective disclosure, peer interactions, and information circulating across school and community networks. Educators also took on informal roles in supporting treatment adherence and monitoring students, apparently without formal guidance.
The authors introduce the concept of an “institutional ecology of disclosure.” It frames knowledge of an adolescent’s HIV status as emerging from interconnected relationships among caregivers, educators, peers, and community actors, rather than from a single deliberate act by the student.
The authors conclude that stronger institutional protocols, educator training, and coordination between schools and health services could better support adolescents living with HIV. Such measures could also reduce stigma and unintended disclosure.