HIV sero-status disclosure in the school context: experiences of adolescents prenatally infected with HIV in Uganda

Francis Obare, Population Council
Harriet Birungi, Population Council
Anne Katahoire, Makerere University

This paper explores the extent to which stigma and discrimination towards in-school HIV-positive young people exist in Uganda as well as the level and outcomes of disclosure of one’s sero-status to school friends, teachers and school nurses by adolescents perinatally infected with HIV. Data come from a study conducted in 2009 whose objective was to understand the needs of in-school HIV-positive young people. The study involved two major components. The first component was a survey among 718 young people aged 12-19 years (that is, of school-going age) who were perinatally infected with HIV and who knew their sero-status. The second component involved: (i) an in-depth assessment of the school environment and their preparedness to support in-school HIV-positive young people, and (ii) student essays on specified themes, namely, the perceived and actual attitudes and practices of students towards colleagues who are HIV-positive as well as possible responses by fellow students and the school administration to the needs of HIV-positive students. Analysis of quantitative data entails cross-tabulations with Chi-square tests as well as significance tests of proportions to examine differences in experiences with disclosure, stigma and discrimination by background characteristics of the respondents. The results show that about two-thirds (66%) of respondents attending school at the time of the survey had disclosed their HIV status to school friends, teachers or school nurses. Disclosure was mostly to school friends (56% of those who had friends) followed by teachers (47%) and school nurses (17%). Whereas some level of stigma and discrimination against in-school HIV-positive young people exists, disclosure mostly elicited positive reactions from those disclosed to, such as showing compassion or sympathy, counseling the respondents, or assisting with taking medication. Disclosure of HIV sero-status in the school context has implications for addressing the needs of in-school HIV-positive young people in the country.