HIV/AIDS-care and Support Competence of Secondary Schools in Western Uganda: A Qualitative Inquiry With School Stakeholders

Abstract

Background Although schools have been identified as significant settings in the response to the HIV/AIDS pandemic, limited research is available on how they can accommodate Youth Living with HIV/AIDS (YLWHA) especially in resource limited countries. In this study we explored how school stakeholders in western Uganda perceived of good practices to include and support YLWHA in their schools. We conceptualized an HIV/AIDS-care and support competent school community. Methods This qualitative inquiry involved school stakeholders (parents/caretakers, school staff and students) purposively selected from 3 secondary schools in western Uganda. A total of 88 participants were involved in focus group discussions and individual interviews. Data analysis followed an inductive and deductive thematic strategy. Results We identified 7 overarching interrelated themes in which participants reported practices to include and support YLWHA: counselling and guidance; social support networks and linkages; knowledge and skills; anti-stigma and anti-discrimination measures; disclosure of HIV status; treatment and management of HIV/AIDS; and affirmative actions for YLWHA. Stakeholders’ perceptions of good practices often differed regarding what was considered appropriate, the approach and who to take lead in supporting YLWHA. Conclusion Despite the meager support for YLWHA currently available in schools, our study points to optimism and high potential. We posit that building competent HIV/AIDS-care and support school communities is a gradual process requiring each school to develop a strong knowledge base about HIV/AIDS and support needs of YLWHA, develop a coherent and school-wide approach, and collaborate extensively with external stakeholders who are significant in supporting YLWHA.

“I was still very young”: agency, stigma and HIV care strategies at school, baseline results of a qualitative study among youth in rural Kenya and Uganda

“…However, baseline data do suggest our sample is fairly representative of AYAH in Kenyan and Ugandan schools, and similar to school-age cohorts throughout Anglophone Africa. Our findings agree with previous studies that despite the optimism brought by a sense of agency, school intensifies stigma triggers, with boarding schools especially ideal for such triggers to flourish and interrupt ART adherence [35,50,51]. We focused on school as a site of stigma without comparison to village-based stigma, partly because though challenging, school is a potential island of support.…”

Perceived barriers and facilitators to antiretroviral therapy adherence among youth aged 15-24 years at a regional HIV clinic in South-Western Uganda: a qualitative study

“…The majority of our participants were in boarding schools and expressed fear of being treated differently/discriminated against in the event of disclosure of HIV status. This appears to be a common reason for non-disclosure as has been described elsewhere [33][34][35][36][37] . In some cases, where the HIV status was disclosed, some experienced stigma and discrimination in the form of rejection, discouragemnt and isolation.…”