“What If He Tells Others”: Negotiating Disclosure of Children’s HIV-Positive Status Amid Stigma in a South African Rural Community

In this study, we explore how HIV-related social stigma in a South African rural township community informs parents’ and caregivers’ decisions to disclose their children’s HIV-positive status to them. To achieve the aim of the study, we conducted qualitative in-depth interviews with 12 parents and caregivers of HIV-positive children between the ages of seven and 14 years in a rural area based in Mpumalanga in South Africa. We found that, despite the development in HIV education across the country, HIV-related stigma is prevalent at a social level in rural townships and serves as a barrier to disclosing children’s HIV-positive status. We established that the parents and caregivers use “passing” as a stigma management strategy where they conceal their children’s HIV-positive status from them and instead tell them that they are infected with less stigmatised medical conditions such as asthma and tuberculosis. Based on these findings, we argue that, although education on HIV is widespread in South Africa, HIV-related stigma is still prevalent in some rural townships. This stigma compels parents and caregivers to avoid disclosing their children’s HIV-positive status to them and instead employ stigma management strategies that will maintain the concealment of their children’s HIV status.