Table 2.

Disclosure themes from the close community domain.

Theme	Illustrative quote
Stigma and discrimination from family members	There was a time when my husband tried to chase me and the child away . . . I was really disturbed . . . We were given a prescription to buy medicine so I took it to [my husband.] When I tried to insist [on getting the medicine] because the condition of the child was not good, I was told to pack and leave with my ‘luggage,’ meaning the child. He was very hard, and we had to spend the night in the neighbor’s house. The issue is bothering me, but I don’t have a place where I can take the child. If I die today, it is only God who can help her. “Caregiver, disclosed”a
	. . . my uncles from my mother’s side never wanted to see me . . . but I thank God that my uncles have come to realize that being positive is not a big thing – it is just the same. “Child”b
Stigma and discrimination from neighbors and friends	[My] neighbor will not say directly that you have HIV but if you try to borrow something, she will give you an excuse like she doesn’t share . . . You will realize that people begin to isolate [you] and ask you funny questions like, ‘Where are you coming from? You are smelling medicine from the district hospital.’ That means the other neighbor has spread the news to others. You might have thought it wise to share the secret with the neighbor, but you will have made the situation worse. “Caregiver, not disclosed”
	They don’t want one to share items with others [with HIV] – for example, a nail cutter. At times, during meals times, your plate is isolated; you are not allowed to share many items with them. “Child”
Keeping the child’s HIV status secret to others	I don’t like the idea of telling other people about the status of the child, that is, outsiders. Not everybody will have positive thoughts once he/she learns the status of the child. Caregiver, disclosed
	She can tell a friend that her mother told her she is HIV positive, the friend goes and tells another person then the news spreads to the whole school. Later on other pupils isolate her saying she is HIV positive “Child”
Taking medicines in private, lying about reasons for taking medicines or going to clinic	You should give [medicines] in the morning and in the evening when others are not around. When we are just the two of us or when the elder brother is present, [I give the medicines, but] I have never given them in the presence of others. “Caregiver, not disclosed”
Support from friends and families in caring for the child	[I told] my family members that [the child] must go with his medication. If they know [his status], they will ensure he takes [his medication] as required. You can’t stay with the child all the time. He has to visit others. “Caregiver, disclosed”
	I take [medication] on my own, but at times my grandmother reminds me. “Child”
Stigma and discrimination from peers	But when I was in class 8 it was really terrible. It hit me like, ‘Now it has happened. They have all run away from me.’ My mum would not come to stay with me in school. Who am I going to share this with? Who will I call a friend? I was all alone, but one of the teachers called me and told me, ‘You are HIV+ but don’t be afraid, all will be good.’ “Child”

^aDenotes caregiver disclosure status: not disclosed – the caregiver had not disclosed to any of their children; disclosed – the caregiver had disclosed to one or more of their children.

^bAll child participants in this study were disclosed – i.e., knew their HIV status.