{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:38:45Z","timestamp":1785404325150,"version":"3.56.0"},"reference-count":29,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Loss to follow-up and treatment defaulting in HIV care led to hospitalisations for advanced complications, undermining retention strategies. Breaches of confidentiality compel patients into transferring clinics to conceal their HIV status. The shift from traditional nurse\u2013patient relationships to team-based care, while improving comprehensive services, complicates confidentiality maintenance and can increase risks of unintended disclosures, eroding trust. Observations across ten community health centres with nurse-led HIV and AIDS services in the OR Tambo district revealed high rates of antiretroviral therapy (ART) defaulting. The absence of a formal confidentiality training framework leads to inconsistent practices and nonadherence to confidentiality guidelines.\nObjectives:\u00a0This study aimed to develop a contextually relevant conceptual framework guiding the design and implementation of a boundary-based confidentiality training programme for HIV care providers.\nMethod:\u00a0Empirical data were collected by semistructured interviews with nurses across ten centres and analysed thematically Dickoff\u2019s six factors, comprising agent, recipient, context, procedure, dynamics and terminus, was used to guide the conceptual framework and ensure relevance and feasibility.\nResults:\u00a0Four themes and twelve sub-themes formed the basis for the framework\u2019s six components. These components provide a systematic approach to addressing training elements aligned with programme goals.\nConclusion:\u00a0The developed framework offers a structured foundation for tailored confidentiality training, guided by Dickoff\u2019s model. This approach aims to improve confidentiality adherence, foster patient trust and promote treatment retention among HIV clients.\nContribution:\u00a0The framework bridges research, practice and education by providing an evidence-based, practically applicable and educationally effective approach to confidentiality training, ultimately improving knowledge and understanding of HIV care.<\/jats:p>","DOI":"10.4102\/curationis.v49i1.2793","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T06:54:43Z","timestamp":1770879283000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A conceptual framework for developing a boundary-based confidentiality training programme for primary healthcare nurses managing patients living with HIV"],"prefix":"10.4102","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1303-4316","authenticated-orcid":false,"given":"Ntombesitatu","family":"Qotoyi","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02svzjn28","id-type":"ROR","asserted-by":"publisher"}],"name":"Walter Sisulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5062-751X","authenticated-orcid":false,"given":"Agrinette N.","family":"Madolo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02svzjn28","id-type":"ROR","asserted-by":"publisher"}],"name":"Walter Sisulu University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Ambrosini, V. & Bowman, C., 2001, \u2018Tacit knowledge: Some suggestions for operationalisation\u2019, Journal of Management Studies 38(6), 811\u2013829. https:\/\/doi.org\/10.1111\/1467-6486.00260","DOI":"10.1111\/1467-6486.00260"},{"key":"ref1","unstructured":"Anderson, L.W., Krathwohl, D.R. & Bloom, B.S., 2001, A taxonomy for learning, teaching, and assessing: A revision of Bloom\u2019s taxonomy of educational objectives, Longman, New York, NY."},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Bahlman-van Ooijen, W., Malfait, S., Huisman-de Waal, G. & Hafsteinsd\u00f3ttir, T.B., 2023, \u2018Nurses\u2019 motivations to leave the nursing profession: A qualitative meta-aggregation\u2019, Journal of Advanced Nursing 79, 4455\u20134471. https:\/\/doi.org\/10.1111\/jan.15696","DOI":"10.1111\/jan.15696"},{"key":"ref3","unstructured":"Cambridge Dictionary, 2020, Cambridge learners dictionary, viewed 12 June 2024, from https:\/\/dictionary.cambridge.org."},{"key":"ref4","unstructured":"Chinn, P.L. & Kramer, M.K., 2017, Knowledge development in nursing: Theory and process, 10th edn., Mosby, St Louis, MO."},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Chiruvella, V. & Guddati, A.K., 2021, \u2018Ethical issues in patient data ownership\u2019, Interactive Journal of Medical Research 10(2), e22269. https:\/\/doi.org\/10.2196\/22269","DOI":"10.2196\/22269"},{"key":"ref6","unstructured":"Collins Dictionary, n.d., Definition of understanding, viewed 12 June 2024, from https:\/\/www.collinsdictionary.com\/dictionary\/english\/understanding#:~:text=If%20you%20have%20an%20understandig,sense%20More%20Synonyms%20of%20understanding."},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Dickoff, J., James, P. & Wiedenbach, E., 1968, \u2018Theory in a practice discipline. 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