Between fear and professional duty: student nurses’ experiences of caring for people living with HIV/AIDS

Clinical exposure to people living with HIV/AIDS (PLWHA) is an important component of nursing education in sub-Saharan Africa, where the burden of HIV remains high. Student nurses often encounter emotional challenges, perceived occupational risks, stigma, and structural constraints during HIV care. These experiences may influence learning and professional identity development. This study explored how student nurses learned to care for PLWHA during clinical placements in Ghana. A qualitative descriptive study was conducted. In-depth semi-structured interviews were undertaken with 12 final-year student nurses during clinical placements. Data were analysed using inductive reflexive thematic analysis. The analysis generated three overarching themes: (1) Crossing the Divide Between Classroom Learning and Clinical Reality, (2) Becoming the Nurse I Ought to Be, and (3) Learning Within Imperfect Systems. Students described a developmental process in which classroom knowledge was tested through direct patient care, fear of occupational exposure was negotiated alongside emerging professional values, and confidence developed through repeated clinical experience. Direct contact with PLWHA challenged pre-existing stigma, strengthened empathy, and reinforced ethical responsibilities, including equality, confidentiality, and advocacy. Organisational factors, including resource constraints, workplace culture, and clinical mentorship, either facilitated or hindered professional learning and confidence. Caring for PLWHA was a formative learning experience that extended beyond the acquisition of biomedical knowledge. Professional learning was shaped by the interaction of emotional, ethical, and organisational influences within the clinical environment. Nursing education programmes and healthcare institutions should provide supportive clinical learning environments, effective mentorship, and adequate infection-prevention resources to strengthen students’ confidence and promote compassionate, evidence-based HIV care.