Scepticism over HIV testing in schools
Explaining its decision, the department says it is a means to prevent new HIV infections in young people.
“Forty-three percent of the population… they are just about 20 years old. And that’s going to be the population that’s going to move to be the adults and if that population doesn’t have the right equipment, the right tools and the right approaches and they are not making the right choices to protect themselves, it means then they will actually move with a higher burden of disease. So, the best people to be protected right now, over and above those we are protecting as adults, is our young people. We don’t want a generation that is going to be affected exactly as our generation. I think all of us are aspiring for an AIDS-free generation. And the only way we can do that is to start very early so that we equip our young people to make sure that they are able to take the right choices and take the responsibility to prevent them from new infections”, says Dr Thobile Mbengashe, Chief Director for HIV/AIDS and STIs in the national Health Department.
But the decision has met with scepticism from various quarters. A Wits School of Education lecturer, Mishack Ndebele, says government has laudable intentions, but is moving too hastily with the campaign. Ndebele, who is currently reading for a doctorate in HIV/AIDS and the schooling system, has accused the Department of ignoring crucial stakeholders in making the decision.
“There is a need for extensive consultation. The government must talk to the people that are going to help it implement this thing. It’s no use having that top-down approach to the whole thing”, Ndebele says.
Who should the Health Department consult? I ask him.
“The learners, themselves”, he answers. “I’m not aware of any input from the organisations that represent learners to start with. We also want to think of the parents. Those are children. We don’t call them adults. We need to consider the views of the parents; and we want to look at the educators and the teacher unions and so forth. I think the main stakeholders here, have been by-passed”.
Ndebele says he finds it surprising that the Health Department believes that a child as young as 12 can give informed consent for an HIV test.
“One thing that the government seems to ignore is the stage at which these learners operate. I don’t believe that an adolescent is able to make informed decisions about these matters. For example, when learners are at that teenage level, according to studies about child development, those children are operating under peer pressure. Most of the decisions that they make are peer-influenced.
Let’s take, for example, a group of children decide to go and have a test… it is very possible that trying to appease your friends and to please them you go out and have the test. But after that when you face the consequences, when the results are out you as an individual child may have to bear with that thing and it may be very, very difficult to actually deal with it. I’m of the opinion that while children may excitedly go for testing as groups, they may not be able to bear with the results”.
He also questioned the decision to have HIV testing in schools.
“We cannot afford to have children that are stigmatised in our schools. We are already having a lot of suicides. We are already having children who are depressed. Teachers are having problems with things like that. I can see chaos emerging out of this. I don’t see the school as the right place for having such a thing”, he says.
While welcoming the campaign, head of rights organisation, Section 27, Mark Heywood also shared his concerns.
“Encouraging voluntary HIV testing amongst people of school-going age is very, very important. And it’s very important that schools are used to educate, to promote HIV testing, to assist people to make the decisions. But what we are worried about is that mass testing in schools carries with it a whole number of risks. It carries with it the risks that the children will not be prepared for positive results, it carries with it the risk that they will not be able to disclose positive results to their parents, it carries with it the risk that teachers may discriminate against children who test positive; it carries with it the risk that there will be breaches of confidentiality of children who test HIV-positive; it carries with it the risk that there will be discrimination between children and stigmatising of one child by another child, or bullying. So, although the motive is a good motive, the means is the wrong means”, said Heywood.
Despite concerns raised by civil society groups, the Health Department is adamant that it will introduce the HIV Counselling and Testing (HCT) campaign in schools. It is not clear yet when the campaign will launch.