This is in a bid to reach the Health Department’€™s target of testing 15 million South Africans for HIV by mid next year. The campaign is targeting learners from age 12. Testing has apparently already started in Ekhurhuleni, on Gauteng’€™s East Rand. But children’€™s rights organisations have criticized the Health Department for taking the HIV Counselling and Testing campaign to schools.

‘€œSchools as environments aren’€™t places where children can actually exercise choice around something of this nature. So, once testing is introduced, children will not be able to give freely their consent no matter what conditions you put in place because if my friend is testing ‘€“ remember back to your own childhood when you were 12 or 14 or 16 ‘€“ kids do what their friends do. Teachers and educators and health workers haven’€™t actually been supported (and) enabled to understand how to practically implement this testing in a school setting, which is very different than a normal clinic setting. Children who are between the ages of 12 ‘€“ 18, who would be in high schools, which is where the testing is targeted, also have very special mental health needs. They are very rapidly changing. They go through mood swings that change within a matter of minutes. Their mental health needs are already not met and, then, you put them in a situation where they didn’€™t really get to choose because they didn’€™t have time to think about it in a massive campaign’€ Cati Vawda, Director of the Children’€™s Rights Centre and member of the children’€™s sector in the South African National AIDS Council (SANAC), explained their opposition.

Vawda is also concerned about the confidentiality of the tests.

‘€œOnce you know the result, what happens afterwards; and what does it mean about what parents are going to say, what the community is going to say, what are the children going to say, and what teachers say for children who do test positive? And it will be virtually impossible in those conditions for it not to be known even if all of the health system’€™s disclosure and confidentiality procedures are followed. If I come out crying, you know I didn’€™t get a good answer’€, she said.

‘€œI wonder about the confidentiality of HIV testing within a school setting. I’€™m concerned about the discrimination that might take place from, not only the educators, but also other kids because a lot of people don’€™t understand the implication of being HIV-positive. There is still a lot of stigma around and based on that a lot of discrimination takes place’€, added Yashmita Naidoo, who works with HIVSA, a not-for-profit HIV/AIDS life-skills education project for people living with HIV.

The South African National AIDS Council or SANAC also voiced concern about the campaign.

‘€œMass testing in schools carries with it a whole number of risks. It carries with it the risk 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. Although the motive is a good motive, the means is the wrong means.

We asked for a halt on the testing in schools pending further discussion and further investigation of the implications of doing this type of campaign. SANAC has endorsed, correctly, the overall HIV Counselling and Testing campaign, but it hasn’€™t endorsed this’€, said SANAC’€™s Deputy Chairperson, Mark Heywood.

The Children’€™s Rights Centre called on the Health Department to stop the testing campaign of learners.

‘€œHCT in schools must be stopped immediately. Anywhere where it’€™s happening it should stop immediately. Anywhere where it has been done, there must be ongoing monitoring and support; and extra support to children who may have tested positive; and dealing with stigma and discrimination that’€™s there’€, said the centre’€™s Cati Vawda.

Instead of testing children in schools, the Health Department must focus on improving its health facilities to attract young people to them.  

‘€œWe need to get our clinics and health services to be child and youth-friendly. If we don’€™t have adolescent health services, which is an incredibly neglected area, then we don’€™t have the context in which to provide children with their full health rights. We need to get child-friendly, adolescent-friendly health services in place’€, Vawda said.

The Health Department failed to comment on this story. But it faces a number of sticky issues with its schools campaign. The big one is whether to supply condoms along with the test, as has been the norm where the HCT campaign has been carried out elsewhere. The supply of condoms would be in direct conflict with the Department of Education’€™s policy of no condom distribution at schools.