South Africa has about 6 000 high schools with some 12 million learners. If all 12 million high school pupils from the age of 12 were to be tested for HIV, the Health Department would far exceed its target of testing 15 million South Africans by June. Currently, about five million South Africans have tested in the HIV Counselling and Testing (HCT) campaign that the Health Department started rolling out last year. School-based HIV testing is an extension of the HCT campaign.

‘€œAs a general point the campaign when it was launched, it was supposed to target 12 year olds to 60 year olds. So, part of the programme was to really make sure that as an extension we’€™re actually reaching school-going young people. Nobody argues about the fact that young people do start sex early these days and, then, in many instances some of them might actually start a sexual relationship without consideration of the risk to themselves and, then, importantly, others might not actually practice what is regarded as safe sex by using condoms, sticking to one partner and all that. So, the campaign, really, is a preventive strategy to try and help young people to really start to understand the dynamics between their sexualities and their sexual relationships and the choices they make around sexualities. And one of those choices is that you need to know your status’€, explained Dr Thobile Mbengashe, Chief Director for HIV/AIDS and STIs at the national Department of Health.

Responding to concerns by some children’€™s rights advocates that testing school children is a human right violation, that children do not have the maturity to give consent for HIV testing, and that schools do not have the ability to protect the confidentiality of a child’€™s HIV status, Dr Mbengashe said HIV testing in schools ‘€œwill be provided in a well-controlled system that makes sure there is confidentiality and young people will have to give consent and they will have to be respected’€.

He added that ‘€œthose who are still very young, we are encouraging parents to really take an interest in their young people. No young person will be forced to take the test. Parents will be given an opportunity to provide consent to their children. They will be given information that explains what the campaign is about, what is going to be done, and they will provide consent for their children to participate. Secondly, even though when we have the consent, it is still the young person who needs to assent to that consent and make a decision to actually take the test’€.

Dr Mbengashe said that HIV testing is not unique to South Africa. It’€™s been done in some countries, including Kenya, Tanzania and Lesotho. He also pointed out that the campaign won’€™t target each and every high school. He said the task team that is working to develop the policy on HIV testing is employing strict criteria to assess every school for its suitability to introduce HIV testing.

‘€œThat assessment, basically, looks first into the governance element of the school ‘€“ the quality of governance. Secondly, the package itself: Whether that package is available. That means the information element, the counselors, the people who are going to prick, the support services, the psychological and the referral systems, including making sure that the local service providers around those areas have been earmarked, targeted, knowing exactly what role they are going to play. Our Minister has been very clear that there will be no testing unless the Ministers are satisfied that the preparation for the testing have been adequate’€, said Mbengashe.

Only schools that meet the set criteria will start testing. Others will follow in phases. Mbengashe said, unlike the current HCT campaign, the schools’€™ programme does not aim to test all 12 million learners within its target group by June or within one year, saying the initiative is long-term and will be sustained over several years.

The Department of Education refused to speak about the campaign. A departmental spokesperson said that ‘€œa resolution had been taken that all comment on the matter will come from the Health Department, which is responsible for developing the policy on schools’€™ HIV testing’€. She said the Department of Education was, through schools, ‘€œonly a host for the testing campaign’€ and that it had ‘€œnothing to do with the policy’€.

‘€œDisappointing’€, is how Meshack Ndebele, a lecturer in Educational Psychology and School-Family Partnerships at the Wits School of Education, described the department’€™s response.    

‘€œI’€™m surprised and disappointed. I think the Department has abdicated its duty. The Department must play a leading role in advising the Department of Health regarding testing programmes on their learners’€, Ndebele said.        

The Health Department could not say exactly when the initiative will start. In the next ‘€œLiving with AIDS’€ feature, we look at the pros and cons of testing learners as young as 12 for HIV.