HIV testing in schools is likely to result in possible anxiety and depression amongst learners, which might impact negatively on their educational performance.   For this reason, it is incumbent on our government to be wary of the possible risks associated with this initiative.   Let me pose a few sub-questions emanating from my primary question on the readiness of schools for HIV testing.

Are we convinced that learners will be subjected to acceptable ethical processes during these HIV tests?  Will every learner tested fully comprehend the purpose of these tests?   Will they  understand the benefits of such tests?   How will schools guarantee confidentiality of information when learners are tested?   Will learners’€™ rights be protected in this exercise?  

While the task of testing learners in schools will not, in itself, be enormous, the challenge will be in dealing with the results of the tests.   Assuming that the escalating numbers of HIV infected learners in schools could be a possible indicator of a high turnout of learners testing positive after the tests, how does government plan to cope with such big numbers, which might keep increasing by the day?  

The independence of learners in making individual decisions regarding HIV testing casts doubts.   According to studies on adolescence, most adolescent learners’€™ decisions are peer-driven.   During the HIV testing in schools, some learners might be put under undue pressure from peers to decide on being tested, while such learners will not be able to deal with test result individually, if the result is positive.        

Parental guidance and support will also be crucial after learners have tested positive.   I am concerned that the majority of parents/guardians, especially from disadvantaged communities, do not have the relevant training and skills to handle HIV positive children.   Imagine a child who has just tested positive and has received brief counselling from staff in a mobile clinic near the school.   Hungry, tired and depressed, he walks a long distance home.    What guarantee do we have that parents/guardians at home will be capable of addressing his fears, needs and anxieties?   Will this child be able to do his homework and return to school to face the challenges of the new school day?

Teachers will also be a huge factor in HIV testing in schools.   Current studies on attitudes of teachers towards teaching HIV/AIDS education and sexuality in schools show that, for various reasons, some of which are personal, traditional, cultural and religious, most teachers are not committed to teaching HIV/AIDS education and sexuality in schools.   This begs the question: how will learners get tested if they have not received effective HIV/AIDS education?

HIV testing in schools, therefore, appears to be a more complex matter than we think.   Before moving on, government must consider several things.   Firstly, learners’€™ rights need to be protected by following appropriate ethical processes.   Government must assure the nation on how this will be done.   Secondly, HIV testing must be an outcome of an effective HIV/AIDS education process.   Focus must be on effective and sustainable ways of changing learner behaviour.     Through scaled up HIV/AIDS education programmes in schools, learners will not only be able to say No to illicit and unprotected sex, but will, on their own volition, be able to stand up and want to be tested for HIV.  

To improve the quality of HIV/AIDS education in schools, government needs to provide quality training for Life Orientation teachers.   Parents will also need relevant training and skills to partner with schools in providing sustainable treatment and care for tested learners. Without properly trained teachers and parents, this programme may not succeed.

Government must not assume that illicit and unprotected sex takes place only amongst learners themselves.   Current studies have proved that much unprotected sex in schools is between young adolescent females and older males (sugar daddies) from outside the school system.   Therefore, HIV testing in schools might not be a real answer until the risk of female learners having sex with older men from outside the school is minimized.  

The state of the schools’€™ readiness will largely depend on the opinion of the main stakeholders in and around the schools.     To start with, learners themselves must be involved in decisions affecting their lives and learning.   Currently, there is no convincing evidence of such involvement.   Parents’€™ views will also be significant in such a campaign.   Teachers, and not just principals of schools, must have their say as well.   Other interested parties like teacher unions, student organisations, youth movements, community leaders, churches, academics, and so on, must also add their voices before government implements this plan.  

There is a need to also research into whether a campaign of this nature has been tried elsewhere outside South Africa and with what results.   If there have been cases of success elsewhere, government could conduct a pilot study locally, in a few selected schools of a particular community.   Findings of a pilot study could be carefully studied and analysed, and used as a guide for more HIV testing initiatives in schools.    

HIV testing in schools will be an extremely risky programme, involving lives and emotions of our learners.   Teachers will be teaching scores of depressed and anxious learners.   Learner stigmatisation and isolation will be the order of the day.     Teachers and parents will be physically and emotionally drained in the process.   For these reasons, government needs to move with caution.   The nation cannot afford to lose in such a campaign.   Government must get all its darts in a row and get things right the first time.   I appeal to government to ensure schools are truly ready, before proceeding with this important initiative.

Mischeck Ndebele is an Education Lecturer at Wits School of Education.  He    holds an M.Phil in Higher Education (University of Stellenbosch).  Currently,  he is  completing a PhD in Educational Psychology (University of the Witwatersrand).      The thesis topic is ‘€œTargeting HIV risk behaviour among adolescents in South African schools’€.