The South African National AIDS Council (SANAC) met last week ahead of the start date of April 1st of the new National Strategic Plan (NSP) on HIV/AIDS, TB and STIs to review the implementation of the Plan. At the meeting it was decided that it is critical to prioritise HIV prevention among young girls and young women over the next five years, particularly in the first year of the Plan.

‘€œWe know that the rates of HIV infection amongst women and girls between the ages of 16, 17 and 23 are much higher than the rates of HIV infection amongst boys and men of the same age. We think that if we can have very strong, very visible, very effective campaigns that target that age group that we’€™ll both be able to cut the rates of new HIV infections amongst young girls, but, hopefully, also influence behaviour so that as girls and women grow older they continue to live and behave in a way that minimises their own risks of HIV infection’€, deputy chairperson of SANAC, Mark Heywood, elaborates on the proposed intervention.        

Heywood says AIDS councils in all of the nine provinces will design programmes that reach out to school girls to educate and empower them to prevent HIV infection. Part of the intervention is also to promote HIV testing in schools.    

‘€œThe question of HIV testing in schools has been put very firmly back on the agenda’€, Heywood says.

But cautious attention must be applied to how  school-based HIV testing should be approached.

‘€œWe shouldn’€™t just look at HIV in schools, but it’€™s very important that schools have effective primary health care programmes running within schools that deal with HIV, but also deal with other causes of illness amongst young people which promote health-seeking behaviour, which deal with eating habits, which deal with sexual habits, which deal with diabetes, which deal with TB. It’€™s those sort of plans that we’€™re beginning to develop’€, he says.        

Rhulani Lehloka, Executive Director of the AIDS Consortium, agrees that HIV testing in schools must not be an isolated intervention, but it must be part of a comprehensive package.

‘€œIt’€™s a health package’€¦ You would be able to have a clinic at the school which has condoms, which has contraceptives, which has counseling for young people, there is support for projects around health education and you’€™ve got posters, you’€™ve got pamphlets, you’€™ve got materials that young people have access to, that they can read. That, for me, is a comprehensive package’€, she says.      

Advocacy manager of the AIDS Consortium, Gerard Payne, adds that HIV awareness and testing in schools will go a long way to help the country achieve its HIV prevention targets.  

‘€œIf we want to win this fight’€¦ If we want to reduce new infections by 50%, as the NSP is alluding to, we have to make sure that we use every form of mechanism ‘€“ whether it’€™s condoms, a full house package ‘€“ we have to make things available to young people’€, says Payne.

Inevitably, HIV awareness and testing campaigns involve the promotion of condoms for safer sex practices. But the Department of Basic Education has remained opposed to condom distribution in schools. For the programme to succeed, the department needs convincing to change its stance.

‘€œSANAC has recommended to the Department of Basic Education that they should change their policy, they should change their opposition to making condoms easily accessible within schools. That’€™s the first step that we have to take. A related step is that we have to engage with parents and engage with school governing bodies to make this acceptable and understood by those bodies. People sometimes say that if you put condoms in schools you are encouraging sexual activity amongst learners. That’€™s not the case at all. If you put condoms in schools what you’€™re doing is recognising the reality. And the reality is evident in high rates of teen-age pregnancy, high rates of HIV infection, unacceptably high rates of sexually transmitted infections that learners’€¦ teenagers are having sex’€, says Mark Heywood.            

Two interventions need to take place for a meaningful HIV prevention campaign in schools.    

‘€œYou should make condoms available, but, simultaneously, you need strong life-skills and sexuality education programmes that discourage young people from having early sexual relationships. But make sure that if they are going to have those relationships, that they have relationships that are safe and respectful of one another. Making condoms available does not mean that you are encouraging sex. (That’€™s) far from it. In fact, you can discourage sex and make condoms available just to make sure that you are able to protect people’€, Heywood says.