HIV/AIDS Testing in Schools in South Africa

This current event post is contributed by Gabby. What is the media saying about children with special needs? Read this controversial piece about HIV and AIDS testing in schools in South Africa. Thank you and enjoy!

This article, although not specifically addressing children who are born with learning disabilities, considers the impact of HIV in South Africa’s public schools. Throughout the past decade South Africa has been struggling with controlling an HIV epidemic of unbelievable proportions; although the country was the last nation in Sub-Saharan Africa to be hit with the disease, a fragmented health care system under the Apartheid regime was inefficient in confining the spread of the virus. Thus, South Africa now possesses the highest HIV prevalence rate in the world (approximately 20%) and the number of individuals infected is increasing steadily. Various public health tactics have been implemented with little success, largely due to the failing economy and poor living conditions endured by the majority of civilians.

I chose this media source because it combines two topics which I am very passionate about: the educational system and public health. This article discusses the consequences of implementing mandatory HIV testing in schools throughout the country. The two main challenges of screening students discussed in this article are confidentiality and consent- students must be willing to be tested at school and their status must be kept private from their peers at school. If students test positive, it is explained how they will be provided with social support and treatment will be administered soon after diagnosis.
After initially skimming this article, I was immediately opposed to the idea of HIV testing in schools. I thought students should learn about the disease first in health class, and then opt to be tested once they become sexually active. A student’s education should be distinct from the healthcare they receive, and it is possible that knowing their status would only distract from their school experience and eradicate any motivation to succeed a child should possess in the classroom. However, I then began contemplating the severity of the HIV epidemic in South Africa. Adolescents largely resist being tested for STDs, and it is rare for a teenager living in a township to know their HIV status. I agree with the article that mandatory screening in schools would be a beneficial public health tactic. Although this idea seems so distinct from anything we experience in an American school, in South Africa this concept must be seriously considered, for millions of lives are at stake.
After you read this article, please take the time to consider the following questions:
1) After learning about the psychological and social development of children, do you think that kids as young as 12 are cognitively equipped to handle a positive diagnosis of HIV? In what ways will knowing their HIV status influence a student’s performance in the classroom?
2) In the United States, various STDs are serious public health concerns in the student age population. How do you think American students and parents would react to the implementation of mandatory STD testing? How would you personally respond?
3) While reviewing previous posts in this blog, I was surprised to see images of Chinese kindergarten students being checked for signs of sickness before permitted entrance into the Lan Xi Road School. As a public health measure in schools, nurses have been provided the authority to disallow any sick student from attending school that day. In what ways does this policy differ from the strategy intended for South African schools? Is one or the other more moral, are both acceptable, or rather are both measures unethical?

5 thoughts on “HIV/AIDS Testing in Schools in South Africa

  1. I think mandatory HIV testing is a great idea. The rates of rape and sexual violence in South Africa are among the highest in the world, and people (mainly girls) are at risk for HIV as a result. What I know about psychology and cultural pressure tells me that young girls being raped in South Africa are not going to come forward and get tested on their own, so having it be mandatory in school could provide them with a chance to know their status and have support creating a treatment plan. Not only that, but HIV positive mothers could be giving birth to HIV positive babies without knowing it, and it could also help in identifying that risk so that the cycle can eventually end.

    With respect to the Lan Xi Road School, I do think their practice is different because they are looking for things like fevers and strep which are contagious and can be transmitted easily in school situations with a high density of children in a small space touching things and coughing all over each other. Clearly HIV is much less likely to be spread in a school situation. However, kids trip and fall and scrape their knees. They get bloody noses. If one of those kids is HIV positive and doesn’t know it, all the children are then at risk if they come into contact with the infected blood. And that’s not a weekend off from school. That’s their entire life.

  2. As a community health major and advocate for public health, I am also in favor of STD testing in schools. Youth are an especially difficult population to screen and treat because they are generally healthy, increasing the likelihood that that they will not see a physician until they are actually sick. In response to your question about psychological and social development, I think a child as young as 12 could handle a positive diagnosis IF he/she had adequate support. Access to supportive and caring adults, whether clinicians or mentors or family members, would be crucial for these adolescents. Consequently, I think this initiative could easily produce unintended consequences if not implemented correctly. Psychological trauma, among other things, could be a major unintended consequence if handled incorrectly. The South African government would also need to directly address the two major issues that you listed, confidentiality and consent, before ever making STD testing a universal requirement.

    I agree that American students and parents would have a much different response to this issue. In our individualist culture, we often value personal rights and freedom over communal well-being. I would predict that many Americans would view this initiative as an invasion of privacy. Since I believe very strongly in the power of preventative public health campaigns, I am personally very supportive of STD testing in schools. However, my political and social views are very liberal, so I realize that my perspective is limited.

  3. This is a really interesting article that brings up a unique situation. I had no idea that the HIV rates in South Africa were so high. I also had a similar reaction to you upon first reading the article – it would never work, it’s a violation of privacy, etc. etc. I think this is because the implementation of mandatory testing in the United States would never fly, especially in more conservative regions. But upon further consideration, I think it’s a good idea, especially with the situation in South Africa. Going to get tested for STDs requires a lot of responsibility, maturity, effort and initiative. Some people just don’t want to face the truth. But how does keeping ourselves ignorant serve us? I’d have to think about the logistics a little more, but I think perhaps yearly testing for STDs in the United States (after say, age 16) isn’t such a terrible idea. Furthermore, with such high prevalence of a life-threatening illness like HIV in South Africa, I think it’s a really good idea to implement mandatory HIV testing there (if there are the resources). Although it would be devastating to find out that you are HIV positive, it’s better to know sooner rather than later so that you can take care of yourself and be sure not to spread the disease. Of course, confidentiality is of utmost importance. These tests shouldn’t change anything in the classroom – except maybe increase hygiene. Like Alli said, we don’t need to quarantine the children with HIV (as if they had a highly contagious illness) – or exclude them from the classroom. Generally, being informed (especially about your own health) can only serve you in the long run.

  4. I also think this would be a great idea and that it is completely different from testing for the common cold because it is not going to be spread through a cough or a hug. That being said it could still be spread through a school if students in that school were sexually active with each other. It is important to know as soon as possible to be able to prevent the spread as well as take care of oneself. Hearing that one has tested positive is difficult to hear at any age and would require a lot of social and psychological support. This support should span a decent period of time and should also monitor the students academic performance after the diagnosis. Confidentiality and support are thus perhaps were efforts need to be concentrated most. Before testing though students should be given some sex education, learn about the testing process and learn about what happens if you test positive. It should also be brought up that one does not have to have gotten in through sex. I think that if 12 year olds are often found to be sexually active it would be a good time to start testing as they could receive treatment and/or education about these issues at a young age.
    Since getting tested does still require the consent of the student and/or the parents I do not really know why people think it would be so resisted in the United States. I think more of the issue of resistance in the U.S. would come from believing that this is a problem we do not deal with or would stem from reluctance to offer sex education. I think it would be a great practice to try to implement in high schools and colleges even if much less frequently. It makes the issue much more real and may reduce risky behaviors.

  5. When it comes to your first question—it’s the age-old battle between “knowledge is power” and “ignorance is bliss.” I think it really would depend on the child. 12 year olds have a wide range of “maturity” levels and I honestly do believe there are quite a few out there who would be well prepared to face the truth of their diagnosis.

    How would Americans react to mandatory HIV testing? I think there would be a portion of people who would feel their rights were being encroached on, that they should not be mandated to do anything by the government, that this somehow promotes sexual activity in students… And then there would be another group of people who support it wholeheartedly. Much like any other social issue in America. 🙂

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