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South African Government Initiates School-Based HIV Testing

In February 2011, South African officials plan to offer HIV testing in designated public schools as part of the federal government’s HIV Counseling and Testing (HCT) initiative. The initiative, headed by President Jacob Zuma, strives to address the HIV epidemic in South Africa. HCT aims to make every South African aware of his or her HIV status by offering mass testing to raise awareness and reduce the county’s rate of infection. Overall, the initiative has been met with positive critique; however, students and teacher unions have expressed outrage over the plan to offer testing within the school system. Particularly, concern has been expressed over students’ ability to cope with the potential psychological effects of a positive test result and the potential risk of harassment by other students.
On World AIDS Day 2009, President Zuma announced that he would be launching a new program to combat the HIV epidemic in South Africa, which has the largest population of people living with HIV in the world, with approximately 5.6 million citizens infected with the virus among a population of 50 million.[1] One of the major initiatives of this program is to have 15 million South Africans tested for HIV by June 2011. The justification behind mass testing is that it will mobilize people to know their status, provide prevention messaging, encourage people to take steps toward a healthy lifestyle, increase health-seeking behavior, and increase access to treatment, care and support.[2] The initiative targets heterosexual couples, sexually active men, commercial sex workers, and men who have sex with men.[3]
In addition to reaching out to high-risk demographics, the HCT initiative has also expanded to target young people, specifically high school students. According to the Human Sciences Research Council, three percent of the South African population under the age of 18 is HIV-positive.[4] Young women between the ages of 15 and 19 are two-and-a-half times more likely to become infected with the virus than their male counterparts. By the time these women reach the age range of 20–24, their risk of infection increases to four times that of young men.[5] The HCT initiative hopes that by providing testing in schools students will be able to learn their status at a young age and that this will help reduce the number of new infections each year. Many parents and teacher unions worry that students will be singled out and pressured into being tested. According to a report published by theGuardian, “opponents of the voluntary programme say children may not be psychologically prepared to deal with a positive result or the stigma likely to follow.”[6] Minister in the Presidency Collins Chabane tried to reassure opponents by stating that the campaign would be carefully planned with support from many different organizations.[7]
Schools on the Western Cape of South Africa have been testing high school students since 2007 and report that they tested 25,000 students in 2010. They have found ways to deal with these parental concerns and with issues of confidentiality. Organizations such as Shout-It-Now and Mpilonhle (A Good Life) are often responsible for conducting these tests and have developed best practices for ensuring confidentiality. Mpilonhle holds a general lecture with all students and then conducts a one-on-one hour-long session with each student individually. During the session, each student has the choice of whether or not to take an HIV test after learning information about the virus. Since all of the sessions take approximately one hour, it is difficult for students to know who opts for a test and who declines. “[Mpilonhle has] a process . . . that never ‘outs’ any child. We keep them out of class in a way that they won’t be missed,” explained Bruce Forgrieve, chairperson of Mpilonhle. “This is something that we’ve worked really hard at, and it’s our best kept secret.”[8]
Health department spokesman, Fidel Hadebe, emphasized the importance of this program and the benefits it will bring to students across South Africa. “The message we are trying to bring across to learners is: if you are [HIV] negative please stay negative, but to those that might test positive we are saying that we will give them the necessary support in terms of counselling and treatment,” said Hadebe.[9] He also noted that another benefit of the program is the ability to reach young people who may not have time to go to clinics and get tested due to the fact that they are in class most of the day. Although the plan was set for the program to begin this month, Hadebe warned that there may be delays in order to ensure that precautions and special measures are taken to protect the confidentiality of students.
“It is imperative that students are educated from a young age about HIV prevention and are provided with the necessary information to maintain a healthy lifestyle,” comments Jen Heitel Yakush, director of public policy for the Sexuality Information and Education Council of the United States. “We applaud the efforts of the South African government and hope that everything runs as smoothly as planned.”

[1]SANAC Secretariat, The National HIV Counseling and Testing Campaign Strategy (South Africa: SANAC, 2010), 4.

[2]Ibid., 9.

[4]“SOUTH AFRICA: HIV Testing in Schools Is a Minefield,” PulseNews Global, 7 February 2011, accessed 22 February 2011, <>.

[5]SANAC Secretariat, The National HIV Counseling and Testing Campaign Strategy, 4.
[6]David Smith, “South Africa Teaching Unions Criticise HIV Testing in Schools,” Guardian, 2 February 2011, accessed 22 February 2011, <>.[7]“South Africa: HIV Testing in Schools Will Be Professional, Responsible,” AllAfrica, 3 February 2011, accessed 22 February 2011, <>.

[8]“SOUTH AFRICA: HIV Testing in Schools Is a Minefield.”

[9]Sipokazi Fokazi, “Schools HIV Test Programme on Track,” IOL News, 29 January 2011, accessed 22 February 2011,