Skip to main content
Top
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

“Students want HIV testing in schools” a formative evaluation of the acceptability of HIV testing and counselling at schools in Gauteng and North West provinces in South Africa

Authors: Sphiwe Madiba, Mathilda Mokgatle

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

The proposal by the South African Health Ministry to implement HIV testing and counselling (HTC) at schools in 2011 generated debates about the appropriateness of such testing. However, the debate has been between the Ministries of Education and Health, with little considerations of the students. The main aim of the study was to assess the students’ opinions and uptake of HIV testing and counselling in general, and the acceptability of the provision of HIV testing and counselling in schools. The study also determined the association between socio-demographic characteristics, sexual behaviour, and HIV testing behaviour of the students.

Methods

A survey was conducted among grade 10–12 high school students in North West and Gauteng provinces, South Africa. Seventeen high schools (nine rural and eight urban) were randomly selected for the administration of a researcher-assisted, self-administered, semi-structured questionnaire.

Results

A total of 2970 students aged 14–27 years participated in the study; 1632 (55%) were girls, 1810 (61%) ever had sex, and 1271 (49.8%) had more than one sex partner. The mean age of first sexual activity was 15.6. Half (n = 1494, 50.1%) had been tested for HIV. Having multiple sexual partners, age, and gender were significantly associated with increased odds of having had a HIV test. Fear, being un-informed about HTC, and low HIV risk perceptions were the reasons for not getting tested. The acceptability of HTC at school was high (n = 2282, 76.9%) and 2129 (71.8%) were willing to be tested at school. Appropriateness, privacy, and secrecy were the main arguments for and against HTC at school. One-third (n = 860, 29%) had intentions to disclose their HIV status to students versus 1258 (42.5%) for teachers. Stigma, discrimination and secrecy were the primary reasons students did not intend to disclose.

Conclusions

A high acceptability of HTC and willingness to be tested at school suggest that HIV prevention programs tailored to youth have a high potential of success given the readiness of students to uptake HTC. Bringing HIV testing to the school setting will increase the uptake of HTC among youth and contribute towards efforts to scale up HTC in South Africa.
Literature
1.
go back to reference Bayer R, Edington C. HIV testing, human rights, and global AIDS policy: exceptionalism and its discontents. J Health Polit Policy Law. 2009;34(3):301–23.CrossRefPubMedPubMedCentral Bayer R, Edington C. HIV testing, human rights, and global AIDS policy: exceptionalism and its discontents. J Health Polit Policy Law. 2009;34(3):301–23.CrossRefPubMedPubMedCentral
3.
go back to reference WHO/UNAIDS. Guidance on Provider-Initiated HIV Testing and Counselling in Health Facilities. Geneva, Switzerland: World Health Organization; 2007. WHO/UNAIDS. Guidance on Provider-Initiated HIV Testing and Counselling in Health Facilities. Geneva, Switzerland: World Health Organization; 2007.
4.
go back to reference DOH. Policy Guideline for HIV Counselling and Testing (HCT). Pretoria: National Department of Health; 2009. DOH. Policy Guideline for HIV Counselling and Testing (HCT). Pretoria: National Department of Health; 2009.
5.
go back to reference Tsegay G, Edris M, Meseret S. Assessment of voluntary counseling and testing service utilization and associated factors among Debre Markos University Students, North West Ethiopia: a cross-sectional survey in 2011. BMC Publ Health. 2013;13(1):243.CrossRef Tsegay G, Edris M, Meseret S. Assessment of voluntary counseling and testing service utilization and associated factors among Debre Markos University Students, North West Ethiopia: a cross-sectional survey in 2011. BMC Publ Health. 2013;13(1):243.CrossRef
6.
go back to reference Addis Z, Yalew A, Shiferaw Y, Alemu A, Birhan W, Mathewose B, et al. Knowledge, attitude and practice towards voluntary counseling and testing among university students in North West Ethiopia: a cross sectional study. BMC Publ Health. 2013;13(714):2–8. Addis Z, Yalew A, Shiferaw Y, Alemu A, Birhan W, Mathewose B, et al. Knowledge, attitude and practice towards voluntary counseling and testing among university students in North West Ethiopia: a cross sectional study. BMC Publ Health. 2013;13(714):2–8.
7.
go back to reference Asante KO. HIV/AIDS knowledge and uptake of HIV counselling and testing among undergraduate private university students in Accra, Ghana. Reprod Health. 2013;10(1):17.CrossRef Asante KO. HIV/AIDS knowledge and uptake of HIV counselling and testing among undergraduate private university students in Accra, Ghana. Reprod Health. 2013;10(1):17.CrossRef
8.
go back to reference Dirar A, Mengiste B, Kedir H, Godana W. Factors contributing to voluntary counselling and testing uptake among youth in colleges of Harar, Ethiopia. Sci J Publ Health. 2013;1:91–6.CrossRef Dirar A, Mengiste B, Kedir H, Godana W. Factors contributing to voluntary counselling and testing uptake among youth in colleges of Harar, Ethiopia. Sci J Publ Health. 2013;1:91–6.CrossRef
9.
go back to reference Omary S. Barriers and attitudes towards HIV Voluntary Counselling and Testing (VCT) among Secondary School Pupils of Sengerema in Mwan. Official Publication of the Tanzania Medical Students’ Association. 2008;15(1):20–3. Omary S. Barriers and attitudes towards HIV Voluntary Counselling and Testing (VCT) among Secondary School Pupils of Sengerema in Mwan. Official Publication of the Tanzania Medical Students’ Association. 2008;15(1):20–3.
10.
go back to reference Henry-Reid LM, Rodriguez F, Bell MA, Martinez J, Peera A. Youth counseled for HIV testing at school-and hospital-based clinics. J Natl Med Assoc. 1998;90(5):287.PubMedPubMedCentral Henry-Reid LM, Rodriguez F, Bell MA, Martinez J, Peera A. Youth counseled for HIV testing at school-and hospital-based clinics. J Natl Med Assoc. 1998;90(5):287.PubMedPubMedCentral
11.
go back to reference Pfaff C, De Beer J. Expanding access to HIV counselling and testing at schools–the Manguzi experience. South Afr J HIV Med. 2011;12(1):16–8. Pfaff C, De Beer J. Expanding access to HIV counselling and testing at schools–the Manguzi experience. South Afr J HIV Med. 2011;12(1):16–8.
13.
go back to reference Munthali AC, Mvula PM, Maluwa-Banda D. Knowledge, attitudes and practices about HIV testing and counselling among adolescent girls in some selected secondary schools in Malawi. Afr J Reprod Health. 2014;17(4):60–8. Munthali AC, Mvula PM, Maluwa-Banda D. Knowledge, attitudes and practices about HIV testing and counselling among adolescent girls in some selected secondary schools in Malawi. Afr J Reprod Health. 2014;17(4):60–8.
14.
go back to reference Lancet. School: a place for children to learn their HIV status? Lancet. 2011;377(9765):528. Lancet. School: a place for children to learn their HIV status? Lancet. 2011;377(9765):528.
15.
go back to reference Smith A, Agius P, Mitchell A, Barrett C, Pitts M. Secondary Students and Sexual Health 2008, Monograph Series No. 70, Melbourne, Australia: Australian Research Centre in Sex, Health & Society, La Trobe University. 2009. Smith A, Agius P, Mitchell A, Barrett C, Pitts M. Secondary Students and Sexual Health 2008, Monograph Series No. 70, Melbourne, Australia: Australian Research Centre in Sex, Health & Society, La Trobe University. 2009.
16.
go back to reference NDOH. Ethics in Health Research: Principles, Structures and Processes. Pretoria: Department of Health; 2004. NDOH. Ethics in Health Research: Principles, Structures and Processes. Pretoria: Department of Health; 2004.
17.
go back to reference Abiodun O, Sotunsa J, Ani F, Jaiyesimi E. Knowledge of HIV/AIDS and predictors of uptake of HIV counseling and testing among undergraduate students of a privately owned university in Nigeria. BMC Res Notes. 2014;7(1):639.CrossRefPubMedPubMedCentral Abiodun O, Sotunsa J, Ani F, Jaiyesimi E. Knowledge of HIV/AIDS and predictors of uptake of HIV counseling and testing among undergraduate students of a privately owned university in Nigeria. BMC Res Notes. 2014;7(1):639.CrossRefPubMedPubMedCentral
18.
go back to reference Ibrahim M, Ipadeola O, Adebayo S, Fatusi A. Socio-demographic determinants of HIV counseling and testing uptake among young people in Nigeria. Int J Prev Treat. 2013;2(3):23–31. Ibrahim M, Ipadeola O, Adebayo S, Fatusi A. Socio-demographic determinants of HIV counseling and testing uptake among young people in Nigeria. Int J Prev Treat. 2013;2(3):23–31.
19.
go back to reference Haddison EC, Nguefack-Tsagué G, Noubom M, Mbatcham W, Ndumbe PM, Mbopi-Kéou F-X. Voluntary counseling and testing for HIV among high school students in the Tiko health district, Cameroon. Pan African Med J. 2013;13(1):18. Haddison EC, Nguefack-Tsagué G, Noubom M, Mbatcham W, Ndumbe PM, Mbopi-Kéou F-X. Voluntary counseling and testing for HIV among high school students in the Tiko health district, Cameroon. Pan African Med J. 2013;13(1):18.
20.
go back to reference Musheke M, Ntalasha H, Gari S, Mckenzie O, Bond V, Martin-Hilber A, et al. A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa. BMC Publ Health. 2013;13(1):220.CrossRef Musheke M, Ntalasha H, Gari S, Mckenzie O, Bond V, Martin-Hilber A, et al. A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa. BMC Publ Health. 2013;13(1):220.CrossRef
21.
go back to reference Ikechebelu JI. HIV prevalence in Nigeria on the decline. J HIV Hum Reprod. 2014;2(1):1.CrossRef Ikechebelu JI. HIV prevalence in Nigeria on the decline. J HIV Hum Reprod. 2014;2(1):1.CrossRef
22.
go back to reference Sisay S, Erku W, Medhin G, Woldeyohannes D. Perception of High School Students on risk for acquiring HIV and utilization of Voluntary Counseling and Testing (VCT) service for HIV in Debre-berhan Town, Ethiopia: a quantitative cross-sectional study. BMC Res Notes. 2014;7(1):518.CrossRefPubMedPubMedCentral Sisay S, Erku W, Medhin G, Woldeyohannes D. Perception of High School Students on risk for acquiring HIV and utilization of Voluntary Counseling and Testing (VCT) service for HIV in Debre-berhan Town, Ethiopia: a quantitative cross-sectional study. BMC Res Notes. 2014;7(1):518.CrossRefPubMedPubMedCentral
23.
go back to reference Sokol D. Commentary on ethics of HIV testing in general practice without informed consent: a case series. J Med Ethic. 2005;31(12):701–2.CrossRef Sokol D. Commentary on ethics of HIV testing in general practice without informed consent: a case series. J Med Ethic. 2005;31(12):701–2.CrossRef
24.
go back to reference Angotti N, Bula A, Gaydosh L, Kimchi EZ, Thornton RL, Yeatman SE. Increasing the acceptability of HIV counseling and testing with three C’s: convenience, confidentiality and credibility. Soc Sci Med. 2009;68(12):2263–70.CrossRefPubMedPubMedCentral Angotti N, Bula A, Gaydosh L, Kimchi EZ, Thornton RL, Yeatman SE. Increasing the acceptability of HIV counseling and testing with three C’s: convenience, confidentiality and credibility. Soc Sci Med. 2009;68(12):2263–70.CrossRefPubMedPubMedCentral
25.
go back to reference Kishor S. Ethical issues related to population-based survyes with HIV testing. In: The 2nd Global HIV/AIDS Surveillance Meeting: 2009. 2009. Kishor S. Ethical issues related to population-based survyes with HIV testing. In: The 2nd Global HIV/AIDS Surveillance Meeting: 2009. 2009.
26.
go back to reference Mwangi M, Kellogg TA, Dadabhai SS, Bunnell R, Baltazar G, Ngare C, et al. Factors associated with uptake of HIV test results in a nationally representative population-based AIDS indicator survey. Open AIDS J. 2014;8:7.CrossRefPubMedPubMedCentral Mwangi M, Kellogg TA, Dadabhai SS, Bunnell R, Baltazar G, Ngare C, et al. Factors associated with uptake of HIV test results in a nationally representative population-based AIDS indicator survey. Open AIDS J. 2014;8:7.CrossRefPubMedPubMedCentral
27.
go back to reference Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27:363–85.CrossRef Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27:363–85.CrossRef
Metadata
Title
“Students want HIV testing in schools” a formative evaluation of the acceptability of HIV testing and counselling at schools in Gauteng and North West provinces in South Africa
Authors
Sphiwe Madiba
Mathilda Mokgatle
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1746-x

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue