A mobile school-based HCT service – is it youth friendly?

Estelle Lawrence,Patricia Struthers,Geert Van Hove

doi:10.1080/17290376.2016.1222597

Abstract

Background: Despite an increase in HIV Counselling and Testing (HCT), few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided) are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS) as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly. Methods: The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions. Key Results: The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and non-judgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care. Conclusion: Providing HCT in the school setting may make HCT more accessible for students, but it needs to be provided in an equitable, accessible, acceptable, and effective way.

Highlights

The HIV epidemic is a major public health problem among youth in South Africa
General observations The mobile school-based HIV Counselling and Testing (HCT) service did not put any restriction on the use of the service based on race, gender, religion, or socioeconomic status
The counselling provided by the HCT service providers did not take into consideration the special needs of marginalised groups such as young men who have sex with men (MSM), and young people involved in transactional sex and intergenerational sex

Summary

Introduction

In accordance with Joint United Nations Programme on HIV and AIDS (UNAIDS) (1997) recommendations, one of the ways that the South African government had tried to address this problem was to include HIV testing in the National HIV and AIDS and Sexually Transmitted Infections (STIs) Strategic Plan for 2007– 2011 (South African National AIDS Council 2007), with a specific focus on young people. Since the mid-1990s, non-governmental organisations (NGOs) in Cape Town have been providing an HIV Counselling and Testing (HCT) service at secondary schools where school governing bodies have given permission. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. Conclusion: Providing HCT in the school setting may make HCT more accessible for students, but it needs to be provided in an equitable, accessible, acceptable, and effective way

Objectives

Methods

Results

Discussion

Conclusion