Abstract
BackgroundHIV counselling and testing (HCT) is an essential element in the response to the HIV epidemic. There are still major research gaps about the best ways to provide HCT, especially to the youth, and school-based HCT is a model that has been suggested. To make HCT youth friendly and to enhance access to the service, the particular needs of the youth need to be addressed.AimTo explore the expressed needs of students about school-based HCT service provision.MethodThe study was conducted in 6 secondary schools in Cape Town where a mobile HCT service is provided by a non-governmental organisation. In each school, two mixed-gender focus groups were held, one with grades 8 and 9 students and one with grades 10 and 11. A total of 91 students aged 13–21 were involved. The focus groups were conducted in the students’ home language. All groups were audio-recorded, transcribed verbatim and translated into English.ResultsContent data analysis was done and the following themes emerged: (1) Where the students want HCT to be done, (2) How they want HCT to be done and (3) Who should do the counselling. Most students want HCT to be provided in schools on condition that their fears and expressed needs are taken into account. They raised concerns regarding privacy and confidentiality, and expressed the need to be given information regarding HCT before testing is done. They wanted staff providing the service to be experienced and trained to work with youth, and they wanted students who tested positive to be followed up and supported.ConclusionTo increase youth utilisation of the HCT service, their expressed needs should be taken into account when developing a model for school-based HCT.
Highlights
HIV counselling and testing (HCT) has been advocated as a critical entry point for care and treatment services, including prevention and clinical management of HIV-related illnesses, and psychosocial support.[1,2,3,4,5] despite a national HCT campaign from 2010 to 2012 in South Africa, only 50.6% of youth aged 15–24 years reported testing, compared with 78.2% of adults aged 25–49 years.[6]As part of the national HCT campaign, the South African Departments of Basic Education and Health announced that they intended to launch an HCT campaign targeting secondary school students.[7]
This announcement was met with widespread concern from child rights, human rights and AIDS organisations, who argued that the school setting was not conducive to providing HCT in a way that does not violate the rights of youth
School-based models have been described in Uganda, where the Kitovu Mission Hospital has provided a mobile HCT service in schools,[8] and the Tholulwazi Uzivikele HCT programme in Manguzi, South Africa, where HCT was offered in schools; drama used to raise awareness and encourage testing amongst the students.[9]
Summary
As part of the national HCT campaign, the South African Departments of Basic Education and Health announced that they intended to launch an HCT campaign targeting secondary school students.[7] This announcement was met with widespread concern from child rights, human rights and AIDS organisations, who argued that the school setting was not conducive to providing HCT in a way that does not violate the rights of youth. Owing to these legal and ethical concerns, the Department of Basic Education put the campaign on hold until policies guiding HCT in schools could be developed. To make HCT youth friendly and to enhance access to the service, the particular needs of the youth need to be addressed
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