HIV prevalence among high school learners - opportunities for schools-based HIV testing programmes and sexual reproductive health services

Ayesha Bm Kharsany,Natasha Samsunder,Salim S Abdool Karim,Mukelisiwe Mlotshwa,Janet A Frohlich,Quarraisha Abdool Karim,Nonhlanhla Yende Zuma

doi:10.1186/1471-2458-12-231

Abstract

BackgroundYoung girls in sub Saharan Africa are reported to have higher rates of human immunodeficiency virus (HIV) infection compared to boys in the same age group. Knowledge of HIV status amongst high schools learners provides an important gateway to prevention and treatment services. This study aimed at determining the HIV prevalence and explored the feasibility of HIV testing among high school learners.MethodsBetween September 2010 and February 2011, a linked, anonymous cross-sectional survey was conducted in two public sector high schools in the rural KwaZulu-Natal midlands. Following written informed consent, dried blood spot samples (DBS) were collected and tested for HIV. The overall and age-specific HIV prevalence were compared with select demographic variables.ResultsThe HIV prevalence in learners aged 12 to 25 in school A was 4.7% (95% CI 2.8-6.5) compared to 2.5% (95% CI 1.6-3.5) in school B, (p = 0.04). Whilst the HIV prevalence was similar for boys at 1.3% (95% CI 0-2.8) in school A and 1.7% (95% CI 0.5-2.8) in school B, the prevalence in girls was consistently higher and was 7.7% (95% CI 4.5-10.9) in school A and 3.2% (95% CI 1.8-4.6) in school B. The age-specific HIV prevalence in girls increased 1.5 to 2 fold for each two year age category, while for boys the prevalence was stable across all age groups.ConclusionsThe high HIV prevalence in female learners underscores the importance of sexual reproductive health and schools-based HIV testing programs as an important gateway to prevention and treatment services.

Highlights

Young girls in sub Saharan Africa are reported to have higher rates of human immunodeficiency virus (HIV) infection compared to boys in the same age group
To understand the evolving HIV epidemic in this rural setting and to establish whether the prevalence in young pregnant girls is similar to that in other non-pregnant young people in this age group we undertook an anonymous survey in high school learners in Vulindlela, KwaZulu-Natal
Sexual debut is associated with higher teenage pregnancy rates, sexually transmitted infections and poor school completion rates leading to poor health and economic outcomes in young women [8,9,10,11,12]

Summary

Introduction

Young girls in sub Saharan Africa are reported to have higher rates of human immunodeficiency virus (HIV) infection compared to boys in the same age group. Knowledge of HIV status amongst high schools learners provides an important gateway to prevention and treatment services. Whilst South Africa is one of few countries that has a supportive legal framework to enable young children to access sexual reproductive health services autonomously from age 12 [5], there are many ethical and programmatic challenges to HIV testing of young children for care and support or for surveillance. To understand the evolving HIV epidemic in this rural setting and to establish whether the prevalence in young pregnant girls is similar to that in other non-pregnant young people in this age group we undertook an anonymous survey in high school learners in Vulindlela, KwaZulu-Natal

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