As the global spotlight falls on
demographic changes today - in honour of World Population Day - South
Africa can boast about having made strong policy strides in combatting
HIV. A new plan to introduce condoms in schools is promising but many
doubts have been raised about its implementation.
It was July 2016. South Africa’s Minister
of Health, Aaron Motsoaledi, was about to introduce a speaker at the
Durban AIDS conference when a group of protestors rose in song. They
were singing about condoms, demanding that the contraceptives be
distributed in schools. The Minister is reported to have responded, “No,
no, no – this session is not about this.”
The government has come a long way in the intervening year. Since then a new policy
has been proposed which will make it possible for condoms to be rolled
out in schools – even at the primary school level. The policy is a
response to some disturbing statistics in South Africa’s fight against
HIV.
According to StatsSA
11,2 percent of the population is HIV positive, which amounted to
6,19 million people in 2015. Those numbers are more alarming among
adolescents. Nearly a third
of all new HIV infections in South Africa occur among 15 to
24-year-olds, with adolescent girls being eight times more likely to get
infected than their male counterparts. And even though mortality rates
among other age groups are declining – generally as a result of
programmes like the rollout of antiretrovirals across the country or
free male circumcision initiatives – the number of teenagers who have
died from HIV-associated conditions is increasing.
Sexual debut before 15
The policy is specifically aimed at
protecting pre-adolescents, given that 37,5% of all school children
reported having had sex in the 2012 National Survey on HIV, conducted by the HSRC. It was also found that 12,6% of respondents had had their first sexual encounter before age 14.
It is hoped that the provision of condoms will help
equip adolescents who are in age-disparate relationships to make safer
choices. The survey found that one fifth of respondents (19,9 percent)
were in a sexual relationship with someone who was five or more years
older than they were. This phenomenon was more highly prevalent among
girls than boys: 33,7 percent of all female adolescents aged between 15
and 19 reported having had a partner more than five years older than
them, whereas this was the case with only 4,1 percent of boys.
Resistance from Christian groups
Though the Basic Education Department reports that many parents have welcomed
the provision of condoms in schools, the matter remains contentious
among Christian groups. The African Christian Democratic Party Western
Cape leader, Ferlon Christians, told the Sowetan newspaper: “The solution is to tell [and] teach our youngsters to stay away from sex and enjoy being at school.”
Christians’ comments come on the heels of
a change in the country’s criminal law, which makes it possible for
children between the ages of 12 and 16 to consent to sexual acts with
one another. The law also allows for girls age 12 to have abortions
without the consent of their parents, a move that Christians decry as
the condoning of killing.
Critics of the policy also argue that providing condoms
in schools will encourage children to have sex much earlier than they
otherwise would have. “This position is not based in fact as no studies
exist to support the claim that condom distribution in schools will
accelerate the age of sexual debut,” says Lisa Eaves Draga of the Equal
Education Law Centre (EELC), a law clinic that aims to reduce inequality
through legal advocacy. “Comparative research actually shows the
existence of condom availability programmes in schools increases
learners’ use of condoms when they are already engaging in sexual
intercourse.”
Strong on paper; weak on the ground
The policy has been welcomed overall by
civil society groups like the EELC but doubts persist about the
implementation process. Lisa Eaves Draga, who is an attorney at the
clinic, is concerned that the current framing seems to make use of
intermediaries (teachers or other authority figures) to dispense the
condoms. “Research
reveals that learners are reluctant to make use of this service if
condoms are issued by an authority figure,” Eaves Draga says. “The
presence of an intermediary would ultimately undermine one of the
purposes of the policy, which is to protect learners from contracting
STIs or HIV/AIDS infection or from unintended pregnancy.”
“When you look at it, it is a good policy report,” Treatment Action Campaign (TAC) general secretary Anele Yawa told the Daily Maverick,
an online paper. “But it lacks a sense of accountability. It doesn’t
help as a country to have good policies if there is no implementation
plan.” The TAC has historically played a big role in forcing government
to find ways of providing antiretrovirals in the country and remains a
strong advocate of accountability.
Professionals working on the ground are also doubtful
about the implementation. Ray Schöne is the founder of an NPO called
Youth Potential South Africa, which offers supplementary educational
programmes in disadvantaged rural schools. Schöne told TIA that
he is not optimistic about the new policy. “Maybe it [it will help] a
little bit,” he says in a telephone interview. “But not as the main
aspect of fighting HIV”. Schöne calls for the rollout to be coupled with
better sex education. Officially, the policy plan does have a strong
education component, but in the kinds of schools where Schöne works,
schools where many of the learners and teachers are HIV positive, it is
difficult to see how the aims of the policy are going to be translated
into action.
“It appears that the Department will be relying on the Integrated School Health Programme
(ISHP) for ensuring condoms are made available in schools,” says Eaves
Draga at the EECL. “But the ISHP is marred by trouble, including
significant staff shortages and a lack of transport. The workability of
this model is therefore doubtful.”
Source: thisisafrica
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