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.
Adolescent girls are eight times more likely to get infected than their male counterparts.
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.
In South Africa, 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.”
“No studies exist to support the claim that condom distribution in schools will accelerate the age of sexual debut.” – Lisa Eaves Draga, Equal Education Law Centre
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.”