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Preventing HIV in schools

UNICEF Malawi/2013/Roelandt
© UNICEF Malawi/2013/Roelandt
Alick Mulozi, HTC Counsellor, addresses pupils in a pre-testing counselling session.

27 November 2013 - On their way to an HIV testing and counselling day (HTCD) in Thyolo, HIV counsellors Ida Mangani and Alick Mulozi seem confident that the day will go well. After all, this isn’t the first time for them.

Four years ago, the two counsellors received 3 weeks of intensive training from UNICEF Malawi, where they were taught the basics on reproductive health, but also how to guide young people through HIV testing. Ever since finishing their training, they have been working in hospitals and schools in Thyolo. “We have learned from experience that youth are often much more optimistic and flexible when it comes to HIV testing. Couples counselling is where the real challenges are, adults often find unexpected results hard to accept. Children just want to know how they can proceed living a normal life without being a risk to themselves or others.”

200 pupils are waiting for them when they arrive at Nanfukwe Primary School. In one classroom, the pre- and post-test counselling will take place. In a second room, other counsellors make sure everything is set for the testing to run smoothly. Dozens of labels, cotton balls and test kits cover the tables.

Ida and Alick enter the classroom, where the students are waiting with a mix of excitement and shyness. Experience is everything in this situation, and if they want to have an honest and open conversation with the pupils sitting in front of them, they’ll have to use all the knowledge they have. “Even though classes on reproductive health are a part from life skills training in school, it is often difficult for teachers. They are scared that the community will think badly of them because they use offensive language.”

Ida starts warming up the pupils by shouting general questions on reproductive health to them in a funny way. The pupils shout back in laughter, but when Alick takes over and starts asking about contraception, they fall silent. The two counsellors keep changing roles when they feel the classroom needs a break and this way, they manage to keep the pupils engaged. One remarkable thing that stands out is that some of the pupils are very young. “Pupils can come for testing without their parents from the age of 13. For the 10 to 12-year olds, we advise them to come back with their parents, since they are often too young to understand the implications.”

UNICEF Malawi/2013/Roelandt
© UNICEF Malawi/2013/Roelandt
A pupil at Nanfukwe Primary School is tested for HIV. One drop of blood is enough.

After the counselling has ended, the pupils line up to be tested. The atmosphere is light and many of them make jokes, until it is their turn to do the test. One little sting with a needle to produce a little drop of blood is enough, but many of them are anxious since this is their first time. 15 minutes later, the results are out, no one tested positive. Good news, but there is still a post-testing counselling session scheduled. “It is important that the youth know how to sustain their negative status. They have to be aware that it’s only a small step from being HIV negative to being HIV positive. Statistics have also indicated that 60% of all youth coming to the testing days aren’t members of youth clubs, so they were driven here by peer influence. We need to use this influence to spread the message.” Ida says.

Fortunately, testing showed no new HIV infections at Nanfukwe Primary School, but even when this is the case, there is follow up from the counsellors. “When one or more pupils tests positive, we refer them to the hospital or health centre. Since we work there, it is easy for us to follow up, and offer care and support.”

When asked what keeps them motivated to work as a volunteer, Ida and Alick are unanimous. “We want to inspire others to become counsellors. Most of all, we want to use our knowledge on mother-to-child transmission of HIV to assist pregnant women in order to produce an HIV-free generation.”

After a long day of testing and counselling, the pupils run home, happy and relieved. Ida and Alick drive back to the district hospital, to prepare for a new HTCD tomorrow in a different school. Hopefully, no young person will test positive there.



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