The long stay at home for young people is likely to expose them to new HIV/Aids infections, experts warn, as schools remain shut to slow the spread of the coronavirus.
Experts say education institutions potentially play a protective role for children but during the lockdown most young people have been left unattended to, thus leaving them vulnerable in communities. In Uganda, at least 10.7 million children in primary schools, two million in pre-primary, two million in secondary schools, and 314,548 students in universities and tertiary institutions have been out of restricted learning environments since March 18, 2020.
The director Basic Education at the Education ministry, Ismael Mulindwa, said whereas school/university gates will eventually reopen, some girls may never return to school.
“As a ministry, we are worried that we may not get back all the numbers of learners that we sent back home. In this period, many may have already fallen victim to HIV and you can’t hide from that truth,” Mulindwa, who is also in charge of the ministry’s Health and HIV unit, said.
He added: “If the school-going girls are getting pregnant during the lockdown, how sure are you that those impregnating them are not HIV positive?”
Mulindwa told The Observer that the sector’s gender unit is trying to reach out to areas with high incidents but it’s tricky that learners and parents can’t be reached for sensitization about HIV due to COVID restrictions.
“I should admit that we are not addressing these lockdown concerns in an organised way because our teams work within limitations of Covid standard operating procedures. So, the best we can do is talking to district officials who cascade this information into communities,” he said.
Currently, the education ministry has shifted to crafting messages – now at printing stage – that will be sent out to learners through the ministry of Health taskforce structures.
SCHOOLS AS SAFE HAVENS
The latest UNAIDS 2020 global report indicates that staying in school longer for adolescent girls and young women aged 15 to 24 has a protective benefit in reducing the risk of HIV infections.
The report showed that this environment, particularly for girls, increases their access to health information, delay their sexual debut, reduce early marriage and teenage pregnancies as well as promote safer sexual behaviours.
The report further noted that countries in the Eastern and Southern region that have higher completion rates for lower secondary school at more than 50 per cent have registered relative reduction in both HIV risks and new infections since 2010.
In the region, the UNAIDS report ranked Eswatini with the highest percentage of completion rates at 62 per cent. It is followed by South Africa (56%), Lesotho (50%), Zimbabwe (46%), Kenya (44%), Botswana (40%), and Namibia with 39%. Angola tops the list of countries with the lowest completion rate with negative three followed by Zambia with 10%, Mozambique 11%, Tanzania 18% and Malawi at 32%. Uganda followed under this docket at 35 per cent, Ethiopia 42%, and Rwanda with 45%.
Mulindwa attributed Uganda’s low retention rates for the girl child to teenage pregnancies, forced early marriages, violence against children, sexual violence, poverty, unfair cultural attitudes, among others.
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The country program director at AHF-Uganda Cares, Henry Magala, said before the pandemic, HIV has been proportionately higher among female adolescents. He said the current lockdown has worsened the situation since social media continues to expose young people to sex with limited information on HIV prevention and protection.
Magala insisted that under the lockdown, a lot of unprotected sexual activity is taking place underground and the probability of HIV infections climbing is high.
“We are still living in denial of the fact that within this age group [15-24], there are no sexual activities. We call this an innocent group yet the reality shows otherwise. Whenever we think that something is not happening yet it is taking place, the likelihood that HIV infections are happening is high…” Magala said.
Magala said before schools closed, young people used to have youth friendly corners and clinic days for HIV-related information but due to congestion, the sessions closed. At AHF-Uganda Cares, health workers used to conduct daily community HIV testing and interact with people and school/university students.
“The lockdown and Covid SOPs restrictions mean that people don’t know their HIV status because they are not tested and cannot access treatment if positive. This is likely to spiral HIV new infections in Uganda,” Magala said.
He added that while females have been active in seeking treatment, their numbers have also suddenly reduced due to increased transport costs. The AHF HIV clinics used to attract as high as 90 per cent attendance but the numbers of females have dropped to 70 per cent, meaning the 30 per cent have been lost somewhere. For males, whose positivity rate is much lower globally, their attendance is at 40 per cent.
IMPROVING RETENTION RATES
In 2018, the Education ministry partnered with the Global Fund to improve the retention of girls in schools. This project ought to have started in 2018 and ended in December 2020. However, the project delayed for two years.
“There were some misunderstandings between Global Fund and the ministry but I will not go into details. The ministry felt that the issues fronted by Global Fund at the time were not a priority in addressing retention rates,” Mulindwa said. “They looked at giving girls subsidies like Vaseline, knickers, sanitary pads, school bags, soap, and half-slips, among others which weren’t the case with us.”
Several meetings were held with the political leadership until they reached a consensus. As such, the ministry procured the items and planned to implement the entire three-year project in one year, starting January 2020. A month later, government closed schools and the project has since stalled.
“If you go to our stores, they are full of items we had to distribute to the girls but when schools closed, we were hit badly. We are worried that some items may go bad but we are having discussions on the modalities of distribution with the political leadership,” Mulindwa, also chairperson of the sector’s COVID taskforce, said.
He added that in the last meeting, the political leadership insisted that distribution of subsidies to girls will attract crowds, thus aiding the spread of COVID-19. According to the project plan, the next phase is expected to run from 2021 to 2023. It intends to, among others, address stigma among HIV positive girls to enable them stay in school.
Mulindwa explained that stigma in schools has forced many parents not to disclose the HIV status of their children – a reason the ministry has no data bank for all learners living with HIV countrywide. UNAIDS current figures showed that there are 1.5 million people living with HIV in Uganda. By end of 2019, Uganda registered 53,000 new HIV infections and 21,000 AIDS-related deaths.
ROLE OF PARENTS
With uncertainty around reopening education institutions, Magala urged parents to engage their children in sexuality education.
“Sex is sacred but circumstances now dictate that it cannot be business as usual. Parents should talk to their children about the dangers of irresponsible sex because if we don’t speak, the community is continually going to take advantage of naivety of our children as we leave them at home,” Magala said.
Having worked at The AIDS Support Organisation (TASO) for at least 12 years, Dr Lydia Mungherera observed that parents have left sexuality education to school heads, NGOs, and religious insitutions.
“Parents need to talk to children about sexual relationships instead of keeping ourselves too busy and exposing our girls and boys to risks of acquiring HIV. Discussing sex is a taboo in some cultures but for how long are you going to observe this taboo?” Mungherera asked. “Talk to your children so that they are aware of dangers of early sex and HIV.”
