HIV This Week

Han J, Bennish ML. Condom access in South African schools: law, policy, and practice. PLoSMed. 2009;6(1):e6.

South Africa’s recently adopted Children’s Act provides children the right to access reproductive health services as a way of addressing the HIV pandemic, but there remains confusion about how socially divisive rights provided for by the Act, such as condom access for youth, will be achieved. The Children’s Act, together with South African government policies, allows individual schools to decide whether to distribute condoms, but most school staff are unaware of South African policy and regulations governing condom provision in schools. Because of confusing and contradictory government policies and public pronouncements regarding provision of condoms in public schools, few schools have undertaken to provide condoms, leaving students, especially in rural areas, with few options for obtaining them. US President’s Emergency Plan for AIDS Relief regulations potentially conflict with South African law by prohibiting US President’s Emergency Plan for AIDS Relief-funded organizations from distributing condoms in schools or providing condom information to youth aged 14 and under. The current South African government’s policy of leaving the decision of whether to distribute condoms in schools to the School Governing Body of individual schools, rather than enacting a clear national policy, is unlikely to be an effective public health strategy for improving access to condoms for the population of youths at high risk for HIV.

Editors’ note: South Africa permits 12 year olds to consent on their own to HIV testing but walking the talk on condom access for youth seems a challenge. The Children’s Act grants children age 12 and older access to condoms but adults, both domestic and foreign, are blocking implementation of this legally sanctioned right. Schools are good venues for youth, teachers, parents, community leaders, and health workers to come together to discuss constructive steps forward in the context of a relentless epidemic and a seeming policy vacuum.