VIEWS OF PARENTS ABOUT VIEWS OF PARENTS ABOUT INTEGRATING HIV POSITIVE CHILDREN INTEGRATING HIV POSITIVE CHILDREN

INTO SCHOOLINTO SCHOOL

J. Meade, P. HamiltonJ. Meade, P. Hamilton

Advanced Training & Research in Fertility ManagementAdvanced Training & Research in Fertility ManagementThe University of the West Indies, MonaThe University of the West Indies, Mona

February 14, 2006February 14, 2006

IntroductionIntroduction

• UN recognizes the right of the child to education regardless of status

• MOEYC, Jamaica expects children living with HIV to be integrated into the school system

• Integration means physically present and functionally equal

ProblemProblem

• Discriminatory environment associated with HIV/AIDS in Jamaica

• Increasing HIV/AIDS prevalence

• Long-term survivability with medication

• Greater numbers of children with HIV in school

• Issues of integration and stigmatization of children in school

Aim and ObjectivesAim and Objectives

• Aim: – to investigate the views of parents regarding

integration of children with HIV into the school system

• Objectives:– Determine how parents would feel about children with

HIV being in school with their children– Explore how parents would react to children with HIV

in the normal school system

MethodologyMethodology

• Focus Group discussions

• 40 parents, male and female

• Proceedings tape recorded, transcribed, analyzed by theme

General FindingsGeneral Findings

• Parents uncomfortable with children living with HIV/AIDS attending normal school

• Children with HIV should be kept separate:– at home– at a special educational facility located at a

distance from regular school

• Cost of facility should be borne by Government

Acceptance of HIV+ Children in Acceptance of HIV+ Children in SchoolSchool

• Parents should know to keep children with HIV/AIDS away from school

“I think that, if the child has that problem, parents should know to keep that child at home and protect him from others because if that child in the classroom and get cut and two of them get together they might get it”.

Acceptance of HIV+ Children in Acceptance of HIV+ Children in SchoolSchool

• HIV/AIDS should be treated like a life threatening communicable disease requiring separation“At the same time, if you go out there and break Guinea Hen or something, chicken pox can deal with right inna you little house deh so. Yet still Ministry of Health will say that child must stay away from school until. So what mek now the pickney with the AIDS must now still be in school with the others?”

• Even if medication allows the child to function normally he/she is viewed as “contaminated”

Alternative Accommodation Alternative Accommodation

• Infected and non-infected children must not be in contact with each other

Parent 1: “Miss, me feel say from you have HIV you fi go somewhere. You fi separate yourself.”

Parent 2: “Remember it is children. Big people might have a little more understanding to say stay away, do not do this. I think they are to be placed in a special school.”

Alternate Accommodation (Contd.)Alternate Accommodation (Contd.)

• Separation is to mitigate risk of infection

“Was she saying that you supposed to have a class, for example on this compound, especially for AIDS children? That couldn’t work because what about the children that don’t have it? They are going to trouble the ones with it and cause fight. So it couldn’t be on the compound.”

Sources of RiskSources of Risk

• Non-infected children deemed vulnerable to infection as a result of:– Injuries during play– Open cuts and sores– Inability of some children to protect themselves– Natural wish to help injured friend– Malicious intent of infected child– Sexual debut in the school environment– Some children’s lack of knowledge

Sources of Risk (Contd.)Sources of Risk (Contd.)

“When children have it some of them are wicked. Because they know they have it and then say alright, you know if I pinch you, you will have AIDS and him leave all the way come pinch you.”

“Most relationships, young relationships, start from in the school also. You have a boy friend and girl friend start from in the school and most of the children in the school have sex often more than even the big people, so by having them in the same school that can also happen. So it is best when they are not in the same school with the other children.”

StigmaStigma

• Psychological barriers to acceptance of HIV+ children exist

“We have the psychological effect on the child. Before we understood the source we could be more sceptical about it. We know it cannot be transmitted like that so you see there is a psychological thing to be careful.”

Stigma (Contd.)Stigma (Contd.)

• Stigma is a major problem in the wider society

“The stigma is still there in a wide cross section of society.”

• Separation of HIV+ children is not thought of as discrimination

Stigma (Contd.)Stigma (Contd.)

• Separate facility is not altogether satisfactory but necessary

“It no sound good for neither the country nor nobody, but instead of the whole of us getting infested with it, it is better to live with it that way.”

Provision for HIV+ ChildrenProvision for HIV+ Children

• Difficulties recognized in catering for children who may be widely dispersed

Parent 1: “It is hard. Maybe one child from Montego Bay have AIDS and the AIDS school in Kingston and it is only the one child from Montego Bay have AIDS?”

Parent 2: “He will go to school. You don’t want it in Kingston. We must have it all over, some of them central, have it all over.”

• Have special facilities centrally located, perhaps in each parish

Provision for HIV+ ChildrenProvision for HIV+ Children

• Specially trained, tolerant people to care for and teach them

“People who are trained, people who are trained to deal with that and they themselves are tolerant about it. They can handle it.”

• Additional taxes would need to be levied to finance facilities

Disclosure at SchoolDisclosure at School

• Problems anticipated if HIV+ status becomes known– Demonstrations– Isolation and scorn

Parent 1: “They would be isolated.”Parent 2: “They would scorn them.”

• Parents do not now know of HIV+ children attending school

Disclosure at SchoolDisclosure at School

• Children should submit medical certificate each term attesting to HIV status

“This is why when we say you are to bring a medical certificate to school every term you must understand it is serious. Take the child to the doctor. When you a come wid you pickney you must bring the medical something.”

Parents Ability to Educate ChildrenParents Ability to Educate Children

• Parents have limited ability to educate children about HIV/AIDS and are in a dilemma

“When I got the letter the other day I tried to talk to my son and he wants to know how it starts. I had a problem explaining to him. I didn’t know what to say and he was asking a lot of questions.”

Parents Ability to Educate ChildrenParents Ability to Educate Children

• Information provided includes:– HIV is a disease– It cannot be transmitted by casual contact– Children with HIV/AIDS normal people except

they are ill

Parent 1: “At our age we really don’t give them any information.”

Parent 2: “We know that it is a disease and that it cannot be transmitted if like you shake hands.”

ConclusionsConclusions

• Parents very reluctant to have HIV+ children integrated into normal school system

• Strongly advocate separate facilities• Attitude derives from:

– Perceived inability of school to guarantee protection of children

– Nature of AIDS and fear of infection– Perceived vulnerability of children – Lack of control over children’s behaviour at school

Conclusion (Contd.)Conclusion (Contd.)

• Education of parents and children necessary

• School environment must be made safer – Code of conduct for schools should be

promulgated– Parents must participate more actively in

school