Meinck, Franziska

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     Edinburgh Research Explorer                                      Can free schools in South Africa reduce HIV risk?Citation for published version:Meinck, F, Can free schools in South Africa reduce HIV risk?, 2019, Web publication/site, TheConversation.Link:Link to publication record in Edinburgh Research ExplorerDocument Version:Publisher's PDF, also known as Version of recordPublisher Rights Statement:This article is republished from The Conversation under a Creative Commons license. Read the original article:https://theconversation.com/can-free-schools-in-south-africa-reduce-hiv-risk-120026General rightsCopyright for the publications made accessible via the Edinburgh Research Explorer is retained by the author(s)and / or other copyright owners and it is a condition of accessing these publications that users recognise andabide by the legal requirements associated with these rights.Take down policyThe University of Edinburgh has made every reasonable effort to ensure that Edinburgh Research Explorercontent complies with UK legislation. If you believe that the public display of this file breaches copyright pleasecontact openaccess@ed.ac.uk providing details, and we will remove access to the work immediately andinvestigate your claim.Download date: 23. Oct. 2019Can free schools in South Africa reduce HIV risk?file:///ed.ac.uk/...rch%20and%20Access/Research%20Publication%20Files/Social%20Work/Meinck,%20Franziska/Meinck_2019_Conversation_CanFreeSchoolsSAReduceHIVRisk.html[18/09/2019 11:35:20]Academic rigour, journalistic flairArts + Culture Business + Economy Cities Education Environment + Energy Health + Medicine Politics + Society Science + Technology BrexitCan free schools in South Africa reduce HIV risk?July 16, 2019 3.49pm BSTSouth Africa has the largest HIV epidemic in the world. An estimated 7.2 millionpeople are living with HIV and 4.4 million are on antiretroviral therapy. Despite theprogress made, AIDS remains the leading cause of death among adolescents. Therewere an estimated 270 000 new HIV infections in 2017. The rate is particularly highin young women between the ages of 15 and 24.Risky sexual behaviour, such as failing to use a condom, or having sex while drunk or on drugs, increases the risk of HIV infection.In our study, we wanted to examine why adolescent girls are engaging in risky sexualbehaviour. Is this behaviour driven by childhood adversity, such as poverty, comingfrom a family where someone is ill with HIV/AIDS, or exposure to violence andexperiencing psychological distress? We also wanted to find out if a governmentpolicy such as free schooling has the potential to mitigate some, or all, of theseAuthorFranziska MeinckPostdoctoral research fellow,University of OxfordDisclosure satementFranziska Meinck has previously consulted forFrontline AIDS, Save the Children and theWorld Health Organization. This study wasfunded by the Economic and Social ResearchCouncil (UK) and the National ResearchFoundation (RES‐062‐23‐2068), the NationalDepartment of Social Development, theClaude Leon Foundation, the NuffieldFoundation (OPD/31598), the HealthEconomics and HIV/AIDS Research Divisionat the University of KwaZulu‐Natal(R14304/AA002), the John Fell Fund(103/757), the University of Oxford ImpactAcceleration Account (1602‐KEA‐189,1311‐KEA‐004, 1069‐GCRF‐227) and theLeverhulme Trust (PLP‐2014‐095). FranziskaMeinck is funded by an ESRC FutureResearch Leader Award (ES/N01747/1).Franziska Meinck is a Counselor of theInternational Society for the Prevention ofChild Abuse and Neglect (ISPCAN).PartnersUniversity of Oxford provides funding as amember of The Conversation UK.The Conversation UK receives funding fromthese organisationsYoung girls play netball in an open field near King Williams Town. EPA/Kim Ludbrook Email Twitter 5 Facebook 122 LinkedIn PrintEdition: Donate Events United Kingdom      Become an author Sign up as a reader Sign inCan free schools in South Africa reduce HIV risk?file:///ed.ac.uk/...rch%20and%20Access/Research%20Publication%20Files/Social%20Work/Meinck,%20Franziska/Meinck_2019_Conversation_CanFreeSchoolsSAReduceHIVRisk.html[18/09/2019 11:35:20]drivers.Our studyWe interviewed 1 498 teenage girls between the ages of 10 and 17 in rural and urbanareas in South Africa using a standardised questionnaire in 2011. We interviewed thesame teenage girls again in 2012.During both interviews we asked them about child abuse experience, exposure todomestic violence, numbers of days per week in which they did not have enough foodin the home, and if a caregiver was ill with AIDS. We screened them for depression,anxiety and suicidal thoughts, measured their drug use, conduct, and peerrelationships. We asked how often they did not use a condom during sex, or had sexwith multiple partners or while they were drunk or using drugs.We also measured if they received a free school meal or free text books and attendeda no-fees school.This is what we foundOur study showed that rates of childhood adversity were high in this study. Wefound that 34.3% of girls had a family member ill with HIV/AIDS. They reported anaverage of two days without sufficient food in the home and an average of threeabusive events in their life.The study also found that 12% did not always use condoms, 2% had sex while drunkor on drugs and 8% had multiple sexual partners in the past year. Of thoseinterviewed, 71% received free schooling.Our research showed that the association between childhood adversity and HIV riskbehaviour is not direct. Instead, we found that increased vulnerability led to certainnegative outcomes. These included internalised psychological distress in the form ofsuicidal thoughts, depression and anxiety, and externalised psychological distress inthe form of drug and alcohol use, problems with behaviour and poor peerrelationships. These pathways, in turn, heightened the probability that girls wouldengage in risky sexual behaviour.These findings are important because they help us understand why girls have riskysex, and help us consider interventions that might help prevent this behaviour. Theysupport and complement existing evidence that suggest vulnerability is an importantdriver of risky sexual behaviour.And this is where free schooling may help.Free schoolingSouth Africa introduced non-fee schools in 2007 and the National School Nutrition View the full listCC BY NDWe believe in the freefow of informationRepublish our articles for free,online or in print, under CreativeCommons licence.Republish this articleCan free schools in South Africa reduce HIV risk?file:///ed.ac.uk/...rch%20and%20Access/Research%20Publication%20Files/Social%20Work/Meinck,%20Franziska/Meinck_2019_Conversation_CanFreeSchoolsSAReduceHIVRisk.html[18/09/2019 11:35:20]Programme for primary schools in 2004. This was extended to secondary schools in2009. Learners in the poorest three-fifths of schools (so called three lowest quintiles)pay no school fees and receive a hot, nutritious meal.To date, school feeding reaches 77% of learners in public schools, while 66% benefitfrom not paying tuition fees.Tentative evaluations of these two policies have shown a reduction in stunting,heightened levels of school enrolment in primary and secondary schools, andimproved attendance and educational outcomes.Our findings show additionally that receipt of free schooling directly reducesexternalising psychological distress and mitigates the association between childhoodadversity and internalising mental health distress; and thereby lessens HIV riskbehaviour.Further research may help us understand why this is the case. One possibility is thatfree schooling reduces hunger and worries about the ability to pay school fees,thereby reducing psychological distress. Free schooling could also increase attendance, giving teenage girls the opportunity to make friends with peers and buildsupport networks .Whatever the mechanisms, our findings suggest that free education in the forms ofno-fees, free meals and text books appear important in promoting mental healthamong teenage girls in South Africa – and, in turn, reducing risky sexual behaviour.This article is based on a paper written in collaboration with Professor Mark Orkinand Professor Lucie Cluver using data from the YoungCarers study.Public health HIV South Africa Risky sexual behaviour Women and girlsYou might also like Tweet  Share  Get newsletterWhen and where do Nilecrocodiles attack?Here’s what we foundSouth Africa’s nuclearresearch facility –Pelindaba – needs tobe repurposedVas subsidies keepingthe fossil fuel indusryafoat should be put tobetter useYoung South Africanswant to farm. But thesysem isn’t readyfor themCan free schools in South Africa reduce HIV risk?file:///ed.ac.uk/...rch%20and%20Access/Research%20Publication%20Files/Social%20Work/Meinck,%20Franziska/Meinck_2019_Conversation_CanFreeSchoolsSAReduceHIVRisk.html[18/09/2019 11:35:20]There are no comments on this article yet. Have your say, post a comment on this article.Sign in to comment Comments0Five climate change sciencemisconceptions – debunkedMeasles outbreaks and political crisesgo hand in handThe Amazon’s tallest tree just got 50%taller – and scientists don’t know howHow fast is the universe reallyexpanding? 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Can free schools in South Africa reduce HIV risk?

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Can free schools in South Africa reduce HIV risk?

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