Open CampusHIV-Related Stigma and Children's School Outcomes in St. Lucia

Joan ThomasCaribbean Child Development Centre

St. Lucia Country ConferenceMay 3-4, 2012

Background Review of studies from developing countriesChildren living and affected by HIV:Low school attendanceMore school problems Additional responsibilitiesStigma & discrimination in classReview of studies from the CaribbeanOnly 2 on Jamaican children: - Ignorance about HIV fueled stigmatization from others - Poor school attendance and performance among children

Objectives 1/2Main objective:To describe the nature and extent of HIV-related stigma and discrimination among school children in the Caribbean.

Objectives 2/2Specific objectives:To describe the experiences of stigma and discrimination by children living with and affected by HIVTo describe the school experiences and learning outcomes of these childrenTo relate the childrens experiences of stigma and discrimination to their school outcomes

Methods 1/4SampleChildren living with or affected by HIV & caregiversCriteria for inclusion10 - 18 years oldAware of their own and/or caregivers HIV statusComparison children & caregiversstudents of same age ( 6 months) and sexsame classroomsnot affected by HIVChildrens class teachers and school principals

Methods 2/4Sample: Recruited 10 children living with or affected by HIV and their caregivers2 HIV +8 affected by HIV5 caregivers10 classmates and their 10 caregivers7 principals and 10 teachers

Methods 3/4In-country collaborator and project steering committee in placeAppropriate instruments developed and pilotedEthical Approval obtainedChildren living with or affected by HIV and their caregivers screenedParent consent and youth assent obtainedInterviews by a trained Research Assistant in-country

Methods 4/4Data analysisChi square and ANOVA to determine equivalence of groups on variables

Hierarchical regressions to relate stigma and discrimination to school performance

Sample characteristics 1/2ChildrenAge 12 17 years old2 HIV+ children olderMothers their primary caregiversLiving circumstances of comparison children better

Sample characteristics 2/2Principals and teachersMales: 57% principals; 100% teachersPublic schools: 86% principals; 90% teachersUniversity educationBachelors degree

Childrens school attendanceChi square: ++ p

Childrens school experiences

Variables(n, %)HIV +(n=2)HIV Affected (n=8)Comparisons (n=10)Like(d) school Very Much2, 1004, 506, 60Got along with Teacher Very Well/Well2, 1007, 889, 90Got along with Classmates Very Well/Well 1, 506, 758, 80

Childrens School PerformanceMathReadingSpelling

Stigma and Discrimination 1/2 Perceived stigma (sample questions)People are uncomfortable around mePeople stay away from meI feel ashamed or guiltyEnacted stigma (sample questions)Friends refused to hug meOthers gossiped about meOthers made fun of me

Stigma and Discrimination 2/2 HIV+ and affected children experiencesStigma: 60% combined groupDiscrimination: 40% combined groupComparison children perceptionsStigma: 90% classmatesDiscrimination: 100% classmates

Stigma & Discrimination and School achievement

Experiences of discrimination predicted lower performance on Math test for HIV+ and affected children (combined group) ( = -1.155, p< 0.05)

Attitudes towards HIV+ children Childrens reports

Variable(n, %)HIV + (n=2)HIV Affected (n=8)Comparisons(n=10)How would feel if a friend told you he/she has HIV? Not Afraid of Them

2, 100

8, 100

9, 90

Attitudes towards HIV+ children Principals & Teachers reports

Variables(n, %)Principal (n=7)Teachers (n=10)Children who live with an HIV positive person should not be allowed to attend school : Disagree/Strongly disagree

6, 86

10, 100A child who is HIV positive should not be allowed to attend school : Disagree/Strongly disagree

6, 86

9, 90If it were up to me, I would allow a child with HIV to remain in my school : Agree/Strongly agree

7, 100

9, 90

Variables(n, %)Principal (n=7)Teachers (n=10)HIV positive students should be segregated for certain activities : Disagree/Strongly disagree

6, 86

9, 90If I had a student who had HIV in my school I would not treat him/her differently from other students : Agree/Strongly agree

7, 100

9, 90If there was a separate class for students with HIV I would be willing to teach it : Agree/Strongly agree

7, 100

10, 100

National HIV Policies and Programmes

Variables(n, %)Principal (n=7)Teachers (n=10)Aware of policies/laws addressing HIV issues : Yes 5, 714, 40Country has HIV policy for school: Yes 5, 713, 30Country has HIV Education Programme for students at schools Yes

4, 57

4, 40

Schools HIV Policies and Programmes

Variables(n, %) Principal (n=7)Teachers (n=10) Your school has HIV policy: No6, 868, 90HIV Education Programme for students at your school : Yes

4, 57

5, 50One time class or incorporated into curriculum: Part of Curriculum3, 434, 40Grades Apply to : All Grades 4, 574, 40

Summary 1/2HIV+ and affected children:were not enrolled in schoolhad similar school experiences as classmatesreported some experiences of stigma and discriminationhad poorer school performanceexperiences discrimination predicted lower school performance

Summary 2/2 Principals and teachers :and the children had positive attitudes toward HIV affected pupils were aware of HIV national policies and education programmes did not have school-specific HIV policies had an HIV education programme for students

ConclusionsHIV may affect school attendance and performance of HIV+ and affected childrenSome stigma & discrimination against these childrenStigma & discrimination may negatively affect children school performanceThe findings should be: - Considered for programme development to support HIV+ and affected children - Cautiously interpreted due to small sample size

AcknowledgementsProf. Julie Meeks Gardner, Head, CCDCMarva Campbell, CCDC Programme Officer Amika Wright, Janet Desouza and Marilyn BrownUNESCO Kingston Cluster OfficeSt. Lucia teamVeronica Simon, Head, OC St. LuciaPat Joseph, Research AssistantProject Steering Committee membersStudy participants: children, parents, teachers and principals

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