Transcript HIV-Related Stigma and Children s School Outcomes in St. Lucia.

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HIV-Related Stigma and Children's School Outcomes in St.
Lucia
Joan Thomas
Caribbean Child Development Centre
St. Lucia Country Conference
May 3-4, 2012
Background
Review of studies from developing countries
• Children living and affected by HIV:
-
Low school attendance
More school problems
Additional responsibilities
Stigma & discrimination in class
Review of studies from the Caribbean
• Only 2 on Jamaican children:
-
Ignorance about HIV fueled stigmatization from others
- Poor school attendance and performance among
children
Objectives 1/2
Main objective:
To describe the nature and extent of HIVrelated stigma and discrimination among
school children in the Caribbean.
Objectives 2/2
Specific objectives:
• To describe the experiences of stigma and
discrimination by children living with and
affected by HIV
• To describe the school experiences and
learning outcomes of these children
• To relate the children’s experiences of stigma
and discrimination to their school outcomes
Methods 1/4
Sample
• Children living with or affected by HIV & caregivers
• Criteria for inclusion
- 10 - 18 years old
- Aware of their own and/or caregiver’s HIV status
• Comparison children & caregivers
- students of same age (± 6 months) and sex
- same classrooms
- not affected by HIV
• Children’s class teachers and school principals
Methods 2/4
Sample: Recruited
• 10 children living with or affected by HIV and
their caregivers
- 2 HIV +
- 8 affected by HIV
- 5 caregivers
• 10 classmates and their 10 caregivers
• 7 principals and 10 teachers
Methods 3/4
• In-country collaborator and project steering
committee in place
• Appropriate instruments developed and piloted
• Ethical Approval obtained
• Children living with or affected by HIV and their
caregivers screened
• Parent consent and youth
assent obtained
• Interviews by a trained Research
Assistant in-country
Methods 4/4
Data analysis
• Chi square and ANOVA to determine
equivalence of groups on variables
• Hierarchical regressions to relate stigma
and discrimination to school
performance
Sample characteristics 1/2
• Children
- Age 12 – 17 years old
- 2 HIV+ children older
- Mothers their primary caregivers
- Living circumstances of comparison
children better
Sample characteristics 2/2
• Principals and teachers
- Males: 57% principals; 100% teachers
- Public schools: 86% principals; 90%
teachers
- University education
- Bachelors degree
Children’s school attendance
Variables
(n, %)
Attends School ++
Yes
No
Current/Last School
Secondary/High
Missed school
Yes
Chi square: ++ p<0.01
HIV +
(n=2)
HIV Affected Comparisons
(n=8)
(n=10)
-2, 100
7, 88
1, 12
10, 100
--
--
6, 75
6, 60
--
6, 75
7, 70
Children’s school experiences
Variables
(n, %)
HIV +
(n=2)
HIV Affected Comparisons
(n=8)
(n=10)
Like(d) school
Very Much
2, 100
4, 50
6, 60
Got along with Teacher
Very Well/Well
2, 100
7, 88
9, 90
Got along with Classmates
Very Well/Well
1, 50
6, 75
8, 80
Children’s School Performance
50
Mean WRAT scores
45
Math
40
25
20
15
10
5
0
Reading
Spelling
35
35
30
39.9
29
31
30.5
29.4
24.5
19
27.4
Stigma and Discrimination 1/2
• Perceived stigma (sample questions)
⁻ People are uncomfortable around me
⁻ People stay away from me
⁻ I feel ashamed or guilty
• Enacted stigma (sample questions)
⁻ Friends refused to hug me
⁻ Others gossiped about me
⁻ Others made fun of me
Stigma and Discrimination 2/2
• HIV+ and affected children experiences
- Stigma: 60% combined group
- Discrimination: 40% combined
group
• Comparison children perceptions
- Stigma: 90% classmates
- Discrimination: 100% classmates
Stigma & Discrimination and School
achievement
• Experiences of discrimination predicted
lower performance on Math test for HIV+
and affected children (combined group)
(β = -1.155, p< 0.05)
Attitudes towards HIV+ children –
Children’s reports
Variable
(n, %)
How would feel if a friend told
you he/she has HIV?
Not Afraid of Them
HIV +
(n=2)
HIV Affected
(n=8)
Comparisons
(n=10)
2, 100
8, 100
9, 90
Attitudes towards HIV+ children –
Principals’ & Teachers’ reports
Variables
(n, %)
Children who live with an HIV positive person
should not be allowed to attend school :
Disagree/Strongly disagree
Principal
(n=7)
Teachers
(n=10)
6, 86
10, 100
A child who is HIV positive should not be
allowed to attend school :
Disagree/Strongly disagree
6, 86
9, 90
If 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, %)
HIV positive students should be segregated for
certain activities :
Disagree/Strongly disagree
Principal
(n=7)
Teachers
(n=10)
6, 86
9, 90
If 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, 90
If 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, %)
Aware of policies/laws addressing HIV issues :
Yes
Principal
(n=7)
Teachers
(n=10)
5, 71
4, 40
Country has HIV policy for school:
Yes
5, 71
3, 30
Country has HIV Education Programme for
students at schools
Yes
4, 57
4, 40
Schools’ HIV Policies and Programmes
Variables
(n, %)
Your school has HIV policy:
No
HIV Education Programme for students at
your school :
Yes
One time class or incorporated into
curriculum:
Part of Curriculum
Grades Apply to :
All Grades
Principal
(n=7)
Teachers
(n=10)
6, 86
8, 90
4, 57
5, 50
3, 43
4, 40
4, 57
4, 40
Summary 1/2
• HIV+ and affected children:
- were not enrolled in school
- had similar school experiences as
classmates
- reported some experiences of stigma and
discrimination
- had poorer school performance
- experiences 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
Conclusions
• HIV may affect school attendance and performance
of HIV+ and affected children
• Some stigma & discrimination against these children
• Stigma & discrimination may negatively affect
children’ school performance
• The findings should be:
- Considered for programme development to support
HIV+ and affected children
- Cautiously interpreted due to small sample size
Acknowledgements
•
•
•
•
•
Prof. Julie Meeks Gardner, Head, CCDC
Marva Campbell, CCDC Programme Officer
Amika Wright, Janet Desouza and Marilyn Brown
UNESCO Kingston Cluster Office
St. Lucia team
- Veronica Simon, Head, OC St. Lucia
- Pat Joseph, Research Assistant
- Project Steering Committee members
• Study participants: children, parents, teachers and
principals