Key finding: Overall, 12.7% of all educators are HIV positive. HIV prevalence is the highest in the 25?34 age group (21.4%), followed by the 35?44 age group (12.8%). Those educators 55 years and older had the lowest HIV prevalence (3.1%). There are major racial differences in HIV prevalence: Africans have a prevalence of 16.3% compared to whites, coloureds and Indians, whose HIV-infection rates are less than 1%.
The study shows that 12.7% of the 17 088 educators who gave specimens for testing are HIV positive, which is similar to the prevalence rate among the general population.
If age and race differences are not taken into account, the HIV prevalence among men and women educators are the same.
HIV prevalence is the highest in the 25-34 age group (21.4%), followed by the 35-44 age group (12.8%). Educators 55 years and older have the lowest HIV prevalence (3.1%).
If the analysis is restricted to men and women in the 25-34 age group, differences become more pronounced: women have a higher HIV prevalence than men, as women are generally more vulnerable to HIV infection because of their biological make-up and their low socio-economic status.
There are also major racial differences in HIV prevalence: Africans have a prevalence of 16.3% compared to whites, coloureds and Indians, who have a prevalence of less than 1%. The differences in age distribution among the different racial groups may partially account for the higher HIV prevalence among African educators, as there is a higher concentration of African educators in the high HIV risk age group of 25?34 than in other race groups.
Africans are also more likely to find themselves in a lower socio-economic position than other race groups, the result of a history of inferior education under the apartheid system. Educators with a low socio-economic status have a much higher HIV prevalence than those in the high socio-economic group, and educators living and working in rural areas have a higher HIV prevalence than their colleagues living and teaching in urban schools. Educators working in schools in urban formal settlements have a significantly lower HIV prevalence (6.3%) than those working in urban informal settlement (13.9%) and rural areas (16.8%).
Educators in poorer rural areas fall in the high-income group by local standards, suggesting that income may be an additional risk factor to HIV infection.
In assessing the different types of institutions, the study finds that HIV prevalence is highest in combined schools (16.5%). The primary and secondary schools also have a high prevalence rate (slightly more than 12% each).
The study found significant differences in the HIV prevalence by province. Educators employed in Kwazulu-Natal and Mpumalanga have the highest HIV prevalence of all nine provinces (more than 19%), followed by the Eastern Cape, Free State and North West (more than 10%, but under 19%). The provinces with HIV prevalence under 10% are Limpopo, Gauteng and Northern Cape. Western Cape has the lowest HIV prevalence at 1.1%.
Part of the objective of this study is to estimate the HIV prevalence of educators by district to allow for the planning of educator supply at a local level. In KwaZulu-Natal, Mpumalanga and Eastern Cape, 11 out of 54 districts have HIV prevalence rates of higher than 20%. Of these, eight are in KwaZulu-Natal. The lowest HIV prevalence among teachers by district (less than 5%) is in 11 districts in the Western Cape, Northern Cape and Gauteng.
Table 4.11: Overall HIV prevalence among educators by province, South Africa 2004
Determinants of HIV/AIDS
The epidemic seems to be driven by multiple sexual partnerships (particularly among men), low condom use, having younger sexual partners (among men), and migration and mobility (spending nights away from home).
Gaps in knowledge of HIV transmission exist, specifically in the areas of oral sex, breastfeeding, and incorrect information on sneezing.
The Department of Education (DoE), working with unions and non-governmental organisations (NGOs), should consider developing HIV prevention programmes targeted at educators, taking the following into account:
- Prevention programmes need to increasingly address issues such as monogamous relationships, HIV testing before engaging in unprotected sex, and having sexual partners within their own age group.
- Educational campaigns should stress that anal and oral sex is not considered safe ? an aspect not currently mentioned in educational programmes.
- HIV prevention should target districts with a high HIV prevalence of 20% or more, as mentioned in Fact Sheet 2.
- Equipping educators with skills to negotiate safer sex.
- Preventing transmission of HIV from educators who are already HIV positive, by promoting VCT and using the healthy relationship model that has been shown to reduce new infections.
- Discouraging migratory practices by deploying educators to specific areas. This would entail a deliberate effort to place teachers near their homes, rather than leaving it to chance. Tertiary institutions could increase intake of education students from rural areas to mitigate the shortage and reduce the chances of urban teachers getting jobs in rural areas, and DoE should provide financial and other incentives for teachers to work in those rural areas where they have family roots.
- Eliminate gender disparities together with civil society to create a social environment that discourages men from engaging in risky behaviour that puts them and consequently women at risk of HIV.