New UNESCO IITE Guide on preventing discrimination against learners and educators living with HIV

In the context of the COVID-19 pandemic, the start of academic year 2020/2021 is going to be a new and challenging experience for both learners and staff of most educational institutions.

However, for children and adolescents living with HIV, the start of each school year also comes with concerns about potential disclosure of their HIV status and negative attitudes or even bullying they may face at school as a result. In response to these concerns, UNESCO IITE has come up with a Practical Guide for educational institutions: Preventing Discrimination against Learners and Educators Living with HIV.

“If they knew, they would avoid me and try to stay away from me as much as possible.”

A lack of HIV awareness and widespread misconceptions about its transmission causes many people to assume that by coming to school as a student or employee, someone who lives with HIV could pose a threat to others. As a result, people living with HIV or those who have HIV-positive family members (e.g. children of parents living with HIV) can face challenges with being accepted in a kindergarten or school and can even be forced to leave if their own or their relatives’ HIV status becomes known.

Practice reveals that where the HIV-positive status of a student or employee is involuntarily disclosed, other people in their educational institution tend to avoid them and refuse any contact or communication; in some cases, HIV-positive learners and educators have faced bullying, psychological abuse and physical violence. Other students’ parents and even other school employees may insist that a person with HIV should be expelled or fired. Such attitudes may cause depression in HIV-positive people; according to the Joint United Nations Program on HIV/AIDS (UNAIDS), between 18% and 81% of people living with HIV are affected by depression, sometimes due to factors such as stigma, discrimination or social isolation.

“If a child attends the same class or group as someone with HIV, there is nothing wrong with that.”

According to a nationwide representative survey conducted in Russia in 2018, 33% of respondents agree that there is no risk in being in the same class as a child living with HIV. This is true, since HIV (unlike COVID-19) cannot be transmitted by airborne droplets during conversation, studying or working together, by using a shared toilet facility or restaurant, playing team sports, shaking hands or hugging. Therefore, laws in many countries, including Russia, make it illegal for educational establishments to deny employment or admission to a person based on their HIV-positive status.

However, 26% of Russians surveyed would never allow their child to attend the same class or group with an HIV-positive child.

Right to confidentiality

Many people, unknowingly or due to deep-rooted stereotypes and irrational fears, may hold intolerant and discriminatory attitudes and even bully persons having certain diseases, including those living with HIV. In Russia, as in many other countries, people are entitled by law to privacy of their data such as any information about their health status, medical diagnosis and other confidential health information. Therefore, no one can be required to get tested or to provide documentary proof of having been tested for HIV as a condition of getting enrolled as a student or hired as an employee by an educational institution.

The Guide explains that administrators, healthcare professionals and other employees of educational institutions who, by virtue of their duties or other circumstances, know about the HIV-positive status of an employee, student or the latter’s immediate family member, may not disclose such information to third parties and can face disciplinary, administrative or criminal penalties if they do.

How school principals or teachers should respond if someone’s HIV status has been disclosed in their school

The Guide provides essential information on HIV, its modes of transmission and methods of prevention, diagnosis and treatment, as well as on the rights of people living with HIV. This information can serve as a reference point for awareness-raising discussions with school staff, students and their parents, as well as guidance in cases where a student’s or employee’s HIV-positive status becomes known to others. Since people tend to trust healthcare professionals in health-related matters, a specialist from the local AIDS Center or an infectious disease doctor can be invited to give a talk on the topic.

Universal precautions

An overview of measures to prevent prejudice and discrimination against people living with HIV is an important part of the Guide. It provides a list of everyday situations in which HIV cannot be transmitted. It also covers universal precautions needed to prevent the spread of blood-borne infections such as HIV and viral hepatitis.

These measures aim to eliminate or minimize contact with others’ blood and include:

  • regular and thorough hand washing;
  • safe handling of sharp objects during their use and storage;
  • proper use of personal protective equipment (disposable gloves) in providing first aid for bleeding, cuts, abrasions and other injuries;
  • rinsing with running water immediately any area of one’s skin or mucous membranes that has been in contact with someone else’s blood;
  • making sure that all educational institutions have first aid kits readily available;
  • safe disposal of personal protective equipment and proper handling of blood-contaminated items, equipment, furniture, clothing, etc.

Full and timely compliance with these simple and affordable universal precautions reduces to zero the likelihood of contracting HIV and hepatitis B and C viruses.

How the Guide was created

The Guide is based on the Recommendations by UNESCO and the International Labor Organization on HIV policy implementation in the education sector in Eastern Europe and Central Asia. Developed in 2011, the Recommendations have been adapted for Russia, Belarus, Ukraine, Kyrgyzstan and Tajikistan.

In 2019, the Russian version of the Recommendations was revised to produce this Practical Guide by a team of authors led by Professor Evgeny Voronin, Head of the Russian Center for HIV Prevention and Treatment in Pregnant Women and Children.

In the course of writing the Guide, the team collected input from more than 300 educators working at schools in the Altai Region and the city of Chelyabinsk, including deputy principals for educational work, psychologists, social educators, and class teachers, who commented on the working draft of the Guide, confirmed its relevance, and provided valuable feedback concerning the contents and presentation.

Administrators and specialists from the Chelyabinsk, Altai, Irkutsk and Volgograd regional centers for AIDS prevention and control advised the team on the content of the Guide.

Natalia Ladnaya (Russian Federal AIDS Center), Larisa Dementyeva (Rospotrebnadzor’s Central Research Institute of Epidemiology), and Sergey Smirnov (Foundation for Social and Cultural Initiatives) provided invaluable assistance in creating the Guide.

Dissemination and implementation

The Guide was recommended by the Russian Ministry of Education for use in educational institutions along with other materials on HIV prevention and it was posted on the website of the Federal Center for Children’s Rights. In November 2019, the Guide was presented to more than 3,000 specialists from Russia’s 67 regions at a nationwide webinar organized by the Center as part of its annual STOP HIV/AIDS campaign.

The educational authorities of the Altai, Chelyabinsk, Volgograd and Irkutsk regions have coordinated the Guide’s dissemination to educational institutions in their regions. On 14 September 2020, the Guide will be presented at the International conference “Current Issues in HIV: Maternal and Child Health” (registration for the conference is open until September 12).

Implementing the recommendations outlined in the Guide will advance the students’ right to education as well as the school employees’ workplace rights and protect their health and wellbeing.