Doc Number: RBC/HOD/5485/2025 Date: 19-5-2025 [Link]

CONCEPT NOTE

Conduct training of teachers to

support Adolescents living with
HIV in school to end stigma. and
discrimination
I. INTRODUCTION
Global analysis has revealed that adolescents are not being reached with adequate HIV interventions. As a result, more new
HIV infections and AIDS-related deaths are occurring among adolescents than adults and children.

In Rwanda, adolescents face similar challenges to other adolescents in low-income countries: early sexual initiation, early
pregnancy, and parenthood. According to the Rwanda Demographic and Health Survey of 2019-2020 (2), 2% of women aged
25-49 initiate sexual intercourse before the age of 15 years. Slightly more than one in every five young women (21%) and 23% of
young men reported having sex before the age of 18. 5% of Rwandan women aged 15-19 have begun childbearing, and 4% have
given birth. The percentage of women aged 15-19 years who have begun childbearing increases with age, from less than 1%
among those aged 15 to 15% among those aged 19 years. Sexually transmitted infections and contraception are other issues
among this population. In 2015, the prevalence of sexually transmitted infections (STIs) among adolescents aged 15-19 years
was 14% in girls and 4% in boys (3). The proportion of young people with comprehensive knowledge about HIV has declined
since 2014-15, from 65% to 59% among young women and from 64% to 57% among young men. Unmet need for family planning
is 8% among married women aged 15-19. These data emphasize the need for a joint effort from health care providers and other
stakeholders to improve access to sexual and reproductive health (SRH) care and education.

The adverse events could be explained by the low knowledge and utilization of SRH and HIV services by adolescents. There are
huge gaps in coverage of key interventions such as the use of condoms to prevent pregnancy and HIV infection, family
planning, male circumcision for HIV prevention, HIV testing, and ART for HIV infected adolescents. However, Rwanda has
multiple activities that aim to improve adolescent health, including the introduction of youth-friendly services in health
facilities where youth receive different health services regarding SRH, prevention and management of gender-based violence
(GBV), the introduction of HPV vaccine for adolescent girls, treating and fighting against HIV/AIDS and STIs among the
adolescent population, and raising awareness on substance abuse prevention.

The fight to overcome the epidemic is at a crossroads. Much has been achieved in the past few decades. Treatment and
prevention for children and adolescents are the two areas of Rwanda's work to stop HIV infections and AIDS deaths. Making
sustainable gains in this work requires increased commitment and better policies at the national level. To strengthen HIV
prevention efforts, positive life skills sessions/ social and behavior change communication have to be taught so that we
empower and equip educators from schools with the required knowledge and skills to attend to ALHIV in schools. However,
challenges and gaps in care and support for adolescents and young adults at schools prevail. Stigma has been highlighted to
be a challenge to adolescents living with HIV and those born to parents living with HIV, even if the stigma index is ranked low
(13), as it has considerably reduced over the years. These cases of stigma may reduce adherence to ARV and retention.

As part of efforts to increase awareness of HIV prevention and management among adolescent girls and boys, young women
and men, Rwanda Biomedical Centre (RBC) through HIV, STIs, Viral Hepatitis, and OVDC Division, Care and Treatment Unit is
conducting a comprehensive training initiative targeting Teachers, dean of discipline, patrons and matrons, head of schools
from secondary schools across the county.
II. JUSTIFICATION
Adolescents living with HIV (ALHIV) in Rwanda face significant
challenges, including limited access to sexual and reproductive health
(SRH) services, low comprehensive HIV knowledge, and persistent stigma
and discrimination in schools. These factors contribute to poor
adherence to antiretroviral therapy (ART), reduced retention in care, and
increased vulnerability to new infections and adverse health outcomes.
Despite national efforts to improve adolescent health, gaps remain in the
support and care provided within educational settings. Training school
staff-including teachers, deans of discipline, patrons, matrons, and heads
of schools, is crucial to empower them with the knowledge and skills
needed to effectively support ALHIV, reduce stigma, and foster an
inclusive school environment
III. OBJECTIVES
a. OVERALL OBJECTIVE
To strengthen the capacity of school staff to support adolescents living with HIV by enhancing their knowledge, skills, and
attitudes toward HIV prevention, care, and stigma reduction in secondary schools.

b. SPECIFIC OBJECTIVES
Equip participants with up-to-date information on adolescent HIV prevention, care, and treatment.

Build skills to identify, support, and refer ALHIV for appropriate services within and outside the school.

Raise awareness and practical strategies to reduce stigma and discrimination against ALHIV in school settings.

Promote comprehensive SRH education and positive life skills among adolescents.

Foster collaboration between schools and health service providers to improve adolescent health outcomes
IV. METHODOLOGY
The training will be conducted for four days with one day of Online
sessions and three days of physical meetings, from the 3rd to 6th June &
10th to 13th June 2025. During the training, mixed approaches will be
used, i.e: Presentations, Group work, and Plenary discussions.
V. EXPECTED OUTCOMES
Increased knowledge and improved attitudes
among school staff regarding HIV, SRH, and the needs of ALHIV.

Enhanced ability of teachers and school leaders

to identify and support ALHIV, Including appropriate referrals.

Reduced stigma and discrimination

toward ALHIV within participating schools.

Strengthened partnerships
between schools and health facilities for adolescent-friendly services.

Improved school environment

that supports adherence to ART and retention in care for ALHIV
VI. PARTICIPANTS
Participants in this training are teachers, dean of discipline, patrons and matrons, and head teachers in selected schools who
are not trained on comprehensive HIV prevention and management to mitigate stigma and discrimination towards students
living with HIV in their

Invited Schools
Nyanza District Ruhango District Gisagara District

E.S. NYANZA GS MURAMA [Link]

GS RWESERO GS RUBONA G.S GIKONKO Catholique
GS HANIKA GS RUSORORO GS MBOGO
GS NYANZA B GS RWINYANA GS CYIRI
KAVUMU MUSULMAN GS BUKOMERO [Link]
GS BUSORO GS BYIMANA G.S NYAGAHURU II
GS GITOVU GS GAHENGELI GS MUDUHA
GS MUNYINYA GS MPANDA GS NYABITARE
GS RUGENGE GS KARAMBI GS GIKORE
GS RWANAMIZA GS MUNANIRA ES KANSI
G.S NOTRE DAME DE KIBEHO GS NZUKI [Link] B
NYABINYENGA GS RUHARE GS NYANGE
GS GAHENGELI GS GISALI GS AKABUGA
GS NYAGISOZI GS NYARUGENGE G.S KIBILIZI
GS RUBONA GS RUTABO A GS KINTEKO
ES MUTIMA GS RUTABO B ES MUZENGA
GS KIBIRIZI GS BWERAMVURA GS JANJA
GS MATARA GS KABUGA K GS RUBONA
GS MBUYE GS MUYUNZWE E.S RWAMIKO
GS MUTUTU GS NYARUTOVU G.S CYUMBA
GS GASORO GS RWINGWE G.S SAGA
G.S GAHOMBO GS CYIMANA G.S MUSHONGI
G.S KIGOMA GS MUTIMA GS MUGOMBWA
GS MULINJA GS NTONGWE GS NYABISONGA
GS CYEREZO GS NYAGISOZI E.S MAGI
GS GATAGARA GS GIKOMA GVT G.S JOMA
GS-MUHORORO GS RUNYINYA
GS MUNINI GS GITWA
GS MUYANGE G.S RWATANO
GS NTENYO G.S ZIVU
GS NYAMAGANA GS MUNYEGERA
GS RUHANGO ADERR GS DAHWE
GS RUHANGO ADVENTIST [Link]
GS RUHANGU VATIJULIUUD G.S NDORA
G.S GISAGARA A
E.S HIGIRO
GS GISUNZU
E.S SAVE
GS MUNAZI
KIGEMBE TVET School
MUGOMBWA TVET School
GIKONKO TVET School
Eugenie SMET TVET School
Notre Dame de la Bonne Esperance
TVET
VII. BUDGET ESTIMATION
Session and Description Quantity Days Freq. Unit Total price
Location.

Focanou M. Allowances 140 4 6000 3,336,000

for Participants

Accommodatio 98 3 36,000 10,584,000

n participants

MA for 12 4 6,000 288,000

facilitators

Accommodatio 12 3 36,000 1,296,000

n for facilitators

Transport for 140 2 10,000 2,800,000

participants

Transport for 177 2 1 354,264

facilitators

S/Total 18,682,264

Source of Budget: This activity will be funded by GF under the RBF_HIV budget line
VIII. Proposed Agenda
DAY 1 (Online session)

9h00-9h30 Registration (RBC)

9h30-10h00 Welcome note and Objectives of the meeting (RBC)

10h00-10h15 Pre-Test (ALL)

10h15-10h30 BREAK (ALL)

10h30-11h30 Overview on HIV/AIDS and young people (RBC)

11h30-12h30 Overview of HIV/AIDS & Antiretroviral Treatment (RBC)

12h30-13h30 Lunch (ALL)

13h30-15h00 Adolescent-responsive sexual and reproductive health

(SRHR) (AHF)

15h00-16h30 Nutrition and HIV in adolescents (RBC)

16h30-17h00 Q&A (ALL)

DAY 2

8h30-9ho0 Recap (ALL)

9h00-10h30 Psychosocial care of ALHIV (RBC)

10h30-10h45 Break (ALL)

10h45-12h30 Adolescent life skills (AHF)

12h30-13h30 Lunch (ALL)

13h30-1430 Retention in care, improving adherence in schools (RBC &

Dream Village)

14h30-16h Group work

Signature
Psychosocial Care Senior Officer Acting Director of HIV/AIDS care and treatment unit

Fortunate ABATONI Gisele MUJAWAMARIYA

(Drafter) (Reviewer)

2025-05-14 [Link].0 2025-05-14 [Link].0

Administrative Lialson Officer HIV, STI, Viral Hepatitis and Other Viral Diseases Control
Division Manager
Ange Uwiragiye
Gallican Rwibasira
(Reviewer)
(Reviewer) 16
2025-05-15 [Link].0
2025-05-16

Head of HIV/AIDs, Diseases Prevention and Control Department Dept