Harvard EdCast: Teaching AIDSBy Matt Weber
Download the mp3: Teaching AIDS: Education’s Work Toward Zero Infection
HGSE: December 1st is World AIDS Day. It has been 30 years since the AIDS epidemic began, and today, according to the World AIDS Day report, there are about 34 million people living with HIV.
However, since the advent of prevention education and anti-retroviral therapy, HIV infection rates are at their lowest levels since 1997. Young people are leading the decline in new infections, with 21 high-prevalence countries reporting declines among people ages 15 to 24. Despite these gains, 2.7 million people became infected with HIV in 2010 and only half of the people eligible for antiretroviral therapy are receiving it. In this economic environment, donor countries have reduced funding to end the epidemic by 10%, at the very moment when an injection of resources could help catalyze and cement the prevention revolution.
That’s why we’ve invited HIV education specialists Joanna Herat, Patricia Machawira and Zoe Marks from UNESCO to talk about how the education sector has played an instrumental role in facilitating the drop in new infections among young people, and the critical role for school and teachers in continuing this global progress against the AIDS epidemic. How are education policy makers and teachers enlisted in the frontlines of the global battle against HIV? In many countries, AIDS and sexuality are socially taboo and subject to misinformation, so what strategies have evolved to overcome these obstacles?
UNESCO: Let’s start with your first question to help frame our discussion. HIV and AIDS are increasingly being taught as part of comprehensive life skills and sexuality education curricula. This is what we at UNESCO recommend and are working hard to formalize support for. In many parts of North America and Europe, teachers have been doing so for years, and this supports the behaviour change and access to services that have spurred the decline in new HIV infections.
As an American, I was especially moved by Hillary Clinton’s recent call to “change the course of the epidemic and usher in an AIDS-free generation”. HIV funding globally has decreased recently, but America continues being a leader & we at the UN commend this. Through education, we at UNESCO are trying to ensure that future generations have zeronew infections, zero AIDS-related deaths, and zero discrimination. It may sound fantastical for those of us who lived through the 1990’s and first decade of this millennium, but it is actually within our grasp.
First, there’s overwhelming evidence for the importance of teachers and schools delivering HIV-related information, much of which is outlined in the research we have done that underpins our Guidance on implementing Sexuality Education. Teaching children about their health and HIV is critical for them to make positive decisions that protect their health and others’. Schools have a responsibility to provide accurate and reliable HIV & AIDS information to young people, to help support parents and communities. In a context where ignorance and misinformation can be life-threatening, sexuality education is part of the responsibility of education professionals.
Secondly, a less obvious point – but an important one for educators – is the fact that reducing HIV infections among young people is reinforced through what is called the ‘protective factor’ of education. Being in school, and also attaining higher education levels minimises risk of HIV infection. UNESCO’s work in achieving Education for All, a Millennium Development Goal, in tandem with our commitment to providing good quality life skills and sexuality education around the world will help further reduce the number of young people becoming infected with HIV. In sub-Saharan Africa, receiving a secondary education significantly increases young women’s HIV & AIDS knowledge levels, their use of antenatal HIV testing and prevention of mother-to-child transmission, thereby improving the health of not just one generation but two. So, education is positive for health in general.
HGSE: What is it about schools and teachers that makes them important for responding to HIV & AIDS?
UNESCO: To answer that question, schools and teachers are well-positioned to provide leadership in how to talk to young people about difficult subjects like HIV & AIDS, relationships and sexual health. UNESCO works closely with other governments and NGOs all over the world to include families and community members in the education sector response, but schools are where children and young people spend the most time outside of the home. It’s where they make friends, talk to peers and establish social norms.
That makes discussions about life skills, HIV, sex and relationships, and healthy decision-making incredibly important, because young people are already going through puberty and discussing these topics. Schools provide a safe and trustworthy environment for students to get accurate information, and sometimes even to ask questions they may not feel comfortable asking their parents.
HGSE: So how exactly do you teach kids about HIV and AIDS?
UNESCO: There are a number of important avenues for building young people’s knowledge and awareness about HIV, AIDS, and other health issues. At UNESCO we support a variety of programmes and interventions, including peer education, creative approaches with theatre and the arts, and even media programming and journalism training, and yes, we even do special textbooks about the issue! You can check out our Facebook, where we posted the full children’s book which we helped to author for the African market, called “Bouba & Zaza learn the truth about AIDS”.
But we think a more comprehensive approach to sexuality education is the way to go. It helps navigate the challenges of puberty, adolescence, relationships, sexuality & obviously HIV. School-based sexuality education can lead to a reduction in HIV and other sexually transmitted infections, a reduction in unintended pregnancies, delayed sexual debut, and increased condom usage and safer sex practices when young people do decide to be sexually active. This basic health knowledge provides a critical foundation for almost all other HIV interventions. Without education, other efforts are not going to have a transformative effect.
HGSE: So, what does Comprehensive Sexuality Education look like in the classroom?
UNESCO: Comprehensive Sexuality Education is effective sexuality education. It provides young people with age-appropriate, culturally relevant and scientifically accurate information. Teachers provide realistic, non-judgmental opportunities for young people to explore their values and attitudes, and to practise the decision-making and other life skills they need in order to make informed choices about their sexual lives and health. To be frank, it means talking to young people about abstinence and condoms, and trust and communication, in the context of a range of risky or safer decisions students may face.
Most importantly, the Comprehensive Sexuality Curriculum allows young people to understand human biology in the context of their own lives and experiences. Students relate to stories that take into account their maturity level and are ‘more real’ and easier to relate to than simply hearing advice from their elders.
As parents and educators, we cannot eliminate the risk of HIV, other sexually transmitted infections, unintended pregnancy, or coercive or abusive sexual activity and exploitation. But fortunately, by providing properly designed and implemented sexuality education we can really reduce these risks and underlying vulnerabilities.
HGSE: As an international organization, what are the challenges of working in so many different educational settings, and where the AIDS epidemic is affecting people at such different levels?
UNESCO: HIV does affect different regions, and different communities, in very different ways. Along with nine other organizations, including UNICEF, the World Bank, and the World Health Organization, we at UNESCO lead a coordinated response to a global problem. This means that we can ensure that HIV education objectives are being delivered in harmony with other interventions and also that we are working with national governments to tailor the response to their country’s demographic and epidemiological needs.
That’s what makes working in different educational contexts so rewarding. We work in countries where the education system is barely reaching half of the children that should be in primary school, and in countries where nearly one in four adults between the ages of 15 and 49 are HIV-positive.
HGSE: How do you engage then with such diverse needs and communities?
UNESCO: Although the challenges facing teachers and students around the world are tremendous, the learning needs of young people and the pedagogical approaches of their teachers are remarkably similar. So, we apply that to HIV and AIDS education.
Young people have broadly similar knowledge needs at given age levels. So we help schools and governments meet broadly similar learning objectives, but through content and an approach that is relevant and applicable to the local culture and context.
A fifteen year-old in Cambridge, Massachusetts, for example, or in Kingston, Jamaica, or in Bangkok, Thailand, is still a fifteen year-old. They are going to be dealing with peer pressure, and the physical and emotional changes of puberty. Through our field offices around the world, we help to ensure that that fifteen year-old knows enough about their own health and the risks involved in sex and relationships to avoid sexually transmitted infections, unintended pregnancy and HIV.
In addition to sexuality education in schools, our local and regional responses are tailored to support the education sector’s work. At the regional and country level, we recently developed books and learning materials, such as the Bouba and Zaza children’s books for francophone Africa, which teach about real life issues like climate change and HIV & AIDS through stories and pictures. Or a training programme in West Africa that utilizes multimedia technology to boost teachers’ knowledge and confidence for teaching about HIV. In Asia, we have supported a mentorship programme for young leaders called New Generation, and helped community groups develop performing arts approaches to HIV education.
At the global level, we connect these direct impact programmes with high-level advocacy and guidance. One of our forthcoming publications focuses, for example, on the needs of learners living with HIV, and is based on consultation and collaboration with HIV-positive young people, in addition to the education professionals and government officials usually seated at the table.
HGSE: Is there something in particular that educators in North America can learn from UNESCO or other teachers around the world?
UNESCO : North America is quite ahead in AIDS & sexuality education, but it still has its debates about the role of these topics in schools, so I think North American educators should remember that these are complicated subjects to talk about for just about everyone. But, fundamentally, what we all want is the best for our children. And as educators, that means providing them with the knowledge and skills to become responsible, healthy and fulfilled adults.
One of the experiences that was really instructive for me was using UNESCO’s technical guidance document on sexuality education as a trainer working with teachers in Southern Africa:
At one workshop I was leading, one woman was really resistant to the idea of teaching young people about sexual health and relationships in the classroom, even after several days spent with peers who were teaching kids about HIV with great success. Surprisingly, at a follow-up workshop, she came up to me and told me that she’d decided to try the learning objectives and lessons we had discussed and now felt completely differently about the idea of talking to her students about life skills issues. She was thrilled with the examples we had given her for how to deal with hard questions, and ensure the discussion was productive and informative, and also how to deal with skeptical parents and communities.
HGSE: What are some of the things UNESCO advises for dealing with sensitive questions?
UNESCO: Well, the most important thing about the sexuality education programming we advocate, is that it needs to be culturally appropriate, age appropriate and context-specific. That doesn’t mean censoring vital information, but rather, putting things into a context that is accessible for learners, and respectful of the students and communities that teachers teach in.
Some teachers may face parents or community members who think HIV and sexuality education deprives children of their innocence. In reality, teachers, as trusted adults, can help emphasise values, personal respect, and healthy relationships at a time when children are increasingly exposed to conflicting or inaccurate images and messages from their peers, media outlets and technology. We help teachers understand and become advocates for HIV and life skills programmes as a way to balance that with scientifically accurate and age appropriate information in a phased process.
Secondly, it is also important that the education sector engage with cultural custodians and community and religious leaders in any context, but especially where there may be increased resistance to sexuality education, despite its proven effectiveness. Key stakeholders really have to be on board in order to provide the information and services young people need to protect themselves from HIV. That said, as an organization founded on the principles of human rights, we stress the need to change harmful social norms and practices, especially for young women and girls, who are more likely to be vulnerable or marginalised.
About the Harvard EdCast
The Harvard EdCast is a weekly series of podcasts, available on the Harvard University iTunes U page, that features a 15-20 minute conversation with thought leaders in the field of education from across the country and around the world. Hosted by Matt Weber, the Harvard EdCast is a space for educational discourse and openness, focusing on the myriad issues and current events related to the field.