Teaching about HIV in schools: the missing link?

HIV continues to affect millions of people worldwide. While significant progress has been made in a number of countries, advances have not been uniform, and the 2.3 million new infections in 2012, point to the need to redouble our efforts. From the beginning, the education sector played a central role in responding to the epidemic, notably by providing school-based HIV education, which has been the subject of much debate. UNESCO new publication, Charting the Course of Education and HIV, builds on the experience of UNESCO staff and contributions from key thinkers and practitioners to examine emerging challenges and opportunities that need to be harnessed to reach the internationally agreed targets related to HIV. . It proposes a way forward for the education sector to contribute to the prevention of new infections, treatment and care, and the reduction of stigma and discrimination. The publication points out how education and health, two basic human rights, are intrinsically linked, as healthy learners learn better, and better educated learners have the skills to be healthy. Education develops the knowledge, values, attitudes and skills required to make informed choices and adopt healthier behaviours. While knowledge is usually insufficient on its own for behavioural change, it is a prerequisite for the adoption of safer sexual behaviours and thus the foundation for an effective HIV response. Education can address harmful gender norms and help to reduce gender-based discrimination and violence which are important both in their own right for equal, fair and prosperous societies and as critical enablers for an effective HIV response. Early on in the epidemic, the rapid spread of the virus and lack of treatment options required urgent action to prevent new infections. Most education approaches were characterized by teaching about HIV as a science topic or as a moral issue. In many contexts, formal education used scare tactics in an attempt to prevent young people from engaging in sexual activity, or promoted ‘abstinence-only’ messages. These methods did not have the intended effect, and infection rates continued to rise. As a result, skills-based approaches such as life skills education, which emphasize cognitive, communication and coping skills, were adopted and the importance of structural and environmental factors such as poverty, gender, culture, values, beliefs, power and policy were recognised and started to be integrated into the HIV response. Evidence laid-out in the book shows that good quality comprehensive sexuality education, including HIV, does not lead to early sexual initiation; instead, it helps delay sexual debut, increase safer sexual behaviour, and improve HIV knowledge. We know what needs to be included in the curriculum and how HIV and sexuality should be covered. However, many existing curricula have weaknesses, including inadequate reference to key aspects of sex and sexuality, lack of information about where to access services, and limited attention to social and cultural factors, sexual rights and sexual diversity. In addition selective teaching is a challenge, particularly in situations where teachers do not feel mandated or supported by the school or community to teach about sexuality and relationships or are unprepared to address them. As such, many adolescents and young people do not receive even the most basic sexuality education and leave school without adequate knowledge. The authors put forward a new approach for HIV education which requires, inter alia, the reframing of HIV education; rethinking teacher training and support; improving implementation; strengthening the links with school health programmes; adaptation to an evolving epidemic; and meeting the increasing demand by young people and their parents for comprehensive sexuality education.