Global Initiatives on HIV/AIDS and Education

1. Global Initiatives on HIV/AIDS and Education Presentation By Dr Inon I Schenker, PhD, MPH Senior HIV/AIDS Prevention Specialist International Bureau of Education - Abuja, Nigeria 10 June 2002

2. Several Milestones • U.S. Surgeon General (E. Koop) Report: • Kids should receive education on AIDS • AIDS Education does not need to be called“sex education” • 1988 WHO/UNESCO Consultation on HIV/AIDS education in schools • CDC Guidelines for effective school health education to prevent the spread of AIDS • 1990 Consensus statement on AIDS in schools (IFFTU, WCT, FISE, WCOTP, WHO, UNESCO, ILO) -

3. More Milestones • 1992 First WHO/UNESCO guidelines on school AIDS education • 1994 World AIDS Day – for the first time focus is on “young people” • 1997 UNAIDS Review: Sex education = promiscuity • WHO School Series #6 on AIDS Prevention and anti discrimination is published + training • 2000 EFA, FRESH, Dakar • ECOWAS Experts Meeting, Ghana • 2001 UNGASS (2) & Education Sc Framework -

4. Five Generations of Programs • First Generation - mid 1980s: • Non-organized, local, fear-driven responses. • Information-based. Limited skills and funds • Text and graphic materials, to aid biology and other teachers • No specific adaptation for age, gender or sub • vulnerable populations -

5. Five Generations of Programs • Second Generation - late 1980s: • More organized responses • Initiation of teacher’s training • No needs assessment • Belief that “Knowledge” will do the work • National curriculum development by: • Government agencies, NAP-University-based groups, NGOs -Private sector -International agencies and donors -

6. Five Generations of Programs • Third Generation - beginning of 1990s: • Knowledge attitudes skills = Prevention • Values • Sex education = AIDS education • Introduction of theory-based components in HIV/AIDS curricula -

7. Five Generations of Programs • Fourth Generation - mid 1990s: • Curriculum development is theory-based, addresses identified needs, integrated with general school curricula • AIDS education = health education: connecting to substance use prevention, family life education, personal development and sex education. • Teacher’s training. New “AIDS educators”(e.g. PLWH) • Research: effectiveness, feasibility, acceptability • Human rights • Caring for infected pupils and teachers -

8. Five Generations of Programs Fifth Generation - today: Reinventing the wheel(sometimes with its ‘flat’ tire) Developing, further improvingand adapting what works! Forlocal, regional, national orinternational settings. - Global movements: EFA, FRESH, IPAAA

9. Theoretical bases for effective school HIV prevention interventions Models focusing on the individual: When provided with enough knowledge on HIV, AIDS and the ways not to be infected, individuals will do all they can to prevent themselves and others from being infected. Informed individuals are rationally geared to maximum gains (e.g. living healthy, and happy life) and minimum loses (e.g. death of AIDS) Examples: Health Belief Model; Social Learning Theory; Theory of Planned Behavior; Theory of Reasoned Action. -

10. Theoretical bases for effective school HIV prevention interventions Interpersonal Models: It takes at least 2 to participate in the “AIDS Tango” thus key is learning what effects the interpersonal communication and decisions processes. Sexual behaviour resembles a theatrical script, which depends on variety of characters, scenes and `stage equipments`. Examples: Sexual Scripts and AIDS Prevention; Information, Motivation and Behavioral skills. -

11. Theoretical bases for effective school HIV prevention interventions Community Models: Individual’s preventative behaviour highly depends on the community, networks, significant-others and culture they are influenced by. Social structures and norms dictate ones risky/ protective behaviour.Examples: Community AIDS/HIV Risk Reduction; -

12. 10 Considerations for Effective School-Based HIV/AIDS Prevention Curricula • Professionally trained and actively involved educators • Establish partnerships • Utilize non-conventional methods of teaching • Introduce open communication • Innovative teaching sessions • Gender-specific approaches • Dealing with culturally-sensitive content • The value of peer-based support • Skill-based education • Monitoring and evaluation -

13. Barriers in Implementing Effective Education for HIV/AIDS Prevention Community level   1.  Denial of the HIV/AIDS problem by community and/or leaders.   2.  Parental negative attitude towards HIV/AIDS education in schools. -

14. Barriers in Implementing Effective Education for HIV/AIDS Prevention Organizational level   3.  Lack of HIV/AIDS education policy for schools.   4.  Lack of pre-service and in-service HIV/AIDS education in professional preparation programs for teachers.   5.  Inadequate preparation of teachers in mastery of skills to teach about HIVAIDS issues, particularly prevention skills.   6.  Lack of proper age-appropriate HIV/AIDS education curricula for different grades of students, with local adaptations. -

15. Barriers in Implementing Effective Education for HIV/AIDS Prevention Psychological level   7.  Teachers’ fears associated with HIV/AIDS and teaching about it.   8.  Student factors characterized by features of adolescence period of human development. -

16. The TRAINGOLAR Model Students AIDS EDUCATOR School Staff Parents/Community -

17. School Curricula that Works • Get Real about AIDS • Target Population: High school classrooms in 10 schools • in Colorado, USA • Theory: Social Cognitive Theory and • Theory of Reasoned Action • Approach: 15-sessions skills-based curriculum. • Teachers training • Results (statistically significant compared with controls): • - Fewer sex partners • Greater frequency of condom use. -

18. School Curricula that Works • Long Live Love • Target Population: second and third-year secondary school students in The Netherlands. • Theory: Combined Social and Cognitive-behavioral. • Approach: Inclusion of HIV/AIDS and STI in the framework of national sex education classes. • Results (statistically significant compared with controls): • -High-risk students engaging in less risky behavior • Favorable changes in knowledge, beliefs, • self efficacy and intentions to use condoms. -

19. School Curricula that Works • The Immune System and AIDS • Target Population: High school classrooms in 17 secondary • schools in Israel • Theory: The Immune System Approach • Approach: 4 to 5 sessions knowledge and skills-based curriculum, using the human immune system as an • entering point to HIV/AIDS prevention. • Two types of trained AIDS Educators were compared: • Medical students and biology teachers. • Results (statistically significant compared with controls): • - Reduced discrimination of HIV infected • Greater frequency of condom use • Attitude change towards responsible sexuality -

20. School Curricula that Work • AFRICAN EXAMPLES • Madarasa AIDS Education and Prevention (Uganda) • Tsa Banana Adolescent Reproductive Health Programme (Botswana) • My Future Is My Choice (Namibia) • Straight Talk (Uganda) • Le system Immunitaire et le VIH/SIDA • (Rwanda) -

21. Training of Teachers • Diffusion of Innovations • Variety of potential effective School AIDS Educators: • Teachers of biology, health education • Teachers of other subjects, specifically trained for • Medical students, selected and specifically trained • Community Nurses • Peers • Pre-service, in-service, on-going updates, NETWORKS -

22. Training of Teachers • WHO is a “good” School AIDS Educator? • Good rapport and communication with pupils • Ability to have open, frank discussions • Ability to identify with students, show sensitivity • Have respect for students, believe in them • Be self consciousness to ones and others sexuality • Ref. Johazy, 1970 • Wealth of knowledge on HIV/AIDS • Openness • Sincerity • Sense of humor • Ref. Schenker, 1991 -

23. Training of Teachers • Topics often presented in 3-5 days training workshops: • ·        Epidemiology of HIV/AIDS • ·        Substance use issues related to HIV/AIDS • ·        Prevention of HIV infection • ·        Basic immunology and virology of HIV infection • ·        Up dates on vaccines and treatments • ·        Care for People Living with HIV/AIDS • ·        Psycho-social aspects of HIV/AIDS • ·        Ethical, legal and policy Issues • ·        Mass media and condom promotion campaigns • ·        Community based AIDS education • ·        Adolescents development • Cultural barriers in AIDS Education -

24. Planning Interventions: School Level • Establishing a School Health Team and a Community • Advisory Committee • Conducting a situation analysis • Fostering political and cultural acceptability • Developing school policies, intervention goals • and objectives • Developing training for selected School • AIDS educators • Linking to global movements: EFA, FRESH -

25. Planning Interventions: National Level • Establishing a National Task Force on Education for • HIV/AIDS Prevention (NTFEHP) • Ministerial level commitment and coordination • National Framework and strategy (Education and Health) • Advocacy and fundraising (Inter/Intra-nationally • Parallel action (Technical) : • Teachers’ training and capacity building • Curriculum development – Primary schools • Curriculum development – Secondary schools • Current curricula integration • Monitoring and evaluation • Progress review and adaptation -

26. Thank you ! -

27. Dr Inon I Schenker, PhD, MPH Senior HIV/AIDS Prevention Specialist International Bureau of Education Geneva, Switzerland Tel: +41 22 9177820 Fax: +41 22 9177801 Email: i.schenker@ibe.unesco.org -