The reason HIV/AIDS education should be done in schools is due to the fact that many parents don’t often talk to their children about sex, and simply don’t know about AIDS. Also, the community—through outreach programs, Boys & Girls Clubs, and churches, for example—doesn’t often provide mentors or confidantes whom teens can go to for information on AIDS. The fact is, AIDS is a relatively new disease, compared to, say, syphilis. Consequently older Americans are often just not equipped with information about HIV, even if they are willing to speak about sex with teenagers. Perhaps more remarkable is the empirical idea that teens and parents often lack the kind of openness and trust necessary for effective communication, in general, to take place. This fact significantly affects the opportunity and confidence parents need in order to bring up the subject of AIDS, especially when tied to conversations on sex. A United Nations report summed up the problem of teen to parent/adult communication in a press release, saying, “One of the biggest needs young people around the world have identified is for understanding on the part of their parents, teachers, and community leaders. They need adults they can turn to and trust, adults who will listen as they explain what they are experiencing . . .,” including teens’s focus on sexuality and concern about HIV. (7).
Therefore schools do have a significant role to play in reaching teenagers with correct information on HIV. “AIDS Education At School,” an article by Avert, an online clearinghouse for AIDS information, points out, “The potential strengths of a school setting are that children there have a curriculum, teachers, and a peer group.” Schools provide the social and scholastic circles through which attitudes are shaped and behavior changes. (1).
The sex education and the abstinence education camps do not generally agree on how to judge the success of their programs. However, the National Research Council’s book, Evaluating AIDS Prevention Programs, establishes some common sense guidelines. One of the book’s focuses is to echo the importance of effective HIV/AIDS prevention measured by the actual behavioral changes the teenagers make. Possible “Behavioral Outcomes” are divided into two subcategories. “Primary prevention behaviors” include elimination of risk behaviors, reduction of risk behaviors, and protective behaviors.
Elimination of risk behaviors include “abstinence from all sexual contact, abstinence from all intravenous drug use, avoidance of anal and vaginal intercourse, avoidance of unsterilized I.V. drug infection equipment,” and “avoidance of pregnancy by HIV-positive women”. (38). It is incredible that a book such as this, written by committee, and sponsored by the federal government, dealing with HIV and AIDS program evaluation, should not include other behaviors in this list, such as avoidance of contaminated blood and/or bodily fluids. This list demonstrates the inability or refusal of even the federal government (through this writing) to treat HIV and AIDS as a sometimes non-sexually transmitted disease!
The committee describes reduction of risk behaviors, which include monogamy, avoidance of anonymous and extradomestic sex, and avoidance of “shooting galleries”. Finally, protective barriers include the use of condoms, the use of anti-HIV spermicides, (which, the CDC are not effective, the use of bleach for cleaning IV drug paraphernalia, and participation in needle exchange programs. (38—42).
The other subcategory for evaluating behavioral outcomes is "Complementary preventive behaviors". Briefly, these include, HIV antibody counseling, HIV antibody testing, enrolling in drug treatment programs, determining HIV status of sexual or drug partners, providing names of contact to public health agents, using family planning services, and personal involvement in HIV prevention programs. (38).
Differences “in the degree to which individuals are aware of AIDS, understand which behaviors transmit HIV, and disparage or devalue those who are ill or infected, may be important determinants of whether they adopt risk reduction or protective behaviors.” (38—44). As far as conventional versus abstinence education, the best prevention of HIV is coming from abstinence-based education, because abstinence policy-makers, including Christian groups, have become successful at reducing the number of sexually active teens. According to Focus On the Family, an organization headed by author and radio commentator, Dr. James Dobson, Congress passed Title V legislation, which provides federal funds—matched by states—to provide the idea of “abstinence-until-marriage to teenagers,” through public schools across the country. The Journal of the American Medical Association, as well as Christian groups are applauding the availability of Title V funds, made possible by the “Personal Responsibility and Work Opportunity Reconciliation Act of 1996. (1). But many abstinence programs, while very moralistic, are ignoring the health side of things, and are lacking in HIV education. In fact many parents and activists keep talk on AIDS out of abstinence-based school curriculums. Successful abstinence curriculums should also be excellent teaching tools on HIV and on AIDS.
One of the problems getting HIV information to teens is the fact that in-school as well as community-based AIDS education of any sort often demands written consent by parents to have their child educated. There is nothing wrong with parents wanting to know what is being taught in schools, of course. But in a very real sense it is incredible that some parents do not allow their kids to learn about HIV and AIDS. More than anything it is a nuisance for educators and I’m not sure which is worse? That a permission slip is required for AIDS education seems to be more a function of our American legal system and the frivolous lawsuits it brings. But it is also disheartening that HIV/AIDS prevention education in a pure sense can be seen as controversial. Avert understands this frustration. One of the silliest and most frustrating obstacles to educating teens about HIV/AIDS is the fact that “the subject can be considered . . . as too sensitive for children or too controversial.” (1).
According to another Avert article, “Does Sex Education Work?” the Kaiser Foundation reported in 1994 that “over 93% of all public high schools currently offer courses on sexuality or HIV”. (1). If the percentage of public schools offering sex education or HIV courses is accurate, it is an indication of the very high lack of efficiency by these programs, considering the current statistics regarding teens and HIV. According to the National Center for Health Statistics (1998), human immunodeficiency virus infection was not even mentioned in 1980, but by 1996, HIV was the sixth leading cause of death among 15 to 24 year-olds, and the third leading cause in 25 to 44 year olds. (216, 217). According to the World Health Organization, 7000 people worldwide between the age of 10 and 24 acquire HIV every day. “That is five young persons every minute.” (1). Since 1997, the United Nations’s themes for World AIDS Day have focused on children and youth, and this year continues the trend. So the prevalence of sex education courses and their utter failure in preventing new HIV transmissions in America’s teenagers is clear evidence that sex education as we know it is not working to fight AIDS.
The NAMES Project AIDS Memorial Quilt organization has long warned about the fact that we must change the focus of HIV prevention in order to reach our children. In a statement entitled “AIDS Is NOT Over”, the NAMES Project stated that 40 to 50 thousand Americans acquire new HIV infections per year, and that “the epidemic is losing it’s gay, white male face more and more every year.” AIDS is the leading cause of death for blacks in the U.S. and African American men “are almost six times more likely to get infected compared to white men while African American women are “sixteen times more likely to get infected than white women.” Fifty-two percent of AIDS cases occur among blacks and Latinos, though they make up only 23% of the population. They also echo the fact that fifty percent of new HIV infections happen among Americans 25 years old or younger (when counting infants and children). Their suggestion: “These changing demographic trends demand that we tailor new HIV prevention programs to better serve groups at increased risk.” (2).
What can we do? Educators, parents and community leaders need to come together to fight AIDS now. A press release from the United Nations for World AIDS Day, 1998 reads: “You have to start from the ground [children and youth] with education, so the youth will grow fruitfully and be protected from AIDS. If not, the tree will die,” said a youth delegate to the 4th International Congress on AIDS. (9). It is ironic that while new AIDS cases have decreased, new HIV infections in young people are on the rise. New drugs are helping full-blown AIDS from killing Americans, but the lack of HIV prevention is causing more and more infections even now. There is still no cure for AIDS, and no HIV vaccine exists to prevent it.
Teenagers need someone to talk to about AIDS. It is not enough to encourage strong family ties. It’s not enough to say, “Parents should have open communication with their children.” We must come up with ways to make that happen. Even so, some parents will not ever be able to talk to their children. However, parents should not preclude their children from talking to a trusted and educated adult on the subject.
What we need to do to combat HIV in teenagers is change the way sex education is done. In a letter to the editor of The Monitor, a local newspaper, published in 1993, I described the need for change as follows: “All too often, a one-time, prepared speech is passed on to a young girl or boy on the verge of puberty. In many cases, this talk is given by a school nurse or a teacher in a roomful of other pupils. A Q & A session follows. Obviously, those who are intimidated by the presence of their peers never ask questions. And unfortunately many students do not have someone at home to talk the subject over with.” (8A). This scenario is still commonly seen today. Unfortunately, sex education—a talk on the “birds and the bees”--happens in the preteen years in elementary or junior high, and then may or may not happen until health class in high school. So, sex education classes are flawed in more ways than in their presentation. If a student is absent on the day of “the talk”, then he might not hear any of this until high school.
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