HIV/AIDS Prevention Through Schools Issues and Challenges Dr S.K. CHATURVEDI

The epidemic - its changing focus Lessons from what ‘works’ Summary of Contents 5 topics: The epidemic - its changing focus Lessons from what ‘works’ Goals for 2005 School HIV prevention - Issues &Challenges UNICEF as partner

In 7 countries, more than 20% of all adults are infected with HIV Evolution of the epidemic Main focus still on Africa In 7 countries, more than 20% of all adults are infected with HIV 15 – 39% 5 – 15% 1 – 5% 0.5 – 1.0% 0.1 – 0.5% 0.0 – 0.1% not available HIV prevalence in adults, end 2001

But HIV Prevalence is increasing rapidly in Asia Evolution of the epidemic But HIV Prevalence is increasing rapidly in Asia

Evolution of the epidemic Over 6 million people in Asia are now living with HIV/AIDS

Lessons learned Effective national response can make a difference Source: UNAIDS/WHO

High level political support for a multisectoral response Lessons learned What are the ‘common’ success factors? High level political support for a multisectoral response Decentralised planning:  for interventions with general populations and key target groups Interventions addressing women and youth, stigma and discrimination Accessible Voluntary counselling

Impact of school HIV education Source: AMREF 2001

UNGASS goal for Young People By 2005, 90% of young people 15-24 yrs have meaningful access to the information, education, and services needed to protect themselves from HIV/AIDS

Young People Today Half of all new infections between 15-24 yrs Young people are having sex, yet don’t know how to protect themselves from HIV Well over 50% of young people 15-24 yrs have serious misconceptions about HIV Risk behaviors are practiced partly as a result of misinformation (or lack of information)

What do we know …. Effective school-based programmes can influence key vulnerability factors Being in school itself reduces vulnerability Programmes that advise only abstinence have not been shown to be effective in behaviour change Coverage remains low Interventions remain information-driven - not skill-based Few genuinely participatory Yet despite this, Well implemented school-based programmes can influence key HIV/AIDS risk factors and conditions

Do school based sexuality programmes lead teenagers to have sex? Important to remind ourselves that…. …HIV education helps prepare young people for life But 3 questions : Do school based sexuality programmes lead teenagers to have sex? What makes a school based education programme successful? At what age should school based programmes about sexuality begin?

Does school-based sexuality education lead adolescents to have sex? 2 most comprehensive recent reviews (WHO, Kirby 2001) Most programmes evaluated did not lead to initiation of sexual relations, or increase in sexual activity A number led to postponement of first sex

What makes a school-based programme successful? A clear consistent message based on accurate information Focuses on reducing one or more specific risk behaviours Uses teaching methods that involve students, are skill-based and use real life situations Motivates and trains teachers to participate Lasts sufficient time

At what age should school based programmes begin? As yet, no clear answers, but research suggests ... programmes should begin at an early age instilling positive norms is easier if behavioural patterns have not yet been formed impact greater if education takes place before student becomes sexually active rather than after

So, to achieve our national goals - what do we need? Bring greater political support behind school HIV initiatives A scaled up response Synergies between education and health Leadership by Education Departments More resources for school- HIV efforts Schools as an opportunity for reaching young people in the community

How to support the National Program Ensuring school AIDS education is a priority intervention for all young people Reinforcing ‘quality’ in scaled-up interventions Bringing young people into the picture-helping their ideas shape the content Facilitating social mobilization with teachers /parents/community Supporting partnerships