Charting the Course of Education and HIV

"From the beginning, the education sector has played a central role in responding to HIV. However, its role and the contribution of school-based HIV education has been the subject of much debate."

Part of the United Nations Educational, Scientific and Cultural Organization (UNESCO)'s Education on the Move series focusing on key trends and challenges, this edition "provides an overview of how the role of the education sector and approaches to HIV education have evolved over time. Building on the findings of recent research and regional studies, it examines lessons learned, emerging challenges and opportunities, and 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 book reviews "the evolution of the education sector response to HIV and AIDS, and the contribution it has made during the past three decades, ...[including] how education has helped to prevent new infections, supported testing treatment and care, and reduced stigma and discrimination." It discusses "what is known about how education can contribute to healthier behaviours, through life skills programmes and those that specifically teach about HIV prevention, treatment, care and support [and] describe[s] how the engagement of the education sector has shifted from an emergency response at the beginning of the epidemic to one that now addresses HIV as part of a more mainstreamed effort, increasingly situated within comprehensive sexuality education and as part of broader health education programmes." According to the book, evidence shows that education can address harmful attitudes, "such as stigmatizing views towards people living with or vulnerable to HIV, and strengthen the skills necessary for people to take decisions and actions that will enable them to lead healthier lives...." It focuses on successful education programmes that increase knowledge of HIV and AIDS, "helping to put to rest an unproductive debate about the role and value of school-based HIV education programmes."

The book argues for interactive paedagogy to promote life skills rather than didactic teaching (often lecture style) and also for age-appropriate sexuality education rather than abstinence-only education policy. Life skills include communication and coping skills as well as cognitive skills for producing better behavioural outcomes along with the empowerment to act on knowledge of HIV as an infectious disease. "[A] recent study demonstrated that education programmes targeting gender inequities, sexual coercion, alcohol and substance use, as well as economic factors, can lead to a reduction in the incidence of sexually transmitted infection." Education now includes treatment education for this, using antiretroviral therapy (ART) and anti-stigma education to support the rights and safety of those who are HIV positive and to increase the likelihood of treatment and of sexuality education in the public sector.

Due to the impact of HIV and AIDS on education workers and a simultaneous emphasis on universal primary education, there was a need for and a response to accelerate comprehensive education sector responses to HIV. The Joint United Nations Programme on HIV/AIDS (UNAIDS) cosponsors, bilateral donors, and civil society organisations accelerated the response with policies, planning, and programmes to expand training for teachers about HIV and increased the breadth of HIV education.

Lessons and recommendations include the following:

• Curricular changes as early as primary school need to reference to key aspects of sex and sexuality, access services, social and cultural factors, sexual rights, and sexual diversity.
• Teachers need a mandate to and training for teaching sexuality education using an inclusive curriculum.
• "Effective HIV education requires participatory methods and other learner-centred approaches as well as a logical sequencing that builds on knowledge and skills and introduces subject matter that is age-appropriate and relevant to learners’ social situation and cognitive development, beginning as early as age five..... In other words, the acquisition of knowledge, attitudes, values and skills starts at an early age and should be provided throughout a learner’s education."
• "Changes in classroom structure and dynamics can be achieved through a number of techniques," including changing authoritarian models of classroom management towards collaborative approaches between teachers and learners.
• Quality pre-service and follow-up in-service training must replace in-service training. The training "needs to cover issues such as human rights, gender, sexuality and sexual diversity, and inclusion and non-discriminatory practices."
• In short, HIV education should be: Life-skills-based; contextually adapted; gender-sensitive; age-appropriate; right-based; scientifically accurate; and integrated into skills-based health education.

The book discusses monitoring and evaluation indicators in chapter 2; chapter 3 covers the global contextual challenges beyond the Millennium Development Goals (MDGs) and integration of the education sector into challenges of sustainability through a holistic framework for education, particularly in secondary education with an emphasis on life skills and with the use of information and communication technology (ICT). Chapter 4 suggests ways in which HIV education may have to adapt to an evolving epidemic and to the future needs of adolescents and young adults. There is also the opportunity of adapting teaching methodologies and, finally, educational metrics for measurement of educational gains.