Introduction to HIV and AIDS Education

back to top Why is HIV and AIDS education important?

The expansion and improvement of HIV and AIDS education around the world is critical to preventing the spread of HIV. There are an estimated 34 million people living with the virus, and each year millions more people become infected.¹ Effective HIV and AIDS education can help prevent new infections by providing people with information about HIV and how it is passed on, and in doing so equip individuals with the knowledge to protect themselves from becoming infected with the virus.

HIV and AIDS education also plays a vital role in reducing stigma and discrimination. Around the world, there continues to be a great deal of fear and stigmatisation of people living with HIV, which is fuelled by misunderstanding and misinformation. This not only has a negative impact on people living with HIV, but can also fuel the spread of HIV by discouraging people from seeking testing and treatment.²

back to top Who needs HIV and AIDS education?

HIV and AIDS education can be effective when targeted at specific groups who are particularly at risk of HIV infection. The groups that HIV and AIDS education needs to target vary depending on the nature of the epidemic in an area. High risk groups can also change over time. For example, in the early years of the AIDS epidemic in America, men who have sex with men and injecting drug users were most at risk of HIV infection. Today, heterosexual African Americans and the Hispanic/Latino population are also identified as groups particularly vulnerable to HIV infection in America.^{3 4}

“AIDS affects many parts of society, and so everyone needs to be aware of HIV and AIDS.”

However, it is important that such a focus does not lead to groups who are considered not ‘at risk’ missing out on HIV and AIDS education. This can lead to a rise in HIV infection rates amongst groups who are often neglected by HIV and AIDS education, for example older people.⁵ Providing the general population with basic AIDS education contributes to the spread of accurate information; promoting awareness and tackling stigma and discrimination.

It is also important that people who are already infected with HIV receive HIV and AIDS education. This can help people to live positively without passing on the virus to anyone else; to prevent themselves becoming infected with a different strain of the virus; and to ensure a good quality of life by informing them about medication and the support that is available to them.^{6 7}

back to top Where does HIV and AIDS education take place?

HIV and AIDS education can take place in many different environments, from classes at school to families and friends sharing knowledge at home. It is important that this education is provided in a variety of settings to ensure that the most vulnerable and marginalised groups in society are reached, and that accurate information about HIV and AIDS is reinforced from different sources.

HIV and AIDS education in schools

The most common place for people to learn about HIV and AIDS is at school. Due to their capacity and universality, schools are a crucial setting for educating young people about AIDS.⁸ As young people are at a high risk of becoming infected with HIV, it is vital that they are educated about HIV transmission before they are exposed to situations that put them at risk of HIV infection (for example, before they are sexually active). Schools play a major role in shaping the attitudes, opinions and behaviour of young people and so are ideal environments for teaching the social as well as the biological aspects of HIV and AIDS.

Members of the wider community can also increase their knowledge about HIV and AIDS through the school environment. Teachers who expand their understanding of the subject while planning lessons and receiving teacher training can pass this information on to adults as well as pupils, and the same can be said for children themselves; once informed about AIDS, they can tell their parents or their friends what they have learned.

HIV and AIDS education in the workplace

“The workplace is a key location for HIV/AIDS prevention and care programmes.” Dr Peter Piot, former UNAIDS Executive Director.⁹

Educating people at work is an important way of providing people with vital prevention information, and can reach people who have previously missed out on HIV and AIDS education. Furthermore, it is estimated that nine out of ten people living with HIV are working. Providing education in the workplace is important for protecting those at work living with HIV, and for helping them to live healthily and stay in work.¹⁰

Some occupations carry an increased risk of HIV infection, making HIV and AIDS education in the workplace even more important for preventing the spread of the virus. Health care workers may be at a higher risk of HIV transmission, for example from needles and other medical instruments, while at work. HIV and AIDS education needs to be a priority in such environments, to ensure that healthcare workers take precautions that will protect them from HIV infection.

Some people may be more vulnerable to HIV and AIDS because of the lifestyle of their work. For example, workers who spend time away from home may be more involved in risky sexual behaviour than those who spend the majority of the time at home with their families.

The International Labour Organisation (ILO) works throughout the world on HIV/AIDS policies and programmes in the workplace. The organisation aims to protect against discrimination in labour laws, promote prevention initiatives within the workplace, and supports those living with HIV by ensuring access to social protection, treatment and care.¹¹ In 2012 they launched the “Getting to Zero at Work” campaign to promote the rights of people living with HIV in the workplace.¹² However, workplace HIV and AIDS education is not universal and as a result, people are still unaware of the dangers of HIV, and those living with the virus are still subject to HIV related stigma and discrimination at work.

back to top How can HIV and AIDS education be delivered?

There are a great variety of methods and materials that can be used to educate people about HIV and AIDS, including radio & television, booklets, billboards, comic strips, street theatre, AIDS fundraising events and many more. The form in which HIV and AIDS education should be delivered depends on those who are being educated. In order to reach the target group, it needs to be considered which environments they will be most receptive in, and what media is most relevant to them.

How HIV and AIDS education should be delivered also depends on the principal aims of the education programme. Sometimes education on HIV and AIDS is about giving people information which they will remember on a long term basis, about how to protect themselves; the difference between HIV and AIDS; and helping to reduce discrimination. Other education strategies are intended to have more immediate effects, and may target people when they are most likely to take part in risky behaviour – in nightclubs or holiday resorts, for example.

There is no set or prescribed form that HIV and AIDS education should take, but there are certain things that need to be considered when carrying out or producing resources for HIV and AIDS education. The following questions have significant implications for the way in which HIV and AIDS education should be delivered:

• Is the education programme targeted at a specific risk-group or more generally at the population as a whole?
• What age are the people to be educated?
• Are the people to be educated already sexually aware?
• Have they been exposed to HIV and AIDS education before?
• Are they literate?
• What language or local dialect do they speak?
• Are there cultural issues to be considered? For example, attitudes to sexuality, or laws against portrayal of explicit images or language.
• Are people able to do what you're suggesting? There's no point in advising people to use condoms if none are available to them, or to use clean needles if needle exchanges are illegal.

HIV and AIDS education through the mass media

The mass media has played a central role in many countries’ responses to AIDS since the very early days of the epidemic. In the UK, as a response to the growing number of new HIV infections during the 1980s, a leaflet about AIDS was delivered to every household and a major advertising campaign carrying the slogan “AIDS: Don’t Die of Ignorance”, was launched. The UK government’s use of the media for broadly targeted or ‘blanket education’ was successful in promoting widespread awareness of HIV and AIDS amongst the general population.

Although media-based HIV and AIDS education is considered effective for raising general awareness, its overall impact is difficult to measure. It is essential that education goes beyond promoting general awareness and instigates behaviour change to reduce the risk of HIV transmission.

If constructed badly, HIV and AIDS education can have the detrimental affect of increasing stigma and discrimination towards people living with HIV. Some media messages try to change people’s behaviour by making the audience afraid of the consequences of becoming infected with HIV. This not only has the potential of making the target audience afraid of people infected with HIV but also carries the risk of portraying HIV positive people as at fault for becoming infected.

Media based HIV and AIDS education can be particularly harmful when targeted at specific risk groups, such as men who have sex with men or injecting drug users. Not only can this fuel stigmatisation of these groups, but it can also hinder HIV prevention. By not representing the broad face of the epidemic, and instead focusing on risks to specific groups, the media encourages the attitude that AIDS is ‘somebody else’s problem’ and that if you are not part of a risk group you don’t need to worry about HIV and AIDS.

Peer education

It is not just teachers who can provide education; people’s knowledge about HIV and AIDS can be influenced by a variety of different people, including family, friends, and the wider community. Peer education is education provided by somebody who is either directly part of the group receiving the information, or who is from a similar social background.

Peer education is a less formal method of educating, which can be more accessible to people who are not used to or dislike a formal classroom environment. At the same time, peer educators are trained on the subject, ensuring that the information they provide is accurate and reliable. This makes peer education a very effective way of reaching marginalised groups. For example, peer education programmes have been found to work well in prisons, where authority figures are often distrusted.^{13 14}

back to top What information needs to be included in HIV and AIDS education?

Although HIV and AIDS education needs to be tailored to the context in which it takes place and to the people who are being educated, there are some key areas that HIV and AIDS education programmes need to cover. It is important that the information provided is a balance of the social and emotional aspects of HIV/AIDS as well as biological and medical information.

Comprehensive HIV and AIDS education includes:^{15 16}

How to protect and promote one’s health

• Basic knowledge of HIV and AIDS – including how to protect oneself from HIV infection.
• Learning about treatment and care - including an understanding of voluntary counselling and testing (VCT) and antiretroviral drugs.

Social and emotional aspects

• How to maintain a healthy level of self-confidence and self esteem.
• Coping with difficult and risky situations.
• Coping with loss.

Sexuality

• Learning about different sexual orientations and the development of sexuality.

Promotion of equity, including gender issues

• Understanding that social, biological, economic and cultural factors affect vulnerability to HIV.
• Understanding that men and women have similar rights in society and family.

Overcoming stigma and discrimination and promoting human rights

• How to show support for HIV positive people and how not to discriminate against or stigmatise people living with HIV.
• Understanding the importance of confronting HIV and AIDS in the community.

Providing the right information is only part of carrying out comprehensive HIV and AIDS education. For the education to be effective, this information needs to be absorbed and remembered. Active learning encourages people to engage with information by giving them the opportunity to apply it.¹⁷

back to top HIV and AIDS education: The issues

Unfortunately when it comes to HIV and AIDS education, ideological and religious views often conflict with science. America has one of the highest teenage pregnancy rates out of high-income countries.¹⁸ Yet despite evidence that young people are having sex, the ideological message of sexual abstinence until marriage plays a key role in sex education. Abstinence-only programmes often do not teach people about contraception and safer sex and therefore many young people remain unaware of how to protect themselves from becoming infected with sexually transmitted diseases (STDs) and HIV. Federal funding for abstinence-only programmes in America has increased significantly since 1997, despite many studies concluding that these programmes have no long-term effect on sexual-health outcomes.¹⁹

Conflicts with science are not only evident in America – in many parts of the world educating about safe sex is against moral and religious views, and therefore people remain unaware of the dangers of HIV infection through sexual intercourse.

“At this moment in time, this school is trying to educate their students about ‘themselves’…but because of the policies of the Catholic Education Office, certain topics are not allowed to be spoken about in class… I feel sorry for these children as they will be totally shocked once they finally learn about ‘sex’. I feel that the school and the Catholic system is trying to protect these children from the horrors of the real world”A personal story received by AVERT from Louise, a social work student taking a work placement at a primary school.

Discriminatory laws and government views can also have a detrimental effect upon HIV and AIDS education. In Zimbabwe, for example, homophobic views are common and homosexuality has been publicly denounced by President Robert Mugabe. This has made it difficult for AIDS organisations to target gay men with educational messages.

“A lot of gay men in Zimbabwe have died silently through ignorance and multiple stigmatisation of homosexuality and seroposivity. As a result, there is a growing sense of urgency to extend services to this community”Samual Madzikure, Gays and Lesbians of Zimbabwe.²⁰

“What we need to do is fight for a change of laws so that gays are given recognition. Without that, fighting AIDS among homosexuals will be futile”Benjamin Mazhindu, chairman of the Zimbabwe National Network for People Living with HIV.²¹

back to top What is needed?

Many people are now aware of the dangers of HIV, and yet each year millions of people become infected with the virus. It is therefore vital that HIV and AIDS education goes beyond simply providing information and that it is supported by other prevention efforts such as providing condoms and clean injecting equipment, and making testing facilities available and accessible. In order to ensure that people are willing and able to turn the knowledge they gain from HIV and AIDS education into action, they need more than basic scientific facts. HIV and AIDS education needs to motivate people by making them aware that what they are learning is relevant to their lives. Empowerment is also crucial, as people must be in a position where they are able to take control of their sexual behaviour or methods of drug use.

Education is a crucial factor in preventing the spread of HIV. Given the huge numbers of deaths that might still be prevented, the importance of effective education cannot be overestimated.

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Sources back to top

• The White House (www.whitehouse.gov)
• The Vatican (www.vatican.va)
• United Nations Office of the High Commissioner of Human Rights (www.ohchr.org/english)

References back to top

1. UNAIDS (2011) 'World AIDS Day Report 2011'
2. WHO/UNAIDS/UNICEF (2011) ‚'Global HIV/AIDS Response: Epidemic update and health sector progress towards Universal Access 2011'
3. Centers for Disease Control and Prevention (2009), 'HIV/AIDS Surveillance Report 2007 (Vol. 19)'.
4. Centers for Disease Control and Prevention (2008, April) ‘HIV/AIDS among Hispanics/Latinos’.
5. AIDS InfoNet (2009, 24th May) ‘Fact sheet number 616: older people and HIV’.
6. GNP+ (2009, April), ‘Living 2008: The Positive Leadership Summit Report’.
7. Kalichman S. (ed) (2006), 'Positive Prevention: Reducing HIV Transmission Among People Living with HIV/AIDS' Springer.
8. UNESCO (2009, May), 'A strategic approach: HIV & AIDS and education'.
9. ILOAIDS (2008, March), 'Saving lives, protecting jobs: International HIV/AIDS Workplace Education Program'.
10. ILOAIDS (2008, March), 'Saving lives, protecting jobs: International HIV/AIDS Workplace Education Program'.
11. ILOAIDS 'The ILO and HIV/AIDS'.
12. UNAIDS (2012, 29th November) 'The International Labour Organization launches “Getting to Zero at Work” campaign'.
13. Family Health International (2003), 'Peer-to-peer HIV and AIDS educators trainers' guide for IMPACT implementing agencies in Nigeria'.
14. UNAIDS (1999), 'Peer education and HIV/AIDS: Concepts, uses and challenges'.
15. IBE & UNESCO (2006), 'Manual for integrating HIV and AIDS education in school curricula'.
16. AVERT (1993), 'AIDS: working with young people'.
17. UNESCO (2008), 'Good policy and practice in HIV & AIDS education: effective learning'.
18. WHO (2007), 'Adolescent pregnancy; unmet needs and undone deeds'.
19. Boler T & Archer D (2008), 'The politics of prevention: a global crisis in AIDS and education', London: Pluto Press.
20. IRIN (2006, 26th October), 'Zimbabwe: Homophobia raises HIV risk for gays'.
21. IRIN (2006, 26th October), 'Zimbabwe: Homophobia raises HIV risk for gays'.