Comprehensive AIDS education can make pupils aware of the need to protect themselves against infection. It can also bring about gradual changes in the wider social environment, making safer sex more acceptable. But what is the best way to introduce AIDS education to schools with scarce resources and a packed curriculum?

Researchers from the Medical Research Council Programme on AIDS tested an extracurricular AIDS education programme in 66 schools in rural south-west Uganda. After a year they found that the programme was poorly implemented by specially-trained teachers and had little overall effect. AIDS education should be included and examined as part of the national curriculum, they conclude.

Pre-marital sexual activity is highly valued among these young people and is encouraged by peer pressure and powerful social norms. Money or other gifts are often involved. Although condom use is increasing, sexual contacts are frequently unprotected. High-risk behaviour continues despite increasing knowledge about HIV.

In this study, over 2000 students from schools involved in the programme and control schools completed questionnaires about their knowledge of HIV and AIDS. The results showed that the programme had very little effect - there was no significant improvement in scores on seven of the nine key questions at the end of the programme.

Researchers also held focus group discussions with 47 girls and 46 boys from 5 schools. This revealed that:

• The intervention was not implemented in the classroom as fully as expected. Classes were irregular and generally unscheduled.
• Students had never seen most of the student activity sheets. Two key sections were almost completely ignored: condoms and role-play.
• Teachers were reluctant to tackle these controversial and unfamiliar topics for fear of antagonising parents, the wider community or head teachers.
• Teachers lacked sufficient classroom time to implement the package due to curriculum overload.
• Students were keen to learn more. They particularly wanted to learn how to use condoms.

Unless teachers are obliged to cover the subject, school-based AIDS education may fail due to incomplete implementation. This would apply to other large AIDS education programmes for schools in sub-Saharan Africa. To improve the effectiveness of these programmes, policy-makers should:

• incorporate AIDS education fully into the national curriculum and examine it as part of life-skills education
• introduce sessions on participatory teaching methods at teacher training colleges and during in-service training programmes
• develop a complementary peer education component to provide children with more accessible sources of sensitive information
• evaluate other channels for teaching about condoms outside the school context.

A Life Skills Education Initiative has recently been introduced into teacher training colleges in Uganda, incorporating a wide variety of topics including HIV/AIDS. In time, this should become a regular part of the curriculum in all schools and is an important step towards a comprehensive school-based AIDS education programme.

Source(s):
'Evaluation of a comprehensive school-based AIDS education programme in rural Masaka, Uganda' by J. Kinsman et al., Health Education Research 16 (2001)

Funded by: UK Medical Research Council

id21 Research Highlight: 26 September 2001

Further Information:
John Kinsman or James Whitworth
Medical Research Council Programme on AIDS
c/o Uganda Virus Research Institute
PO Box 49
Entebbe
Uganda

Tel: +256 (0)41 320272/320042
Fax: +256 (0)41 321137
Contact the contributor: mrc@starcom.co.ug

Other related links:
UNAIDS produced these HIV/AIDS fact sheets for the UN General Assembly Special Session on HIV/AIDS, 2001.

Take a look at AIDS Action - a newsletter on AIDS prevention and care from Healthlink Worldwide.

The WHO's Department of HIV/AIDS also provides lots of relevant information.

This site provides more information on AIDS and Africa.