'All red in the face': students' views on school-based HIV/AIDS and sexuality education

School-based HIV/AIDS and sexuality education is a fraught area, the site of struggles around moral values, knowledge, the nature of childhood and adolescence and pedagogy. The dominant discourses on HIV/AIDS and sexuality education in Australian secondary schools, as evident in policy documents, are currently predominantly libertarian and therapeutic, championing the need for 'openness' in the interests of the students' emotional maturity and social responsibility and their good health. However, Policy does not always translate readily into practice. This article draws upon a study involving focus group discussions with Australian senior high school students concerning their responses to the school-based HIV/AIDS and sexuality education programmes in which they have taken part and other sources of knowledge about HIV/AIDS. The article focuses in detail upon the students' valorizing of openness, trust and expertise in the face of the embarrassment, their perception of surveillance and their fears of lack of confidentiality that characterize their experience of HIV/AIDS and sexuality education. It is concluded that the nature of the teacher-adolescent relationship tends to work against the achievement of the objectives of such education.     

Putting the “S” Back into Sexual and Reproductive Health

ABSTRACT

Sexuality is the most fundamental aspect of our lives and yet it has long been the silent partner in sexual and reproductive health (SRH). Growing awareness of the rights-based approach to health, the commitment of governments and international bodies to promote sexual health and well-being, and the failure of many of the interventions to combat the HIV/AIDS epidemic are helping the reproductive health community put the “S” back into SRH even as the Millennium Development Goals fail to address SRH directly. The disconnect is due to the fragmented, non-holistic approach to reproductive health, short-sightedness in neglecting violations like gender-based violence, a lack of training for students and health care professionals in sexuality, a dearth of indicators and sexuality research and discrimination against vulnerable groups like youth and sexually diverse populations. Recommendations include reaching consensus about the nexus between sexuality and reproductive health and strengthening the commitment to gender equity, empowerment, sexuality and sexual rights among policymakers. Ensuring that explicit and positive references to sexuality are universal, especially in comprehensive sexuality education, youth-focused programs and the integration of HIV and other SRH programs, and strengthening the ability of program managers and service providers to work on sexual health issues are key to successful integration and program sustainability. Strengthening understanding, acceptance and competence in serving sexually diverse populations and improving the research and evaluation specific to sexuality are longer processes, but equally important in the paradigm shift to non-stigmatizing, gender-equitable, rights-based, pleasurable sexual health services.     

A systematic review of education for the prevention of HIV/AIDS among older adults

Through a comprehensive literature search, the authors of this systematic review identified 21 articles focused on primary prevention of HIV/AIDS for adults aged 50 and over. Three major challenges to providing HIV/AIDS education for older adults include health professionals' ageism, older adults' reluctance to discuss sexuality, and their misconception of their HIV risk. Clinical guidelines for social workers, nurses, and physicians identified the importance of sharing information and assessing risk, considering cultural diversity, and devising creative delivery strategies. Three models of HIV/AIDS education include group education programs delivered by social workers or other health professionals, peer education models, and one-on-one early intervention models including HIV/AIDS testing. Additional outreach and research on HIV/AIDS prevention among older adults is needed.     

Qualitative evaluation of HIV/AIDS IEC activities in Madagascar

UNICEF commissioned a qualitative evaluation of a program in which two partners conducted prevention activities concerning HIV/AIDS and STIs amongst youth in Madagascar. The evaluation assessed project activities and conducted a practical exercise in focus group methodology, following a workshop on evaluation techniques. Information was collected from a wide range of people, including 441 participants in 46 focus groups in nine sites. Six sites were areas of project activities and three sites were targeted for future activities. Clubs that integrated HIV/AIDS and STI information into their regular activities were most successful in their information, education and communication activities. A more participatory approach is recommended, to achieve a better match between target groups and messages delivered, and to foster trust and support. Another challenge remaining is to address fears and stigma through advocacy for the care and support of affected people.     

Sex education and HIV/AIDS: political conflict and legal resolution

Throughout the last decade sex education has been a site of intense political struggle. This article identifies how the legal regulation of sex education operates in such a way as to incorporate conflicting discursive problematisations of HIV/AIDS and childhood sexuality through the construction of distinct categories within the sex education curriculum and the legitimisation of distinct roles for parents, teachers and health professionals within those categories. In particular it seeks to explain why sex education in schools fails at present to be a primary source of information about HIV/AIDS for young people and, consequently, identifies the urgent need for new guidance from the Department of Education and Employment.     

Incorporating human sexuality content into a positive youth development framework: Implications for community prevention

As approaches to positive youth development (PYD) gain momentum, the issue of sexuality – a critical component of human development – is being subsumed by ideological debates. In the current political climate, sexuality education is often relegated to biological and/or values-based approaches, neglecting essential relational and collective aspects of sexuality. Through the explication of sexuality as an important component of youth's social ecology, this paper provides a conceptual link between the goals of the Sexuality Information and Education Council of the United States' (SIECUS) Guidelines for comprehensive sexuality education and those of PYD. We argue that sexuality, as a normative part of human development, culture, identity, and relationships, be approached from an asset-based perspective, rather than a deficit-based perspective. We propose a framework that illustrates how aspects of sexuality are embedded within PYD contexts, and demonstrates how a sexuality education program rooted in SIECUS guidelines can further PYD goals across community contexts.     

Sexuality Education

Summary

Sexuality education is described as an ecological phenomenon, reflecting a variety of dialectical tensions in the context of U.S. society. A brief overview of sexuality education highlights historical trends in the past century. After disclaiming the notion that history repeats itself, I outline seven tentative “lessons,” or guiding principles, for planning future sexuality education efforts.     

Sexuality,Morality and Lifestyle: The ABC of HIV Prevention Strategies in Rural Papua New Guinea

This article explores the national program for the prevention of the spread of HIV/AIDS in Papua New Guinea and its intersection with the experiences of a rural community in Western Province. The social marketing of HIV/AIDS awareness and prevention has seen an influx of categories and definitions of people, sexual behaviour and HIV/AIDS that have the potential to create confusion, but also spaces in which rural populations can understand and conceptualise AIDS. In the present paper, the preventative program is examined from the perspective of the Gogodala, whose understandings of sickness and prevention are based on an intimate and interactive relationship with the local environment. In this context, ‘lifestyle’ (ela gi) and the maintenance of certain ‘laws’ is the primary method of sickness prevention. I argue that an exploration of the local dynamic between sexuality, morality and lifestyle is vital to the evaluation of the impact of these awareness and prevention programs and the possibilities for future prevention strategies.     

Evaluation of community-based AIDS education and risk reduction projects in ethnic and racial minority communities: A survey of projects funded by the U.S. public health service

The purpose of this study was to describe proposed program evaluation methods used to determine effectiveness of selected federally funded AIDS education and risk reduction interventions focused on ethnic and racial minority populations. Funding for AIDS prevention programs has grown significantly since 1985, when the first allocation of $11 million was earmarked for general AIDS prevention and education. In 1987, funds specifically targeting minority populations were set aside from AIDS prevention and education programs. Nine agencies/divisions within the Department of Health and Human Services (DHHS) were identified as having funded AIDS prevention and education projects targeted toward ethnic and racial minority populations. The grants and contracts reviewed for this study were limited to those programs receiving Federal funding through DHHS. Few programs provided information within the broader context of sex education and drug education. The modification of needle-sharing behavior among IV drug users and unprotected sex with an IV drug user were the two most frequent risk factors targeted. All 63 programs used at least one formative evaluation method. The most frequently used formative techniques were monitoring achievement of project objectives and counting the number of people participating in program activities. Forty programs counted the amount of AIDS literature distributed. Thirty-three programs conducted a baseline assessment of AIDS knowledge, and 33 programs conducted a baseline assessment of risk behaviors for HIV infection. Results from this study support the National Academy of Sciences recommendation that while summative evaluation will ultimately be valuable, it would be premature to begin developing outcome evaluation strategies at the present time. It is incumbent upon program planners and evaluators to ensure that premature program evaluations are not made in an effort to eliminate direct federal funding of minority community-based strategies to stop the spread of HIV infection.     

AIDS education and prevention programs for intravenous drug users: the California experience

The state of California, pursuant to 1985 legislation, established the California AIDS Program (CAP) within the state Office of AIDS. As part of this program, the Office of AIDS contracts with public and private agencies to provide AIDS education to specific target groups throughout the state. Intravenous drug users (IVDUs) constitute one of the target populations singled out for special attention by the state. This article, based on a statewide evaluation, describes the AIDS education programs for IVDUs funded by the Office of AIDS. The types of educational interventions used are presented, both for IVDUs in treatment and those not in treatment. The unique problems in reaching this target population are also discussed. The article concludes that the state is making a good effort to reach IVDUs, but that further educational and evaluative efforts are needed. Specifically, the individual educational programs must move beyond the transmission and evaluation of cognitive knowledge about AIDS to an assessment of the attitudes that impede behavior change.     

How to reduce the risk of HIV infection for the seriously mentally ill.

1. The professional literature increasingly indicates the need to educate persons with serious mental illness regarding HIV/AIDS. 2. Community-based organizations currently responding to the AIDS epidemic are poorly equipped to respond to the special needs of persons with serious mental illness. 3. Persons with serious mental illness are concerned by HIV/AIDS. Some, however, will incorporate education into their pathology via delusional systems or misunderstandings. 4. Effective programs for this population can be developed following community health nursing principles.     

Family-Based HIV Preventive Intervention

Summary

Social indicators suggest that African American adolescents are in the highest risk categories of those contracting HIV/AIDS (CDC, 2001). The dramatic impact of HIV/AIDS on urban African American youth have influenced community leaders and policy makers to place high priority on programming that can prevent youth's exposure to the virus (Pequegnat & Szapocznik, 2000). Program developers are encouraged to design programs that reflect the developmental ecology of urban youth (Tolan, Gorman-Smith, & Henry, 2003). This often translates into three concrete programmatic features: (1) Contextual relevance; (2) Developmental-groundedness; and (3) Systemic Delivery. Because families are considered to be urban youth's best hope to grow up and survive multiple dangers in urban neighborhoods (Pequegnat& Szapocznik, 2000), centering prevention within families may ensure that youth receive ongoing support, education, and messages that can increase their capacity to negotiate peer situations involving sex. This paper will present preliminary data from an HIV/AIDS prevention program that is contextually relevant, developmentally grounded and systematically-delivered. The collaborative HIV/AIDS Adolescent Mental Health Project (CHAMP) is aimed at decreasing HIV/AIDS risk exposure among a sample of African American youth living in a poverty-stricken, inner-city community in Chicago. This study describes results from this family-based HIV preventive intervention and involves 88 African American pre-adolescents and their primary caregivers. We present results for the intervention group at baseline and post intervention. We compare post test results to a community comparison group of youth. Suggestions for future research are provided.     

Gender-specific changes in students' sexual behaviors and attitudes at a southeastern university between 1973 and 1988.

This study investigated the gender-specific, self-reported sexual behaviors and attitudes of never-married college students attending a southeastern university in 1973 and 1988. Data were collected by means of a mailed questionnaire that remained essentially unchanged for both years. The authors found that both men and women reported an increase in heterosexual relationships that included sexual intercourse and a decrease in nonsexual relationships with the other gender. The majority of the students perceived themselves as adequately informed about sexuality and satisfied with their relationships, although the proportion of men who reported being satisfied with their relationships declined over the 15 years. The students indicated that sexuality education should focus primarily on information about AIDS and on preparation for marriage.     

Lesbian,Gay, Bisexual,Transgender, Queer,and Questioning Youths' Perspectives of Inclusive School-Based Sexuality Education

Sexuality education is perceived as one way to prevent unhealthy sexual behaviors. However, current sexuality education materials are not tailored to fit the needs of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth, and many have been critiqued for disenfranchising these populations. This study solicited the perspectives of LGBTQ youth on their experiences with school-based sexuality education in order to create a framework of LGBTQ-inclusive sexuality education. Five semistructured focus groups (N = 30 LGBTQ participants) were conducted to investigate the sexuality education experiences of LGBTQ youth and to solicit youth suggestions for improving the inclusiveness of sexuality education curricula. Results indicate that LGBTQ youth perceive current sexuality education as primarily “exclusive,” although examples of “inclusive” sexuality education were provided. In addition, participants provided suggestions for creating a more inclusive experience, such as directly discussing LGBTQ issues, emphasizing sexually transmitted infection (STI) prevention over pregnancy prevention, and addressing healthy relationships. Educators and policymakers can use these ideas to help improve the quality of sexuality education—not only to make it more inclusive for LGBTQ youth but to make sexuality education more inclusive for all young people.     

Calendars on the Wall

This study explores the evidence of social and personal forces in discussions concerning sexuality in client/provider interactions about HIV/AIDS. It unravels the complex ways that such forces influence the interactions, each other, and, in turn, how interactions can influence the forces themselves. The interactions were observed using participant observation techniques, and were analyzed using a framework suggested by Giddens (1979) and augmented by the author. Analysis suggested that such forces as societal norms about sexuality, promiscuity, and monogamy and the guilt associated with their violation influence client/provider interactions about HIV/AIDS. Unraveling the mutual influences of the forces may provide an opportunity to identify possibilities for altering the reproduction of the system.     

Risk, sexuality and economy

From the mid 1980s onwards HIV/AIDS became a new subject of work reform, with a range of experts producing new knowledges on work and the worker in regard to HIV/AIDS and workplace organizations putting in place workplace HIV/AIDS policies and programmes. To date, much of the discussion in sociology in regard to such policies and programmes has focused on the issue of effectiveness and has been concerned with making such policy 'better'. In this article however, and with particular reference to sexuality, I suggest that such approaches fail to register that workplace HIV/AIDS policies concern new conceptualizations of worker identities. Specifically, I suggest that such policies may be viewed as part of an assemblage of work reforms which are reworking worker identities as risk identities. Thus I argue that workplace HIV/AIDS policies and programmes are best understood as risk rationalities. Further, I consider the alignment between such rationalities and neo-liberal modes of rule, and in particular consider the ways in which workplace HIV/AIDS policies render both HIV/AIDS and sexuality calculable and governable in terms of notions of risk, self-responsibility and self-management.     

Reading Sociology into Scholarship on School‐Based Sex Education: Interaction and Culture

School‐based sex education (SBSE), an institutional attempt to interrupt and correct the sexual socialization of young people, operates at the levels of structure, interaction, and culture. At the structural level SBSE has been found to endorse a particular set of cultural messages about sex and sexuality that reinforce patterns of inequality. This is often the case regardless of program type (e.g., abstinence versus comprehensive). However, there is little empirical focus on the actual classroom practices and other social interactions that constitute SBSE in the United States. In this paper, I will provide an overview of the field of SBSE research, reading the findings at the interactional level. In particular, I will review findings on curricula, stakeholder perspectives, and effects in a discussion of the importance of both interaction and culture in SBSE practices. Finally, I will use criticisms raised in existing SBSE scholarship to pose opportunities for sociological research into the topic.     

A Model Program for Increasing Treatment Access for African American Women Who Use Crack Cocaine and Are at Risk of Contracting HIV

ABSTRACT

In the United States, the threat of HIV/AIDS to African-American women's health has become the focus of much concern. This article describes a federally funded community-based program that provides services to African-American women at risk for HIV/AIDS in Nashville, TN. This program provides a culturally relevant set of interventions specific to crack cocaine users aimed at reducing substance use and HIV/AIDS risk behaviors. The model is important to the continued development of culturally relevant interventions that are vital to stemming the disproportionate rates of HIV/AIDS within the African-American community by ensuring treatment access to all populations.     

Gender-Specific Changes in Students' Sexual Behaviors and Attitudes at a Southeastern University between 1973 and 1988

Abstract

This study investigated the gender-specific, self-reported sexual behaviors and attitudes of never-married college students attending a southeastern university in 1973 and 1988. Data were collected by means of a mailed questionnaire that remained essentially unchanged for both years. The authors found that both men and women reported an increase in heterosexual relationships that included sexual intercourse and a decrease in nonsexual relationships with the other gender. The majority of the students perceived themselves as adequately informed about sexuality and satisfied with their relationships, although the proportion of men who reported being satisfied with their relationships declined over the 15 years. The students indicated that sexuality education should focus primarily on information about AIDS and on preparation for marriage.