ERIC Identifier: ED309564
Publication Date: 1989-00-00
Author: Liontos, Lynn Balster
Source: ERIC Clearinghouse
on Educational Management Eugene OR.
AIDS/HIV Education. ERIC Digest Series Number EA 38.
If AIDS education hasn't already been mandated by your state, it may be soon.
Increasingly, school administrators and board members will feel pressure to
implement HIV* education programs. Teenagers are one of the highest at-risk
groups, and, as John Washburn, a former superintendent who has AIDS, has pointed
out (Kathleen McCormick 1989), education is the only vaccine we presently have
When administrators begin to approach this issue, however, they often find
themselves aswirl in controversy. HIV education, because it has to do with
community values, religious beliefs, and customs, is a complex and sensitive
subject. It involves talking about sex and also about death and dying, topics
that make many people feel uncomfortable. In addition, although a growing body
of research confirms how HIV is and is not transmitted, there's still a great
deal of fear based in misinformation and mistrust. The who, what, when, and how
of HIV education are all issues that need to be thoroughly explored and
discussed before implementing an HIV program.
WHY ARE TEENAGERS AT RISK?
Adolescents are considered a
high risk group because (1) they're exploring their sexual identities and often
are experimenting not only with sex but with drugs; (2) their behavior tends to
be impulsive and greatly influenced by peer pressure; and (3) they often feel
invulnerable and have trouble seeing long-term consequences. McCormick reports
that one out of every five cases of AIDS has occurred among those 20-29 or
younger, and because of the long incubation period we now believe that many of
these young people were infected as adolescents. Changing the behavior of
adolescents, says epidemiologist Helene Gayle (McCormick), is going to make a
big difference. Thus the goal of HIV education, according to Centers for Disease
Control (CDC) guidelines (Dennis Tolsma and others 1988), is to prevent
infection through behavior changes.
WHAT SHOULD BE TAUGHT WHEN?
Most critics of HIV education
support instruction, but often not at the elementary level. However, many young
children have fears about AIDS, and the Surgeon General's report on AIDS
stresses the need to educate children at an early age. Mainly they need to be
reassured that even though AIDS is a serious disease, it's hard to get.
Most educators believe that specific instruction should begin no later than
grade 7 (the age at which many kids are either starting to experiment with sex
and drugs--or thinking about it). However, unless your state has a mandated
curriculum, the age at which children should learn explicit facts about HIV
infection may vary, depending on your community.
Controversy also centers around the issue of stressing abstinence only--or
the "Just Say No" approach. The CDC thinks that the "Just Say No" approach isn't
enough, especially for those teenagers who, no matter what you say, won't
abstain from drugs or sex. The 1988 Gallup Poll revealed overwhelming support
for schools to teach "safe sex" as a means of preventing HIV transmission
Both the National School Boards Association (NSBA) and the American
Association of School Administrators (AASA) were consulted on the development of
the CDC guidelines for comprehensive K-12 education. Most educators agree that
one-shot programs are acceptable only if there's no other way for students to
get information on HIV infection. As family life educator Clair Scholz puts it:
"Most kids don't get it the first time" (McCormick). She thinks the study of HIV
prevention would be like the study of U.S. history--taught repeatedly and
extending knowledge as students become more sophisticated in their
understanding. McCormick lists questions to ask in selecting and evaluating the
many curricula currently available (as well as pros and cons on developing your
own) and also includes an extensive list of resources, plus information on the
CDC's computerized database.
WHO SHOULD TEACH IT--AND IN WHAT DEPARTMENT?
guidelines recommend using regular classroom teachers at the elementary level.
But with secondary programs most educators, along with the CDC, advocate
integrating HIV education into health education. William Yarber (1987) says that
HIV infection is fundamentally a public health problem, so the most logical
place for it is in the communicable disease unit of a health course: "Such
placement makes sense pedagogically because health educators are prepared in
methods to help students make wise preventive health decisions, which is the
essence of AIDS education." If the program is placed in biology, he fears too
much emphasis will be placed on biomedical aspects, or if in social studies, on
the social/ethical elements. Also, health education teachers are generally more
comfortable dealing with the issues of sexuality and death.
But there are other options. Some school systems use family life specialists,
science teachers, or home economics departments; in other districts classes are
taught by health professionals, such as nurses, physicians, or the Red Cross.
Several states have linked HIV education with teen pregnancy prevention
programs. Finally, the use of peers has been a significant part of HIV programs
in some districts. "Peers are much more effective at altering each other's
behavior than teachers or other adults," says Dr. Mervyn Silverman ("Issue Scan"
WHAT ABOUT TEACHER TRAINING?
Both Katherine E. Keough
(1988) and McCormick recommend educating all staff--with emphasis on inservice
for teachers--before students receive classroom instruction. Staff training
might be accomplished through local or state health departments, local
hospitals, or a health education specialist. Other questions: Should staff be
trained before curriculum decisions are made, or after? Or should they be
provided with general HIV education and then specific training once materials
are chosen? How will up-to-date information be continually provided?
No matter who is trained to teach HIV education, CDC guidelines emphasize
that schools have a responsibility to reach all school-age youth. Groups often
overlooked include special education students, those who don't speak English,
and dropouts or runaways. The latter are usually best reached by working with
local youth-oriented agencies. Finally, schools also need to educate parents and
the whole community so that they reinforce what schools are teaching.
HOW CAN CONTROVERSY BE AVOIDED OR DEALT WITH?
policies beforehand. Don't adopt a "wait and see" approach. There are no
foolproof ways for school boards to avoid controversy, says McCormick, but if
it's anticipated and planned for, controversy can be managed and constructive.
Focus on process. The process of policy development, for instance, can help
resolve disagreements and build consensus and support for HIV education.
Involve the whole community. "Many educators agree that HIV education is more
easily accepted," says McCormick, "when the curriculum, materials and activities
are developed locally, with the community's needs and values in mind." Do
assessments of what your community needs and who's at risk, then work with
parents and other groups, including clergy, to reach consensus.
Educate the public. Many school systems credit well-planned public
information programs with helping to usher in HIV education without incidence.
There are many ways to do this, including community information meetings,
letters to parents about HIV and how HIV fits into the curriculum, working with
grass-roots organizations, and inviting the community to participate on advisory
committees to develop HIV education programs.
Hone your public relations skills. "We think AIDS is the biggest public
relations problem we've ever encountered," says National School Public Relations
Association Executive Director John Wherry (McCormick). McCormick suggests
developing short- and long-range plans for HIV instruction, appointing one
spokesperson to deal with press and public inquiries and letting parents, staff,
and the community know that curriculum materials are available for review.
Give people time to adjust. Just getting people to talk about HIV education
is a first step. You can't reach all the community groups, parents, and teachers
and get the kind of support you need to implement a really successful program
overnight, says Ableson: "We learn day by day what is needed."
Is it worth it? Can HIV education really be effective? A study on school
health education suggest yes (McCormick). Also, comprehensive health education
has been effective in reducing smoking--and several programs report success in
reducing teen pregnancies. As Harvey Fineberg (1988) sums up: "The best we can
do in AIDS education offers no guarantee of success. To do less invites
Fineberg, Harvey V. "Education to Prevent AIDS:
Prospects and Obstacles." SCIENCE 239,4840 (February 5, 1988): 592-96. EJ 366
"Issue Scan." EDCAL (Association of California School Administrators), March
13, 1989. 4 pages.
Keough, Katherine E. "Dealing with AIDS: Breaking the Chain of Infection."
Arlington, Virginia: American Association of School Administrators, 1988. 30
McCormick, Kathleen. "Reducing the Risk: A School Leader's Guide to AIDS
Education." Alexandria, Virginia: National School Boards Association, 1989. 44
"Oversight Hearings on Education on AIDS in Elementary and Secondary
Schools." Congress of U.S., House Committee on Education and Labor, February 3,
1988. 114 pages. ED 295 913.
Schall, Jane, and Mary Harbaugh. "Teaching Children about AIDS." INSTRUCTOR
97,2 (September 1987): 26-28. EJ 361 852.
Strouse, Joan. "Education divided by AIDS = ?" Paper presented at the annual
meeting of the American Educational Research Association, New Orleans,
Louisiana, April 5-9, 1988. 10 pages. ED 292 786.
Tolsma, Dennis, and others. "Guidelines for Effective School Health Education
to Prevent the Spread of AIDS." JOURNAL OF SCHOOL HEALTH 58,4 (April 1988):
142-48. EJ 374 327.
Yarber, William L. "AIDS Education: Curriculum and Health Policy." Fastback
265. Bloomington, Indiana: Phi Delta Kappa Educational Foundation, 1987. 60
pages. ED 288 876.
*Actually the term AIDS (the clinical
stage of the disease) has become obsolete; HIV infection (the state of being
infected with the human immunodeficiency virus) more accurately defines the
problem; thus this term will be used here on.