|WHO Information Series on School Health - Document 6 - Preventing HIV/AIDS/STI and Related Discrimination: An Important Responsibility of Health-Promoting Schools (UNAIDS - UNESCO - WHO, 1999, 59 p.)|
Young people (10 to 24 years) are estimated to account for up to 60% of all new HIV infections worldwide. Many young people can be reached relatively easily through schools; no other institutional system can compete in terms of number of young people served. Prevention and health promotion programmes should extend to the whole school setting, including students, teachers and other school personnel, parents, the community around the school, as well as school systems. Such activities are a key component of national programmes to improve the health and development of children and adolescents.
2. HIV/STI Prevention and Health Promotion
HIV/STI-related programmes provide an opportunity to strengthen and accelerate existing health promotion activities in schools. Education to prevent HIV/STI should be integrated into education about reproductive health, life skills, alcohol/substance use, and other important health issues; included in other subject areas as appropriate and established by official policies; enhanced by school practices that foster self-esteem, caring, respect, decision-making, self-efficacy, and conditions that allow for the healthy development of students and staff. This is done, inter alia, through materials development, teacher training, supervision, and the participation of parents and communities.
Developing and monitoring a range of policies will be essential for effective programmes. This includes policies on: human rights (right to education, to non-discrimination, to confidentiality, to protection of employment, to protection from exploitation and abuse); access to school by students and school workers living with HIV/AIDS; pre- and in-service teacher training; community/parent participation; content of curricula and extra-curricular activities, and link with health services capable of providing diagnosis and treatment of STI for young people as well as the means of protection against unwanted pregnancy and HIV/STI, including contraceptives and condoms. Policies are developed at different levels, according to the degree of centralization of the school system.
4. Learning How to Cope
For young people to develop healthy and responsible behaviour patterns, and avoid infection, it is not sufficient to lean the biomedical aspects of sexual and reproductive health. Equally important is learning now to cope with the increasingly complex demands of relationships, particularly gender relations and conflict resolution; how to develop safe practices, and how to relate with the increasing number of people living with HIV and AIDS.
Prevention and health promotion programmes should begin at the earliest possible age, and certainly before the onset of sexual activity. They should reach students before most of them leave or drop out of school, particularly in countries where girls tend to leave at a younger age. This means that age-appropriate programmes should start at primary school level.
6. Life Skills
A life skills approach is important in such programmes. Skills that enable young people to manage situations of risk for HIV/STI are also essential for the prevention of many other health problems. Such skills include how to respond adequately to demands for sexual intercourse/offers of drugs; how to take responsible decisions about difficult options; how to apply risk reduction techniques; how to refuse unprotected sex when sexually active, and how to seek appropriate support and care, including health services and counselling.
7. Response of School Systems
Although prevention education through school settings is recognized by almost all countries as necessary, significant institutional, political, religious and cultural barriers to its implementation will need to be resolved. In each country, the school system as a whole must respond to HIV/STI and AIDS, in close collaboration with the Ministries of Education, Health, Youth and other government sectors, teachers' associations and other NGOs and the wider community.
8. UNAIDS Action
UNAIDS will (i) facilitate the strengthening of national capacity to develop, implement, monitor and evaluate programmes that integrate HIV/STI prevention, health promotion and non-discrimination into school policies, curricula as well as extra curricular activities, and training; and (ii) identify effective and innovative policies, strategies and action in this area.
9. Goals By the Year 2000
By the year 2000, UNAIDS will aim to:
· increase significantly the number of countries which have developed detailed policies and implemented programmes for non-discrimination and HIV/STI prevention in the school setting; and
· increase towards full coverage the percentage of young people attending school, who learn how to avoid discrimination and reduce the risk of infection.
1. UNAIDS (1997). Integrating HIV/STD prevention in the
school setting: a position paper. Joint United Nations Programme on