Annex 2. School Curricula That Work (1)

We have evidence that school health education aimed at preventing HIV infection can prevent or reduce risk behaviour and promote solidarity among young people. In addition, programmes that have been found to produce significant results are targeted to meet the specific needs of those who will receive the education.

Four rigorously evaluated programmes, targeting adolescents and implemented in the United States or the Netherlands, provide such evidence. An examination of these programmes can provide insight into planning and implementing such programmes in other countries. These programmes are described below. Furthermore, an American programme targeting younger children (kindergarten and primary school) proved to increase knowledge and conceptual understanding of AIDS and to decrease concern about transmission.(2,3)

Programme Example #1 Title: BE PROUD! BE RESPONSIBLE

This programme clearly identified the target group: Hispanic, African American and Caucasian male youth aged 12-19 who attended inner-city schools. The curriculum was designed specifically to address issues and concerns relevant to the target group. The specific issues and concerns addressed included:

1) Knowledge about the virus, transmission and prevention of HIV/AIDS and other STI.

2) Beliefs about personal risk of HIV infection; use of condoms and spermicides to reduce risk of HIV infection; a partner's willingness to accept safer sexual practices; and condoms as a means of enhancing sexual enjoyment.

3) Negotiation, refusal and condom-use skills to reduce risky behaviours.

4) Self-efficacy and confidence in using the skills taught.

The results for students who participated in this programme included:

- engaging in less risky behaviour

- reporting having sexual intercourse on fewer occasions

- using condoms more consistently when engaging in sexual intercourse

- a decrease in the number of individuals in the target group who were engaging in anal intercourse

Programme Example #2 Title: REDUCING THE RISK

The target group for this programme were first- and second-year secondary school students. The curriculum was age specific in addressing issues and concerns of the target group. The specific issues and concerns addressed included:

1) Perception of vulnerability to HIV infection.

2) Knowledge of HIV, how it is and is not transmitted, the effects of HIV.

3) Discussion of myths and facts about HIV and other STI; testing for the presence of HIV antibodies; use of condoms.

4) Skills to avoid risk situations.

5) Norms related to sexuality and AIDS.

The results for students who participated in this programme included:

- being more likely to delay initiation of intercourse
- reporting use of contraception more often
- being more likely to talk to their parents about abstinence and contraception

Programme Example #3 Title: BECOMING A RESPONSIBLE TEEN

This programme involved a target group of primarily African-American adolescents between 14 and 18 years of age. The curriculum addressed issues and concerns of this group and included:

1) Information about HIV and AIDS.
2) Sexual pressures as they affect adolescents.
3) Condom use skills.
4) Assertiveness and communication skills.
5) Transforming the understanding of a risk into a personal concern about risk.
6) Making decisions about sexuality or drugs.
7) Educating peer and family members about HIV/AIDS

The results for students who participated in this programme included:

- being more likely to delay initiation of intercourse
- being more likely to use condoms
- being less likely to engage in unprotected vaginal or anal intercourse

Programme Example #4 Title: LONG LIVE LOVE

This Dutch curriculum targeted students in years two and three of schools for lower secondary education. It presents education about HIV/AIDS and other STI in the framework of education about sexuality and relationships. The specific issues and concerns addressed included:

1) Expectations and problems with regard to relationships, making contact, falling in love, making love, homosexuality.

2) Knowledge of HIV, how it is and is not transmitted, the difference between HIV and AIDS.

3) Knowledge of other STI and how they are transmitted.

4) Perception of vulnerability to infection with HIV and other STI.

5) Discussion of beliefs, norms and values pertaining to HIV and safer sexual practices.

6) Communication (negotiation, assertiveness) and condom-use skills.

The results for students who participated in this programme included:

- high-risk students engaging in less risky behaviour
- favourable changes in knowledge, beliefs, self-efficacy and intentions(4)

1. Centers for Disease Control, (1992). Programs That Work. CDC, Atlanta.

2. Schonfeld, D. & Quackenbush, M. (1996a). Teaching kids about... how AIDS works. A curriculum for grades K-3. Santa Cruz, CA: ETR Associates.

3. Schonfeld, D. & Quackenbush, M. (1996b). Teaching kids about... how AIDS works. A curriculum for grades 4-6. Santa Cruz, CA: ETR Associates.

4. Schaalma, H.P., Kok, G., Bosker, R.J., Parcel, G.S., Peters, L., Poelman, J., & Reinders, J. (1996). Planned development and evaluation of AIDS/STD education for secondary school students in the Netherlands: short-term effects. Health Education Quarterly, 23, 469-487.