AIDS-related education:

Are we ready?

WAR AGAINST AIDS: When Acquired Immune Deficiency Syndrome (AIDS) first made headlines in 1980, few could have foreseen the terrible shadow, which the deceptive mnemonic of AIDS is now set to cast over generations to come.

Although the HIV retrovirus is an opportunistic infection with no will or agenda of its own, we talk of the 'war' against AIDS as if it were some otherworldly invader. In truth, the war is with our own very human qualities of ignorance, fear and prejudice.

Although the disease is a global issue, a pandemic as opposed to an epidemic since the fight to control it extends well beyond the borders of any given country or continent, the personal matter of sexual behaviour is critical. In fact, social mores about sexual behaviour are the 'minefields' of this 'war'.

Close to 6 million people are infected with HIV/AIDS in South Asia. More than 90 percent of them live in India. Social factors like widespread poverty and inequality increase the region's vulnerability to the epidemic.

Sri Lanka detected the first AIDS victim in 1987. Gradually this number has increased to around 800. We have been able to maintain a low-prevalent status through the effective control measures undertaken by the Health Ministry, supported by all other relevant sectors including NGOs and UN agencies.

Yet, as the President said in his message for the World AIDS Day, the challenge for the future would be to further maintain the low-prevalent status in the presence of all the ingredients in Sri Lanka to end up in an epidemic, if we do not get together in our prevention efforts.

While all HIV testing and treatment is principally covered by the Government, the primary objective is to negotiate these 'minefields' in order to inform those who are most at risk of infection. The Government has to work closely with non-governmental organisations (NGOs) on education and awareness campaigns.

The prime need in this "war" is for a comprehensive programme of education directed for young people.

This is clear. The topics may cover the teaching of delaying sexual activity, how to say "no" to sexual advances, the correct way to use a condom, the risk of AIDS, how to discuss condom use with a sexual partner, and the importance of not having premarital sex.

But before we venture into a sensitive project of that nature, I believe we should do a study to assess the perceptions of our parent population regarding the appropriate approach of teaching various AIDS-related topics to higher grade students.

We should understand that in a country where religions play an important role in the lives of most of the people, particularly in the rural sector, support for sex education at school can be minimal. In fact, educating young people about becoming infected through sexual contact can even be controversial.

Therefore it is absolutely necessary that school systems should obtain broad community participation to ensure that school health education policies are locally determined and are consistent with each community's social and religious values.

I believe education about AIDS may be most appropriate when carried out within a more comprehensive school health education program that establishes a foundation for understanding the relationships between personal behaviour and health.

For example, education about AIDS may be more effective when students at suitable ages are more knowledgeable about sexually transmitted diseases, drug abuse, and community health. It may also have greater impact when they have opportunities to develop such qualities as decision making and communication skills, resistance to persuasion, and a sense of self-esteem.

Although information about the biology of the AIDS virus, the signs and symptoms of AIDS, and the social and economic costs of the epidemic might be of interest, such information is not the essential knowledge that students must acquire in order to prevent becoming infected with HIV.

Similarly, a single film, lecture, or school assembly about AIDS will not be sufficient to assure that students develop the complex understanding and skills they will need to avoid becoming infected.

At the same time, we should not forget that thousands of children living and/or working on the streets are in danger of being exploited for sex, and there is a clear need for concerned agencies to offer counselling, advice and protection from the hazards of infection.

Above all, these children need to be sheltered from the dangers of life on the street: they need the safety and security of home and a place in society.

While HIV/AIDS is clearly a health problem, the world has come to realize it is also a development problem that threatens human welfare, socio-economic advances, productivity, social cohesion, and even national security. If there is any fight against HIV/AIDS, it is not with the retrovirus.

The real fight is to educate, inform and counsel against the lack of knowledge and discrimination which puts communities and individuals the world over at risk.