skip to main |
skip to sidebar
Cambodia is one of other poorest countries. there are lot of poor people especially original Khmer living at the country side or remote area. lost of good security and lack of food and developing. Raping between fathers and their daughters is at remote area or in the town too. However, there are also some organization to observe this problem right now Like A federal jury has convicted a retired US Marine captain of travelling to Cambodia to have sex with underage girls after hearing testimony from his victims.
Michael Joseph Pepe, 54, of Oxnard, California faces up to 210 years in prison for the guilty verdicts on seven felony counts, the US Attorney's office in Los Angeles said in a statement on Thursday.
During the trial, six girls testified that Pepe drugged, bound, beat and raped them and a prostitute told the court on videotape about bringing him young victims, federal prosecutors said.
A total of seven girls, ages 9 to 12 at the time, were sexually abused by the former Marine captain, the statement said.
Prosecutors also provided evidence seized by Cambodian authorities including rope and cloth strips used to restrain the victims, sedatives and homemade child pornography.
"This case represented one of the most egregious examples of international sex tourism we have ever investigated and the jury's verdict is a reminder that pedophiles who attempt to evade detection and prosecution by committing sex crimes overseas face serious consequences," said Robert Schoch, special agent of the US Immigration and Customs Enforcement office of investigations in Los Angeles.
Pepe was prosecuted under a federal law adopted five years ago, the Protect Act, that bolstered penalties against predatory crimes involving children outside the United States.
The investigation was a joint effort by the Cambodian National Police, US Immigration and Customs Enforcement, the Federal Bureau of Investigation and the State Department's Diplomatic Security Service....ok if any one have more about this please share your comment bellow
Cambodia is one of other poorest countries. there are lot of poor people especially original Khmer living at the country side or remote area. lost of good security and lack of food and developing. Raping between fathers and their daughters is at remote area or in the town too. However, there are also some organization to observe this problem right now Like A federal jury has convicted a retired US Marine captain of travelling to Cambodia to have sex with underage girls after hearing testimony from his victims.
Michael Joseph Pepe, 54, of Oxnard, California faces up to 210 years in prison for the guilty verdicts on seven felony counts, the US Attorney's office in Los Angeles said in a statement on Thursday.
During the trial, six girls testified that Pepe drugged, bound, beat and raped them and a prostitute told the court on videotape about bringing him young victims, federal prosecutors said.
A total of seven girls, ages 9 to 12 at the time, were sexually abused by the former Marine captain, the statement said.
Prosecutors also provided evidence seized by Cambodian authorities including rope and cloth strips used to restrain the victims, sedatives and homemade child pornography.
"This case represented one of the most egregious examples of international sex tourism we have ever investigated and the jury's verdict is a reminder that pedophiles who attempt to evade detection and prosecution by committing sex crimes overseas face serious consequences," said Robert Schoch, special agent of the US Immigration and Customs Enforcement office of investigations in Los Angeles.
Pepe was prosecuted under a federal law adopted five years ago, the Protect Act, that bolstered penalties against predatory crimes involving children outside the United States.
The investigation was a joint effort by the Cambodian National Police, US Immigration and Customs Enforcement, the Federal Bureau of Investigation and the State Department's Diplomatic Security Service....ok if any one have more about this please share your comment bellow
Wow, talking about sex, every one need it, even though Ta Jas ( old men) think of it and always think of SRey Kmeng (young girls). we, all men should care about our wife I mean if you like sex if you get married with any one who are older than you, you will be dis pointed with having sex. as you know clearly about girls and women, she will be desire less of having sex when she gets weak during her Ror.Doe get low, so she will be lazy of having sex any more. Ok for now if you have more idea about this please leave the comments here
Wow, talking about sex, every one need it, even though Ta Jas ( old men) think of it and always think of SRey Kmeng (young girls). we, all men should care about our wife I mean if you like sex if you get married with any one who are older than you, you will be dis pointed with having sex. as you know clearly about girls and women, she will be desire less of having sex when she gets weak during her Ror.Doe get low, so she will be lazy of having sex any more. Ok for now if you have more idea about this please leave the comments here
Cambodia
The first case of HIV/AIDS in Cambodia was officially identified in 1991 through screening of blood donors, although HIV had been detected in Cambodian refugees in Thailand two years earlier. Sex workers and men seeking treatment for sexually transmitted infections were among the first groups to report high levels of HIV infection. Today, with an adult prevalence rate of 2.7 percent, Cambodia, one of the region’s poorest countries, has the highest infection rate in Asia, with an estimated 170,000 persons living with HIV/AIDS in 2001. Under the President's Emergency Plan for AIDS Relief, Cambodia received more than $16.8 million in Fiscal Year (FY) 2004, approximately $17.4 million in FY 2005, approximately $19.3 million in FY 2006, and is providing $19 million in FY 2007 to support an integrated HIV/AIDS prevention, treatment and care program. 2008 Country Profile: Cambodia
National HIV prevalence rate among adults (ages 15 to 49): 0.8 percent1
Adults and children (ages 0-49) living with HIV at the end of 2007: 75,0001
AIDS deaths (adults and children) in 2007: 6,9001
AIDS orphans at the end of 2007: not available1
Under PEPFAR, Cambodia received more than $16.8 million in Fiscal Year (FY) 2004, approximately $17.4 million in FY 2005, approximately $19.3 million in FY 2006, and $19 million in FY 2007 to support an integrated HIV/AIDS prevention, treatment and care program. PEPFAR is providing nearly $17.9 million in FY 2008.
Recognizing the global HIV/AIDS pandemic as one of the greatest health challenges of our time, President George W. Bush announced the President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003 — the largest international health initiative in history by one nation to address a single disease. The United States is changing the paradigm for development, rejecting the flawed “donor-recipient” mentality and replacing it with an ethic of true partnership. These partnerships are having a global impact and transforming the face of our world today.
Partnership to Fight HIV/AIDS
The Royal Government of Cambodia has committed significant resources to fighting HIV/AIDS. Through PEPFAR, the U.S. Government (USG) and its partners are working in partnership with the Royal Government of Cambodia to implement Cambodia’s National Strategic Plan for HIV. Close cooperation between partner governments; non-governmental, community-based and faith-based organizations; and people living with HIV/AIDS are essential in building effective and sustainable HIV prevention, treatment and care services. Given the limited health care resources and capacity in many communities, PEPFAR is committed to building integrated HIV/AIDS prevention, treatment and care services that maximize the effectiveness of available services.
PEPFAR Results in Cambodia
# of individuals receiving antiretroviral treatment in fiscal year 2007 5,700
# of pregnant women receiving prevention of mother-to-child HIV transmission (PMTCT) services in fiscal year 2007 31,200
# of pregnant women receiving antiretroviral prophylaxis for PMTCT in fiscal year 2007 170
# of counseling and testing encounters (in settings other than PMTCT) in fiscal year 2007 108,100
Note: All USG bilateral HIV/AIDS programs are developed and implemented within the context of multi-sectoral national HIV/AIDS strategies, under the host country’s national authority. Programming is designed to reflect the comparative advantage of the USG within the national strategy, and it also leverages other resources, including both other international partner and private-sector resources. The numbers reported reflect USG programs that provide direct support at the point of service delivery. Individuals receiving services as a result of the USG’s contribution to systems strengthening beyond those counted as receiving direct USG support are not included in this total. Numbers may be adjusted as attribution criteria and reporting systems are refined. Numbers above 100 are rounded to nearest 100.
HIV/AIDS in Cambodia
HIV prevalence in Cambodia is among the highest in Asia. Although Cambodia is one of the poorest countries in the world, extraordinary HIV prevention and control efforts exerted by the Royal Government of Cambodia and its partners have helped to reduce the spread of HIV.2 Cambodia’s HIV/AIDS epidemic is spread primarily through heterosexual transmission and revolves largely around the sex trade. HIV transmission occurs mainly in sexual partnerships where one partner has engaged in high-risk behaviors.3 This increased proportion of infections among women may reflect declining prevalence rates among males, as well as deaths among males infected in the early years of Cambodia’s epidemic. Significantly, a low prevalence rate in the general population masks far higher prevalence rates in certain sub-populations, such as injecting drug users, people in prostitution, men who have sex with men, karaoke hostesses and beer girls, and mobile and migrant populations.
1 UNAIDS, Report on the Global AIDS Epidemic, 2008.
2 Vonthanak Saphonn, MD, PhD, et al. “Trends of HIV-1 Seroincidence Among HIV-1 Sentinel Surveillance Groups in Cambodia, 1999-2002.” Journal of Acquired Immune Deficiency Syndromes. 39(5), August 15, 2005: pp. 587-592.
3 Elizabeth Pisani, et al. “Back to Basics in HIV Prevention: Focus on Exposure,” British Medical Journal. 326(21), June 2003: pp. 1384 -1387.
Cambodia Logo PEPFAR Achievements in Cambodia to Date
Challenges to PEPFAR Implementation
Cambodia is a post-conflict country, making scaling up activities a significant challenge. Major constraints to the implementation of HIV/AIDS activities include:
* High levels of high-risk sexual and substance use behaviors;
* Poverty, which drives prostitution, survival sex, and corruption;
* Barriers limiting access to prevention, treatment and care services, including distance to service locations, limited financial resources, a lack of transportation and infrastructure, and geographic barriers;
* Low salaries in the public health care sector; and
* Limited skills and capacity of health care providers.
Reducing Stigma and Discrimination against People Living with HIV/AIDS
With support from PEPFAR, Pact Cambodia, an indigenous non-governmental organization, and the Cambodia People Living with HIV/AIDS Network are implementing the Community Response to Reducing HIV/AIDS Stigma and Discrimination Project. The project uses community fora to educate community members about HIV/AIDS. Lorn Khoeun, an HIV-positive 35-year-old from Tanuk village, witnessed the positive impact of the PEPFAR-supported community forum in her village. After losing her husband to an HIV/AIDS-related illness three years ago, Lorn Khoeun and her daughter faced stigma and discrimination from members of the community as a result of Lorn Khoeun’s HIV-positive status. Neighbors were afraid to buy watermelons or food from Lorn Khoeun, and her food selling business suffered as a result. Lorn Khoeun and fellow community members attended the community forum in her village where they discussed HIV/AIDS awareness; stigma and discrimination; HIV/AIDS law; and raising and mobilizing support for people living with HIV/AIDS from communities, local authorities, health care providers and opinion leaders. Since the forum, community members have altered their behavior and are more supportive of people living with HIV/AIDS. They are also friendlier towards Lorn Khoeun, buying her food and products, visiting her house, playing with her children, and eating together with her. Now, she can continue her business and support her daughter.
Lorn Khoeun’s food selling business is supported by community members.
Lorn Khoeun’s food selling business is supported by
community members.
Phally lives positively and teaches others to do the same.
Phally lives positively and teaches others to do
the same. Phally: The Story of a Courageous Woman
When the home-based care team first visited Phally in December 1999, she was depressed and sick with an HIV-related illness. At that time, there were minimal HIV/AIDS services available in her area, and a referral system linking patients to other available services was non-existent. Support from PEPFAR helped to establish a continuum of care for people living with HIV/AIDS in Phally’s home district. Phally never gave up her desire to make a positive difference in the lives of people living with HIV/AIDS. The involvement of Phally and other people living with HIV/AIDS in the continuum of care is central to the process of integrating and improving the quality of HIV/AIDS care, treatment and support services. Phally is now a skilled and active peer-educator and counselor, who serves as a positive role model for her peers. Her friendly, lively personality inspires all who meet her. “I’m a member of the care and treatment team at Moung Russey Referral Hospital,” Phally said. “I facilitate the ‘Friends Help Friends’ monthly support group meetings at the hospital. I also conduct counseling sessions with people living with HIV/AIDS, to prepare them for beginning antiretrovirals. An important part of my job is to visit people living with HIV/AIDS and their families while they are hospitalized, to provide moral support and information about HIV/AIDS and self care.”
Buddhist Monks Provide HIV/AIDS Care
With support from PEPFAR, Buddhism for Development is helping to bridge the gap between the religious and secular communities in Cambodia. Buddhism for Development provides home-based care to people living with HIV/AIDS and services to children who have lost parents to HIV/AIDS. The group operates a six-week “Peace Development School,” at which monks learn to provide HIV/AIDS-related health care and study vocational training and agricultural extension methods. Of the monks who have gone through the Peace Development School, many returned to their home villages and established HIV/AIDS associations that provide HIV-prevention services and home-based care. These monks also established centers at pagodas, providing direct care and support for orphans and vulnerable children, and working to find ways to keep these children in school.
Overview of AIDS and HIV in Asia
In the early to mid-1980s, while other parts of the world were beginning to deal with serious HIV & AIDS epidemics, Asia remained relatively unaffected by this newly discovered health problem. By the early 1990s, however, AIDS epidemics had emerged in several Asian countries, and by the end of that decade, HIV was spreading rapidly in many areas of the continent.
Today, HIV/AIDS is a growing problem in every region of Asia. East Asia has been identified by UNAIDS as one of the areas of the world where ‘the most striking increases’ in the numbers of people living with HIV have occurred in recent years (along with Eastern Europe and Central Asia).1 Although national HIV prevalence rates in Asia appear to be relatively low (particularly in comparison with sub-Saharan Africa), the populations of some Asian countries are so vast that these low percentages actually represent very large numbers of people living with HIV. The latest statistics compiled by UNAIDS suggest that at the end of 2007, 5 million people were living with HIV in Asia.2
Various factors make Asia vulnerable to the spread of HIV, including poverty, inequality, unequal status of women, stigma, cultural myths about sex and high levels of migration.3 4 Some experts predict that Asia may eventually overtake Africa as the part of the world with the highest number of HIV-infected people. Others, however, argue that Asia’s epidemics are on a different trajectory to those found in Africa, as HIV infection in Asia is still largely occurring among members of ‘high-risk groups’, unlike Africa where HIV and AIDS are widespread amongst all sections of some countries’ populations.5
Although its useful to understand the overall impact that AIDS is having on the Asian region as a whole, there is no single ‘Asian epidemic’; each country in the region faces a different situation.
“It’s very difficult to speak about ‘the Asian epidemic’. Whatever we come up with, we always find a big exception in Asia.”
Peter Piot, head of UNAIDS 6
Asian countries are experiencing different trends. HIV infection rates are growing in parts of India, but have stabilised or declined in other parts of the country. In Cambodia, Myanmar and Thailand, there has been evidence of declines in HIV infection levels. In Indonesia, Pakistan and Vietnam, meanwhile, the number of people living with HIV has rapidly increased. In Vietnam, this number more than doubled between 2000 and 2005, and HIV has now been detected in every province and city in the country. It is feared that the the speed and severity of the growing HIV epidemic in Pakistan, is outpacing the response. The number of people newly infected with HIV is also rising in China and Bangladesh, although at a much slower pace.7
How HIV is transmitted in Asia
* When HIV is transmitted through unprotected sex in Asia, it’s often during paid sex. More people in Asia engage in sex work (either as a client or a worker), than any other type of behaviour that can carry a high risk of HIV infection.8 High levels of HIV infection have been documented among sex workers and their clients in parts of India, and this situation is mirrored in other Asian countries; in South and South East Asian countries outside India, it’s thought that sex workers and their clients accounted for almost half of people living with HIV in 2005.9
* Injecting drug use is a major driving factor in the spread of HIV throughout Asia, notably in China, Indonesia, Malaysia and Vietnam. In China, nearly half of all people infected with HIV are believed to have become infected through injecting drug use, and in North-East India injecting drug use is the most common HIV transmission route.10 There is often an overlap between communities of IDUs and communities of sex workers in Asia, as those who sell sex may do it to fund a drug habit, or they may have become involved in sex work first before turning to drug use.11
* Sex between men accounted for some of the earliest recorded cases of HIV in Asia, and transmission through this route is still a prominent feature of many countries’ epidemics. Most men who have sex with men (MSM) in Asia do not identify themselves as gay because of cultural norms that discourage homosexuality; in some cases they may even be heads of families, with children.12 This means that MSM can serve as a ‘bridge’ for HIV to spread into the broader population. HIV outbreaks are becoming evident among MSM in Cambodia, China, Nepal, Pakistan, Thailand and Vietnam.13
* Mother-to-child transmission is also a significant HIV transmission route in Asia. At the end of 2007, it was estimated that 140,000 children in South and South-East Asia, and 7,800 children in East Asia, were living with HIV, most of whom became infected through mother-to-child transmission.14
HIV prevention in Asia
HIV prevention sign, Ho Chi Minh City, Vietnam
HIV prevention sign in Ho Chi Minh City, Vietnam
Asia has been the base for some extremely successful large-scale HIV prevention programmes. Well-funded, politically supported campaigns in Thailand and Cambodia have led to significant declines in HIV-infection levels, and HIV prevention aimed at sex workers and their clients has played a large role in these achievements. The Indian state of Tamil Nadu is another area where HIV prevention has had a substantial impact. Here high-profile public campaigns discouraged risky sexual behaviour, made condoms more widely available, and provided STI testing and treatment for people who needed them. These efforts resulted in a large decline in risky sex.15
Successes such as these prove that interventions can change the course of Asia's AIDS epidemics. As HIV infection rates continue to grow however, it's clear that more needs to be done. The groups most at risk of becoming infected – sex workers, IDUs, and MSM – are all too often being neglected. For instance, although injecting drug use is one of the most common HIV transmission routes in Asia, it is estimated that less than one in ten IDUs in the region have access to prevention services.16 Similarly men who have sex with men are overlooked and poorly monitored by most governments, even though it is firmly established that this group play a significant role in some countries’ epidemics.17
The coverage of prevention of mother-to-child transmission (PMTCT) services is also very low in Asia. In South-East Asia, less than 5% of pregnant women are offered HIV counselling and testing.18 Across East, South and South-East Asia, the proportion of HIV-infected pregnant women receiving ARVs is just 5%.19
See our HIV prevention around the world page for more about efforts to stem the spread of HIV in Asia and other parts of the world.
AIDS treatment in Asia
The availability of AIDS treatment has more than tripled in Asia since 2004. At the end of 2007 an estimated 420,000 people in the region were receiving antiretroviral drugs (ARVs). Although this rise is encouraging, access to treatment varies widely across the region. Overall it is estimated that three quarters of people in need of ARVs in Asia still have no access to them.20
HIV Positive man and antiretroviral medicines
HIV positive man sitting at home
before taking his antiretroviral medicines
A major constraint is the high cost of ARVs, as both first- and second-line drugs are still unaffordable to most governments. Cheaper generic drugs are now produced by a number of pharmaceutical manufacturers in Asia, and together with the increasing availability of lower-cost branded ARVs, it’s hoped that this will make it easier for governments to obtain and distribute the drugs. Yet even where drugs are available, the poor state of healthcare in many Asian countries, particularly a shortage of trained doctors, is hindering governments' abilities to organise life-long treatment programmes for millions of people living with HIV.21
For the latest statistics for treatment provision in individual countries in Asia, see our AIDS treatment targets page.
Country profiles - South East Asia
Cambodia
Cambodia’s HIV epidemic can be traced back to 1991. After an initial rapid increase, HIV infection levels declined after the late 1990s, and have reached a steady level in recent years. It’s believed that interventions with sex workers, carried out by the government and non-governmental organisations (NGOs), played a role in this decline; the adoption of a ‘100% condom’ policy that enforced condom use in brothels led to a substantial rise in condom use among sex workers and their clients, and a drop in HIV infection levels among brothel-based sex workers. Despite these achievements, Cambodia still has the second highest HIV prevalence rate in Asia, with 0.8% of the adult population infected. Ongoing concerns include low levels of condom use among MSM, an increase in sex work occurring outside of brothels (making it harder to reach sex workers with interventions), and mother-to-child transmission of HIV – around one third of new infections occur through this route. HIV is mostly transmitted through heterosexual sex in Cambodia, and almost half of those infected are women.22 23
Indonesia
High levels of HIV infection are found amongst IDUs in Indonesia, and also among sex workers and their clients. Around 270,000 people in Indonesia are living with HIV, this number has risen sharply in recent years due to several factors: the country’s extensive sex industry; limited testing and treatment clinics and laboratories for sexually transmitted infections (STIs); a highly mobile population; a rapidly growing population of people who inject drugs; and the challenges created by major economic and natural crises that Indonesia has experienced (the Asian financial crisis heavily affected the country in 1997, and the 2004 Tsunami devastated parts of Northern Sumatra, the largest island in Indonesia).24
Lao People's Democratic Republic (Laos)
Despite being surrounded by countries that have relatively high HIV infection levels (Thailand, China, Vietnam, Cambodia and Myanmar), Laos has a comparatively small HIV problem. There are various reasons for this: the government was quick to acknowledge AIDS when it first emerged in the country, and took action to warn people about it; Laos has not seen the same level of large-scale migration that has occurred in other parts of Asia; there are relatively high rates of condom use among sex workers and their clients; and it’s thought that very few people in the country inject drugs.25 26
Malaysia
Malaysia’s HIV epidemic is largely driven by injecting drug use. Other than IDUs, HIV is spreading quickly amongst women, fishermen, lorry drivers and factory workers. A senior health official in Malaysia has warned that the number of people living with HIV in the country – currently around 80,000 – could rise to 300,000 by 2015 if nothing is done. The government launched a five-year strategic plan to tackle HIV in 2006, which includes drug substitution therapy and needle exchange programmes for drug users.27
Myanmar (Burma)
After first appearing in the mid-to-late 1980s, HIV became increasingly common in Myanmar. Today, with an estimated 0.7% of the adult population infected, the country faces a serious epidemic. Myanmar’s authoritarian military regime is widely condemned for its human rights abuses, and in 2005 these concerns led the Global Fund to Fight HIV, TB and Malaria to withdraw it’s proposed $98.4 million grants for the country.
The Philippines
The Philippines has a very low HIV prevalence, with well under 0.1% of the population infected. Even in groups such as sex workers and MSM that are typically associated with higher levels of HIV, prevalence rates above 1% have not yet been detected – in the case of sex workers, this is possibly due to efforts to screen and treat those selling sex since the early 1990s. There are reasons to believe that this situation may not last, however. Condom use is not the norm in paid sex, drug users commonly share injecting equipment in some areas, and among Filipino youth, there is evidence of complacency about AIDS.
Singapore
Although the number of people living with HIV in Singapore is relatively small, the country’s status as an international travel and business hub, along with the high number of infections found in surrounding countries, make it possible that the country will experience a more serious epidemic in the future. In 2006 a record 357 people in Singapore were newly diagnosed with HIV. To combat these rising figures, the government has chosen to focus on preventing mother-to-child transmission, but controversially, has rejected widespread condom promotion.28 Another controversial policy in Singapore is the strict law banning sex between men, which campaigners argue undermines efforts to promote safe sex among MSM.29
Thailand
Thailand is an example of a country where a strong national commitment to fighting AIDS has paid off, with widespread access to treatment and an admirable history of HIV prevention efforts. However, some of these past prevention successes are starting to be undermined by a current lack of HIV prevention, rising STI rates, and a growing number of MSM becoming infected with HIV.
Vietnam
Around 40,000 people are becoming infected with HIV each year in Vietnam, mostly through injecting drug use or paid sex. The number of people living with HIV in Vietnam doubled between 2000 and 2005, and this rise included a large increase in the number of people who became infected through injecting drug use. Levels of HIV among injecting drug users reached as high as 63% in Hanoi, and 67% in Hai Phong, in 2005.
See our South East Asian statistics page for more data on this region.
East Asia
China
China is seen as a major source of concern by many AIDS experts, because of the large size of its population and the existence of social, economic and cultural factors that make it easy for HIV to spread. At the moment 700,000 people in China are living with HIV (0.1% of the adult population), but it’s feared that this number will increase dramatically in future years, as HIV spreads from the groups most at risk – injecting drug users and those who buy or sell sex – to the general population.30 31
Japan
In 2007, around 9,600 adults and children were living with HIV in Japan.32 Data released by the Japanese government in February 2007 showed that annual numbers of new HIV infections and AIDS cases has risen to an all time high in 2006, to 914 and 390 people respectively.33 The most prominent rise occurred among MSM, who it’s previously been documented account for at least 60% of annually reported HIV infections in Japan.34
South Asia
Afghanistan
There have only been a small number of cases of HIV in Afghanistan, in contrast to the relatively large numbers recorded in the neighbouring nations of Pakistan and Iran. Nonetheless HIV and AIDS are growing problems. Conditions are in place for an epidemic to develop, including high numbers of displaced people, high levels of illiteracy, low social status for women, and a shortage of health facilities. Afghanistan is one of the world’s leading producers of opium, and the availability of drugs could lead to increased levels of injecting drug use.35 A 2006 study found that around one third of IDUs in the capital city of Kabul had shared contaminated injecting equipment, and that 4% were infected with HIV.36
Bangladesh
The first HIV/AIDS case in Bangladesh was reported in 1989. Since 1994, HIV infection levels have increased, although the problem is still relatively small scale, with around 12,000 adults – 0.2% of the total population – infected. It's nonetheless predicted that Bangladesh may gradually be heading towards an epidemic, unless a greater response is developed. At the moment HIV is mainly confined to groups such as IDUs, migrant workers and MSM, and it's reported that this focus on risk groups has led to a lack of urgency among policy makers in dealing with the problem.37
India
India is experiencing a diverse HIV epidemic that affects states in different ways, and to different extents. The groups most affected include injecting drug users, sex workers, truck drivers, migrant workers, and men who have sex with men. Some have predicted that India will soon be experiencing a ‘generalised’ epidemic, where the HIV prevalence rate – currently 0.3% in India – rises above 1%. Others have played down current estimates of the numbers infected, and have argued that, because HIV transmission in India still largely occurs among risk groups, its unlikely that HIV will spread widely among the general population.38 Regardless of the future path of India’s epidemic, it’s undeniable that AIDS is having a devastating impact, and that there are still many major issues – including stigma and poor availability of AIDS treatment – that urgently need to be addressed.
Pakistan
Pakistan’s first reported case of HIV occurred in 1987. Until the late 1990s, most subsequent cases occurred in men who had become infected while living or working abroad. After 1999, HIV and AIDS cases began to be recorded among Pakistani sex workers, IDUs, and prisoners.39 Despite a low overall HIV prevalence (0.1%), social and economic conditions in Pakistan – including poverty, low levels of education, and high levels of risk behaviour among IDUs and sex workers – are likely to facilitate the spread of HIV in coming years.40
Preference From… http://www.pepfar.gov/pepfar/press/81877.htm. http://www.avert.org/
Cambodia
The first case of HIV/AIDS in Cambodia was officially identified in 1991 through screening of blood donors, although HIV had been detected in Cambodian refugees in Thailand two years earlier. Sex workers and men seeking treatment for sexually transmitted infections were among the first groups to report high levels of HIV infection. Today, with an adult prevalence rate of 2.7 percent, Cambodia, one of the region’s poorest countries, has the highest infection rate in Asia, with an estimated 170,000 persons living with HIV/AIDS in 2001. Under the President's Emergency Plan for AIDS Relief, Cambodia received more than $16.8 million in Fiscal Year (FY) 2004, approximately $17.4 million in FY 2005, approximately $19.3 million in FY 2006, and is providing $19 million in FY 2007 to support an integrated HIV/AIDS prevention, treatment and care program. 2008 Country Profile: Cambodia
National HIV prevalence rate among adults (ages 15 to 49): 0.8 percent1
Adults and children (ages 0-49) living with HIV at the end of 2007: 75,0001
AIDS deaths (adults and children) in 2007: 6,9001
AIDS orphans at the end of 2007: not available1
Under PEPFAR, Cambodia received more than $16.8 million in Fiscal Year (FY) 2004, approximately $17.4 million in FY 2005, approximately $19.3 million in FY 2006, and $19 million in FY 2007 to support an integrated HIV/AIDS prevention, treatment and care program. PEPFAR is providing nearly $17.9 million in FY 2008.
Recognizing the global HIV/AIDS pandemic as one of the greatest health challenges of our time, President George W. Bush announced the President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003 — the largest international health initiative in history by one nation to address a single disease. The United States is changing the paradigm for development, rejecting the flawed “donor-recipient” mentality and replacing it with an ethic of true partnership. These partnerships are having a global impact and transforming the face of our world today.
Partnership to Fight HIV/AIDS
The Royal Government of Cambodia has committed significant resources to fighting HIV/AIDS. Through PEPFAR, the U.S. Government (USG) and its partners are working in partnership with the Royal Government of Cambodia to implement Cambodia’s National Strategic Plan for HIV. Close cooperation between partner governments; non-governmental, community-based and faith-based organizations; and people living with HIV/AIDS are essential in building effective and sustainable HIV prevention, treatment and care services. Given the limited health care resources and capacity in many communities, PEPFAR is committed to building integrated HIV/AIDS prevention, treatment and care services that maximize the effectiveness of available services.
PEPFAR Results in Cambodia
# of individuals receiving antiretroviral treatment in fiscal year 2007 5,700
# of pregnant women receiving prevention of mother-to-child HIV transmission (PMTCT) services in fiscal year 2007 31,200
# of pregnant women receiving antiretroviral prophylaxis for PMTCT in fiscal year 2007 170
# of counseling and testing encounters (in settings other than PMTCT) in fiscal year 2007 108,100
Note: All USG bilateral HIV/AIDS programs are developed and implemented within the context of multi-sectoral national HIV/AIDS strategies, under the host country’s national authority. Programming is designed to reflect the comparative advantage of the USG within the national strategy, and it also leverages other resources, including both other international partner and private-sector resources. The numbers reported reflect USG programs that provide direct support at the point of service delivery. Individuals receiving services as a result of the USG’s contribution to systems strengthening beyond those counted as receiving direct USG support are not included in this total. Numbers may be adjusted as attribution criteria and reporting systems are refined. Numbers above 100 are rounded to nearest 100.
HIV/AIDS in Cambodia
HIV prevalence in Cambodia is among the highest in Asia. Although Cambodia is one of the poorest countries in the world, extraordinary HIV prevention and control efforts exerted by the Royal Government of Cambodia and its partners have helped to reduce the spread of HIV.2 Cambodia’s HIV/AIDS epidemic is spread primarily through heterosexual transmission and revolves largely around the sex trade. HIV transmission occurs mainly in sexual partnerships where one partner has engaged in high-risk behaviors.3 This increased proportion of infections among women may reflect declining prevalence rates among males, as well as deaths among males infected in the early years of Cambodia’s epidemic. Significantly, a low prevalence rate in the general population masks far higher prevalence rates in certain sub-populations, such as injecting drug users, people in prostitution, men who have sex with men, karaoke hostesses and beer girls, and mobile and migrant populations.
1 UNAIDS, Report on the Global AIDS Epidemic, 2008.
2 Vonthanak Saphonn, MD, PhD, et al. “Trends of HIV-1 Seroincidence Among HIV-1 Sentinel Surveillance Groups in Cambodia, 1999-2002.” Journal of Acquired Immune Deficiency Syndromes. 39(5), August 15, 2005: pp. 587-592.
3 Elizabeth Pisani, et al. “Back to Basics in HIV Prevention: Focus on Exposure,” British Medical Journal. 326(21), June 2003: pp. 1384 -1387.
Cambodia Logo PEPFAR Achievements in Cambodia to Date
Challenges to PEPFAR Implementation
Cambodia is a post-conflict country, making scaling up activities a significant challenge. Major constraints to the implementation of HIV/AIDS activities include:
* High levels of high-risk sexual and substance use behaviors;
* Poverty, which drives prostitution, survival sex, and corruption;
* Barriers limiting access to prevention, treatment and care services, including distance to service locations, limited financial resources, a lack of transportation and infrastructure, and geographic barriers;
* Low salaries in the public health care sector; and
* Limited skills and capacity of health care providers.
Reducing Stigma and Discrimination against People Living with HIV/AIDS
With support from PEPFAR, Pact Cambodia, an indigenous non-governmental organization, and the Cambodia People Living with HIV/AIDS Network are implementing the Community Response to Reducing HIV/AIDS Stigma and Discrimination Project. The project uses community fora to educate community members about HIV/AIDS. Lorn Khoeun, an HIV-positive 35-year-old from Tanuk village, witnessed the positive impact of the PEPFAR-supported community forum in her village. After losing her husband to an HIV/AIDS-related illness three years ago, Lorn Khoeun and her daughter faced stigma and discrimination from members of the community as a result of Lorn Khoeun’s HIV-positive status. Neighbors were afraid to buy watermelons or food from Lorn Khoeun, and her food selling business suffered as a result. Lorn Khoeun and fellow community members attended the community forum in her village where they discussed HIV/AIDS awareness; stigma and discrimination; HIV/AIDS law; and raising and mobilizing support for people living with HIV/AIDS from communities, local authorities, health care providers and opinion leaders. Since the forum, community members have altered their behavior and are more supportive of people living with HIV/AIDS. They are also friendlier towards Lorn Khoeun, buying her food and products, visiting her house, playing with her children, and eating together with her. Now, she can continue her business and support her daughter.
Lorn Khoeun’s food selling business is supported by community members.
Lorn Khoeun’s food selling business is supported by
community members.
Phally lives positively and teaches others to do the same.
Phally lives positively and teaches others to do
the same. Phally: The Story of a Courageous Woman
When the home-based care team first visited Phally in December 1999, she was depressed and sick with an HIV-related illness. At that time, there were minimal HIV/AIDS services available in her area, and a referral system linking patients to other available services was non-existent. Support from PEPFAR helped to establish a continuum of care for people living with HIV/AIDS in Phally’s home district. Phally never gave up her desire to make a positive difference in the lives of people living with HIV/AIDS. The involvement of Phally and other people living with HIV/AIDS in the continuum of care is central to the process of integrating and improving the quality of HIV/AIDS care, treatment and support services. Phally is now a skilled and active peer-educator and counselor, who serves as a positive role model for her peers. Her friendly, lively personality inspires all who meet her. “I’m a member of the care and treatment team at Moung Russey Referral Hospital,” Phally said. “I facilitate the ‘Friends Help Friends’ monthly support group meetings at the hospital. I also conduct counseling sessions with people living with HIV/AIDS, to prepare them for beginning antiretrovirals. An important part of my job is to visit people living with HIV/AIDS and their families while they are hospitalized, to provide moral support and information about HIV/AIDS and self care.”
Buddhist Monks Provide HIV/AIDS Care
With support from PEPFAR, Buddhism for Development is helping to bridge the gap between the religious and secular communities in Cambodia. Buddhism for Development provides home-based care to people living with HIV/AIDS and services to children who have lost parents to HIV/AIDS. The group operates a six-week “Peace Development School,” at which monks learn to provide HIV/AIDS-related health care and study vocational training and agricultural extension methods. Of the monks who have gone through the Peace Development School, many returned to their home villages and established HIV/AIDS associations that provide HIV-prevention services and home-based care. These monks also established centers at pagodas, providing direct care and support for orphans and vulnerable children, and working to find ways to keep these children in school.
Overview of AIDS and HIV in Asia
In the early to mid-1980s, while other parts of the world were beginning to deal with serious HIV & AIDS epidemics, Asia remained relatively unaffected by this newly discovered health problem. By the early 1990s, however, AIDS epidemics had emerged in several Asian countries, and by the end of that decade, HIV was spreading rapidly in many areas of the continent.
Today, HIV/AIDS is a growing problem in every region of Asia. East Asia has been identified by UNAIDS as one of the areas of the world where ‘the most striking increases’ in the numbers of people living with HIV have occurred in recent years (along with Eastern Europe and Central Asia).1 Although national HIV prevalence rates in Asia appear to be relatively low (particularly in comparison with sub-Saharan Africa), the populations of some Asian countries are so vast that these low percentages actually represent very large numbers of people living with HIV. The latest statistics compiled by UNAIDS suggest that at the end of 2007, 5 million people were living with HIV in Asia.2
Various factors make Asia vulnerable to the spread of HIV, including poverty, inequality, unequal status of women, stigma, cultural myths about sex and high levels of migration.3 4 Some experts predict that Asia may eventually overtake Africa as the part of the world with the highest number of HIV-infected people. Others, however, argue that Asia’s epidemics are on a different trajectory to those found in Africa, as HIV infection in Asia is still largely occurring among members of ‘high-risk groups’, unlike Africa where HIV and AIDS are widespread amongst all sections of some countries’ populations.5
Although its useful to understand the overall impact that AIDS is having on the Asian region as a whole, there is no single ‘Asian epidemic’; each country in the region faces a different situation.
“It’s very difficult to speak about ‘the Asian epidemic’. Whatever we come up with, we always find a big exception in Asia.”
Peter Piot, head of UNAIDS 6
Asian countries are experiencing different trends. HIV infection rates are growing in parts of India, but have stabilised or declined in other parts of the country. In Cambodia, Myanmar and Thailand, there has been evidence of declines in HIV infection levels. In Indonesia, Pakistan and Vietnam, meanwhile, the number of people living with HIV has rapidly increased. In Vietnam, this number more than doubled between 2000 and 2005, and HIV has now been detected in every province and city in the country. It is feared that the the speed and severity of the growing HIV epidemic in Pakistan, is outpacing the response. The number of people newly infected with HIV is also rising in China and Bangladesh, although at a much slower pace.7
How HIV is transmitted in Asia
* When HIV is transmitted through unprotected sex in Asia, it’s often during paid sex. More people in Asia engage in sex work (either as a client or a worker), than any other type of behaviour that can carry a high risk of HIV infection.8 High levels of HIV infection have been documented among sex workers and their clients in parts of India, and this situation is mirrored in other Asian countries; in South and South East Asian countries outside India, it’s thought that sex workers and their clients accounted for almost half of people living with HIV in 2005.9
* Injecting drug use is a major driving factor in the spread of HIV throughout Asia, notably in China, Indonesia, Malaysia and Vietnam. In China, nearly half of all people infected with HIV are believed to have become infected through injecting drug use, and in North-East India injecting drug use is the most common HIV transmission route.10 There is often an overlap between communities of IDUs and communities of sex workers in Asia, as those who sell sex may do it to fund a drug habit, or they may have become involved in sex work first before turning to drug use.11
* Sex between men accounted for some of the earliest recorded cases of HIV in Asia, and transmission through this route is still a prominent feature of many countries’ epidemics. Most men who have sex with men (MSM) in Asia do not identify themselves as gay because of cultural norms that discourage homosexuality; in some cases they may even be heads of families, with children.12 This means that MSM can serve as a ‘bridge’ for HIV to spread into the broader population. HIV outbreaks are becoming evident among MSM in Cambodia, China, Nepal, Pakistan, Thailand and Vietnam.13
* Mother-to-child transmission is also a significant HIV transmission route in Asia. At the end of 2007, it was estimated that 140,000 children in South and South-East Asia, and 7,800 children in East Asia, were living with HIV, most of whom became infected through mother-to-child transmission.14
HIV prevention in Asia
HIV prevention sign, Ho Chi Minh City, Vietnam
HIV prevention sign in Ho Chi Minh City, Vietnam
Asia has been the base for some extremely successful large-scale HIV prevention programmes. Well-funded, politically supported campaigns in Thailand and Cambodia have led to significant declines in HIV-infection levels, and HIV prevention aimed at sex workers and their clients has played a large role in these achievements. The Indian state of Tamil Nadu is another area where HIV prevention has had a substantial impact. Here high-profile public campaigns discouraged risky sexual behaviour, made condoms more widely available, and provided STI testing and treatment for people who needed them. These efforts resulted in a large decline in risky sex.15
Successes such as these prove that interventions can change the course of Asia's AIDS epidemics. As HIV infection rates continue to grow however, it's clear that more needs to be done. The groups most at risk of becoming infected – sex workers, IDUs, and MSM – are all too often being neglected. For instance, although injecting drug use is one of the most common HIV transmission routes in Asia, it is estimated that less than one in ten IDUs in the region have access to prevention services.16 Similarly men who have sex with men are overlooked and poorly monitored by most governments, even though it is firmly established that this group play a significant role in some countries’ epidemics.17
The coverage of prevention of mother-to-child transmission (PMTCT) services is also very low in Asia. In South-East Asia, less than 5% of pregnant women are offered HIV counselling and testing.18 Across East, South and South-East Asia, the proportion of HIV-infected pregnant women receiving ARVs is just 5%.19
See our HIV prevention around the world page for more about efforts to stem the spread of HIV in Asia and other parts of the world.
AIDS treatment in Asia
The availability of AIDS treatment has more than tripled in Asia since 2004. At the end of 2007 an estimated 420,000 people in the region were receiving antiretroviral drugs (ARVs). Although this rise is encouraging, access to treatment varies widely across the region. Overall it is estimated that three quarters of people in need of ARVs in Asia still have no access to them.20
HIV Positive man and antiretroviral medicines
HIV positive man sitting at home
before taking his antiretroviral medicines
A major constraint is the high cost of ARVs, as both first- and second-line drugs are still unaffordable to most governments. Cheaper generic drugs are now produced by a number of pharmaceutical manufacturers in Asia, and together with the increasing availability of lower-cost branded ARVs, it’s hoped that this will make it easier for governments to obtain and distribute the drugs. Yet even where drugs are available, the poor state of healthcare in many Asian countries, particularly a shortage of trained doctors, is hindering governments' abilities to organise life-long treatment programmes for millions of people living with HIV.21
For the latest statistics for treatment provision in individual countries in Asia, see our AIDS treatment targets page.
Country profiles - South East Asia
Cambodia
Cambodia’s HIV epidemic can be traced back to 1991. After an initial rapid increase, HIV infection levels declined after the late 1990s, and have reached a steady level in recent years. It’s believed that interventions with sex workers, carried out by the government and non-governmental organisations (NGOs), played a role in this decline; the adoption of a ‘100% condom’ policy that enforced condom use in brothels led to a substantial rise in condom use among sex workers and their clients, and a drop in HIV infection levels among brothel-based sex workers. Despite these achievements, Cambodia still has the second highest HIV prevalence rate in Asia, with 0.8% of the adult population infected. Ongoing concerns include low levels of condom use among MSM, an increase in sex work occurring outside of brothels (making it harder to reach sex workers with interventions), and mother-to-child transmission of HIV – around one third of new infections occur through this route. HIV is mostly transmitted through heterosexual sex in Cambodia, and almost half of those infected are women.22 23
Indonesia
High levels of HIV infection are found amongst IDUs in Indonesia, and also among sex workers and their clients. Around 270,000 people in Indonesia are living with HIV, this number has risen sharply in recent years due to several factors: the country’s extensive sex industry; limited testing and treatment clinics and laboratories for sexually transmitted infections (STIs); a highly mobile population; a rapidly growing population of people who inject drugs; and the challenges created by major economic and natural crises that Indonesia has experienced (the Asian financial crisis heavily affected the country in 1997, and the 2004 Tsunami devastated parts of Northern Sumatra, the largest island in Indonesia).24
Lao People's Democratic Republic (Laos)
Despite being surrounded by countries that have relatively high HIV infection levels (Thailand, China, Vietnam, Cambodia and Myanmar), Laos has a comparatively small HIV problem. There are various reasons for this: the government was quick to acknowledge AIDS when it first emerged in the country, and took action to warn people about it; Laos has not seen the same level of large-scale migration that has occurred in other parts of Asia; there are relatively high rates of condom use among sex workers and their clients; and it’s thought that very few people in the country inject drugs.25 26
Malaysia
Malaysia’s HIV epidemic is largely driven by injecting drug use. Other than IDUs, HIV is spreading quickly amongst women, fishermen, lorry drivers and factory workers. A senior health official in Malaysia has warned that the number of people living with HIV in the country – currently around 80,000 – could rise to 300,000 by 2015 if nothing is done. The government launched a five-year strategic plan to tackle HIV in 2006, which includes drug substitution therapy and needle exchange programmes for drug users.27
Myanmar (Burma)
After first appearing in the mid-to-late 1980s, HIV became increasingly common in Myanmar. Today, with an estimated 0.7% of the adult population infected, the country faces a serious epidemic. Myanmar’s authoritarian military regime is widely condemned for its human rights abuses, and in 2005 these concerns led the Global Fund to Fight HIV, TB and Malaria to withdraw it’s proposed $98.4 million grants for the country.
The Philippines
The Philippines has a very low HIV prevalence, with well under 0.1% of the population infected. Even in groups such as sex workers and MSM that are typically associated with higher levels of HIV, prevalence rates above 1% have not yet been detected – in the case of sex workers, this is possibly due to efforts to screen and treat those selling sex since the early 1990s. There are reasons to believe that this situation may not last, however. Condom use is not the norm in paid sex, drug users commonly share injecting equipment in some areas, and among Filipino youth, there is evidence of complacency about AIDS.
Singapore
Although the number of people living with HIV in Singapore is relatively small, the country’s status as an international travel and business hub, along with the high number of infections found in surrounding countries, make it possible that the country will experience a more serious epidemic in the future. In 2006 a record 357 people in Singapore were newly diagnosed with HIV. To combat these rising figures, the government has chosen to focus on preventing mother-to-child transmission, but controversially, has rejected widespread condom promotion.28 Another controversial policy in Singapore is the strict law banning sex between men, which campaigners argue undermines efforts to promote safe sex among MSM.29
Thailand
Thailand is an example of a country where a strong national commitment to fighting AIDS has paid off, with widespread access to treatment and an admirable history of HIV prevention efforts. However, some of these past prevention successes are starting to be undermined by a current lack of HIV prevention, rising STI rates, and a growing number of MSM becoming infected with HIV.
Vietnam
Around 40,000 people are becoming infected with HIV each year in Vietnam, mostly through injecting drug use or paid sex. The number of people living with HIV in Vietnam doubled between 2000 and 2005, and this rise included a large increase in the number of people who became infected through injecting drug use. Levels of HIV among injecting drug users reached as high as 63% in Hanoi, and 67% in Hai Phong, in 2005.
See our South East Asian statistics page for more data on this region.
East Asia
China
China is seen as a major source of concern by many AIDS experts, because of the large size of its population and the existence of social, economic and cultural factors that make it easy for HIV to spread. At the moment 700,000 people in China are living with HIV (0.1% of the adult population), but it’s feared that this number will increase dramatically in future years, as HIV spreads from the groups most at risk – injecting drug users and those who buy or sell sex – to the general population.30 31
Japan
In 2007, around 9,600 adults and children were living with HIV in Japan.32 Data released by the Japanese government in February 2007 showed that annual numbers of new HIV infections and AIDS cases has risen to an all time high in 2006, to 914 and 390 people respectively.33 The most prominent rise occurred among MSM, who it’s previously been documented account for at least 60% of annually reported HIV infections in Japan.34
South Asia
Afghanistan
There have only been a small number of cases of HIV in Afghanistan, in contrast to the relatively large numbers recorded in the neighbouring nations of Pakistan and Iran. Nonetheless HIV and AIDS are growing problems. Conditions are in place for an epidemic to develop, including high numbers of displaced people, high levels of illiteracy, low social status for women, and a shortage of health facilities. Afghanistan is one of the world’s leading producers of opium, and the availability of drugs could lead to increased levels of injecting drug use.35 A 2006 study found that around one third of IDUs in the capital city of Kabul had shared contaminated injecting equipment, and that 4% were infected with HIV.36
Bangladesh
The first HIV/AIDS case in Bangladesh was reported in 1989. Since 1994, HIV infection levels have increased, although the problem is still relatively small scale, with around 12,000 adults – 0.2% of the total population – infected. It's nonetheless predicted that Bangladesh may gradually be heading towards an epidemic, unless a greater response is developed. At the moment HIV is mainly confined to groups such as IDUs, migrant workers and MSM, and it's reported that this focus on risk groups has led to a lack of urgency among policy makers in dealing with the problem.37
India
India is experiencing a diverse HIV epidemic that affects states in different ways, and to different extents. The groups most affected include injecting drug users, sex workers, truck drivers, migrant workers, and men who have sex with men. Some have predicted that India will soon be experiencing a ‘generalised’ epidemic, where the HIV prevalence rate – currently 0.3% in India – rises above 1%. Others have played down current estimates of the numbers infected, and have argued that, because HIV transmission in India still largely occurs among risk groups, its unlikely that HIV will spread widely among the general population.38 Regardless of the future path of India’s epidemic, it’s undeniable that AIDS is having a devastating impact, and that there are still many major issues – including stigma and poor availability of AIDS treatment – that urgently need to be addressed.
Pakistan
Pakistan’s first reported case of HIV occurred in 1987. Until the late 1990s, most subsequent cases occurred in men who had become infected while living or working abroad. After 1999, HIV and AIDS cases began to be recorded among Pakistani sex workers, IDUs, and prisoners.39 Despite a low overall HIV prevalence (0.1%), social and economic conditions in Pakistan – including poverty, low levels of education, and high levels of risk behaviour among IDUs and sex workers – are likely to facilitate the spread of HIV in coming years.40
Preference From… http://www.pepfar.gov/pepfar/press/81877.htm. http://www.avert.org/
Basic AIDS education remains fundamental to the global effort to prevent HIV transmission. AIDS education can – and does – target all ages, and sexually active adults are one principal target. AIDS education is also vitally important for young people and the school offers a crucial point-of-contact for their receiving this education. Providing AIDS education in schools, however, is sometimes a contentious issue. This page will explain why AIDS education in school is so vital, why it is so controversial, and offer some suggestions as to how an effective program can be sensibly and efficiently achieved.
Why do we need AIDS education in schools?
Many young people lack basic information about HIV and AIDS, and are unaware of the ways in which HIV infection can occur, and of the ways in which HIV infection can be prevented. Schools are an excellent point of contact for young people – almost all young people attend school for some part of their childhood, and while they are there, they expect to learn new information, and are more receptive to it than they might be in another environment.
Most young people become sexually active in their teens, and by the time this occurs they need to know how to prevent themselves becoming infected with HIV.
Other ways in which young people might access AIDS education may not be universal – not all young people will access the same media, for example, or access the same medical services. However, the school is a place where almost all young people can receive the same message. Other media by which young people are presumed to learn about sexual health may not exist in all cases or may be misleading.
Traditionally, the responsibility of teaching a young person about ‘the birds and the bees’ has been seen as being a parental one. In these days of HIV, however, this type of basic information about reproduction is insufficient and will not give young people the information they need to be able to protect themselves. Parents may not provide even this limited information because they are too embarrassed, or because their beliefs oppose it. Young people, too, may be embarrassed discussing sexual matters in a situation where their parents are present. At school they are in a situation where they are independent, and not subject to parental disapproval.
“ If I wouldn't of learned about all the STD's that I could get from being sexually active I might not be a virgin right now. ”
- Erika -
In some countries, young people may not be able to access family planning or sexual health clinics because of their age – or they may be able to access such services but think that their age precludes them from access. Young people often know that they require information, especially if they are becoming sexually active, but may feel too embarrassed to actively seek out sexual health information, or may fear that their parents may find out. In many parts of the world, the fear of ‘what if they tell my parents’ still prevents young people from approaching medical staff, especially family doctors who may know their parents.
The principal reason that AIDS education in schools is so important is that all over the world, a huge amount of young people still become infected with HIV. Most young people become sexually active in their teens, and by the time this occurs they need to know how to prevent themselves becoming infected with HIV. If they are to be enabled to protect themselves, they must be given the information that empowers them to do so.
Attitudes to AIDS education in schools
The main obstacle to effective AIDS education for young people in schools is the adults who determine the curriculum. These adults – parents, curriculum planners, teachers or legislators – often consider the subject to be too ‘adult’ for young people – they have an idea of ‘protecting the innocence’ of young people. This often occurs for moral or religious reasons, and can cause very heated debate.
There is also obstruction to adequate AIDS education from adults who are concerned that teaching young people about sex, about sexually transmitted infections, HIV and pregnancy – that providing them with this information will somehow encourage young people to begin having sex when they otherwise might not have done.
“ I come from a family who believes that having sex out of marriage is not the moral thing to do. I also don't think sex ed. is something that young kids should be learning. Learning sex at a young age is like provoking more young people to have sex just for the fact they want to experience it for themselves instead of just getting information about it. ”
- Monica -
This attitude still prevents adequate HIV and sex education from being taught in schools, in spite of the fact that it is a view that the majority do not share. A study in America, for example, shows that the majority of Americans (55%) believes that giving teens information about how to obtain and use condoms will not encourage them to have sexual intercourse earlier than they would have otherwise (39% say it would encourage them)1 .
The same study tells us that only 7% of Americans believe that young people should not receive sex education in schools. Many adults recognise that informing young people about the dangers of HIV is the best way to prevent them from becoming infected in later life. Many schools in many countries do provide adequate AIDS education – but many, sill, do not. Young people are rarely asked for their opinions by those adults who decide what they will study – but when they are asked, they almost always demand more comprehensive sex and HIV education.
“ I am a student, living in Johannesburg, South Africa. I believe that sex ed that is handled appropriately, and that is age-appropriate, will really empower kids to make healthier, informed and positive choices. ”
- Maire -
In some places, legislation may dictate the type and quality of AIDS education that schools are allowed to offer – some countries have no policies on AIDS education, allowing schools to include it or not, as they decide. Other countries may have policies that specifically preclude AIDS education, or certain types of AIDS education. Legislation allowing or inhibiting certain types of AIDS education often comes from the moral views of the voting majority – or reflects the religious attitudes of the government in power. The most commonly used types of AIDS education are discussed in our page on AIDS education and young people.
It is within the context of these attitudes and beliefs that teachers and educators must work to provide the most effective information and education they are able to.
When should young people start to be taught about AIDS?
There is no set age at which AIDS education should start, and different countries have different regulations and recommendations. In some areas this is a very sensitive subject, and some groups regard teaching young people how to protect themselves as a form of abuse. It seems obvious, however, that people should know how to protect themselves before they begin having sex, rather than after.
“ At school, my sex ed was pretty poor. It started in year 8 when we are about 12-13, which is kind of 2 late really. Quite a few of my friends had already had heterosexual sex and had not protected themselves at all. ”
- Laura -
Especially when educating young people, AIDS education often shares territory with sex education. Education which teaches about sex and sexuality can also teach about preventing pregnancy and STI infection.
“ I know by the time I was taught about sex it was too late, I had already made my mistake. ”
- Safiyyah -
AIDS education should start at about seven or eight years of age. When working with very young people, this type of education does not necessarily need to involve learning about sexual activities or drugs, but should at least teach children that 'AIDS' is not a pejorative term of abuse. Playground name-calling, to some extent, reflects attitudes in general society, but it can also grow up to become discrimination.
Planning a good curriculum
In an academic situation, especially with younger learners, some subjects fail to impart information to the students simply because the students are not interested, and do not pay attention. This is unlikely to be the case with AIDS education; the simple fact that AIDS education involves the discussion of sex – a topic of fascination for young people who are discovering their own sexualities – is likely to ensure at least initial attention. This attention will wane, however, if the information is not imparted in a lesson interesting enough to maintain students’ concentration. It is not only important to have AIDS education, but to provide AIDS education in the right way.
In addition to providing information, a good, class-based lesson where a pupil is amongst his/her peers can help to shape attitudes, reduce prejudice, and alter behaviour.
The following are a few of the important points to consider when planning an AIDS education lesson or curriculum.
Age of students
Is the material that you intend to cover appropriate to the age of the young people in the class? Education about HIV needs to commence early in childhood and develop through adolescence and into adulthood – starting before students are of an age at which they might encounter high-risk situations, but at an early age young people do not require detailed information. This information should be delivered gradually, as they grow older.
Classroom prejudices
School playgrounds often contain many prejudices, and you will probably have to deal with more than one in an AIDS-awareness lesson. HIV+ people, especially, face prejudice around the world that can lead to the continued spread of the virus. In some schools, the words ‘gay or ‘AIDS’ may be used as a term of abuse – this must be addressed, too. Certainly, the material covered in class must reflect the diversity of the community. Prejudices often result from ignorance. ‘Can I get it from toilet-seats?’ is a common question illustrating just such ignorance. This type of misunderstanding not only engenders prejudice, it also causes unnecessary anxiety.
Current knowledge
AIDS education can be targeted towards areas of informational need if you are aware of what young people already know about AIDS. The best way to find out this information is by asking them.
Active learning
It is not enough to simply give students information about HIV and AIDS for them to learn. The learning-by-rote approach common in traditional academic settings provides students with information but does not allow them to absorb the social and practical aspects of how this information might be put to use. AIDS education should never involve pupils sitting silently, writing and memorising facts.
Active learning offers an opportunity to make AIDS education lessons fun
‘Active learning’ approaches are now seen as the most effective way that young people can learn health-related and social-skills. Group-work and role-play are particularly important methods in which students might discover the practical aspects of the information they are given. These methods also allow pupils an opportunity to practise and build skills –saying “No” to sex, for example – and pupils retain information better if they are offered an opportunity to apply it.
Active learning, furthermore, offers an opportunity to make AIDS education lessons fun. AIDS education classes can be constructed to involve quizzes, games, or drama, for example – and can still be very effective learning sessions.
Involving parents and guardians
Many schools already have a good deal of input from parents and families of their pupils, and this input may go as far as being allowed to determine the content of the curriculum. If possible, it is usually advantageous to involve the parents and guardians in the planning process, before an AIDS education curriculum is decided – parents who have already agreed the content that their children will study are unlikely to complain about it being unsuitable. Furthermore, parents who are involved in the education of their children will be able to give additional support, if it is needed, outside the classroom.
Other sources
Outside agencies or organisations may also be able to make a positive contribution to an AIDS education curriculum in a way that the school’s internal resources will not. Some local health agencies will offer talks within a school, as will some local HIV organisations. Check out what is available. This has the additional advantage of building a bridge between the pupils and an external source of help or advice.
Legislation
Some areas and countries will have legislation covering what sex or AIDS education can or should be given. If this is the case, you will have to make sure that your curriculum conforms to local guidelines. Other legislative areas in which AIDS may effect your school are :
Bullying
– does your school’s anti-bullying policy adequately protect HIV+ and gay pupils?
Admissions
– does your school’s admissions policy contain measures to prevent discrimination against HIV+ pupils?
Health and Safety
– does your school’s health & safety policy include universal precautions policy?
Considering cultures
Planning an AIDS education syllabus should involve some consideration of the culture in which the learners live. Many cultures have a specific and well-defined set of views on human sexuality, and even at an early age, young learners will have been influenced by them.
The primary factor in determining what information is given to the class should be their age (see above), and cultural attitudes cannot be allowed to censor the information given. Most cultures frown, for example, on talking openly about HIV transmission routes, but this is a necessary part of the education process. AIDS education should provide this information and still remain sensitive, wherever possible, to cultural and religious sensibilities.
The culture of the learners is an ever-present factor in the classroom, and this culture provides the context in which AIDS education must take place.
What materials are already available?
In the years since the AIDS epidemic began, there have been many disparate efforts to prevent or reduce HIV infection by educating people about the dangers of AIDS, and enabling them to protect themselves from infection. A good deal of classroom material has been created, focusing on young people from cultures around the world. Too often, when an AIDS education curriculum is to be planned, the planners spend considerable time constructing a resource that is ultimately unnecessary as there are already materials available that would suffice. If necessary, spend time adapting existing resources for your class, but it should now never be necessary to produce completely new material.
Making it cross-curricular
HIV and AIDS education is often provided that deals only with medical and biological facts, and not with the real-life situations that young people find themselves in AIDS should also not be looked at from an entirely social perspective, either – effective AIDS education needs to take into account the fact that both scientific and social knowledge are vital to providing a pupil with adequate AIDS awareness. There is much more to HIV prevention than simply imparting the basic facts. Knowing how the virus reproduces, for example, won’t help someone to negotiate condom use. AIDS education must be a balance of scientific knowledge and social skills. Only if life skills are taught, and matters such as relationships, sexuality and the risks of drug use discussed, will young people be able to handle situations where they might be at risk of HIV infection. Furthermore, questions or comments about HIV may arise at unexpected moments, and teachers from a wide range of disciplines need to know how to answer them.
Are any students HIV+?
When dealing with any class of young people, you can’t make assumptions about their HIV status. In high-prevalence areas it is especially likely that one or some class-members will be HIV+, but this could be the case anywhere. Universal precautions should be taught as part of a HIV awareness lesson. AIDS education specifically tailored for HIV+ people is an important aspect of HIV prevention, but applies only in a class where every student is HIV+.
Sexuality of students
On average, at least one student in every class will be gay. You can’t make assumptions about the sexuality of the students in your class, or about the sexualities in the families that they come from – and for this reason, your HIV lessons need to include information about and for people of all sexualities.
Making it work in the classroom
The process of educating young people about AIDS can be a challenging one. Even if all the factors mentioned above are considered, a lesson can be unsuccessful if the teacher is inadequately prepared, uncomfortable or uncommitted. Anyone who has experienced the education system is aware that the atmosphere within a lesson is key to students retention of the course information.
Teaching the teachers
Teachers need to be clear on their own feelings and beliefs.
AIDS education necessarily involves some detailed discussion of sexual matters. If teachers are uncomfortable with this, they will convey this discomfort to the class – and the message that ‘sex is not nice to talk about ’ is the precise opposite of what AIDS education aims to convey. Before taking an AIDS education class, teachers need to be clear on their own feelings and beliefs as they relate to sex, death, illness and drug use.
Teachers also need to feel that they are entirely clear on the information that they will be passing on – they need to feel confident that they are able to answer any questions that might be asked. This necessitates an adequate level of teacher-training – something that is sadly lacking in many parts of the world. In India, for example, where estimates suggest that more than 2 million people are living with HIV, 70% of teachers have been given no training or information at all 2.
Listening to the learners
Young people who have an input into their AIDS education have said that they want their AIDS education to take place in all academic years of their school, to use active learning methods, to include a balance of facts and social awareness, to be built on what pupils already know – and, crucially, to be a separate topic. Whilst Biology, Geography and English can – and should – mention AIDS in the context of their subject matter, young people specifically ask for syllabus time devoted to providing them with good, well-planned and balanced AIDS education.
It is also important to recognise that the young people who make up the class may be uncomfortable with the subject – for cultural or personal reasons. Learners cannot be compelled to feel comfortable, but can be induced. Some basic tips that can help to decrease discomfort are : * Don’t expect a learner to speak in front of their classmates – unless they have volunteered to do so.
* Allow learners to consult and plan in groups before presenting any information to the class.
* Remember that some learners may have relevant personal issues that they will be reluctant to share – they may be gay, for example, of HIV+.
* Listen to the learners – allow the class to ask questions and to express what they want from an AIDS syllabus.
Last word
In spite of all the efforts that the past two decades have seen in AIDS prevention, the epidemic still presents a serious challenge to societies around the world. Every year, increasing numbers of people globally are infected with HIV, and people continue to die. AIDS education for young people is a crucial weapon in the HIV-prevention arsenal, young people are one of the main groups who must be targeted, and the school is the most important means of reaching them.
Still, however, schools in many countries around the world do not have adequate AIDS education curriculum. Although it is not a legislative requirement in all countries that AIDS education is provided, it remains a requirement of the global effort against AIDS. Every young person who passes through the school system anywhere in the world should come out knowing how to protect themselves from AIDS. This is not only the responsibility of every adult who is involved – it is the right of young people everywhere.From..http://www.avert.org
Basic AIDS education remains fundamental to the global effort to prevent HIV transmission. AIDS education can – and does – target all ages, and sexually active adults are one principal target. AIDS education is also vitally important for young people and the school offers a crucial point-of-contact for their receiving this education. Providing AIDS education in schools, however, is sometimes a contentious issue. This page will explain why AIDS education in school is so vital, why it is so controversial, and offer some suggestions as to how an effective program can be sensibly and efficiently achieved.
Why do we need AIDS education in schools?
Many young people lack basic information about HIV and AIDS, and are unaware of the ways in which HIV infection can occur, and of the ways in which HIV infection can be prevented. Schools are an excellent point of contact for young people – almost all young people attend school for some part of their childhood, and while they are there, they expect to learn new information, and are more receptive to it than they might be in another environment.
Most young people become sexually active in their teens, and by the time this occurs they need to know how to prevent themselves becoming infected with HIV.
Other ways in which young people might access AIDS education may not be universal – not all young people will access the same media, for example, or access the same medical services. However, the school is a place where almost all young people can receive the same message. Other media by which young people are presumed to learn about sexual health may not exist in all cases or may be misleading.
Traditionally, the responsibility of teaching a young person about ‘the birds and the bees’ has been seen as being a parental one. In these days of HIV, however, this type of basic information about reproduction is insufficient and will not give young people the information they need to be able to protect themselves. Parents may not provide even this limited information because they are too embarrassed, or because their beliefs oppose it. Young people, too, may be embarrassed discussing sexual matters in a situation where their parents are present. At school they are in a situation where they are independent, and not subject to parental disapproval.
“ If I wouldn't of learned about all the STD's that I could get from being sexually active I might not be a virgin right now. ”
- Erika -
In some countries, young people may not be able to access family planning or sexual health clinics because of their age – or they may be able to access such services but think that their age precludes them from access. Young people often know that they require information, especially if they are becoming sexually active, but may feel too embarrassed to actively seek out sexual health information, or may fear that their parents may find out. In many parts of the world, the fear of ‘what if they tell my parents’ still prevents young people from approaching medical staff, especially family doctors who may know their parents.
The principal reason that AIDS education in schools is so important is that all over the world, a huge amount of young people still become infected with HIV. Most young people become sexually active in their teens, and by the time this occurs they need to know how to prevent themselves becoming infected with HIV. If they are to be enabled to protect themselves, they must be given the information that empowers them to do so.
Attitudes to AIDS education in schools
The main obstacle to effective AIDS education for young people in schools is the adults who determine the curriculum. These adults – parents, curriculum planners, teachers or legislators – often consider the subject to be too ‘adult’ for young people – they have an idea of ‘protecting the innocence’ of young people. This often occurs for moral or religious reasons, and can cause very heated debate.
There is also obstruction to adequate AIDS education from adults who are concerned that teaching young people about sex, about sexually transmitted infections, HIV and pregnancy – that providing them with this information will somehow encourage young people to begin having sex when they otherwise might not have done.
“ I come from a family who believes that having sex out of marriage is not the moral thing to do. I also don't think sex ed. is something that young kids should be learning. Learning sex at a young age is like provoking more young people to have sex just for the fact they want to experience it for themselves instead of just getting information about it. ”
- Monica -
This attitude still prevents adequate HIV and sex education from being taught in schools, in spite of the fact that it is a view that the majority do not share. A study in America, for example, shows that the majority of Americans (55%) believes that giving teens information about how to obtain and use condoms will not encourage them to have sexual intercourse earlier than they would have otherwise (39% say it would encourage them)1 .
The same study tells us that only 7% of Americans believe that young people should not receive sex education in schools. Many adults recognise that informing young people about the dangers of HIV is the best way to prevent them from becoming infected in later life. Many schools in many countries do provide adequate AIDS education – but many, sill, do not. Young people are rarely asked for their opinions by those adults who decide what they will study – but when they are asked, they almost always demand more comprehensive sex and HIV education.
“ I am a student, living in Johannesburg, South Africa. I believe that sex ed that is handled appropriately, and that is age-appropriate, will really empower kids to make healthier, informed and positive choices. ”
- Maire -
In some places, legislation may dictate the type and quality of AIDS education that schools are allowed to offer – some countries have no policies on AIDS education, allowing schools to include it or not, as they decide. Other countries may have policies that specifically preclude AIDS education, or certain types of AIDS education. Legislation allowing or inhibiting certain types of AIDS education often comes from the moral views of the voting majority – or reflects the religious attitudes of the government in power. The most commonly used types of AIDS education are discussed in our page on AIDS education and young people.
It is within the context of these attitudes and beliefs that teachers and educators must work to provide the most effective information and education they are able to.
When should young people start to be taught about AIDS?
There is no set age at which AIDS education should start, and different countries have different regulations and recommendations. In some areas this is a very sensitive subject, and some groups regard teaching young people how to protect themselves as a form of abuse. It seems obvious, however, that people should know how to protect themselves before they begin having sex, rather than after.
“ At school, my sex ed was pretty poor. It started in year 8 when we are about 12-13, which is kind of 2 late really. Quite a few of my friends had already had heterosexual sex and had not protected themselves at all. ”
- Laura -
Especially when educating young people, AIDS education often shares territory with sex education. Education which teaches about sex and sexuality can also teach about preventing pregnancy and STI infection.
“ I know by the time I was taught about sex it was too late, I had already made my mistake. ”
- Safiyyah -
AIDS education should start at about seven or eight years of age. When working with very young people, this type of education does not necessarily need to involve learning about sexual activities or drugs, but should at least teach children that 'AIDS' is not a pejorative term of abuse. Playground name-calling, to some extent, reflects attitudes in general society, but it can also grow up to become discrimination.
Planning a good curriculum
In an academic situation, especially with younger learners, some subjects fail to impart information to the students simply because the students are not interested, and do not pay attention. This is unlikely to be the case with AIDS education; the simple fact that AIDS education involves the discussion of sex – a topic of fascination for young people who are discovering their own sexualities – is likely to ensure at least initial attention. This attention will wane, however, if the information is not imparted in a lesson interesting enough to maintain students’ concentration. It is not only important to have AIDS education, but to provide AIDS education in the right way.
In addition to providing information, a good, class-based lesson where a pupil is amongst his/her peers can help to shape attitudes, reduce prejudice, and alter behaviour.
The following are a few of the important points to consider when planning an AIDS education lesson or curriculum.
Age of students
Is the material that you intend to cover appropriate to the age of the young people in the class? Education about HIV needs to commence early in childhood and develop through adolescence and into adulthood – starting before students are of an age at which they might encounter high-risk situations, but at an early age young people do not require detailed information. This information should be delivered gradually, as they grow older.
Classroom prejudices
School playgrounds often contain many prejudices, and you will probably have to deal with more than one in an AIDS-awareness lesson. HIV+ people, especially, face prejudice around the world that can lead to the continued spread of the virus. In some schools, the words ‘gay or ‘AIDS’ may be used as a term of abuse – this must be addressed, too. Certainly, the material covered in class must reflect the diversity of the community. Prejudices often result from ignorance. ‘Can I get it from toilet-seats?’ is a common question illustrating just such ignorance. This type of misunderstanding not only engenders prejudice, it also causes unnecessary anxiety.
Current knowledge
AIDS education can be targeted towards areas of informational need if you are aware of what young people already know about AIDS. The best way to find out this information is by asking them.
Active learning
It is not enough to simply give students information about HIV and AIDS for them to learn. The learning-by-rote approach common in traditional academic settings provides students with information but does not allow them to absorb the social and practical aspects of how this information might be put to use. AIDS education should never involve pupils sitting silently, writing and memorising facts.
Active learning offers an opportunity to make AIDS education lessons fun
‘Active learning’ approaches are now seen as the most effective way that young people can learn health-related and social-skills. Group-work and role-play are particularly important methods in which students might discover the practical aspects of the information they are given. These methods also allow pupils an opportunity to practise and build skills –saying “No” to sex, for example – and pupils retain information better if they are offered an opportunity to apply it.
Active learning, furthermore, offers an opportunity to make AIDS education lessons fun. AIDS education classes can be constructed to involve quizzes, games, or drama, for example – and can still be very effective learning sessions.
Involving parents and guardians
Many schools already have a good deal of input from parents and families of their pupils, and this input may go as far as being allowed to determine the content of the curriculum. If possible, it is usually advantageous to involve the parents and guardians in the planning process, before an AIDS education curriculum is decided – parents who have already agreed the content that their children will study are unlikely to complain about it being unsuitable. Furthermore, parents who are involved in the education of their children will be able to give additional support, if it is needed, outside the classroom.
Other sources
Outside agencies or organisations may also be able to make a positive contribution to an AIDS education curriculum in a way that the school’s internal resources will not. Some local health agencies will offer talks within a school, as will some local HIV organisations. Check out what is available. This has the additional advantage of building a bridge between the pupils and an external source of help or advice.
Legislation
Some areas and countries will have legislation covering what sex or AIDS education can or should be given. If this is the case, you will have to make sure that your curriculum conforms to local guidelines. Other legislative areas in which AIDS may effect your school are :
Bullying
– does your school’s anti-bullying policy adequately protect HIV+ and gay pupils?
Admissions
– does your school’s admissions policy contain measures to prevent discrimination against HIV+ pupils?
Health and Safety
– does your school’s health & safety policy include universal precautions policy?
Considering cultures
Planning an AIDS education syllabus should involve some consideration of the culture in which the learners live. Many cultures have a specific and well-defined set of views on human sexuality, and even at an early age, young learners will have been influenced by them.
The primary factor in determining what information is given to the class should be their age (see above), and cultural attitudes cannot be allowed to censor the information given. Most cultures frown, for example, on talking openly about HIV transmission routes, but this is a necessary part of the education process. AIDS education should provide this information and still remain sensitive, wherever possible, to cultural and religious sensibilities.
The culture of the learners is an ever-present factor in the classroom, and this culture provides the context in which AIDS education must take place.
What materials are already available?
In the years since the AIDS epidemic began, there have been many disparate efforts to prevent or reduce HIV infection by educating people about the dangers of AIDS, and enabling them to protect themselves from infection. A good deal of classroom material has been created, focusing on young people from cultures around the world. Too often, when an AIDS education curriculum is to be planned, the planners spend considerable time constructing a resource that is ultimately unnecessary as there are already materials available that would suffice. If necessary, spend time adapting existing resources for your class, but it should now never be necessary to produce completely new material.
Making it cross-curricular
HIV and AIDS education is often provided that deals only with medical and biological facts, and not with the real-life situations that young people find themselves in AIDS should also not be looked at from an entirely social perspective, either – effective AIDS education needs to take into account the fact that both scientific and social knowledge are vital to providing a pupil with adequate AIDS awareness. There is much more to HIV prevention than simply imparting the basic facts. Knowing how the virus reproduces, for example, won’t help someone to negotiate condom use. AIDS education must be a balance of scientific knowledge and social skills. Only if life skills are taught, and matters such as relationships, sexuality and the risks of drug use discussed, will young people be able to handle situations where they might be at risk of HIV infection. Furthermore, questions or comments about HIV may arise at unexpected moments, and teachers from a wide range of disciplines need to know how to answer them.
Are any students HIV+?
When dealing with any class of young people, you can’t make assumptions about their HIV status. In high-prevalence areas it is especially likely that one or some class-members will be HIV+, but this could be the case anywhere. Universal precautions should be taught as part of a HIV awareness lesson. AIDS education specifically tailored for HIV+ people is an important aspect of HIV prevention, but applies only in a class where every student is HIV+.
Sexuality of students
On average, at least one student in every class will be gay. You can’t make assumptions about the sexuality of the students in your class, or about the sexualities in the families that they come from – and for this reason, your HIV lessons need to include information about and for people of all sexualities.
Making it work in the classroom
The process of educating young people about AIDS can be a challenging one. Even if all the factors mentioned above are considered, a lesson can be unsuccessful if the teacher is inadequately prepared, uncomfortable or uncommitted. Anyone who has experienced the education system is aware that the atmosphere within a lesson is key to students retention of the course information.
Teaching the teachers
Teachers need to be clear on their own feelings and beliefs.
AIDS education necessarily involves some detailed discussion of sexual matters. If teachers are uncomfortable with this, they will convey this discomfort to the class – and the message that ‘sex is not nice to talk about ’ is the precise opposite of what AIDS education aims to convey. Before taking an AIDS education class, teachers need to be clear on their own feelings and beliefs as they relate to sex, death, illness and drug use.
Teachers also need to feel that they are entirely clear on the information that they will be passing on – they need to feel confident that they are able to answer any questions that might be asked. This necessitates an adequate level of teacher-training – something that is sadly lacking in many parts of the world. In India, for example, where estimates suggest that more than 2 million people are living with HIV, 70% of teachers have been given no training or information at all 2.
Listening to the learners
Young people who have an input into their AIDS education have said that they want their AIDS education to take place in all academic years of their school, to use active learning methods, to include a balance of facts and social awareness, to be built on what pupils already know – and, crucially, to be a separate topic. Whilst Biology, Geography and English can – and should – mention AIDS in the context of their subject matter, young people specifically ask for syllabus time devoted to providing them with good, well-planned and balanced AIDS education.
It is also important to recognise that the young people who make up the class may be uncomfortable with the subject – for cultural or personal reasons. Learners cannot be compelled to feel comfortable, but can be induced. Some basic tips that can help to decrease discomfort are : * Don’t expect a learner to speak in front of their classmates – unless they have volunteered to do so.
* Allow learners to consult and plan in groups before presenting any information to the class.
* Remember that some learners may have relevant personal issues that they will be reluctant to share – they may be gay, for example, of HIV+.
* Listen to the learners – allow the class to ask questions and to express what they want from an AIDS syllabus.
Last word
In spite of all the efforts that the past two decades have seen in AIDS prevention, the epidemic still presents a serious challenge to societies around the world. Every year, increasing numbers of people globally are infected with HIV, and people continue to die. AIDS education for young people is a crucial weapon in the HIV-prevention arsenal, young people are one of the main groups who must be targeted, and the school is the most important means of reaching them.
Still, however, schools in many countries around the world do not have adequate AIDS education curriculum. Although it is not a legislative requirement in all countries that AIDS education is provided, it remains a requirement of the global effort against AIDS. Every young person who passes through the school system anywhere in the world should come out knowing how to protect themselves from AIDS. This is not only the responsibility of every adult who is involved – it is the right of young people everywhere.From..http://www.avert.org
