April 18, 2018 launched the 6th International Conference on HIV/AIDS in Eastern Europe and Central Asia. Over 3,000 representatives from the public health system, academia, medicine, education and civil society came together to present the best strategies and practices on HIV/AIDS prevention in Russia, Belarus, Armenia, Kyrgyzstan, Kazakhstan and other countries. Alongside other world-class experts – Chris Castle, UNESCO Global Coordinator for HIV and AIDS, Chief of Section for Health and Education at UNESCO Headquarters.
On the first day of the conference Chris Castle took part in the discussion “30 years of HIV infection in the Eastern Europe and Central Asia: what is needed to stop the epidemic by 2030?” Among the participants were Vadim Pokrovsky (Head of the Federal Center for HIV/AIDS Prevention and Control, Russia), Michel Kazatchkin (UNAIDS Special Adviser on HIV in Eastern Europe and Central Asia) and Ndaba Mandela (politician, founder of the “Africa Rising” foundation, South Africa). The experts were set to review the achievements of the last 30 years in the area of treatment and prevention of HIV/AIDS. They also considered the necessary factors for developing effective strategies for countering the global epidemic.
Chris Castle shared his vision of the role education system plays in preventing the spread of HIV among adolescents and youth.
“Young people are the future and the key to effective HIV prevention. However, awareness of HIV alone is not enough for change; we need a comprehensive approach: we should give young people not only knowledge about the nature of the disease, but also the opportunity to think about relationships, healthy lifestyles as well as to ask questions about sexuality and about love “.
On 19 April, within the framework of special programme “HIV, Children, Adolescents and Youth”, Chris Castle attended the youth forum on HIV prevention. He introduced a new edition of the International technical guidance on sexuality education, developed by UNESCO, and outlined the benefits of comprehensive educational programmes on reproductive health and relationships.
«What is very important about children and teenagers is that they are very young and they cannot imagine themselves at some point taking drugs, having intimate relationships or being involved into commercial sex. They are just not mature enough, they do not think about it. This is why it is important to reach every young person, so that they already have the necessary information when at some point in their lives they face these risks. And it is crucial for them to know that there are things they can do to reduce the risks and their vulnerability».
Chris Castle shared his ideas and spoke further about UNESCO’s approach to health education in the interview to Teenergizer youth movement. With the permission of the authors, we publish abstracts from this conversation.
What are the links between the topics of healthy lifestyle and HIV prevention with education agenda? What is the approach of UNESCO?
Ministries [of Education] would often ask the UNESCO colleagues, “Please make sure our programmes are effective. Do we have the evidence? Please tell us about the most effective programmes.” One of the things that we do is we look very closely at the programmes that are effective. It is extremely important for us to understand what works best and this is important for the participating countries as well.
Young people have a right to education that will be useful for their lives, not just literacy and mathematics, but also skills on how to live a healthy life. The UN Sustainable Development Goal 4 does not only address the traditional topics in education, but also things like citizenship, learning to live in a community and education to lead a healthy life. This includes education in sexual and reproductive health.
One of the things that we learned from the research is that far more people are worried about pregnancy than the HIV. For us it is not about prioritising one over the other, but it is about listening to the concerns that young people have and making sure that they know there is a way to prevent both: unintended pregnancy and HIV.
Another clear thing is that we should reach young people at the early age, as we want to make sure the education about these issues reaches kids before they face problems. As an example, in many countries young girls do not know anything about menstruation. We need to make young people aware of such things.
Of course, the teachers should be trained too. Even though nowadays teachers can get information from various sources, it may not be age-appropriate or fully correct. It is very important that our programmes are grounded in scientific facts and the best possible evidence.
How can the new International technical guidance on sexuality education be helpful?
There are different topics and they are organised by age ranges. If we want to talk about reproduction with the children 5-8 years old, it will be a very simple basic conversation, which would eventually get more and more complicated as we move to the group of 9-12 years old, 12-15 and so on, as children get older. The use of the guidance is voluntary, so countries will decide when and how to introduce it in the curricula, when and how to teach it. It is a basic tool for them to review a range of different topics and see at what age to introduce them.
It is important that the young people could get scientifically approved information from a trustable adult (and for many young people it would be teacher!). So part of this guidance is used to train teachers so they understand the best methods to teach kids on sexuality education and feel more comfortable to talk about these topics. It is a sensitive issue to discuss in the classroom, so we need to make sure they know how to do it better. At the same time, adults should be aware of these programmes. No parent would want their child to be at the risk of HIV and unintended pregnancy! At UNESCO we work with the ministries of education, we share the research data with decision-makers and address their concerns.
On the controversy surrounding sexuality education in schools
There is a fear that the sexuality education programmes will result in early sexual experiment, but actually, the research data is the opposite. The evidence we have shows that when young people have this information, their sexual relationships are delayed. When they have the necessary knowledge, they feel empowered to decide when and how they want to start these relationships. And they are more likely to do it in a healthy and more responsible way.
It is a pretty common thing in many countries that sexuality education is perceived as a controversial practice. This is why it is important to begin talking about the actual situation, present the research data, look at the rates of teenage pregnancy and at what age teens become pregnant, what are the rates of HIV among young people etc. When we look at it, we will see very quickly that parents and decision-makers are concerned about these issues. Then we can explain that there are approaches to promote healthy lifestyles and to protect the next generation. One of the ways is sexuality education.
Sexuality education does not teach teens how to do sex, that is something they figure out on their own. First thing that we want to achieve is making young people aware of what they can do to reduce the risks; and the second – is access to services they might need. Young people should know how to access psychological, medical, reproductive services; they need access to contraception, condoms. Education alone will not solve things.
Another problem is that young people are often shy and intimidated to go and access these services. In some countries young women will say that they will feel judged and embarrassed to go and buy condoms. This is not just education to increase awareness, but also to increase confidence and skill: a skill to know how to find the service and a skill to know how to go and access it. It is also good to have a teacher or a nurse that young people can go to, ask about the access and receive the necessary information.
What are the lessons learned?
What we see is that a scaring approach is not effective. If we try to scare young people to persuade them not to have sex because of HIV and AIDS or possible pregnancy, we will not succeed. What we want to teach young people to do is to ask themselves: If I want to start a relationship, what knowledge and skills should I have, what attitude should I adopt, so that this relationship would be healthy and safe?