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Effective teaching about sexuality, sexu-ally transmitted infections (STIs) including HIV, and HIV prevention requires an open, facilitating environment. This is difficult to achieve in traditional class-rooms. Besides the power differential and distance between teachers (adults) and pupils (often children and adolescents), the search for the ‘right’ answers for the exam is what often drives teaching on HIV prevention. The establishment of adequate hygiene and sanitation facilities is also key to the learning environment. About 1 in 10 school-age African girls do not attend school during menstruation or drop out at puberty because of the lack of clean and private sanitation facilities in schools (UN World Water Assessment Programme 2003). Moreover, there is evidence that when children have to leave school and walk significant distances for clean drinking water, for example, they may not always return to class. At the system level, five dimensions are concerned with regard to educational quality and HIV and AIDS. These include school and education programme management and transparency, relevant and appropriate policies and practices, legal aspects, resources, and implications related to measuring learning outcomes. School level and other learning activities are ‘down-stream’ operations and must be supported by ‘up-stream’ policy frameworks, strong leadership and sustained advocacy. Well-run schools and other learning spaces make it possible to bring difficult issues into the open, a key first step to addressing them. The UNESCO Office in Brazil has had sig-nifi cant success supporting a programme called “Making Room” designed to foster social inclusion and to instil a ‘culture of peace’ within classrooms as a response to high rates of violence. Such initiatives rely on well-managed schools where parents, students, teachers and administrators can come together to identify and seek solutions for problems in school, with violence often topping the list. In settings highly impacted by HIV and AIDS, this openness and transparency will allow for a dialogue on how the learning place can play its part in the response to the epidemic. For example, there might be a need to alter the school timetable to accommodate the work responsibilities of children who head households, or to identify ways to provide childcare so that older siblings can participate in educational activities. A study in Ethiopia, for example, found that schools that began and ended the day earlier than usual and scheduled breaks during harvest time had improvements in students’ continuation and achievement rates. The author concluded “the quality of a school and the quality of teaching of the individual teacher is higher in schools that are able (and willing) to make more efficient use of the available time of its teachers and its pupils” (Verwimp 1999). Teachers and others in the education system who are affected or infected by HIV must be able to function professionally in a safe, secure, and supportive environment as well. They also bring to the system their own experiences, both positive and difficult, which will influence how learning occurs.
Having relevant and appropriate overall policies in place are an essential foundation for safe and secure schools, and will help to address issues relating to HIV and AIDS. However, in light of the pandemic, many policies may need to be re-viewed to ensure that they take sufficient account of the relationships between the pandemic and education systems. For example, attention needs to be paid to issues of inclusion and discrimination, the status of teachers and other education staff affected or infected by HIV and AIDS, and violence, in all its forms, in education. The estab-lishment of a code of conduct for teachers and disciplinary procedures for sexual relationships between teachers and students should also be encouraged.
Typically ministries of education set these policies; however, these may not be widely known and understood by all, particularly in the learning place. Therefore, a helpful starting point is to raise awareness among administrators, teachers and students about these school policies. The next step is to ensure that there are mechanisms to implement and enforce the policies, since it is pointless to have rules and procedures if they are not observed. Some of the more successful efforts to promote, implement, and enforce appropriate policies are those that have built the broad involvement of teachers and students in setting and respecting them. Taking a rights-based approach to review and elaborate school policies on violence and HIV and AIDS, for example, will help to ensure inclusiveness and respect. Such policies should cover not only students but also teachers affected by HIV and AIDS, and should leave no room for the tolerance of any form of violence or exclusion. Clearly all school policies will need to be consistent with national laws and legislation, which themselves should be regularly reviewed and updated to ensure relevancy (UNAIDS IATT on Education 2006).
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2. Mencl F, Birkle M, Blanda M, Gerson LW. EMT’s knowledge regarding transmission of infectious disease. Pre-hospital Emergency Care 2000;4(1): 57-61.
3. Eutis TC, Wright SW, Wrenn KD, et al. Compliance with recommendations for universal precautions among pre-hospital providers. Annals of Emergency Medicine 1992; 21:1353-9.
4. Cydulka RK, Matthews, JJ, Born M, Moy A, Parker M. Paramedics: knowledge base and attitudes towards AIDS and hepatitis. Journal of Emergency Medicine 1991; 9(37-43).
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