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Learners with HIV or coming from homes where one or more family members has HIV often bring to the learning environment a range of experiences that were previously less common. They may also have increased familial responsibilities and participate in income generating activities to supplement family income and labour. An estimated ten percent of all children orphaned by HIV and AIDS in Africa are heads of households and caring for siblings (Rau 2002). These learners may have very high levels of competence and responsibility due to the demands that have been placed on them to support and care for their families, and skills such as work-related skills and household management. These experiences can enhance their and others’ learning. At the same time, children affected by or orphaned due to HIV and AIDS bring an-other set of challenges. Millions of children have already lost one or both parents due to AIDS, and UNICEF estimates that 11 million of these children are under the age of 15 and living in sub-Saharan Africa (UNICEF 2003). They are often disadvantaged in numerous ways, from having experienced the psychological trauma of witnessing one or both parents’ death, separation from siblings, to increased poverty and diminished health status com-pared to non-orphans.
Education systems must also take into account the increasing numbers of learners with HIV. UNAIDS estimates that at the end of 2005, 2.3 million children under age 15 were living with HIV and AIDS (UNAIDS 2005). Projections suggest that unless dramatic measures are taken, an additional 45 million will become infected before 2010 (UNAIDS 2003). In sub-Saharan Africa, adolescent girls are the most affected segment of the population. In a number of countries, including Ethiopia, Malawi, Tanzania, Zambia and Zimbabwe, five to six girls in the 15 to 19 year old age range are infected for every one boy of the same age while in Trinidad and Tobago, infection rates among females aged 15 to 19 are five times that of boys of the same age (UNICEF, UNAIDS, WHO 2002). HIV is spreading fastest in this group through “age mixing,” in which girls have sexual relationships with older men, but also be-cause of greater biological susceptibility, lack of financial security, forced and early marriage, rape and sexual abuse and gender inequality.
The epidemic is forcing teacher trainers and curriculum planners to reassess what is being taught on the subject of HIV and AIDS. Appropriate and relevant education about HIV and AIDS that is age- and sex-specifi c must be considered. Stu-dents, families, communities, teachers, and administrators understand that the seriousness of the epidemic requires new thinking about the educational content of HIV and AIDS curricula. Where there may have been resistance in the past to broaching sensitive issues such as sex and sexu-ality, there is now compelling evidence of the need to teach about HIV and AIDS in the context of how transmission occurs, how it can be prevented, and including negotiation and decision-making skills to help young people avoid unwanted sex or unsafe situations. While half of new HIV infections occur in youth aged 15 to 24, prevalence rates are lowest among those in the 5 to 14 year age group (UNAIDS 2005). Therefore, addressing children and youth during this age period is a real “window of hope” for preventing the spread of HIV (World Bank 2002). There is further evidence that HIV and AIDS education taught before young people become sexually active does not result in an earlier age of sexual debut, and in fact it may have the opposite effect of delaying the initiation of sexual activity and encouraging protective behaviour upon sexu-al initiation (Kirby 2001, Alford et al. 2003, UNAIDS 1997). Schools and other learning places have an obli-gation to equip students with these facts and skills for life, including how to avoid coercive and unwanted sex. The challenge remains of finding the most effective way to bring this learning into the curriculum, and there is now a strong argument not to integrate HIV and AIDS education across subjects as it tends to get too diffused and, therefore, is not suffi -ciently effective. The HIV and AIDS pandemic present an opportunity to improving school health programming and creating health-promoting schools, going beyond a focus on HIV and AIDS. In this regard, attention is drawn to the multi-partner initiative Focusing Resources on Effective School Health (FRESH).
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