Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

12th World AIDS Conference

Abstracts 13496-13500 185

13496 School project: HIV-positive people teach boys
and girls
Sylviane Guerin, R. Kellenberger. AIDS-Hilfe Schweiz Postfach CH-8031 Zurich,
Switzerland
Project: Direct intervention of People with HIV/AIDS in a school/youth environment in order to deal in a concrete manner with the many human implications of
life with HIV.
Objectives: To strengthen prevention discourse by stressing the need to protect oneself, to empower young people with a message of personal responsibility
for one's own and other's life and to question and fight prejudice.
Design: Young people spontaneously proposes topics such as discrimination,
sexuality, death, etc, in the form of questions which the speakers answer sincerely and straightforward. The systematic presence of two speakers allows each
session to present the issues sensitively and in their greatest possible diversity.
The speakers follow regularly compulsory training sessions under professional
supervision.
Results: Since 1992, the Swiss Public Health Ministry has promoted and financed the School Project. Prevention professionals work closely with this project.
Approximately 30,000 young people throughout Switzerland have attended 600
speaking sessions within the Project Ecoles. At present, there are about 50
People with HIV/AIDS participating as speakers. The social value and utility of
this activity have contributed to an definite improvement in the quality of life for
speakers.
Conclusion: Direct intervention by People with HIV/AIDS is an effective mean
of prevention and the contribution of these speakers is important and unique.
F3497 Interdisciplinary teaching contents for secondary school
AIDS education
Daniel Motta. Institut National de Recherche Pedagogique, 29 rue d'Ulm -
75005, Paris, France
Objectives: To identify the epistemological and institutional conditions to which
validated AIDS education programs may be integrated within regular curricula in
most school systems.
Methods: a two-year qualitative study was performed in four french secondary
schools at two different grade levels (students aged 13 and 17 yrs). The introduction of teaching contents responding to the characteristics of "effective
programs to reduce sexual risk behaviors" (Kirby et al, 1994) was negociated
with 15 teachers in various subjects: French, Physical education, Biology, Arts
and Philosophy.
A multiple-case analysis was completed on data collected in the four sites:
interviews with teachers and students, video recordings of teaching situations,
teaching material and transcripts of teachers meetings.
Results: Major epistemological obstacles and facilitators were identified for the
interdisciplinary programs and for each specific teaching subject.
- A (conceptual field) x (teaching subject) interaction was evidenced for contents related to sex roles, physicality and communication in the relationship, due
to specialized curricula and content of teacher training.
- A (learning method) x (teaching subject) interaction was found; the major
effect was at the senior High School level, due to certification requirements and
preparation of exams.
- Positive motivational effects were found for all students and especially for low
achievers.
- Elements of confusion between the functions of teaching personnel and
health personnel were identified.
- Significant individual effects showed only for principals and administrators.
Conclusion: Increased int(,gration of effective AIDS education programs within
regular school curricula is highly desirable for public health and economy reasons,
especially in (rich or poor) countries with no tradition of school health education.
I order to achieve this objective, new AIDS education teaching contents and
teacher education contents should at least fulfill the major epistemological and
institutional requirements of the regular school subjects as evidenced in this
study.
36*/13498 Sex education and HIVISTD prevention program for
adolescents
Ines Quental Ferreira1, Elizabeth Ferraz2, N.F.P. Costa2. 'Avenida Republica De
Chile, Andar, Rio De Janeiro; 2Sociedade Civil Bem-Estar Familiar, Rio De
Janeiro, RJ, Brazil
Objectives: The aim of this project which was implemented in high schools
in Northeast of Brazil was to diminish the vulnerability related to sexual and
reproductive health among adolescents students in interface with teachers and
parents, reducing the incidence of STD/HIV and unwanted pregnancy. To increase
knowledge, to change behaviour, to promote safe sex practice, to increase access
to reproductive health services and to built up school potential for project self
sustainability were focus points of this program.

Methods: For pre-assessment, process and evaluation analysis the methodology used was a combination of quantitative and qualitative methods. The
intervention process, adopted the main aspects of socially transformatory education model. A random sample of students were tested before and after project
implementation. The pre and post test assessed knowledge of STD and accompanying symptoms, HIV transmission and prevention, family planning methods,
and knowledge and attitudes on sexual and reproductive health.

Results: Adolescent learn about STD/AIDS and sexuality. Schools activities
reached 6,500 adolescents. Training were provided for 170 teachers and 340
peers. Several activities were held at schools in conjunction with celebrations
such as carnival and World AIDS Day. Appropriated materials were developed,
including a comic book on STD/AIDS and a manual for educators. Parents were
very receptive and motivated to participate in the activities, saying they were
glad their children had the opportunity to be informed by this important subject.
Peer students played an important role in the success of this project, promoting
educational activities and encouraging other students to participate.
Conclusions: Students had a positive change in attitudes and practices regarding to sexual and reproductive health issues. In the schools were project was
developed many of the myths surrounding STD transmission, contraceptives,
and pregnancy were clarified. The project actively promoted condom use among
adolescents. Positive outcomes have also occurred in improving communication
between students and both teachers and parents.
S13499 Best practices in school AIDS/life skills education:
Selected case studies
Karen Heckert1, M. Baldo2. 1 Univ of Otago Dept of Public Health, PO Box 4345
Christchurch, New Zealand; 2UNAIDS, New York, US
Issues: To identify case studies in School AIDS/Life Skills Education that meet
UNAIDS Best Practices guidelines. To achieve UNAIDS 1998-99 Programme
Objectives to prevent risk taking behavior and HIV infection among young people
by widely disseminating lessons learned from successful programmes.
Project: A Review Update published by UNAIDS in October 1997 provides
evidence from 68 studies conducted primarily in developed countries that sexual
health education for young people promotes safer sexual practice and does not increase sexual activity. It is time to document programming and impact of AIDS/Life
Skills education in developing countries. The 1997 regional AIDS conferences in
Manila, Abidjan, and Lima provided a forum to screen school programmes that
meet the UNAIDS Best Practices guidelines for relevance, effectiveness, efficiency, ethical soundness, sustainability, and replicability. Case studies were also
expected to satisfy quality standards established by the UNAIDS Inter-Agency
Working Group on Integrating HIV/STD prevention in the school setting.
Results: Eight case studies were identify from India, Hong Kong, Zimbabwe,
Uganda, Kenya, South Africa, Brazil, and the Caribbean. Each case study satisfies at least three of the six Best Practices guidelines across components critical
to successful programmes; 1) policy, 2) curriculum, and 3) teacher training. The
Life Skills approach offers the best promise for strengthening skills among young
people to develop healthy behaviors before risk taking commences.
Lessons Learned: Lessons learned for all six Best Practices guidelines are
provided. For example, Uganda's ten year old programme integrates AIDS and
Life Skills education into comprehensive school health education. Zimbabwe's
mandatory curriculum provides full coverage among primary school children.
Kenya's Youth Initiative Project offers an out-of-school alternative via national
radio that resulted in 24% of participating youth reporting the adoption of healthy
behaviors. A UNAIDS Best Practices publication is forthcoming.
13500 Sexual behavior, individual STD prevention, and self
reported STDs of first year university students
Luise pruefer-kraemer, C. Stock, S. Oteng, A. Allgoewer, A. Kraemer. School of
Public Health University Bielefeld, PO Box 100131 D-33501, Bielefeld, Germany
Background: In Germany, population based studies are lacking for the prevalence of sexually transmitted diseases (STDs) in relation to sexual behavior and
individual STD prevention.
Methods: In a cross-sectional questionnaire study 538 of 625 students (age
18-30 years; 55% women, mean age 20.7 years; 45% men, mean age 21.4
years) reported about their sexual behavior, individual STD prevention and the
incidence of STDs in the last 12 months. The following self reported diseases were
defined as STDs: genital herpes, urogenital chlamydial and fungal infections, HIV,
genital warts, gonorrhea, syphilis and vaginal inflammation. Uni-and multivariate
analyses were used to detect potential risk factors.
Results: The mean age at first intercourse was 17.13 years for women and
17.05 for men (p = 0.09). In the preceding three months 63.2% had sexual
intercourse, most of them 2-3 times per week. The number of partners in the
last 12 months was higher in men than in women, 1.7 vs. 1.5, respectively (p
= 0.05). To prevent STDs, students used condoms in 57.8%, chose not to have
multiple partners in 54.0%, and estimated the risk of infection in 21.2% after a
conversation with the partner. The incidence of STDs in the last 12 months was
19.8% in those who had been sexually active in this period (n = 391), with a
significant difference between women (29%) and men (7.1%), p = 0.0001. The
majority reported genital fungal infections (15.3%), followed by vaginal inflammation (4.4%), genital herpes (1.0%), and chlamydial infections (0.8%); HIV infection
was not reported. We identified the following risk factors for STDs by multivariate
logistic regression analysis: female sex (OR = 7.8; 95% Cl 3.7-16.3), use of
oral contraceptives (OR = 2.8; 95% Cl 1.3-6.4), and older age (OR = 1.3; 95%

Cl 1.1-1.4). The frequency of sexual intercourse, number of partners, type of
relationship, and the consequent use of condoms had no significant influence.
Conclusions: STDs other than HIV are a frequent problem in sexually active
female university students in Germany. The increase of STDs with age may
indicate a cumulative effect of undiagnosed and/or not adequately treated STDs.
Client specific interventions are needed to prevent later infertility (chlamydial
infection), cervical neoplasia (human papilloma virus) and HIV infection.