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

I

186 Abstracts 13501-13505

12th World AIDS Conference

13501 Why AIDS education did not work in schools: The implicit
rules and paradoxal powers of teachers and students
Robert Bastien. 1616, Rene-Ldvesque West - Room 300A Montrel, Quebec,
Canada
Objectives: To draw a theory of health (including AIDS) prevention based on the
symbolic interactions between students and teachers in schools.
Design: Ethnomethodology and symbolic interactionism
Methods: Medium-term (6 months) participant observation in one urban secondary school; focus groups conducted among students (N = 800); semi-open
interviews with teachers, health staff (10) and at-risk youth (18). Data were also
collected by direct observation in the classroom and after-school health and
prevention activities. Data were analysed in an interpretative perspective to support the development of a short-range theory of prevention and health in total
institutions.
Results: Results presented here are part of a Ph.D research in progress.
In schools, AIDS prevention knowledge is closely linked and structurally associated to some other forms of academic or other health-related subjects. Because
correct answers are often associated with some sort of evaluation (pass or fail)
process, students rationally have no choice but to give the right answers to the
right questions. This conundrum, well-known by sensative teachers, pushes them
to create new forms of communication to stimulate interaction. These strategies
are many: testimonies, dramatic and personnal experiences, etc. Despite the
quest for new communication strategies, the power of teachers to create involvement is still constrained by a low degree of interaction between colleagues and
by the power of the students to disengage from communication.
Conclusion: Symbolic interactionism can provide new ways of understanding
the degree of success of health programmes, and more specifically of AIDS
prevention programmes. An understanding of problems associated with education and communication provides a new conceptual framework to develop AIDS
intervention programmes.
S135021 STDs and HIV/AIDS information in SFI (Swedish for
immigrants) schools
Anne-Marie Wallin. Dept. of Comm. Medicine and Public Health, Orebro, Sweden
Issues: In 1992 a study was completed in Orebro county council about STDinformation in the schools for immigrants learning the Swedish language (SFI).
The study showed that only a few schools had such information. There was no
lack of interest but the staff needed further education, material and external help
from persons medically trained in this field.
Project: A collaboration project between the Dept. of Community Medicine and
Public Health and the SFI-schools was designed. The intention was to develop
a model about STDs which could be incorporated into the existent Swedish
language syllabus. The model that was created consisted of four different stages:
(a) Watching of a video film: "Love, sexuality and Swedes" followed by discussion.
(b) Distribution of brochures with facts about STDs available in different languages.
(c) Studying a special glossary. Explaining different terms used during the
information process.
(d) Lecture about STDs based on overhead pictures.
Men and women were informed separately and had a teacher of the same
sex. The teachers were responsible for moment 1-3 and external medically educated persons were involved in the last activity. Each school had a person with
responsibility for planning the information and contacts with the external lecturers.
Results: The students have been very interested and engaged in the topic.
This model is suitable for education for students with this background. The person
who has responsibility to plan the information into groups should not be a teacher.
Other groups such as schools welfare workers are more suitable as they work in
all classes.
Lessons Learned: SFI-schools are probably the best scene to inform immigrants about STDs. In schools, groups already are established and the students
know each other. To use interpreter is not necessary if the information is given
as a part of the last term. The immigrants also practise the language with others
than teachers.
S13503 School AIDS education: Improving the quality of policies
and curricula
Mariella Baldo. UNICEF - TA 26, 3, U.N. Plaza - New York - N.Y. 10017, USA
Issues: Children and adolescents have a right to learn the information and skills
needed to develop a healthy sexuality, manage relationships, and avoid HIV /
STDs. Access to AIDS education is increasing, but only quality programmes are
effective for the development of healthy behaviour.
Project: The United Nations Programmes on HIV/AIDS distilled from evaluation research the characteristics of effective programmes, and disseminated
peer-reviewed technical documents to educational planners, worldwide.

Results: The following were published by UNAIDS, Geneva, in 1997: a) Impact
of HIV and sexual health education on the sexual behaviour of young people,
a review update: sexual health education does not increase sexual activity, but
promotes both delay of first intercourse and safer practices among those sexually
active; features of effective programmes. b) Integrating HIV/STD prevention in the
school setting: a position paper: basic principles of school AIDS education, using
a Life Skills perspective. c) Learning and teaching about AIDS at school, UNAIDS

Technical Update: rationale for school AIDS education, its challenges, content of
sound school policies, steps to design a quality curriculum, nine basic requirements for an effective education programme according to evaluation research,
life skills relevant to HIV/STD prevention, 10 key materials. d) Live it!: a video
with young students, and a booklet for educators and communty workers. The
following are available as work in progress and/or are scheduled for publication
by UNAIDS in 1998: e) Quality standards: policy, curricula, training: what national
policy documents, curricula and training programmes should include to ensure
effectiveness, f) Set of 20 slides: visuals on the above, g) Best Practices in school
AIDS education, a collection of case studies: good examples of policies and
programmes.
UNAIDS promotes for children aged 12-16 the prototype curriculum included
in School health education to prevent AIDS and STD: a resource package for
curriculum planners, Geneva and Paris, WHO and UNESCO, 1994.
Lessons Learned: Effective programmes reflect studies of impact on behaviour
(not studies of effects on knowledge, attitudes). Sound policies include: human
rights, access to sex/health education at early age, teacher training, collaboration
with the community, clear definition of objectives, links with local health services. Quality curricula include: practice of life skills (such as negotiation), gender
sensitivity, presentation of all prevention methods, link with students' concerns
(relationships, abuse), discussion of social norms presented by adults and the
media.
13504 Less partners, but not less sex
Giovanni Ara1, A. Casadidio2, A. Martinotti2, A. Palma2, F. Piunti2. 1Servizio
Igiene E Sanita' Publica ASL 12 Via Don Sturzo Biella (BI); 2ASL 12 Biella, Italy
Background: to evaluate trends in knowledge about HIV/AIDS, attitudes towards
people living with HIV/AIDS (PLWHA) and sexual behaviour among students
18/19 years old in Biella, Italy, a province with a high AIDS incidence. Since 1992,
an educational program about AIDS/STD has been carried out in the high schools
of the city, with the distribution of a book developed after surveying 4166 students
in 1991.
Methods: comparison between results of self administered questionnaire completed by 769 (in 1997) and 644 (in 1991) senior students (age 18/19 years)
attending high schools in Biella.
Results: (1st value: 1997, 2nd: 1991): knowledge has increased (higher percentage of correct answers in 10 of 12 questions); main source of information:
mass media (58% vs 81%) and health professionals (15% vs 2%). Attitudes:
accept a classmate who is HIV+: 80% vs 70% (P < 0.001); think that awareness
of AIDS could change their present or future sexual behaviour: 68% vs 59% (P <
0.001). Sexual behaviour: had already had sex: males (M) 45% vs 36%, females
(F) 51% vs 28%: the difference may depend on the time of the survey (end of
the school year in 1997, beginning of the school year in 1991); mean age at first
intercourse remained stable (17 years for both sexes); have had no or 1 partner
only in the last year: M 71% vs 54%, F 81% vs 77%; always use condom: M 47%
vs 34%; F 42% vs 33%; never use condom: M 16% vs 25%, F 17% vs 31%.
Conclusions: In our setting, in 1997 students seem to have better knowledge
of HIV/AIDS and attitudes towards PLWHA compared to 1991; condom use has
increased; the reduction in the number of sexual partners, particularly among
male student, seem to be the most utilized risk reduction behaviour.
13505 Evaluation of a school condom availability program:
Impact on sexual behavior and condom use
Nancy Brener1, D. Kirby2, N. Brown3, J. Moore1. 'CDC Dash MS K33 4770
Buford HWY NE, Atlanta, Georgia; 2ETR Association, Santa Cruz, CA; 3Palo
Alto Medical Foundation RSCH Inst., Palo Alto, CA, USA
Background: In an effort to reduce unprotected sexual intercourse, 10 high
schools in a US city began making condoms available through vending machines, baskets in school clinics, or both. This study measured the number of
condoms students obtained and the impact of condom availability on sexual
behavior and condom use.
Methods: School-wide student surveys were administered in spring 1993 and
in spring 1995, before and during the implementation of the condom availability
program. These data were compared with data from nationally representative
surveys administered at the same time.
Results: Students in the ten high schools obtained an average of 4.6 condoms
per year, the vast majority from baskets and very few from vending machines. In
two schools with both vending machines and baskets, students obtained more
than 70 times as many condoms from baskets than from machines. Relative to
the national samples, the percentage of students who had ever had sex remained
the same after the program began (46% in 1993 vs. 42% in 1995); the percentage
of students who had sex during the three months preceding the survey decreased
significantly (32% of students in 1993 vs. 28% in 1995, p =.02); and the percentage of sexually experienced students who used a condom the last time they had
sex decreased significantly (57% in 1993 vs. 51% in 1995, p =.04), particularly
in the five schools with clinics and baskets of condoms (57% vs. 47%, p =.005).

Conclusions: Making condoms available in this city's high schools enabled
students to obtain relatively large numbers of condoms, but did not increase condom use. One explanation for this finding is that condoms were already accessible
to students; the school-based program created a substitution effect. In addition,
school condom availability may not have addressed the barriers to condom use.