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

190 Abstracts 13521-13525

12th World AIDS Conference

13521 Knoweldge of and need for AIDS/STD/safer sex education
among first year medical students in Beijing and
Shanghai
Yuan Gao'2, Z.Z. Lu3, P.F. Zhao4, S.G. Gu5, R.V. Short2. 1c/o Division of Health
Education, Beijing Medical University, Beijing 100083; 3 Beijing Medical
University Beijing; 4 Shanghai Institute of Planned Research Beijing; 5 China
Preventive Medical Association Beijing, China; 2Royal Women's Hospital
Melbourne, Australia
Issues: Baseline information needs to be collected prior to designing an adolescent AIDS/STD Safer Sex peer education program that can be tailored to the
needs of the target population.
Project: A combination of questionnaire surveys, focus group discussions and
in depth interviews was used to collect baseline information on sexual knowledge,
attitudes and practice of first year medical students at Beijing Medical University
and Shanghai Medical University. A total of 570 students aged 16 to 23 filled in
the questionnaires. Ten focus group discussions and 18 in-depth interviews were
conducted with medical students, university administrative officials in charge of
students, university clinic doctors and senior university officisals.
Resulta: The return rate of the questionnaires was 100%. The results ahow
that the first year medical students and very little formal education about
AIDS/STDs/Safer Sex, and their knowlodge in this area needed to be improved.
They had some misconceptions about AIDS/STDs, which need to be addressed.
Their attitudes towards AIDS patients or HIV carriers were ganerally harah,
About 1.5% of the surveyed students practiced pre-marital sex (2.3% males and
0.6% famales) without using any form of modern contraception. Although the
prevalenca of pre-marital sex was low, their attitudes to this behaviour ware in
general liberal and tolerant. Over 96% of them thought thst AIDS/STD/Safer Sex
education was necessary for them.
Lessons Learned: Not only do the students have insufficient know Igedge
about AIDS/STD/Sater Sex and tolerant attitudes towards pre-marital sex, but
they also think they need much more AIDS/STD/Safer Sex education. Therefore,
it is necassary to carry out such an educational progrm among first year medical
students at these two universities.
S13522 Young children need to know about sexuality, STD, AIDS
and drug abuse
Cledy Eliana Santos, M.C. Pimenta, I.P. Negrao. Brazilian AIDS Program MOH,
Espl. Ministerios BL. G. Brasilia DF 70058-900, Brazil
Issue: Between 1993 and 1996 the number of childbirth for 10 to 14 year old
girls increased from 0.93% (26,505) to 1.16% (31,911) of the childbirth carried
out within the public health service in Brazil. By August 1997, 2.5% (2,879) of the
total officially notified AIDS cases were among adolescents 10 to 19.
Project: Recognising the vulnerability of this segment of the population to AIDS
and other STD infection, the Ministry of Health developed a joint public policy
project with the support of the Ministry of Education to introduce STD, AIDS and
drug abuse at the elementary public schools. Educational materials and teacher
training was developed for children age 4 to12 on themes related to self-steam,
interpersonal relationships and social responsibility, as well as, teaching about
health care (hygiene and prevention of diseases), sexuality, sexually transmitted
diseases, AIDS and drug abuse prevention. Due to the fact that adolescent girls
in Brazil are engaging in sexual intercourse in early adolescence, we assume
that sexual education and empowerment as it relates to self-steam will be more
effective when taught prior to their first sexual experience having as a possible
consequence the postponement of sexual activities for a few years, reduction of
STD and AIDS infections, as well as, unintended pregnancies.
Results: A series of 3 teaching manuals and 15 stories (comics style) were
created for pre-school, elementary and first grade teachers and children. The
materials present theoretical information for teachers, activities and games to aid
children's learning. Each set of material presents five units: 1) human body and
its development; 2)home, school and friends (interpersonal relationship); 3) the
importance of communication for good social living; 4) STD and AIDS prevention;
5) drug abuse prevention. In August 1997, 80 thousand teachers were trained to
work with approximately 2 million children aged 4 to 12.
Lessons Learned: 1) In developing STD, AIDS and drug abuse prevention
programs addressed to children we are seeking, to provide them with information;
to increase their sense of positive behaviour towards themselves, self care and
care for others as a tool for better decision making; 2) In short, its easier to
develop positive attitudes and behaviour earlier in life than to change negative
ones with adults.
13523 Formation of multipliers of information in Brazilian high
school communities
Antonio Luiz Martins Dos Reis. Rua Cruz Machado 353/03 Curitiba-PR
80410-170, Brazil
Issues: Between 1980 and 1997, 34.3% (39,925) of reported AIDS cases oc
curred in young people in the age group 15-29 in Brazil. This suggests that
traditional sex and AIDS education in public High Schools has not been effective
in AIDS prevention.
Project: 11 High Schools were selected in the city of Curitiba (Southern Brazil)
to participate in an STD/AIDS prevention project. The selection took place in
conjunction with the local health authorities so that not only the school but also
the local health centre are jointly involved in the project. A 24 hour course was

held in each school for up to 30 people, including students, teachers, parents and
health workers. The course was conducted using interactive methodology with
total participation of all those present. The main topics dealt with were HIV transmission and prevention, safer sex, prejudice/discrimination and social exclusion,
effective communication, seropositiveness, drugs and how the community can
help in the fight against AIDS.
Results: 103 students, 37 teachers, 29 parents and 33 health workers were
trained as multipliers of information. 11 schools are participating in the project.
Each school has formed its own community organisation to ensure the project's
continuity. The 11 organisations meet every 3 months to exchange experiences.
Lessons Learned: The importance of training not only students and teachers
to be multipliers of information, but also parents and local health centre staff, so
as to root the project in the community and guarantee its continuity even after the
students have graduated. The mixture of age groups in the training courses also
broke down barriers regarding the discussion between adults and adolescents of
sexuality and AIDS prevention.
S135241 Consciousness raising school-based AIDS intervention
among Mayan youths in the Guatemalan highlands
Janet Ikeda1'2, J.E. Barrios Mena2, G.G. Polanca Aguilar2, E.S. Garcia
Piedrasantos2, C.A. Lopez Tellez2. 121 Avenida 3-22, Zona 3 Quetzaltenango;
2lnstituto de Educacion Integral (IDEI) Quetzaltenango, Guatemala
Issue: Rural youths living in male-dominated societies require innovative interventions that focus on how socioeconomic and cultural factors influence in AIDS
prevention.
Project: Given the increase in HIV cases in youths living in the rural countryside, religious influences, and traditional gender beliefs held by Mayan youths in
Quetzaltenango, a school-based intervention was developed using critical educational techniques to analyze the socioeconomic and cultural barriers to safe sex
practices. Strategies include: confidence gaining activities, historical reference to
socioeconomic and cultural barriers, HIV prevention workshop, inter-school debates, after-school peer education training, community advocacy, and inter-school
poster competition. The program used oral and written evaluation methods.
Results: The Consciousness Raising AIDS intervention was well received
by the rural schools. Before the intervention, 74.86% (533/712) Mayan youths
showed strong masculine gender beliefs and 78.93% (562/712) had misconceptions about the spread of HIV/AIDS. After the intervention, 78.40% (558/712) of
the Mayan youths were able to devise strategies to prevent contracting HIV. The
6 male and 10 female trained peer educators participated in a local televised talk
show and held a forum with local authorities to discuss strategies for preventing
HIV/AIDS in youths.
Lessons Learned: Consciousness raising AIDS interventions in rural schools
may assist youths in male dominated societies in changing attitudes about safe
sex practices: postponing sexual relationships, fidelity, within sexual relationships,
and condom use. Further studies need to evaluate the impact of the intervention.
13525 1 Overcoming barriers: Talking about SID/AIDS and sex
among campus students in Pokhara, Nepal
Rajendra Prasad Bhadral, Y.R. Timsina1, K.P. Bista1, A. Erpelding2. 1BP
Memorial Health Foundation c/0 STD HIV Project, Kathmandu, Nepal; 2Dept.
Tropical Hygiene & Public Health UOH, Heidelberg, Germany
Issue: Peer education is an effective way of addressing taboos like sexuality,
risky behaviour and SID/HIV prevention among Nepalese adolescents.
Project: Like in many other countries, campus students in Nepal were found
to be a group with potential risk behavior. Away from home to study, they have
more freedom to enjoy sex but, because of cultural barriers have insufficient
knowledge on how to protect themselves from SID/HIV infections. Therefore, a
peer education program was introduced in Pokhara which was selected because
it is in educational centre for the region and a major tourist centre. The program,
the first of its kind in Nepal, started in two campuses, 28 students (16 male, 12
female) were selected and trained on SID/HIV/AIDS, sex and sexuality and skills
on how to protect themselves and their peers. The training also enabled them to
design and implement their activities. The first training (7 days) was followed by a
5-day refreshed course. We provided IEC material, technical and financial support
for the activities. Frequent supervision and monitoring visits were done along with
regular meetings. Close relationship and non-monetary incentives were provided
to the peer educators.
Results: Since the beginning of the program, peer educators educators educated 2697 students in an informal setting. Two quiz and 15 video shows were
organised for 619 and 738 students respectively. Though it was sometimes difficult to provide technical information, they were able to educate their friends
about these taboo issues. This student to student approach also helped minimize
political polarization and get support from student unions and campus authorities,
which was essential for the program success.
Lesson Learned: Peer education programs are very effective and efficient
as student peer educators are in a better position to discuss topics related to

HIV/AIDS/STD, sex, sexuality and behaviour change with their friends. Training, constant supervision, monitoring, incentives, good relation and balancing of
political polarisation were key elements to the success in this program.