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Almost all the states in America promote some form of sexuality and HIV education through mandates or recommendations. According to an article entitled "Sexuality Education in American Public Schools," 47 states require or encourage teaching about human sexuality, and 48 states require or encourage instruction about HIV/AIDS. Although these statistics suggest that sexuality and AIDS education is widely available in American schools, the quality and comprehensiveness of this education can vary considerably.
In some schools, teachers of HIV and sexuality education are prohibited from mentioning topics such as intercourse, homosexuality, or condoms. (SIECUS Internet) In contrast, a comprehensive HIV and sexuality education program features a thorough and accurate curriculum that examines such subjects as human development, sexual behavior and health, relationships, and society and culture. This type of curriculum explains the facts of HIV and sex, and does not leave room for misunderstanding and misinterpretation by the students. Less than 10% of American students receive comprehensive sexuality education throughout their school years. (SIECUS Internet) This paper is going to discuss the characteristics of a successful, comprehensive HIV and sexuality education program that is so badly needed in our schools today. It will also look at community and parent/child programs also available.
As reported by The AIDS Knowledge Base, the Division of Adolescent and School Health within the Centers for Disease Control and Prevention has an important "Research to Classroom" initiative in which it rigorously examines the evidence for the effectiveness of programs in reducing sexual risk-taking behaviors. (SIECUS Internet) It then supports the adoption of those programs in schools and communities. So far, it has identified four curricula as having particularly strong evidence for success. The four curricula are Be a Responsible Teen, Be Proud and Be Responsible, Get Real about AIDS, and Reducing the Risk. (SIECUS Internet) According to the article "HIV Prevention Among Adolescents" these four curricula and other successful curricula share nine characteristics that make them such a thriving AIDS and sexual education curriculum. In the following paragraphs I would like to look at the nine characteristics of a successful curricula, the two current comprehensive community HIV education programs and the HIV education programs for parents and their families.
The first characteristic of an effective program is that it focused clearly on reducing sexual behaviors that lead to unintended pregnancy or HIV infection.
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Next, behavioral goals, teaching methods, and materials were appropriate to the age, sexual experience, and culture of the student. For example, programs for younger youth, few of whom had engaged in intercourse, focused upon delaying the onset of intercourse. Programs designed for high school students, some of who had engaged in intercourse, emphasized that students should avoid unprotected intercourse, either by not having sex or by using contraception if they did have sex. And programs for higher-risk youth, many of whom were already sexually active, emphasized the importance of using condoms and avoiding high-risk situations. In addition, effective programs tried to be sensitive the language and culture of the targeted youth.
Third, effective programs were based upon theoretical approaches that have been demonstrated to be effective in influencing other health-risk behaviors. Some examples are: social cognitive theory, social influence theory, social inoculation theory, cognitive behavioral theory, and the theory of reasoned action. When applied to sexual behavior, social learning theories hypothesize that behavior such as delaying the initiation of intercourse or using protection will be affected by an understanding of what must be done to avoid sex or to use protection (knowledge), a belief in the anticipated benefit of delaying sex or using protection (motivation), the belief that particular skills or methods of protection will be effective (outcome expectancy) and the belief that one can effectively use these skills or methods of protection (self-efficacy). Social learning theories give considerable recognition to the fact that youths gain these understandings and beliefs directly through education and indirectly by observing the behavior of others. In addition, social influence theories address the communal pressures upon youths, and the importance of helping youths understand and resist those pressures. Thus, these programs go far beyond the cognitive level; they focus on recognizing social influences, changing individual values, changing group norms, and building social skills.
Fourth, effective programs last a sufficient length of time to adequately complete important activities. Shorter programs appeared to have less effect, while longer programs provided the opportunity to complete many of the activities discussed below. Effective programs tended to fall into two categories, those that lasted 14 or more hours, and those that lasted a smaller number of hours, but that implemented the curriculum in small group settings with a leader for each group. This may have enabled them to involve the youth more completely, to tailor the material to each group, and to cover more material and more concerns more quickly in each group.
The next characteristic is that effective curriculums employed a variety of teaching methods designed to involve the participants and have them personalize the information. Instructors reached students through active learning methods of instruction, not through didactic instruction. Students were involved in numerous experiential classroom and homework activities: small group discussions, games or simulations, brainstorming, role-playing, written rehearsal, verbal feedback and coaching, locating contraception in local drugstores, visiting or telephoning family planning clinics, and interviewing parents.
Sixth, curriculums provided accurate information about risks of unprotected intercourse and methods of avoiding unprotected intercourse. Increasing knowledge of sex was not the primary goal of these programs, but rather providing basic information that the students needed to assess risks and avoid unprotected sex. Typically, this information was not unnecessarily detailed. For example, the curricula did not provide detailed information about all methods of sex or contraception. Instead, they emphasized the basic facts needed to make significant choices.
Seventh, effective programs included activities that address social pressures on sexual behaviors. This took several forms. For example, at least one curriculum addressed media influences (e.g., how sex is used to sell products and how the television shows often suggest that characters have unprotected intercourse but don't experience the consequences). Several curricula discussed situations that might lead to sex. Most of the curricula discussed "lines" that are typically used to get someone to have sex, and some discussed social barriers to using contraception (e.g., embarrassment about buying condoms) and how to overcome those barriers. Some of them also addressed peer norms.
Eighth, effective programs provided modeling and practice of communication, negotiation, and refusal skills. Typically, the programs provided information about the skills, modeled effective use of the skills, and then provided some type of skill rehearsal and practice (e.g., verbal role-playing or written practice). There were, however, significant variations in the quality of and amount of time devoted to skill practice.
Finally, effective programs selected teachers who believed in the curriculum that they were teaching and then provided training for those individuals. The training for these teachers ranged from six hours to three days. In general, the training was designed to give teachers information on the curriculum as well as rehearse using the teaching strategies included in the curricula.
In addition to these nine characteristics, it has been observed that programs implemented with African-American youth may be more effective at changing behavior than programs for white youth. This may reflect the fact that HIV is more prevalent among African-Americans and thus is a greater threat. It has also been observed that programs implemented in community settings may be more effective than programs in schools. This pattern may reflect the fact that when programs are implemented in community settings, youth voluntarily participate in them, and may therefore be more receptive to their messages. (SIECUS Internet)
Currently, there are two large and comprehensive community-wide HIV education program(s) for adolescents that have been implemented and evaluated to date. The first was a intervention in New England that was designed to increase the use of condoms and reduce HIV transmission. Trained peer leaders implemented workshops in schools, community organizations and health centers; organized group discussions in the homes of youth; gave presentations at large community events; and conducted street corner and door-to-door canvassing. They also passed out condoms and pamphlets on how to use them. In addition to these peer-led activities, there were radio and television public service announcements, and posters in local businesses and public locations. In comparison with youth in another city, males were less likely to initiate intercourse, and females were less likely to have multiple partners. However, the program did not significantly affect other measures of sexual activity or condom use. (Motamed Internet)
A second study examined the impact of a social marketing campaign in Portland, Oregon. Three public service announcements were developed and aired on television, condom vending machines were installed in locations recommended by youth, and teenagers were trained to facilitate small-group workshops that focused upon decision-making and assertiveness skills. Results indicated that the campaign did not increase the proportion of higher risk youth who had ever had intercourse, nor did it increase their acquisition of condoms or their use of condoms with their main partners. However, after the campaign began, there was a significant increase in their use of condoms with casual partners; after the campaign ended, this use returned to baseline levels. In combination, these two studies suggest that comprehensive community programs may have an impact upon adolescent sexual behavior, but the evidence is not yet strong. (Motamed Internet)
Many parents and adolescents have observed a scarcity of communication between parents and their own teenagers about sexuality. Consequently, programs have been developed to increase this communication and thereby decreasing adolescent sexual risk-taking behavior. Studies have indicated that programs can increase parent/child communication. However, only two studies have actually examined the impact of these programs upon adolescent sexual behavior. (Kirby)
The first of these was implemented by Girls Incorporated (formerly Girls Clubs) and included five two-hour sessions for mothers and their daughters. Although the comparison group was much more likely to initiate intercourse, the result was not statistically significant.
The second program included a well-designed video and written materials to be viewed at home. It also increased parent/child communication, but failed to delay significantly the onset of intercourse, in part, because very few youth in the control group initiated sex in the conservative community. Thus, it remains unclear whether or not these programs can reduce sexual risk-taking behavior. (Kirby)
It is understandable that not all AIDS and sex education programs for students, families or communities effectively stop unprotected sex, but according to a study performed by Planned Parenthood, curriculum based HIV and sex education with the afore mentioned nine characteristics combines with community or family involvement may be able to delay the onset of intercourse, reduce the frequency of intercourse, and increase the knowledge of risks that come with unprotected sex. Giving students access to full and accurate information regarding HIV and sex gives them the power to make informed choices starting at a very young age.
"AIDS Education and Young People." AVERT. 5 September 2000. http://www.avert.org/aidsyoun.htm
"AIDS Education and Young People at School." AVERT. 5 September 2000. http://www.avert.org/aidsyoun.htm
Alter, J Wilson. Teaching Parents to Be the Primary Sexuality Educations of Their Children: Final Report. Princeton, NJ: Mathtech Inc.,1982
"HIV Prevention Among Adolescents." The Aids Knowledge Base. 10 September 2000. http://hivinsite.ucsf.edu/akb/current/09adol/
Kirby D. Sexuality Education: An Evaluation of Programs and Their Effects. Santa Cruz, CA: Network Publications, 1984
Motamed, Susan. "Condom Availability and Responsible Sexuality Education." Planned Parenthood. 10 September 2000. http://www.plannedparenthood.org/articles/sexed.html
"New Facts and Data." The Sex Education Coalition. 22 November 2000. http://www.sexedcoalition.org/surveys.htm
"Sexual Education in the Schools." Abortion-A Personal Decision. 10 September 2000 http://www.aborto.com/escola-1.htm
"Sexuality Education in the Schools: Issues and Answers." SIECUS. 10 September 2000. http://www.siecus.org/pubs/fact/fact0007.html
"What You Should Know about Sexuality Education." Planned Parenthood. 10 September 2000. http://www.plannedparenthood.org/library/SEXUALITYEDUCATION/whatyoushouldknow.htm
Thesis: This paper will illustrate the benefits of AIDS education by discuss the nine characteristics of effective HIV education curricula, community HIV programs and parent involved HIV programs.
I. There are nine characteristics associated with successful AIDS education curricula.
A. Focused on reducing sexual behaviors.
B. Age, experience and culture appropriate.
C. Theoretical approaches.
D. Length of time.
E. Variety of teaching methods.
F. Accurate information about risks.
G. Activities that address social pressures.
H. Modeling and practice of communication.
I. Selection of teachers.
II. There are currently two comprehensive community HIV education programs.
A. New England intervention.
B. Oregon marketing campaign.
III. There are HIV education programs for parents and their families that help increase communication.
A. Girls Incorporated program.
B. Video and written material program.
Teachers Comments: This paper definitely deserves and A for excellent research and application to argument.