Panos | 31 May 2008

By Kristin Palitza

South Africa (2010 Features): South African children and teenagers know quite a lot about HIV and AIDS, but very little of this information translates into behaviour change when they become sexually active. Experts put this dangerous trend down to a gap between education and lived experience.
There is a lot of information on HIV and AIDS easily available in South Africa, through the many AIDS awareness campaigns run by government and non-governmental organisations (NGOs).

About 95 per cent of young South Africans say they know about HIV, how it is spread and how to protect themselves. But when asked what can be done, the vast majority only identify using condoms to prevent HIV infection, according to a 2003 study by the Reproductive Health Research Unit (RHRU) of the University of the Witwatersrand in Johannesburg.

Almost 70 per cent of sexually active youth do not use condoms consistently, and 31 per cent say they never used a condom with their most recent sexual partner, note RHRU researchers. They also found that the majority of youth do not think they are personally at risk of contracting HIV. Sixty one percent of HIV positive and 73 per cent of HIV negative youth think they are at no risk at all or have a small chance of getting HIV.

Although AIDS awareness campaigns may have been successful in terms of improving knowledge about HIV, the actual difference they have made in changing behaviour driving the spread of the epidemic is questionable. The prevailing high rates of HIV found across South Africa suggest that people receive information but fail to act upon it. According to the United Nations Children’s Fund (UNICEF), there are more than 5 million persons living with HIV in South Africa today.

“There is definitely a gap between knowledge and implementation. Changing mindsets is a long process that needs a lot of open and frank communication and involvement of all levels of society,” says LoveLife information manager Vera Mothopeng.

Statistics show that South Africans’ sexual behaviour remains unchanged despite the education efforts. Condom use remains at a low of about 10 per cent among males and one in three women gives birth before the age of 18.

One reason for the slow change in behaviour might be that AIDS education often starts at a late age. Although there is information available for teenagers and adults, few educational materials and programmes are targeted at children under the age of twelve.

“We are neglecting the group of people that is so important to reach,” says Johanna Ncala, national treatment literacy coordinator for the Treatment Action Campaign (TAC). “If we don’t educate children on HIV, we will face even worse challenges in ten years time than we already do now.”

In 2001 the South African government took a major step forward in addressing the issue of HIV and AIDS education for children and youth. The national Departments of Health and Education jointly developed a national life skills and HIV and AIDS education programme, which has since been made an integral part of the school curriculum. There are however challenges in delivery of this school life skills module.

“The information provided in schools is too abstract and value-heavy. There is a reluctance to give information that is directly related to children’s lives,” explains Donique de Figueiredo, manager of Soul City’s Soul Buddies Club project where children and youth meet at least twice a month to talk about health-related issues, including HIV and AIDS. “And most of our AIDS education is not facilitated correctly or not pitched at the right age.”

Teachers often lack adequate knowledge of the disease. Many feel uncomfortable discussing sexuality and safe sex with young learners. Experts also say that the school-based approaches are mainly based on the ABC of AIDS prevention – abstinence, being faithful and using condoms – a method that teaches youngsters how to protect themselves from HIV transmission, but ignores the gender inequalities and gender-based violence which put girls and women at special risk.

Another factor preventing South African children from translating knowledge into behaviour is that the behaviours they see in their homes do not match the lessons learnt at school, de Figueiredo notes. She says that inside their family context, many children witness role models (parents, guardians and older family members) living with domestic violence, financial dependence, patriarchy and ignorance.

“There is not enough role modelling. Life at home often contradicts what children have been taught about prevention and positive living. It’s confusing for them,” she says._ _Cati Vawda, director of the Children’s Rights Centre, agrees, noting that as a result, most South African children don’t grow up with healthy attitudes towards sexual relationships and intimacy: “Young children learn from what we do, not from what we say. As much as knowledge is power, it’s not enough.”

This means that parents cannot solely rely on schools, television programmes and civil society organisations to educate children. They need to play their part, too. Caregivers need to talk more often and more openly with children about HIV and sexuality. However adults are often unable to speak to children about difficult issues, such as disease, sexuality, death and relationships. Almost 70 per cent of South African teenagers say they wish they had learnt about sex from their parents, but only 22 per cent say they did, a 2002 American Foundation for AIDS Research study revealed.
South Africa, the country with the highest HIV infection rate in the world, needs to roll out a special prevention education strategy targeted at children, local experts say.

“Our high teenage pregnancy rates indicate that the current HIV education [aimed mainly at teenagers and adults] is insufficient. Otherwise, there would be less young girls and boys who have unprotected sex,” says Ncala, adding that an effective strategy must address gender roles, children’s rights, poverty and violence, besides providing medical information.

AIDS service organisations working with young people say HIV and AIDS education messages in South Africa must be consistent if they are to be effective.

“Government departments, NGOs and civil society organisations all have their own campaigns, focusing on different themes within HIV and AIDS, yet what we need is one, clear message,” says de Figueiredo.
Finally, the family, the community and national and community institutions must be mobilised and supported to provide effective HIV and AIDS education which addresses the social and cultural realities of young people.

“You will find that many children have basic knowledge of what HIV and AIDS is and how it is transmitted, but they don’t understand how it translates to their day-to-day lives,” says de Figueiredo. For her, the most important aspect of HIV education for children is that “it has to take place in the context where people live. We need to discuss with them what it means to be a child in the time of HIV.”/2010 Features