DeLoach 1

Brandon DeLoach

Tatum

AP Language 4th

23 February, 2020

HIV and AIDS Education Reform

Introduction

In 1981, numerous cases of rare diseases, such as Kaposi’s Sarcoma and Pneumocystis

pneumonia, were repeatedly popping up in major cities across the United States. This epidemic

baffled epidemiologist because these were such rare and deadly diseases and almost all of the

cases occurred in the same groups of people: homosexuals, hemophiliacs, heroin addicts, and

Haitians, a group later called the 4-H Club, a term coined by the American public (AVERT).

After looking into these cases further, scientists linked these rare diseases to an

immunodeficiency disorder known as the Human Immunodeficiency Virus (HIV) commonly

found in the Democratic Republic of the Congo, and in June of 1981, the first case of HIV was

documented in the United States. Scientists then found that, if left untreated, HIV would develop

into an even deadlier illness known as Acquired Immunodeficiency Syndrome (AIDS). The

incident rate drastically increased annually until around 1995, then began to slowly decrease due

to treatments and prevention education. However, once the climax of the epidemic abated and

treatments increased, prevention education eventually decreased as a result.

AIDS/HIV prevention and risk education has not only decreased since the climax of the

epidemic in the 80’s, but has also become ineffective in thoroughly educating the younger

generations. Many of today’s youth learn about HIV/AIDS through an unengaging lecture in

their health class, leading many students to not pay attention and learn the seriousness of the
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problem. They understand that HIV is a virus they can obtain through sexual contact, but they

don’t truly understand or even care about the risk and danger of it. In the peak of the epidemic,

the public saw this deadly disease up close; however, the modern youth did not live through the

peak of the epidemic, causing them to not truly understand or worry about the disease.

The diluted significance projected onto the youth in today’s society has caused a

spike in HIV/AIDS incidence rates in younger generations. Although the youth receive

mandatory education in the form of health classes, this tactic does not work effectively as the

incident rate is relatively stagnant compared to the older generations (concession). Due to the

youth’s lessened exposure to HIV/AIDS, they need to be educated more than older generations

in newer, specific, and more modern ways.

Literature Review

Misinformation can cause students to not understand the risks of this disease, while also

causing dramatic increases in the stigmas surrounding HIV. Joanna Moorhead, a journalist for

the Guardian, explains in the article How Schools are Getting It Wrong on HIV and AIDS, that

many teachers and adults are misinformed regarding HIV and AIDS, leading their students to

learn and hear wrong information. Most of the information given by these adults is outdated,

wrong, or built from stigma. In HIV Stigma and Discrimination, Avert, a 34-year-old HIV

charity, explores the direct relationship between stigma and discrimination and vulnerability.

HIV stigma comes directly from associations with death and homosexuality and sex work and

drug use and inaccurate transmission information (polysyndeton). Stigma not only creates

misconceptions and inaccurate information, but also marginalizes at risk groups. This

marginalization directly leads to increased incident rates and sickness. Since HIV is so closely
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related to these marginalized groups, many people are unwilling to get tested as they do not want

to be marginalized as well, contributing to a surge in infections and AIDS related death.

Schools are often the only source of information for youths and unfortunately, most do

not prioritize health education in their core curriculum. According to Kathleen Ethier, director of

the Division of Adolescent and School Health at the Centers for Disease Control and Prevention,

schools are a key factor in “promoting the health and safety of youth and… [fighting] to prevent

HIV.” Schools should give students the background and knowledge needed to prevent HIV and

other sexually transmitted diseases; however, the curriculum has barely changed since the 1980s.

New education methods and prevention programs need to be implemented in ways that will

reach the newer at-risk populations to reduce infection and stigma. Studies from the CDC show

that prevention programs and education dramatically decreased mother to child HIV

transmission over 95% since the mid 1990s. However, around 80% of homosexuals, a large at-

risk group, have not been reached by these same prevention methods (CDC).

While more modern schools do offer HIV prevention programs they are often futile as

many youths ignore them or aren’t even included. Marcia Quackenbush, an experienced HIV

health researcher and senior editor at ETR, lists five ways that schools can improve their HIV

prevention programs to not only be more effective, but to reach a wider range of at-risk youth

(Quackenbush). Since the majority of at-risk youth belong to marginalized groups, such as men

who have sex with men and transgender women, prevention programs and education can reach

them by using inclusive language and content. Inclusivity methods help to create a safe and

welcoming school environment that will protect and engage at-risk youth, all while educating

them on how to be safe outside of this environment. Also, in a safe environment, teens are more

likely to disclose their diagnoses to trusted adults and friends, helping to improve mental health
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and education. Marian Hodgkin, an educational development specialist, and Marian

Schilperoord, an experienced HIV author for United Nations High Commissioner for Refugees)

believe that all children have the inherent right to learn skills and information that will keep them

safe while they “begin to express their sexuality” (Hodgkin and Schilperoord 29). Learning

these skills can help to prevent and provide protection from both HIV and AIDS in not just at-

risk youth, but everyone. Since many students do not choose abstinence, a 100% effective and

common safe sex method prescribed by schools, modern, logical, and safe approaches to risky

behaviors need to be discussed. The information being taught should be accurate and current as

HIV and AIDS is no longer a death sentence due to the numerous treatments available,

something Quackenbush believes should also be taught about in depth. In contrast, Gregg

Gonsalves, a long time AIDS activist and researcher, believes talking about treatments gives a

false sense of hope and “[distracts] from the work [needed] to [be focused] on” (Gonsalves).

Teaching skills that address how to deal with all types of risky behaviors is beneficial in the long

run because “[students] who can resist [drugs]… are less likely to engage in all kinds of risky

behaviors” (Quackenbush). Ethier states that over the past ten years youth condom-use has

continually decreased, while simultaneously “1 in 5 new HIV diagnoses were … in young people

aged 13-24 years” (Ethier). Increases in risky behavior, such as lessened condom-use, directly

link to increases in HIV incident and infection rates. Information regarding access to condoms

and healthy behaviors allow for students to be safer with their risky behaviors, therefore leading

to reduced infection rates. Focusing on “functional knowledge [related] to choosing healthy

behaviors” instead of abstruse information regarding the biology behind the disease helps to lead

the youth into safer habits and less risky behavior (Quackenbush). Once students understand the

usefulness of these skills and prevention methods, they can put them to use. However, many
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youths are not able to buy condoms or get tested for HIV due to their age and/or restrictions from

legal guardians. Schools giving students easy access to resources such as “condoms,

contraception, and STD/HIV testing” allow them to be more responsible and protect themselves.

Creating on campus “health centers” allows schools to provide these resources or suggest other

youth resources provided by community (Quackenbush).

Argument

HIV/AIDS has changed tremendously since the peak of its epidemic. In its peak, HIV

mainly affected middle aged 4-H club communities; however, now HIV’s demographic is

shifting toward the younger generations with in 4 new HIV infections being youth aged 13-24

(Quackenbush). Schools did not focus on HIV/AIDS prevention education because their

audience was not being affected directly. In the current education system, the topic of HIV and

AIDS needs to be readdressed through the use of reformed curriculums, modernized information,

and the creation of inclusive and safe environments in order to reduce the number of HIV and

AIDS cases in the youth aged 13 to 24.

Health education classes in school should encompass all aspects of health; social,

physical, mental, and sexual. Since sex is considered a taboo and an uncomfortable topic to talk

about with young people, sexual health content is often either skimmed through or completely

ignored, leading to an sexually uneducated youth population. Personally, in middle school, a

time many would consider an important developmental stage, my health class spent the majority

of the time talking about drugs, social troubles, and physical health. Although these topics are

very important, it left us with only a week to talk about sexual health. Within this week of class,

a total of 3 hours and 45 minutes, we had to cover anatomy, sexually transmitted diseases,

contraception options, pregnancy, and abstinence. Even with the limited amount of time to cover
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all of these topics, my teacher spent four out of the five days teaching about abstinence and the

biological processes involved in sex, leaving the rest of the information to either be left out or

hastily skimmed through. Luckily, I grew up very curious so I was able to learn much of the left-

out information by myself through the years, but I cannot say the same for my peers. I remember

that HIV and AIDS was not spoken about at all, and I did not learn what it was until my high

school health class a few years later (anecdote). The sex education curriculum, specifically

surrounding STDs such as HIV and AIDS, needs to be changed in order to put more focus on

prevention methods and increased perceptions of risk. Curriculums need to focus not only on

abstinence but also safe sex methods, such as condoms, birth control, and knowing one’s status,

as many youths do not choose abstinence. Focusing on all types of safe sex methods allows

young people be more cautious in their risky behaviors, ultimately decreasing their risk and

prevalence of HIV and AIDS.

Also due to the decreased education, many youths believe that HIV and AIDS are no

longer important or prevalent in society. They do not see a significant risk attached to these

diseases, leading to an ignorance that cyclically leads to more ignorance. Increasing the youth’s

perception of risk regarding HIV and AIDS is one of the simplest ways to help decrease the

infection rate. The more the youth know about the risks and outcomes of HIV and AIDS, the

more likely they are to go through the steps to try to prevent it.

Another aspect in the risk perception is the fear factor. Knowing the risks surrounding

HIV is not enough to spark action, the youth must be fearful of the disease. For example, almost

all the youth understand the risks associated with vaping and nicotine; however, many continue

to go through with these risky behaviors because they are not scared of the risks. However, a

recent case where the fear factor worked is in the COVID-19 virus. The media portrayed the
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virus as a very serious problem, which scared the vast majority of the public into using

prevention methods, such as washing their hands and socially isolating themselves. If the youth

becomes fearful of HIV and AIDS then they are much more likely to go through the steps of

preventing the virus.

After learning the true risks involved with HIV and AIDS, youths need to understand the

ways they can go about preventing the disease. Many educators are misinformed on the modern

prevention methods, still thinking that HIV and AIDS is a “deadly disease [with] no known cure”

(Moorhead 7). Due to the lessened prevalence of HIV/AIDS information in the media, many

educators and adults base their knowledge of this disease on the campaigns released in the peak

of the epidemic. Educating the educators on these new prevention methods will directly impact

the students and youths in a beneficial way. The educators need to be well versed on the new

advancements in prevention tactics, not just condoms and abstinence. Using information from

the 80s fails to inform the youths of modern treatments such as antiretroviral therapy (ART), the

most effective HIV/AIDS treatment, and prevention medicines such as Pre-Exposure

Prophylaxis (PrEP), a common medicine that not only treats HIV and lowers the viral load, but

also helps an HIV negative person to protect

themselves against HIV. Another topic that

needs to be addressed by the educators is the

new fatality rate of HIV and AIDS. As I have

stated before, these diseases have changed

tremendously since their emergence in 1st world

countries. They used to be considered a death
sentence by many as there was very little known
The number of HIV and AIDS cases in the
American youth population (13-24) from
1995-2017 (CDC)
The grey line represents when PrEP was
released to the public.
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about them and no specific treatments for them; however, with the advancements in research,

numerous treatments have been created leading to a drastic decrease in their mortality rate.

While the youths do need to be fearful of the virus, they also need to understand that with the

right help living with HIV or AIDS is not only possible but actually very common. Gonsalves is

correct that the hope created by these treatments distracts from the work that needs to be done;

however, I believe that the only way to help decrease the incident rate of this virus in younger

populations is to inform them of the treatments and prevention methods available to them.

Another piece of information that needs to be readdressed by educators in a modern way is the

at-risk groups. In its emergence the virus mainly affected homosexuals, heroin addicts,

hemophiliacs, and Haitians (alliteration), and while it still does greatly affect these groups of

people, it also now affects all groups and communities. Educators need to teach that the virus is

not limited to only these groups of people and all sexually active youth, and adults, need to take

the precautions necessary to eliminate HIV and AIDS.

Although the virus does not discriminate, there is a very large discriminatory stigma

surrounding this disease. Adults often associate this disease with homosexuals and intravenous

drug users, two groups that are extremely discriminated towards. This idea likely gets passed

down to their children and other youths, which can ultimately be deadly and help to cause more

cases of HIV and AIDS. Due to the stigmas around these associated groups, many youths and

even adults are afraid of asking for help, disclosing their status, and getting treatment, due to the

fear of others associating them with these discriminated groups. This problem is especially

serious in youth due to the fear of what their guardians might think or do. And more than often,

youth don’t have a trusted adult outside of their family they can talk to, meaning they go

untreated without help. Schools and educators can help this problem by creating an inclusive safe
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environment in which youths feel comfortable asking for help. The first step in creating an

environment in which all students feel safe is to use inclusive language and content. Health

classes should teach content involving LGBTQ topics and use inclusive language when talking

about these topics. This change would help to better engage at-risks groups and could help to

reduce the stigma surrounding them, which in turn would cause more youth to be comfortable

asking for help regarding HIV and AIDS. It would also allow LGBTQ youth to feel more

comfortable at school, which would increase attendance rates and directly increase one of the

most at-risk group’s educations in all areas.

Conclusion

With young people aged 13-24 making up 21% of the new HIV infections in 2017, the

sexual education programs are clearly not working for today’s youth. Throughout my research of

HIV and AIDS education in today’s youth, I found a broad range of problems that needed to be

addressed. Before my research, I believed that HIV and AIDS was not a problem anymore

because no one spoke of it and I never heard about it other than in health classes; however,

during my research, I found that this ignorance imbedded in the youth directly causes more cases

of these diseases. The rarity of this subject in today’s society in contrast to the prevalence of HIV

and AIDS in today’s youth is what prompted me to pursue this topic as I wanted to protect

myself and my loved ones. My opinion on this topic developed through the extensive research

and analysis of the problems in HIV and AIDS education and how they directly cause increases

in case incidence. In order to reduce the number of cases of HIV and AIDS in youths and prevent

another epidemic, the education system and educators alike must reform the dated and

ineffective ways of teaching these consequential issues (loaded words).

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Works Cited

Avert. "Origin of HIV & AIDS." Avert, 30 Oct. 2019, www.avert.org/professionals/history-hiv-

aids/origin.

CDC. "CDC Washington Testimony September 16, 2008." Centers for Disease Control and

Prevention, 28 Dec. 2018, www.cdc.gov/washington/testimony/2008/t20080916.htm.

Ethier, Kathleen. "Schools Are Vital in the Fight Against Youth HIV Infection." HIV.gov,

10 Apr. 2019, www.hiv.gov/blog/schools-are-vital-fight-against-youth-hiv-infection.

Gonsalves, Gregg. "Opinion | This is Not A Cure for My H.I.V." The New York Times - Breaking

News, World News & Multimedia, 9 Mar. 2019,

www.nytimes.com/2019/03/09/opinion/sunday/cure-hiv-aids.html.

Hodgkin, Marian, and Marian Schilperoord. “Education: Critical to HIV Prevention and

Mitigation.” Forced Migration Review, vol. 1, Oct. 2010, pp. 29–30. EBSCOhost,

search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=55149903&site=ehost-live.

Moorhead, Joanna. "How Schools Are Getting It Wrong on HIV and Aids." The Guardian,

29 Nov. 2017, www.theguardian.com/education/2015/nov/24/schools-getting-wrong-hiv-

aids.

Quackenbush, Marcia. "Five Ways to Help Improve School HIV Prevention Programs." BioMed

Central, 29 Mar. 2016, http://blogs.biomedcentral.com/on-health/2016/03/29/five-ways-

help-improve-school-hiv-prevention-programs/.
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Works Consulted

Avert. "HIV Stigma and Discrimination." Avert, 10 Oct. 2019, www.avert.org/professionals/hiv-

social-issues/stigma-discrimination.

Bowie, C., and N. Ford. "Sexual behaviour of young people and the risk of HIV

infection." Journal of Epidemiology & Community Health, vol. 43, no. 1, 1989, pp. 61-

65.

Gutierrez, Jaime. "HIV Education in the Schools." The Body Pro: For the HIV/AIDS Workforce,

1 Feb. 2009, www.thebodypro.com/article/hiv-education-schools.

"HIV Among Youth | Age | HIV by Group | HIV/AIDS | CDC." Centers for Disease Control and

Prevention, 2 Dec. 2019, www.cdc.gov/hiv/group/age/youth/index.html.

"HIV Surveillance | Reports| Resource Library | HIV/AIDS | CDC." Centers for Disease Control

and Prevention, 27 Feb. 2020, www.cdc.gov/hiv/library/reports/hiv-surveillance.html.

Koenig, Linda J., et al. "Young People and HIV: A Call to Action." American Journal of Public

Health, vol. 106, no. 3, 2016, pp. 402-405.

Mathur, Sanyukta, et al. “Re-Focusing HIV Prevention Messages: A Qualitative Study in Rural

Uganda.” AIDS Research & Therapy, vol. 13, Nov. 2016, pp. 1–9. EBSCOhost,

doi:10.1186/s12981-016-0123-x.