'Sex education should be taught, fine…but we make sure they control themselves’
In a recent article in Sex Education: Sexuality, Society and Learning, NCHSR Professor of Health and Education Peter Aggleton and Padmini Iyer, a doctoral student from the School of Education and Social Work at the University of Sussex, address the role of teachers in delivering sex education programs. Globally, young people (15–24 years) are particularly vulnerable to sexual and reproductive health risks, including HIV and other STIs, unintended pregnancies, and coercive or abusive sexual activity. In the global south, increasing levels of school enrolment enables school-based sex-education of large numbers of young people about sexual and reproductive health.
However, little is known about how adults facilitate or hinder young people seeking help on sexual and reproductive health issues. Within a school context, sex education is unlikely to succeed if teachers don’t feel comfortable with the content of the school curriculum or have personal values which conflict with the program.
Based on a preliminary qualitative study with teachers at a Ugandan secondary school, they found that teachers’ attitudes, beliefs and superstitions relating to young people’s sexual activity strongly limits the sexual and reproductive health information made available to students. A strictly ‘abstinence-only’ focus among teachers appeared to be linked to official Ugandan sex education policies, as well as teachers’ own deeply conservative Christian beliefs.
Additionally, an adherence to negative gender stereotypes led to young women’s sexuality being problematised with girls perceived as ‘the ones who caused all the problems’, and young men’s sometimes aggressive pursuit of sexual activity being ignored.
Findings from this study suggest that it should not be assumed that teachers act as neutral delivery mechanisms for school-based sex education programs. Instead, it is crucial that teachers’ own attitudes and beliefs surrounding sexual and reproductive health are addressed when implementing sex education for young people.
Iyer, P. & P. Aggleton (2012). ‘Sex education should be taught, fine…but we make sure they control themselves’: teachers' beliefs and attitudes towards young people's sexual and reproductive health in a Ugandan secondary school. Sex Education: Sexuality, Society and Learning.
Published in: Sex Education: Sexuality, Society and Learning: http://dx.doi.org/10.1080/14681811.2012.677184
Prof John de Wit addressing the silence&articulation opening plenary
The 12th HIV, Hepatitis C and Related Diseases Social Research Conference, “silence&articulation” was recently held at The University of New South Wales 12 - 13 April. This biennial conference plays an important role in providing a platform for networking and knowledge sharing between social and behavioural science researchers, policy makers, health professionals and community organisations. Keynote speakers including Prof Jane Ussher, Mr John Godwin and Prof Alison Ritter explored how society understands and approaches stigmatised illnesses, sexualities and illicit drug use. (John Godwin writes an opinion piece covering his views about human rights and the 'prevention revolution', below)
In a plenary address, former NSW Minister of Health, Hon John Della Bosca described the politics involved in the establishment of the Medically Supervised Injecting Centre in Kings Cross.
Audio recordings of these presentations are available for download here.
NCHSR Director Prof John De Wit thanked the conference sponsors (Gilead, ASHM, NUAA, ACT Health Directorate, UNSW Faculty of Arts and Social Sciences and the UNSW Bookshop) whose support helped produce a high quality conference with a registration fee that was affordable for participants.
It was pleasing that the conference was deemed a success by several measures: the calibre of speakers; number of attendees; and the timeliness and significance of the discussions. The conference abstract booklet is available to download here.
Expressing her high regard for the courage of conference participants—including sex workers, those living with HIV or hepatitis and people who inject drugs—for speaking out about the issues confronting them, NCHSR’s Deputy Director Prof Carla Treloar closed by saying, “I feel so fortunate that we have such people who are prepared to take such risks, and I have been privileged to learn from and be inspired by so many colleagues”.
Does the format and framing of sexual health promotion messages matter?
In spite of several STI awareness campaigns, the prevalence of STIs among young heterosexual people in Australia remains high.
Even though knowledge of STIs has increased, many young people do not feel vulnerable to STIs and do not use condoms or test for STIs as frequently as they should. More effective ways to influence young people’s perceived vulnerability and sexual health behaviours still need to be developed.
The experimental study, Facts & stories about sex and STIs by NCHSR researchers Else van Miltenburg, John de Wit and Philippe Adam, recruited UNSW university students to assess the influence of various messages’ frames and formats on their perceived vulnerability to become infected with an STI and their intention to use condoms. The study used a two (number of frames) by two (number of formats) experimental design. Participants received messages presenting either the advantages of using condoms (gain frame) or the disadvantages of not using condoms (loss frame). Messages were presented as a magazine article presenting either statistics (statistics format) or a story told by a peer (testimonial format).
The study found that the testimonial format was more effective than the statistics format in increasing perceived vulnerability of young people. Also the combination of message format and message framing was important. The most effective way to increase intention to use condoms among participants was to use a testimonial which focused on the advantages of using condoms.
This study in health communication has implications for sexual health promotion. It shows that both the framing and format of messages are essential elements in influencing people’s perceptions, intentions and behaviours.
Else van Miltenburg will submit these results as part of her masters thesis in social psychology at the end of June 2012. Further information on the study will then be made available on the NCHSR website.
Opinion: Human rights and the 'prevention revolution'
by John Godwin1
John Goodwin speaking at silence&articulation
UNAIDS has termed it the ‘prevention revolution’. We are told that it is the dawning of a new era in which ARVs are to be central to elimination of HIV, through PrEP, microbicides, or early treatment. However, it is unclear how these biomedical approaches will benefit communities who are politically disempowered, legally marginalised, and alienated from the health system. A true ‘prevention revolution’ requires populations who have been historically silenced to be empowered to lead the way, and to decide when and on what terms new options will be made available to them. It is attention to power relationships, rather than clinical efficacy, that will ultimately determine the success of new prevention approaches.
For the epidemics of Asia Pacific, it is hard to imagine how new biomedical strategies can be implemented without addressing the rights context. In our region the legal environment for HIV responses remains highly punitive, due to criminalisation of sex work, illicit drug use and sexual minorities, and police harassment of HIV-affected populations. Populations often remain hidden and avoid contact with the health system. Punitive laws make it difficult for communities to organise, to register their organisations and to participate in planning HIV responses.
In Australia, sex workers and people who use drugs remain marginalised and they lack protections from discrimination. Sex workers are subject to an illogical patchwork of laws, with four jurisdictions operating licensing systems that generate an unlicensed underclass of workers who are alienated from health services.
Australia’s drug laws are dominated by a criminal justice paradigm. Access to pharmacotherapies is limited in terms of scope and geography, and only Kings Cross benefits from a safe injecting room. Heroin prescription and prison syringe programs have proved politically impossible to progress.
The issue of criminalisation of HIV transmission has particular impacts for gay men and sex workers. There have been 36 prosecutions for HIV exposure or transmission in Australia. These prosecutions demonise positive people and undermine messages of mutual responsibility. It makes little sense for the state to launch prosecutions, with all the distrust of authority this generates, at the same time as clinicians are urging people to test and treat early.
In all these areas, the law is out of step with prevention. A medicalised response potentially silences an agenda focusing on empowerment and rights. Social transformation requires engaging with the structural determinants of power, including laws and law enforcement practices. Nothing revolutionary is going to happen to prevention, unless we focus on power and rights.
1 John Godwin is a consultant in HIV, law and development in Sydney, who spoke on the 'prevention revolution' at the recent 12th HIV, Hepatitis C and Related Diseases Social Research Conference, “silence&articulation” at UNSW.