The Impact of HIV/AIDS on Education Worldwide: Volume 18

Little is known about the impact of HIV/AIDS on education worldwide. Much of the mystery surrounding HIV/AIDS and education lies in the fact that their intersection is contextualized by many other factors. For example, many of the children who are at risk of not finishing school or have never had the chance to attend school live day-to-day in communities with high HIV/AIDS infection rates. To exacerbate the problem, in some countries the highest HIV/AIDS infection rates are in marginalized and extremely poor communities while in others it is among the most affluent communities. Girls, young women, orphaned and vulnerable children either living or working in disadvantaged communities have some of the highest risk for HIV/AIDS infection because of their frequent exposure to HIV/AIDS. But, those who are more mobile due to their occupations or wealth are also at high risk in countries worldwide.

Impact mitigation strategies in sub-Saharan Africa on HIV/AIDS in the education sector involved initially the development of education sector policies. This study traces the policy development initiatives, level of implementation, progress made and existing challenges. The study is based on a close (textual) reading of authoritative literature from United Nations Programme on HIV/AIDS (UNAIDS), World Bank, UNESCO and UNICEF for the last decade on global monitoring of HIV/AIDS and statistical data. Studies on the impact of HIV/AIDS on the education sector in sub-Saharan Africa have been brought into focus and themes have been extracted and synthesised from a comparative perspective to guide the development of this chapter. Across the countries, the education sector HIV/AIDS policies had concurrence with the countries’ national HIV and AIDS policy or guidelines, and conformed to international conventions, national laws, policies, guidelines and regulations. Most of the countries in Sub-Saharan Africa showed a significant decline in HIV prevalence among young women or men and opportunities to improve HIV-prevention knowledge and behaviour still abound. Antiretroviral therapy and other types of treatment have expanded since the early 2000s, but the number of AIDS-related deaths remains high. This chapter fulfils an identified information/resources need and amplifies the progress achieved in the mitigation of the impact of HIV/AIDS on the education sector specifically and humanity in general.

In the absence of a medical vaccine against HIV infection, research shows that educating individuals about actions they can take to protect themselves is the most effective means to control the epidemic. School-based HIV/AIDS education programs are premised on this assumption and are considered the best social vaccine to influence young people's attitudes, behaviors, and knowledge about HIV infection, prevention, and access to treatment and care. Drawing upon a larger ethnographic study, we use a tripartite analytic framework for understanding HIV/AIDS-related education to examine how schools in western Kenya implement HIV/AIDS education programs. Findings reveal that the implementation of these programs is context-driven and contested along patterns of sociocultural beliefs, religious morals, economic challenge, and a wider crisis in education. We argue for de-localization of principals and teachers and that HIV/AIDS education programs should not only be informational, but also empowering and focused on the individual as well as the context within which the individual functions.

This study examines attitudes of students, teachers, and administrators about HIV education in Ugandan secondary schools. Results indicated significant differences between these groups regarding perspectives about sexuality, transmission of HIV, and AIDS stigma. Behavioral assessment indicated low prevalence of high-risk activities among students, which implies a need for continued education and behavioral reinforcement in the curriculum in the intervention programs for behavioral maintenance. This study provides important insights as to how a comprehensive HIV education program can be more effectively and efficiently integrated in the school system. An ongoing discussion within the public and private sector of the country addresses the need for a comprehensive education curriculum, which includes teacher training, peer education, and strong involvement of governmental and nongovernmental organizations. Results from this study provide an important step in this process.

Understanding of the effects of formal education on HIV/AIDS infection in South Saharan Africa (SSA) has been a complex task because consecutive waves of research offer different, seemingly contradictory results and explanations of what exactly are the schooling effects on HIV/AIDS and the causal mechanisms driving those effects. This chapter concentrates on the narrative and implications of the key substantive findings from a multidisciplinary scientific team that was formed to explore the precise nature of the relationship between population education and the HIV/AIDS pandemic in SSA and to determine the main causal mechanisms behind the association. As members of this team, this chapter reviews and synthesizes our technical demographic, epidemiological, and health research. This, and other relevant research, suggests that, like in other cases of education and health risk, because of a historical change in the public health and information environment during the pandemic there was a shift in which outcomes of education dominated individual's sexual and disease prevention behavior. The SSA HIV/AIDS case is thoroughly examined, and then used to bridge to a general discussion of the effects of educational development on population health.

The purpose of the study was to analyse approaches to HIV/AIDS education adopted by the Zambian Ministry of Education (MoE), using a holistic approach and focusing on the Zambian culture. This chapter reports on an explorative qualitative study involving focus group discussions and in-depth interviews with Ministry of Education and Health officials, pupils, students, and members of the community. Qualitative analysis was applied and themes from ecological theory were used to organise and discuss data. At the macro level, there was inadequate implementation of HIV/AIDS education in schools, very few handbooks, textbooks and learners’ reading materials, and no discussion of the Zambian cultural (sexual) practices in relation to HIV/AIDS education. Inadequate laws and policies on HIV/AIDS prevention, poverty, unemployment, lack of job creation, and lack of social security were blamed for the lack of positive sexual behaviour changes. Communities had strong theological and metaphysical beliefs including witchcraft and sex with a widow, a menstruating woman or a woman who had an abortion as possible causes of HIV and incurable diseases being a curse from God. At the individual level, the knowledge of HIV/AIDS was high with radio and television being sources of information. Respondents viewed sexual cultures in communities not to have significantly changed. A majority of respondents did not use condoms; most adults continued having multiple sexual partners and women were submissive in marriages. This chapter is useful to policy makers, teachers, pupils/students, and the community, and in understanding interactions and influences of cultures on HIV/AIDS education and government's role in creating an enabling environment to sustain desirable changes.

HIV and AIDS have had a significant impact on education and society in Botswana. By giving a background of HIV and AIDS in the country and outlining the main response activities in Botswana's education sector, the author provides a detailed foundation for understanding the phenomenon of HIV/AIDS in Botswana as well as the conditions and activities used to respond to this epidemic. The methodology primarily consisted of document analysis of government policies and other documentation as well as research reports of studies conducted on education and HIV and AIDS or related topics.

Fifty-one orphans from five primary schools in the Maseru District, whose parents died of HIV- and AIDS-related illnesses, were interviewed for their experiences of HIV and AIDS. They were interviewed with regard to their psychosocial problems, their attendance at school, stigma and discrimination, nutrition and career aspirations. The interview schedule comprised of 37 items developed and validated by the researcher. Sixty-four per cent of the orphans lived with maternal grandmothers, 8% with maternal aunts, 8% with the elder sisters, 12% with elder brothers and 8% lived on their own, including looking after younger siblings. The orphans do not only have unmet basic or material needs but also have markedly increased psychosocial problems, exacerbated by their inability to access essential services such as healthcare due to poverty. Thus, their long-term psychological health, resilience, self-worth and self-esteem are in jeopardy. There is an urgent need to enhance and expand all current community and school intervention programmes not only to meet the basic needs of orphans but also to include psychosocial support (PSS), improved counselling services and training of caregivers and teachers in critical areas of care and support for the orphans.

In recent years, access to schooling for children orphaned and made vulnerable by AIDS has emerged as a major humanitarian concern, particularly in sub-Saharan Africa. International discourse largely fails to define what “vulnerability” means, while also depicting “orphans and vulnerable children” as passive victims of complex social processes. This ethnographic study of a “typical” secondary school in semirural Lesotho investigates the research question: At the secondary level, how does “vulnerability” shape the educational participation and home life of young Basotho? Through extended observation, in-depth interviews, and student diaries, the study reveals that “vulnerable” children in Lesotho, who are locally defined as those without strong adult caregivers, actually exercise a high degree of autonomy that is often manifested through “stubbornness.” “Stubborn” students resist adult control and are closely associated with early sexual debut and high-risk behaviors. As a result of their resistance, they are often singled out by teachers for corporal punishment, increasing the likelihood that they will drop out of school. This chapter adds to the literature on youth agency by demonstrating that “acting stubborn” is one way in which “vulnerable” children can exercise control over their own lives and resist the status quo. In addition, the findings point to the failure of the school model, which is highly authoritarian, to retain “vulnerable” students and teach them valuable life skills, including HIV/AIDS prevention. Finally, this study demonstrates that local and culturally inflected definitions of “vulnerability” may not always align with international definitions and policy prescriptions.

The HIV epidemic in South Africa affects young people in their teenage years, the majority of whom are young women located in schools. Sexual violence and gender inequalities create vulnerabilities for young women increasing their risk of HIV. Promoting their sexual health as well as preventing the disease amongst young people remains a substantial educational and health priority. South African education has well-developed policies related to HIV and AIDS education in schools. Despite this the disproportionate burden that young women bear in relation to HIV remains acute. What remains missing is the development of an integrated HIV and AIDS education approach that takes children, gender and sexuality seriously. Given the urgency of the disease in the country, there is need for renewed efforts to integrate gender and sexuality within HIV and AIDS education. This is the central focus of this chapter.

School-going young people in South Africa engage in HIV risk behaviour despite high levels of HIV knowledge and a variety of interventions focusing on HIV prevention. The lack of empirical evidence on the effectiveness of current interventions leaves programme implementers with little consensus about how best to prevent HIV infection among young people. This research was done to explore factors underlying HIV risk of young people with the aim of developing HIV prevention in the third decade of the epidemic. Focus group discussions were conducted with young people, educators and parents in eight schools in four provinces of the country. A thematic analysis revealed risk factors especially on the interpersonal and community level. Peer pressure, gender norms and culture, poverty and financial gain and a culture of alcohol use were prominent themes. Negative family relationships, lack of role models and lack of sexual education from home contributed to risk behaviour. Community processes such as exposure to media, lack of recreational facilities, and an erosion of supportive culture and community structures created an environment which did not support healthy behaviour. Factors that prevented risk behaviour were identified as self-respect, open communication with parents, implementation of school programmes, positive peer pressure and a focus on young people's future. Prevention programmes should therefore not only focus on individual factors but should be multi-layered interventions involving various community structures aimed at changing the social ecology in communities to support an alternative lifestyle for young people.

This chapter is an exploratory piece to comprehend how national policies react to regional policy solutions designed to cope with the HIV/AIDS epidemic. It uses data from the national strategic plans for HIV/AIDS from 13 of 15 Caribbean Community (CARICOM) members to illustrate how they interpret the regional response to the pandemic. In drawing upon the existing literature on transfer, it focuses on what I term cooperative policy transfer – explore how policy concepts flow back and forth between the national and regional levels through cohesive harmonization – to understand how new policy trends emerge. A cross-sectional analysis based on a content analysis reveals the emergence of three new policy trends distinct to the region that guide HIV/AIDS education: (i) creating a multisectoral approach; (ii) setting international targets; and (iii) establishing regional benchmarks. These new trends are identified as what I call the rise of new mutualism in education. The chapter concludes that the national and regional policy responses to HIV/AIDS in CARICOM countries, centered on new mutualism, became a rallying cry based on the belief that the Caribbean Single Market and Economy (CSME) can only function if CARICOM countries combine their resources to reverse the effect of HIV/AIDS on national educational systems.

Laban Ayiro holds a PhD in Entrepreneurship Development, an MA in International Relations, an MSc in Entrepreneurship Development, and a BEd in the teaching of Chemistry. He worked for many years as a Senior Deputy Director for Policy and Planning in the Ministry of Education and was instrumental in the development of the HIV/AIDS Education Sector Policy in Kenya. He teaches at Moi University in Kenya and his areas of specialization include Research Methods and Statistics, Entrepreneurial Management, Management Information Systems and Leadership, and Policy Studies. Dr. Ayiro is a Senior Fulbright Scholar having been on a research program at the University of Texas A&M in the United States in 2011–2012.