Sexuality and HIV Education: Time for a Paradigm Shift

This 4-page brief from the Population Council publication transitions to adulthood examines curriculum-based sexuality education as a cornerstone of school- and community-based efforts to improve young people’s sexual and reproductive health, and, more recently, to prevent HIV infection. A review of the impact of school-based sexuality and HIV education programmes in developed and developing countries found that two-thirds of the programmes reduced the risk associated with one or more reported sexual behaviours. In order to further increase these programmes' effectiveness, the authors examine several key areas in need of rethinking to further address curricular effectiveness.


The following are areas examined with next steps suggested:

1. "The content of curricula has focused on specific behaviors but has not kept pace with the growing body of research demonstrating the effects of underlying gender attitudes and behaviors on young people’s sexual health and well-being....Young people can learn about, and reflect upon, how gender norms function. For example, how do messages about masculinity lead boys and men to “prove” their manhood and heterosexuality, including through sexual conquest and gender-based violence? And how do girls’ economic circumstances interact with their status as females to increase their risk of HIV through unprotected, coerced, and/or transactional sex? It is time to take these leads and test them in systematic ways in a variety of settings."
2. "Although HIV and adolescent health experts repeatedly call for reaching young people at earlier ages, policymakers and program leaders have few viable options....Almost absent from schools are HIV/adolescent health programs that teach younger adolescents about fundamental issues of social studies; notions of equality/ inequality; ...and communication and decisionmaking tools that would set the stage for young people to make use of explicit information about sex, contraception, infection prevention, and the like at the appropriate time....Communities and schools need clear guidance about the ... value of programs that examine broader issues of social context and do so at younger ages."
3. "What contributes to - or detracts from - classroom approaches to sex education?....[G]ender bias is a reality in most classrooms....[R]ote learning prevails in the vast majority of developing-country classrooms....Participatory learning and an open culture in the classroom have been linked with positive attitudes toward gender equality. Investments in training teachers in interactive, learner-centered methods and in fostering critical thinking skills could provide significant benefits both to educational and to sexual and reproductive health outcomes."
4. "What do evaluations of sex and HIV education programs suggest about gender and about evaluation outcome?....Future studies might examine how the motivations for sex (pleasure, control of a partner, seeking love) influence girls’ or women’s vulnerability to coercion, their sexual self-efficacy, and their reproductive health....Research could help inform us about the value of coeducational and same-sex programs in different settings and with different content mix..."
5. "Are we reaching the young people we intend to reach? There is a need for a simple demographic assessment of the likely coverage of existing school-based programs on the basis of a country’s patterns of school enrollment by age, gender, and race/ethnicity...."

From the Conclusion:
"While we have learned a good deal about effective sexuality and HIV education, we can do much better. Several areas of research suggest that it is time to develop and test a “social studies” approach to sex and HIV education - one that starts earlier and fosters critical thinking skills, gender equality, and human rights. Such an effort may have important lessons for improved sexual and reproductive health outcomes and contribute to other aspects of young people’s preparation for active, informed participation in civil society."