A New Approach to Global HIV/AIDS Education

Given how widespread HIV/AIDS awareness campaigns are, you'll be surprised to learn how little knowledge many people actually have about the diseases. It is not at all easy to teach people about them either.
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In 2010, given how widespread HIV/AIDS awareness campaigns are, you might be surprised to learn how little knowledge about HIV and AIDS many people actually have. It turns out that it is not at all easy to teach about HIV/AIDS, especially in some of the highest-risk regions in the world. Prevention education is a highly localized problem that does not lend itself to a one-size-fits-all solution. Commercial sex work, intravenous drug-use, premarital sex, and homosexuality are controversial topics in many parts of the world, and prevent many HIV/AIDS curricula from being used in those regions.

In a study we conducted in India through Stanford University in 2006, we found that children had essentially superficial knowledge about HIV and AIDS. For years, they had been bombarded with mass media messages teaching them the right answers to some common questions. But when we asked them questions that were slightly different or deeper, they were unable to answer correctly. For example, when we asked whether they could get HIV from blood, they all knew that the answer was yes. But when we asked them "How do you get HIV from blood?", presenting them with options like looking at blood or touching blood, they did not know the right answer. We saw this pattern again and again in questions about HIV transmission, revealing a consistent lack of ability to make decisions about HIV/AIDS in novel situations.

Sex education, as most of us know it, is also not allowed in many regions of the world. This makes it challenging for HIV/AIDS education to enter schools, as it has traditionally been thought of as a component of sex education. In cases of more conservative societies where sex education is still allowed, educators have created a number of approaches to teach about HIV/AIDS despite cultural challenges. Some educators believe the best way to relieve a topic of its taboo status is to talk openly and directly about it, regardless of the resulting discomfort among participants. The assumption is that with plain discussion, individuals will become more comfortable or at least desensitized, and in time, the taboo will diminish or even cease to exist. However, this strategy is often ineffective or even illegal when the taboo is reified through law and custom. Advocates of addressing taboos "head-on", by providing materials which themselves become taboo, often find themselves in a Sisyphean exercise -- which also limits the materials' ability to ever be used in the contexts in which they are most needed. In addition, changing cultural norms is a long-term goal at best, and universal education still needs to be provided in the interim.

Another approach to HIV/AIDS education in conservative societies employs metaphors or euphemisms to illustrate a concept without directly mentioning the sensitive subjects. However, since it is often difficult to find metaphors or euphemisms that accurately communicate particular concepts clearly, the validation of the clarity, accuracy, and acceptability of these mechanisms within the target group is essential to their effectiveness. Some educators will use technical terms in place of more commonplace words hoping to boost comfort levels by avoiding taboo expressions. This is a common technique to educate about sexuality or more generally the human body. The use of technical terminology can mask or distance the subject, making it more comfortable for both educators and learners to communicate about an issue. However, it can also hamper a learner's ability to understand, let alone absorb the materials.

For HIV/AIDS education to be understood by the students, we need to balance accuracy with completeness. This is normally not a consideration for evaluating non-health curricula because it is assumed that all materials within a competently designed curriculum will be both accurate and complete. However, in educating about taboo topics, there are often tradeoffs that must be made between social acceptability, accuracy, and completeness. If a curriculum is accurate to the point of being blunt about a topic whose discussion is taboo, then it will fail the social acceptability test. In other cases, the curriculum may be accurate but incomplete, leaving out the most taboo details in order to provide education on related but less taboo ones.

The best curriculum would find a way to present accurate and complete information using an alternate vocabulary, medium, or conceptual model, in order to keep the materials socially acceptable. But the materials must also be liked by learners, accepted by teachers, and most of all, effective at teaching.

These are the problems we have been working to solve for the past several years. What we came up with was a new way to introduce the topic of HIV/AIDS to students, decoupling it from sex education, and emphasizing its biological basis. The resulting curriculum and learning tools have demonstrated extremely high learning effects coupled with greater than 98% comfort rates.

The TeachAIDS tutorials are created as animations to provide images which balance comfort and clarity; as self-directed software to create private learning environments; and they emphasize biological concepts to create a coherent conception of HIV/AIDS. As a result, students, teachers, parents, and governments find the curricula socially acceptable, yet learners are for the first time able to fully understand and internalize how HIV transmission works -- all in one 25-minute tutorial.

Last year, TeachAIDS was spun out of Stanford as a 501(c)(3) nonprofit. Since then, our pilot versions have been used in over 25 countries around the world, including in regions where HIV/AIDS education was previously banned. All of our materials are distributed for free, under a Creative Commons License.

Today, on World AIDS Day 2010, we are launching the first production versions of our animated tutorials in India and Botswana, incorporating our latest research-based learnings and the voices of numerous celebrities from those countries. India's National AIDS Control Organisation approved our curriculum earlier this year, and the state of Karnataka (population 52 million) has committed to distributing it in their schools. In Botswana, the Ministry of Education and Skills Development will be using the materials in every primary, secondary, and tertiary (university-level) school in the country, reaching over 480,000 students.

This launch represents an important step in our global efforts to help prevent and ultimately eradicate HIV/AIDS around the world. You can use or download our tutorials -0 for free and without providing any personal information -- from teachaids.org. Please spread the word and help us achieve universal HIV/AIDS education.

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