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alleviate conditions, such as poverty, ignorance, gender discrimination that facilitate the spread of HIV/AIDS

reduce vulnerability to the risk situations of prostitution, streetism, dependence of women on men.

In the longer term, and more generically, education plays a key role in establishing conditions that render the transmission of HIV/AIDS less likely—conditions such as poverty reduction, personal empowerment, gender equity. It also reduces vulnerability to a variety of factors, such as streetism, prostitution, or the dependence of women on men, which are a breeding ground for HIV infection.

The Correlation between HIV Infection and Level of Education

Before developing some ideas on the potential role of education in combating HIV infection and the impact of AIDS, it is necessary to face up to one troublesome issue, namely, the positive correlation that regularly appears between HIV infection and level of education. The probability of having a non-regular sexual partner, and hence the risk of contracting STDs and HIV, rises with the level of education (Filmer, 1998; Ainsworth & Semali, 1998). An early Zambian study found a strong linear relationship between level of education and HIV infection—the percentage of infected persons in a hospital population rose monotonically with the level of education. This could be occurring because higher levels of education are associated with higher income and greater mobility, factors that can contribute to greater sexual promiscuity. It could be because those who are in an education system establish transient relationships to compensate for the almost necessary deferment of a stable partnership in marriage. It could be because schooling has engendered a more liberal set of values, freeing the individual from inhibitions and restrictions transmitted through family and community systems.

But even in this regard there are signs of hope. Very recent evidence from Zambia shows a substantial decline in HIV prevalence among younger people in both urban and rural areas (Fylkesnes & others, 1999). In Lusaka, HIV prevalence in the 15–19 year-old age group fell over the past five years from 28 to 15 percent, while in a rural area it fell from ten to five percent. A consistent finding, restricted to urban areas, was a marked decline in prevalence rates among 15–19 year-olds with medium or higher educational backgrounds. On the negative side, the trend was for HIV prevalence to increase amongst young people at lower educational levels. This suggests that the correlation between HIV infection and level of education is no longer linear as in the past. It also suggests that education may be realising its expected impact of reducing transmission, though so far the effect is limited to medium and higher levels, and is not yet seen to be operative at the primary level.

How Education Can Modify the Transmission and Impact of HIV/AIDS

If it is to reduce the likelihood of HIV transmission, strengthen the capacity of infected and affected individuals to cope with their situation, and support bereaved and disoriented school members and their families, the formal education system needs to do certain things. It should

(1) Ensure Access and that Real and Relevant Learning Occurs

This Conference is concerned with the way in which countries have adopted in practice the World Declaration on Education For All. Two of the fundamental articles of this Declaration are particularly relevant in the context of the encounter between education: and HIV/AIDS:

Education in the sense of schooling can do nothing to reduce the transmission and impact of HIV/AIDS for children who, for whatever reason, are denied access to school. It can work only with children who attend school. Hence the AIDS epidemic underscores the crucial importance of universalising access to primary school. It also underlines the tragedy of Africa where, in 1995, an estimated 40 percent of children were not enrolled in school and where, on present trends, the number of children not attending school seems set to increase dramatically in the coming years (Oxfam, 1999).

Second, attention to real learning achievement is necessary on two grounds. First, as the World Declaration states, if there is no real and worthwhile learning, then no meaningful development occurs. No matter how well attended, the schools will not contribute as they should to poverty reduction, personal empowerment, gender equity. Neither will they promote the knowledge and understanding which are fundamental to the reduction of HIV transmission. Those leaving school will remain a prey to the poverty trap which will see many of them being sucked into prostitution, streetism, gender subordination, and other ways of life that will increase their risk of HIV infection. They will also remain much weaker than they should be in the face of HIV risks. Second, if there is real learning achievement then it becomes more likely that school messages about HIV will be taken on board, that learners will incorporate the "useful knowledge, reasoning ability, skills, and values" that will contribute to their protection against HIV/AIDS.

(2) Integrate HIV/AIDS and Sexual Education into the School Curriculum

Good quality sexual health and HIV/AIDS education is needed in order to equip young people with the information which they rarely get from their parents or senior family members, which they no longer get from traditional training such as is customarily provided at the time of initiation, which they frequently pick up haphazardly from peers and books, and which they sometimes augment by high-risk experimentation. This education should go beyond the biological facts to include many aspects of behaviour and ultimately of attitudes and values.

It is nothing new that a school should seek to influence behaviour and inculcate values. That it should do so is regarded as part of its traditional role. It consciously seeks to influence students through its curriculum and through the values that the curriculum embodies. We need to have a clearer perception of "education as being the process of identifying the valuable, opening it to others and, yes, inculcating it into them" (Greenfield, 1991, p.194). This view is reinforced by the modern approach to the school as an organisation. Contemporary theory recognises that organisations, from the simplest village school to the most complex multinational, are built on marshalling people around values, those learned concepts of the desirable which have motivating force and which serve as criteria against which we appraise and evaluate actions (Beare, Caldwell & Millikan, 1989). Through its sexual health and HIV/AIDS programmes, the school should also seek to help each student to develop a personally held value system which will empower the young person to make correct and safe choices, while at school and throughout life.

Incorporating these areas is also integral to the universal right to education. Article 26 of the United Nations Declaration on Human Rights proclaims the right to an education that is directed to the full development of the human personality. Since HIV infection inhibits the possibility of such full development, the right to education includes the right to the knowledge and skills needed for HIV prevention. Such a right can only be exercised if the school curriculum deals effectively with sexual health and HIV/AIDS prevention and care. The Jomtien Declaration defined the basic learning needs, which should be met for every person, as including the content required by human beings in order to survive (Art 1). In our AIDS-scarred world, sexual health and HIV/AIDS education are a prerequisite for individual and community survival.

Fears are sometimes expressed that integrating reproductive health and HIV/AIDS education into the school curriculum will increase sexual activity among youth, thereby potentially aggravating rather than alleviating the problem. On the basis of what has been investigated, these fears appear to be unfounded. In a comprehensive literature review, UNAIDS found that of 53 studies that evaluated specific interventions, 27 reported that HIV/AIDS and sexual health education neither increased nor decreased sexual activity and attendant rates of pregnancy and STDs. Twenty two reported that HIV and/or sexual health education either delayed the onset of sexual activity, reduced the number of sexual partners, or reduced unplanned pregnancy and STD rates. Only three studies found increases in sexual behaviour associated with sexual health education (UNAIDS, 1997, p. 5).

The UNAIDS study concludes that there is little evidence to support the contention that sexual health and HIV education promote promiscuity.

The review also reported study findings that

It should be noted, however, that the studies in question were evaluations of school-based programmes in industrialised countries, principally in the United States. Little more than anecdotal evidence is available to show that reproductive health education leads to delayed sexual activity and safer sex in developing countries. There is urgent need for more rigorous evaluations of such programmes in African settings, research that might well commence in countries such as Uganda which have adopted a forthright and quite explicit approach to integrating HIV/AIDS and sexual education into the school curriculum.

(3) Promote the Development of Life Skills

Quite apart from the HIV/AIDS epidemic, schools have a responsibility to help students develop skills which equip them for positive social behaviour and for coping with negative pressures. The Zambian Ministry of Education sees a core set of these life-skills as including "decision-making, problem-solving, creative thinking, critical thinking, effective communication, interpersonal relationships, self-awareness, stress and anxiety management, coping with pressures, self-esteem, and confidence" (MOE, 1996, p. 43). The Ministry also calls for the investment of time and resources in the fourth ‘R’, that is, seriously conducted human relations education and the development of interpersonal skills that will lead to a better understanding of oneself and of others (ibid., p. 56). Promoting these skills is the responsibility of all who are concerned with the education of youth. It is doubly so because of the HIV/AIDS crisis.

The UNAIDS review of research highlighted the importance of the skill of interpreting the conflicting messages that come from adult role models, television, other media and advertisements. Society creates an almost impossible task for young people, expecting them to behave in a certain way but confronting them with social norms, expectations and role models that point in a very different direction. The young are expected to know how to protect themselves, but information about sex has to be acquired furtively and almost by osmosis, while sexual behaviour is kept under wraps. At the same time, masculinity tends to be associated with extensive sexual knowledge and practice, femininity with naïveté and inexperience. The models placed incessantly before the young through advertisements, in the media, and through the entertainment industry glorify the physical aspects of sex, but say little about the arduous task of building enduring human relationships which support and are supported by sexual practice. A critical life-skill that schools should seek to develop in today's young people is the ability to interpret and challenge these and other social norms that put pressure on them to run their lives on the pleasure principle and to experiment with sex, with the attendant increase in the risk of HIV infection.

(4) Establish a Vigorous Human Rights Approach

Human rights and HIV/AIDS are intimately connected. "An environment in which human rights are respected ensures that vulnerability to HIV/AIDS is reduced, those infected with and affected by HIV/AIDS live a life of dignity without discrimination, and the personal and societal impact of HIV infection is alleviated" (UNAIDS, 1998, page 5). It is all too easy for educational institutions to fall into the trap of denying access to students infected or affected by HIV, whether because of their HIV status, because of pressure from the parents of non-infected students, or because their HIV status makes it difficult for the students in question to meet attendance requirements or pay educational costs. It is tempting for the institutions to restrict the participation of infected students in certain curricular and extra-curricular activities. As noted earlier in this paper, schools and the entire educational system need to be constantly on the alert to ensure that the care, employment, privacy, and other rights of infected teachers and education employees are not violated.

Provisions for dealing with the many-faceted aspects of human rights and education need to be developed and implemented by education ministries and teaching and research institutions. At the school level, social science and other disciplines that deal with human rights need to extend their treatment to HIV/AIDS applications, such as the right to marry and found a family, the right to privacy, the right to work, the right to expression and information, and the right to the highest attainable standard of physical and mental health (UNAIDS, 1998, pp. 40–51).

Part of the schools' human rights programme should surely be to bring HIV and AIDS out into the open, to contribute to breaking the silence, the secrecy, the stigma, the shame that are associated with AIDS. The Executive Director of UNAIDS reminded the Lusaka ICASA Conference that

AIDS in itself is a calamity for an individual, a family, a community. It does not need the inhuman response of aggravating it through stigma, silence and shame. Through its sexual health and HIV/AIDS programmes, through equal treatment for all its members, through vigorous action against petty hole-in-the-corner teasing and bullying of those infected or affected by the disease, through arranging for people living with AIDS to address the school community, through role-playing and drama presentations that bring HIV/AIDS out into the open, through consistent manifestation that it is ashamed of the shame itself, the school can counter the silence and reduce the stigma and discrimination surrounding HIV/AIDS. By doing so, it moves the response forward.

(5) Increase the Attention Given to Care, Counselling and Compassion

AIDS has greatly increased the number of orphaned school pupils, the number who are living in households containing an infected member, the number who have lost or may shortly lose a grandparent or other close family member, and the number who have had to change home and possibly school because of various AIDS effects. Tragically, it has also increased the number of school pupils who are themselves infected by AIDS—in 1995,a newspaper report stated that out of 63 secondary school pupils who donated blood in a Zambian hospital, only 11 were not HIV infected (Times of Zambia, 21st July, 1995). Situations such as these point to the urgent need that school children have for more guidance, counselling and psychological support. Referring back once again to Article 26 of the United Nations Declaration on Human Rights, the full development of the human personality of these young people requires that they be provided with the special counselling and psychological support they need so badly in this situation. This, in turn, requires that the school extend its mission beyond the strictly academic to include more attention to counselling and care for its members.

Important life-skills in the HIV/AIDS area include showing compassion and solidarity towards infected individuals; and caring for people with AIDS in the family and community (UNAIDS, 1999b, p. 18). As a significant and ubiquitous social service provider the school cannot remain aloof from the tragedies that affect families, and possibly some of its own members, in the community it serves. Instead, it can translate its health and hygiene studies programmes into action by training in home-based care for children from all families; it can modify its social studies and works programmes to include activities in support of affected families; it can extend its religious education programmes to the practical and universal manifestation of the human compassion and concern that are at the heart of all true religion.

Put HIV/AIDS at the Centre of the National Education Agenda

All of the foregoing may sound as if we are greatly extending the school curriculum and throwing the whole system topsy-turvy, so that it is no longer school as we have traditionally known it. This is a correct impression. The world with AIDS is not the same as the world without AIDS. The school in an AIDS-infected world cannot be the same as the school in an AIDS-free world. Quoting once again from Dr. Piot's opening address to the Lusaka ICASA Conference, "the time is now to declare AIDS in Africa a state of emergency, requiring emergency-type efforts and emergency-type resources". The time is now to declare our schools in Africa in a state of emergency because of AIDS, requiring emergency-type efforts, emergency-type responses. The time is now to put the HIV/AIDS crisis at the centre of our national education agendas.

Taking the proposed and other measures may help to stem the advance of the infection, may help to make infection more bearable, may help to make the impact of the infection more manageable. Refusing to take this or comparable action means burying our heads in the sand, hoping that somehow the storm will pass. But it will not pass. In fact, it is worse than anticipated, and unless we take appropriate measures it will get even worse again. What then will our response be to little Tsepo Sitali and the millions of other African children who are looking to us to give them hope—"when we do meet again, perhaps soon, I hope you will bring good news that there is hope, hope for us little children of Africa"? That hope is education, education that responds imaginatively to the crisis and not necessarily education as we have known it. Let us commit ourselves to the necessary changes and transformations. Let us put HIV/AIDS right there at the centre of the national education agenda. Let us bring hope to the children of Africa and the world.

M. J. Kelly
School of Education
University of Zambia
Lusaka

References

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Fylkesnes, K., Musonda, R. M., Sichone, M., Ndhlovu, Z., Tembo, F., Monze, M., Kaetano, L., Malamba, C., Phiri, S., & Mwakamui, C. (1999) "Favourable Changes in the HIV Epidemic in Zambia in the 1990s". Late Breaker Abstract for XI- ICASA, the Eleventh International Conference on AIDS and STDs in Africa, Mulungushi International Conference Centre, Lusaka, 12–16 September, 1999.

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—— (1998) HIV/AIDS and Human Rights. International Guidelines. Geneva: UNAIDS.

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—— (n.d.) The Impact of AIDS on Capacity Building. The Partnership for Capacity Building in Africa. Africa Region, The World Bank. Washington, DC: The World Bank