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Fighting the spread of AIDS in Southern Africa

"The world has never before experienced death rates of this magnitude among young adults of both sexes across all social strata. It is hard to play down the effects of a disease that stands to kill more than half of the young adults in the countries where it has its firmest hold."

—UNAIDS Report

According to UNAIDS, the Joint United Nations Program on HIV/AIDS, 18.8 million people around the world have died of AIDS, 3.8 million of them children, and 34.4 million people are living with HIV, the virus that causes AIDS. In African nations, which have been particularly hard-hit by the epidemic, HIV is spread primarily through heterosexual sex.

As grim as those statistics are, the UNAIDS report also contained glimmers of hope-signs that AIDS prevention activities in Africa are having some effect: Infection rates have fallen in Uganda and Zambia, and Senegal has stabilized its HIV infection rate at less than 2 percent. (In developed countries, the rate is well below 1 percent; it exceeds 10 percent in 16 African nations.) Uganda heavily promoted prevention messages through community organizations and religious leaders in the early 1990s, lowering that nation's infection rate from 14 to 8 percent. A large increase in condom use is believed to have contributed to both lower rates of infection and significant declines in teenage pregnancy.

Education and social marketing initiatives have proven to be effective prevention strategies in several African nations. Building on successful school-based prevention efforts in the United States, EDC/HHD is collaborating with other international organizations to enlist African teachers in the fight against AIDS. In partnership with Education International, the World Health Organization, UNAIDS, UNESCO, and African teachers, EDC/HHD developed an HIV prevention training manual for use in Botswana, Zambia, Zimbabwe, Malawi, Namibia, Lesotho, Swaziland, and South Africa.

The involvement of Education International, the world's largest teachers union, will ensure widespread dissemination of the manual. The organization will distribute the publication to its affiliates and members throughout southern Africa. "As a partner with EDC/HHD, Education International shares a sense of urgency to address AIDS prevention needs by working with both schools and individual teachers," says Phyllis Scattergood, who coordinates school health programs for EDC/HHD under its WHO Collaborating Center to Promote Health Through Schools and Communities. "Teachers can be true agents of change in preventing the further spread of this devastating disease in the classroom and the community," adds Scattergood.

Much of the manual is devoted to building teachers' communication and advocacy skills around HIV prevention, mainly through role-playing, brainstorming, and small-group discussions. The manual includes sections on what teachers can do to protect themselves against the virus, how to address discrimination, and how to equip students with negotiation and other skills to protect themselves against HIV. Teachers are also encouraged to expand their role beyond the school and take leadership positions in their communities, both to prevent HIV and to advocate for those with the virus.

The manual is unique because it grows out of a shared endeavor between the teachers and the international agencies. The teachers served as advisors and partners to ensure that the manual was sensitive to their language, customs, and culture. Many commented that other manuals, developed without teacher involvement, simply sat on school shelves untouched.

Because of the tremendous stigma surrounding the disease and the difficulty of broaching the topic of sexuality, teachers are often afraid to talk about AIDS with children. "Educators, parents, and community members know that when they don't answer a controversial question, the child will never ask it again-and that places the child at risk," says Scattergood. The manual will give teachers a way to initiate discussions about these challenging topics.

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