Challenges in Meeting HIV/AIDS Counselling Needs in Nigeria

The HIV/AIDS pandemic is recognized globally as the greatest health challenge of the present generation. It is widely acknowledged to be the foremost killer disease in Africa. Since the first Aids case was publicly announced in 1986, the astronomical increase in victims has been a matter of concern. The rates of HIV/AIDS infection indicate that Nigeria currently has the third largest rate of HIV/AIDS patients. The UNAIDS (2008) reported that as at 2007, the population of children and adults with HIV/AIDS in Nigeria was 2.6 million. Due to the fact that there is no cure for the virus, HIV/AIDS, counselling is an important aspect of its management. Counsellors in Nigeria have provided pre- and post-test counselling, preventive education seminars, and referrals to other health professionals. However, counsellors’ efforts have only yielded limited success because of a number of major challenges. This paper examines some of the challenges involved in meeting the HIV/AIDS counselling needs of Nigerians. Specifically, it addresses challenges faced by government, potential clients, and the Counselling Association of Nigeria, as well as challenges associated with existing cultural practices (indigenous counselling practices). It concludes with specific recommendations for various stakeholders.     

Discourses of education,protection, and child labor: case studies of Benin,Namibia and Swaziland

This article analyses discontinuities between local, national and international discourse in the fields of education, protection of children, and child labor, using Benin, Namibia and Swaziland as case studies. In Benin, child abuse and child labor are related to poverty, whereas in Namibia and Swaziland they are also interrelated with HIV/AIDS. In these countries, the notion of childhood is seen as continuous with adulthood, and the change from education to work is not abrupt and age-determined, but a smooth transition. The international discourse defines children in binary terms (child or adult), and promotes free and compulsory education for children, without recognizing the direct and indirect costs of education. Projects based on an international discourse may have little relevance in a poverty context where it is natural to make children work to ensure food safety. Local communities consider children from a logic of community survival; the external aid agencies consider them from a logic of individual children's rights. There is a need to find a bridge between these two interpretations of childhood.     

美国中小学艾滋病教育管窥

文章首先介绍了美国开展艾滋病教育的几个原则．之后结合美国疾病探制及预防中心开展的艾滋病教育调查介绍了美国艾滋病教育的总体概况．最后以最具代表性的纽约市作为个案介绍了地方是如何开展艾滋病教育的。     

University teaching and social cohesion in the age of AIDS: A South African case study

In the context of ongoing social divisions, lack of coherent leadership by government, and even divisiveness over medical advances and public health mandates, how might universities respond? What university actions can support social cohesion in a society splintered by class, race, gender, colonial legacies, the history of apartheid, and HIV/AIDS? More specifically, what approaches to university teaching of HIV/AIDS might foster social cohesion? During 2006, I interviewed 22 instructors at the University of KwaZulu-Natal (UKZN) at three campuses. The interviewees were faculty members in education, sociology, history, psychology, theology, gender studies, and theater. I observed numerous classes that focused on HIV/AIDS and interviewed approximately 40 undergraduate, honours (4th year), and graduate students. I found that the curriculum and teaching went beyond the technical, individualistic, rational, self-interested assumptions and approaches (such as how to distribute information and condoms) typical of much safe-sex education. The courses explicitly critiqued assumptions, beliefs, and stereotypes that contribute to social divisions and stigma. The teaching efforts consciously included cultural understandings, specifically Zulu cultural understandings of health, community responses, and individuals within communal relationships. The approaches explicitly connected HIV/AIDS with social divisions and inequities of power. The teaching promoted an awareness that public health initiatives (and church or counseling responses) are fraught and controversial. Thus, the teaching tried to place its own ideas within history and society, offering a post-colonial/critical understanding of knowledge, theories, and social “solutions.” In foregrounding social divisions in relation to AIDS, these programmes promoted a critical-edged social cohesion.     

An investigation into the effects of LMS on headteachers’ use of time

Background: HIV/AIDS poses a major threat to development and poverty alleviation, particularly in Sub-Saharan Africa. Education has been declared an effective preventative approach and the single most powerful weapon against HIV transmission. However, there is a paucity of research on the type of education required, the appropriate teaching/learning methods, and generally how such education influences change of attitudes and behaviour on the part of the students.

Purpose: In the context of Swaziland, a country with the highest HIV prevalence rate at 42.6%, this study explores how students at the University of Swaziland perceive an HIV/AIDS course. The students' comments cover the course content, the teaching/learning methods used in the course, the regulations governing the course, and the impact of the course.

Sample and design: A sample of 15 students was randomly selected from all the year 1 Faculty of Agriculture students to form focus group 1. Another sample of 15 was randomly selected from year 3 students who were enrolled on a new programme to form focus group 2. Of the 15 invited students in each focus group, 11 (seven males and four females) attended the focus group 1 meeting, and 12 (eight females and four males) attended the focus group two meeting. A pilot-tested and pre-prepared interview schedule was used during the focus group interviews to collect information on the students' perceptions. This data was analysed using themes.

Results: The findings reveal that the perceptions of the two groups were very similar. The students identified some topics that they felt were treated in great depth, and other topics, particularly dealing with traditional healers, that they felt should be added to the course content. They further criticised the excessive use of the lecture method in teaching the course and recommended that more visual materials, presentations by HIV-positive people and workers, as well as site visits to relevant places should be encouraged to make the course more interesting and give it greater educational value. Overall, the students felt that the course had been effective in changing their attitudes and behaviour. The students cited numerous benefits that they had derived from this course and recommended that it should be offered to all first-year students at the university.

Conclusions and recommendations: This small scale study suggests that providing HIV/AIDS education is an important intervention in changing the attitudes and behaviour of university students and in combating the spread of HIV. It further stresses the importance of engaging all the relevant stakeholders, particularly the students, in working out the content of such a course.     

Perceptual Influence of Ugandan Biology Students’ Understanding of HIV/AIDS

In Uganda, curbing the spread of HIV/AIDS has largely depended on public and private media messages about the disease. Media campaigns based on Uganda’s cultural norms of communication are metaphorical, analogical and simile-like. The topic of HIV/AIDS has been introduced into the Senior Three (Grade 11) biology curriculum in Uganda. To what extent do students’ pre-conceptions of the disease, based on these media messages influence students’ development of conceptual understanding of the disease, its transmission and prevention? Of significant importance is the impact the conceptions students have developed from the indirect media messages on classroom instruction on HIV/AIDS. The study is based in a theoretical framework of conceptual change in science learning. An interpretive case study to determine the impact of Ugandan students’ conceptions or perceptions on classroom instruction about HIV/AIDS, involving 160 students aged 15–17, was conducted in four different Ugandan high schools: girls boarding, boys boarding, mixed boarding, and mixed day. Using questionnaires, focus group discussions, recorded biology lessons and informal interviews, students’ preconceptions of HIV/AIDS and how these impact lessons on HIV/AIDS were discerned. These preconceptions fall into four main categories: religious, political, conspiracy and traditional African worldviews. Results of data analysis suggest that students’ prior knowledge is persistent even after biology instructions. This has implications for current teaching approaches, which are mostly teacher-centred in Ugandan schools. A rethinking of the curriculum with the intent of offering science education programs that promote understanding of the science of HIV/AIDS as opposed to what is happening now—insensitivity to misconceptions about the disease—is needed.     

Managing Risk and Experiencing Danger: tensions between government AIDS education policy and young women's sexuality

Much of the early panic relating to AIDS has focused on non‐heterosexual sexualities and the identification of high risk groups. It can be argued that fear of the spread of HIV and AIDS into the heterosexual population was the spur for the development of government policy in this area. The protection of the population in general depends on changes in high risk sexual practices, and the part played in these changes by young women has been given scant attention. We argue here that the sexual knowledge and practice of young women are crucial factors in the spread of HIV and AIDS, and that information on these factors is limited and interpreted within a framework of patriarchal ideology which obscures the power relations embedded in sexual relations. These issues are discussed using data from an investigation of young women's sexual beliefs and behaviour (the Women Risk and AIDS Project — WRAP) in relation to government AIDS education campaigns.

     

What Older Adults Know about HIV/AIDS: Lessons from an HIV/AIDS Education Program

Despite being one of the fastest growing segments of the HIV/AIDS caseload, persons age 50 and older have been largely neglected in terms of HIV/AIDS education. This study describes a project involving HIV-related health education for persons ≥50 in an urban area of Ohio. Data from 50 persons age ≥50 were collected. Pre-and postsurveys were used in the completion of repeated measures ANOVA, and focus groups provided qualitative data. Despite a paucity of available educational materials addressing HIV/AIDS, older adults are willing to participate in sessions about HIV/AIDS. Findings suggest the need for alternative approaches to providing HIV/AIDS education.     

Using adult education principles for HIV/AIDS awareness intervention strategies in Botswana

This paper reports on a mainly qualitative study into company strategies for HIV/AIDS information, education and communication (IEC) strategies in the Botswana workplace. The authors argue that HIV/AIDS awareness and prevention strategies in Botswana need a new approach. The research proposal hypothesized that IEC strategies need to take account of adult education theory that promotes the active involvement of learners in developing their own curriculum. It also proposed that an Africa‐centric gender perspective should be incorporated into future IEC materials. That is, the particular cultural position of women and their vulnerability to HIV/AIDS infection in Botswana needs to be theorized as an issue of power. Integrated with this issue is the argument that it is not always appropriate to try to persuade women to take the initiative in preventing infection when culturally they have no power to do so. The paper therefore critiques some of the adult education and feminist arguments for empowerment that do not take account of existing male power positions within the Botswana social framework. Using new educational material that derived from the research findings the authors argue for a dual strategy towards behavioural change; one that takes account of the current health crisis, but also one which uses a radical pedagogical approach that engages with ‘where people are at’.     

Can we use young people’s knowledge to develop teachers and HIV-related education?

Despite recent progress in meeting the goals of the Education for All agenda, certain groups of young people are particularly vulnerable to exclusion and underachievement, including children with HIV/AIDS, children living in poverty, and children with disabilities. HIV/AIDS has reduced many young people’s rights to access education, to live a full and healthy life, and to have a life as a child. This article focuses on attempts to continue to empower young people to protect themselves from HIV by exploring the dynamics around HIV-related education in schools, in particular by examining the role that young people’s knowledge can play in improving curricula and thus reducing HIV/AIDS rates. The authors draw on qualitative research in a total of eight schools in Kenya, Tanzania, and South Africa. Preliminary findings suggest that pupil consultation and dialogue can be used to inform thinking on the curriculum for HIV education.     

The provision of HIV/AIDS education in English colleges of further education

This paper focuses on the provision of HIV/AIDS education for 16–19 year olds in colleges of further education and offers both qualitative and quantitative insights into the English approach to HIV/AIDS education for this age group. It outlines the findings from two pieces of research conducted in England by the Health Education Authority 16–19 HIV/AIDS Project.     

The role of teachers in sex education and the prevention and control of HIV/AIDS in Nigeria

Research was undertaken to assess the role of primary school teachers with regard to the prevention and control of HIV/AIDS in Nigeria. Structured and semi‐structured questionnaires were responded to by 210 teachers drawn from primary schools in Eastern Nigeria (with pupils aged 6–15 years). These were supplemented by focus group discussions and key informant interviews. The findings show that the teachers have a reasonably high knowledge of the modes of HIV transmission, the behavioural risk factors and modes of prevention. The teachers, however, are reluctant to teach this because of socio‐cultural and religious factors, lack of teacher training in delivery of sex education as well as poor motivation. The motivation and participation of primary school teachers in the prevention of HIV in Nigeria are very low. This calls for serious and urgent policy intervention to remedy the situation and increase the role of primary school teachers in combating the spread of HIV/AIDS in Nigeria.     

HIV knowledge and risk among Zambian adolescent and younger adolescent girls: challenges and solutions

In sub-Saharan Africa, young women are at the highest risk of HIV infection. Comprehensive sexuality education and open parent–child communication about sex have been shown to mitigate risky sexual practices associated with HIV. This study aimed to identify sources of HIV prevention knowledge among young women aged 10–14 years and community-based strategies to enhance HIV prevention in Zambia. Focus group discussions were conducted with 114 young women in Zambian provinces with the highest rates (~20%) of HIV. Discussions were recorded, transcribed and coded, and addressed perceived HIV risk, knowledge and access to information. Participants reported that limited school-based sexuality education reduced opportunities to gain HIV prevention knowledge, and that cultural and traditional practices promoted negative attitudes regarding condom use. Parent–child communication about sex was perceived to be limited; parents were described as feeling it improper to discuss sex with their children. Initiatives to increase comprehensive sexuality education and stimulate parental communication about sexual behaviour were suggested by participants. Culturally tailored programmes to increase parent–child communication appear warranted. Community-based strategies aimed at enhancing protective sexual behaviour among those most at risk are essential.     

‘I Never Knew that Pictures Could Convey Such Powerful Messages’: Chinese Students in an English Department Explore Visual Constructions of HIV and AIDS

This article reports on a recent project in which 25 Chinese college students in an English Department of an urban university in China engaged in a series of photovoice workshops. In the context of a youth as cultural producers framework, the project was meant to engage youth in media production. This approach helped not only to expand their vision and experience related to HIV and AIDS, but also to mobilise their engagement in social issues related to HIV and AIDS, and to pave a path to action and social change. The study has implications across a range of areas, including implications for cross‐curricular integration (in this case English) of HIV and AIDS in higher education institutions and the issue of ‘which language’ (L1 or L2) and why in studying sexuality education.     

Knowledge, attitudes, and beliefs about HIV/AIDS among Hindu students from a government women's college of South India

The purpose of the study was to determine the attitudes of Hindu students from a government women's college of South India toward people with AIDS, to assess their beliefs about HIV/AIDS, to determine their knowledge level about HIV/AIDS and to determine how they gain information about HIV/AIDS. The sample consisted of four hundred female students at a government funded Women's University in Southern India who participated in an AIDS survey research project. Participants completed a survey asking about their knowledge, attitudes and beliefs about HIV/AIDS. Results indicated that a majority of the participants learned about HIV/AIDS from reading material while some learned about HIV/AIDS from school classes, and only a few learned from family members. Thirty-nine percent had never communicated to any one about HIV/AIDS. The results indicated that the majority of Indian women in this study did not know about explicit sexual behaviors which transmit the virus. The study also showed that those Indian women university students, by and large, are accepting of people with AIDS but still have fears of getting HIV/AIDS. This data suggest a need to increase educational efforts at the university. It was suggested that counselors take responsibility for helping this population of Indian women become self advocates, particularly in a society which permits men to have multiple sexual relationships. Educators and counselors working with this population must initiate programs that impart accurate and specific knowledge to these female college students and begin to address the multiple psychosocial issues related to HIV/AIDS.     

HIV/AIDS knowledge, attitudes, and risk-behaviors among African-American and Caribbean college women

The HIV/AIDS knowledge, attitudes, and sexualrisk-taking behaviors of a sample ofAfrican-American and Caribbean college wereinvestigated. The study also explored therelationship between the women's self-esteem,self-efficacy, sexual communication, andreligiosity and their HIV knowledge, attitudes,and risk behaviors. Findings revealed thatwhile both groups of women were fairlyknowledgeable about HIV/AIDS transmission andprevention, their sexual risk-taking behaviorswere still relatively high. TheAfrican-American women were more knowledgeableabout HIV/AIDS than were the Caribbean women. Also, the African-American women engaged insignificantly fewer sexual risk-takingbehaviors than their Caribbean femalecounterparts. No significant cultural groupdifferences emerged on attitudes towardHIV/AIDS as a disease, HIV infected persons,and AIDS-related issues. A number ofsignificant correlations were found. The studyconcludes that HIV/AIDS counseling andprevention approaches that are ethnic,cultural, and gender appropriate are vital forincreasing both cognitive and behavioralchanges in culturally diverse young women.     

Unveiling their worlds: the use of dialogue as a health-promotion tool for HIV/AIDS education in a poor community in Kenya

Three decades since the onset of HIV/AIDS, 33.2 million people worldwide are infected and prevalence in Kenya is on the rise. This paper contributes to discussions about HIV/AIDS education and draws on the health promotion approach and the emancipatory theory of Paulo Freire. Freire argued that through dialogue people unveil their world. The researchers used the method of dialogue to facilitate parents' and teachers' reflections on sexuality education for the children. The dialogues seemed to facilitate some reflection and showed the attitudes of the community to matters that impact on sexuality education (e.g. gender and sexuality). This paper illustrates how dialogic processes can be useful to the process of constructing realistic and contextually relevant HIV/AIDS education. The challenges for the researcher as an outsider are also discussed.     

The impact of HIV/AIDS on primary education in Botswana: educating children as agents of change

HIV/AIDS can no longer be regarded solely as a public health issue as its impact extends well into all spheres of life, sectors of society and levels of the education system. This paper argues that not only is it paramount to draw on children's understanding of the impact of AIDS on their lives, but it is equally important to draw on their solutions in order to foster their agency. Using the ‘draw and write’ methods, this research explores children's perception of the impact of HIV/AIDS and their understanding of the capabilities needed in order for them to become active change agents. The findings indicate that short-term intervention programmes are insufficient in curbing the HIV trends and in mitigating its impact. The authors argue that there is now a paramount need to re-evaluate the role and goal of education to allow it to serve as a prophylaxis for HIV/AIDS.     

Enhancing school HIV and AIDS strategic plan through expanded stakeholder involvement

Abstract

This article focuses on the need for expanded stakeholder involvement as a means of enhancing the Botswana Department of Secondary Education (DSE) HIV and AIDS strategic plan. Research has indicated that the effects of HIV and AIDS on the supply of and demand for education are considerable. Using a questionnaire and interviews, the research has established that the current DSE HIV and AIDS strategic plan lacks comprehensive strategies for preventing HIV spread in schools. Furthermore, the study has shown that there is limited external stakeholder involvement. The study, therefore, has explored how greater success could be realized. The study has concluded that the strategic plan can be improved through expanded external stakeholder involvement at all the stages of the strategic plan. In order to enhance the DSE strategic plan, a stakeholder involvement model is presented.     

UNESCO艾滋病预防教育策略初探

艾滋病已成为危害人类社会的国际问题.到目前为止,预防教育是解决艾滋病问题最为有效的方法.联合国教科文组织提出艾滋病预防教育的目的是增进人们对艾滋病传播和预防的知识、意识、技能,形成和树立正确的态度和价值观念,减少艾滋病的传染,减轻艾滋病对社会造成的影响,同时缓解艾滋病对教育系统带来的压力.本文介绍了UNESCO在全球性和地区性两个层面实施艾滋病预防教育的策略,并讨论了这些策略的意义.