The death toll from AIDS continues to rise in the United States. As of May 1, 1995, 441,528 cases of AIDS had been recorded in the U. S. One of the most powerful ways to control the spread of this disease is prevention education. In 1988, Oregon passed OAR 581-22-412 requiring implementation of HIV/AIDS education as a part of a comprehensive health education program throughout grade levels K-12. The Oregon Department of Education and the Oregon Health Division produced a curriculum and implemented a statewide inservice program in 1988. There has been no uniform statewide training since then, nor have implementation practices been monitored consistently. Sixth grade is a pivotal time in childhood when children are passing through puberty into adolescence. Sixth grade may be placed in a middle school with a health specialist, or in an elementary school with no health teacher. This grade may be the final opportunity for intervening before students adopt behavior patterns which may lead to HIV/AIDS. The purposes for this study were twofold. The first was to determine the extent to which Oregon sixth-grade teachers were implementing HIV/AIDS education. The second was to discover what factors might predict whether a sixth-grade teacher would be an implementer. A random stratified sample of 400 was drawn from the population of 1,333 sixth-grade teachers employed during 1993-1994. These teachers received a written questionnaire. Three-hundred and six teachers returned surveys. One-hundred and twenty of the subjects met the definition for implementer and 48 were determined to be non-implementers. The remaining 138 did not supply enough information to be categorized but their responses were used where applicable. Null hypotheses were tested using the chi-square and Mann-Whitney U statistics. Significant factors were whether teachers had some training and having had training in characteristics of HIV infection, low-risk behaviors leading to HIV infection, prevention behaviors, infection control, and social implications of AIDS. Regression analysis was employed to determine factors which predict that a teacher will be an implementer. Significant factors were a) having had inservice in low-risk behaviors, b) teaching in a self-contained classroom, c) and not defining oneself as politically conservative. / Graduation date: 1996

Nearly 37 million people are living with HIV and there are an estimated 2.1 million new HIV infections each year, equating to 5,700 new infections per day. Approximately half of new HIV infections occur in Eastern and Southern Africa. Young people are at particularly high risk of HIV; 35% of new infections are among young people ages 15-24 years. In sub-Saharan Africa, 25% of new infections are among young women. Throughout the course of the HIV epidemic, research has described the associations between social structural and behavioral determinants of HIV acquisition. The influences of socioeconomic status, household characteristics, gender, geographical residence, and risky sexual behaviors on HIV acquisition are well reviewed in the literature. Evidence on the impact of education on factors that influence HIV acquisition is less robust and associations have changed over time as both education and the HIV epidemic have evolved. Globally, access to education and educational attainment has increased over the past several decades. In developing countries, the number of years enrolled in school for both men and women has significantly increased. The impact of increased educational attainment has contributed to reductions in child mortality, improvements in reproductive health, and reduced HIV transmission. In many countries, the gap in education between men and women has reversed, with women now achieving higher levels of educational attainment than men. However, in several low and middle income countries, gender disparities persist. Global public health, development, and policy communities recognize the importance of education and its influence on health outcomes. Over the past decade, education has been highlighted in the Millennium Development Goals (MDG) and now is continuing as a priority for the Sustainable Development Goals (SDG) in the post 2015-agenda. The goal of MDG 2 was to achieve universal primary education for all children; building on this goal, SDG 4 focuses on quality education, ensuring inclusive and equitable education and promoting lifelong learning opportunities for all. The goal of this dissertation is to highlight the importance of education by summarizing the current state of literature that reviews associations between education and HIV infection for adolescents in low- and middle- income countries and illuminating the key entry points for research, policy, and programming by examining the relationship of education on determinants of HIV infection for young people. This dissertation accomplishes the stated goal by: (1) Systematically reviewing associations between education and HIV infection for youth ages 13 – 24 years living in low- and middle- income countries (Chapter 1); (2) Examining the relationship between educational attainment on HIV acquisition for young adults ages 20 – 24 years in Rakai, Uganda (Chapter 2); and (3) Commenting on the pathways to HIV acquisition and identifying key entry points and best practices in policy and research to promote improved health outcomes for adolescents (Chapter 3). This dissertation is guided by both the proximate determinants of health framework as described in Chapter 2 and the socio-ecological theory adapted from the Bronfenbrenner Model as presented in Chapter 3. This dissertation adds to both the field of HIV and education research by synthesizing the literature that currently exists, illustrating the influence of education on known determinants of HIV acquisition, and concluding with actionable research and policy recommendations to continue progress toward educational attainment and improving health outcomes. A systematic review summarizes publications that analyze the association between education and HIV for young people living in low- and middle- income countries. Twenty-two articles include over 315,000 participants from 18 countries. While over half of the articles included in this review indicate that higher education is associated with lower rates of HIV sero-positivity, there is still significant variability in the findings. Two studies indicate that those with higher education have an increased risk of HIV; four studies show no association between education and HIV; and five studies result in mixed conclusions based on gender and age or grade level. Key conclusions from this review echo previous systematic reviews. Dates of data collection influence the conclusion of published studies. In this review, articles that show that those with more education had a lower HIV prevalence were more likely to have data collected after the year 2000. Although articles from 2007 – 2017 are eligible to be included in this review, the most recent publications identified are from 2015 and the most recent data are from 2013. More updated data collection and publications on the association between education and HIV are needed to continue to improve this field of study. This review highlights the importance of continuing research on the association between education and HIV in low- and middle- income countries to support continued progress toward MDG 2 and SDG 4. Not only is it imperative to study the relationship and magnitude of the association in a variety of settings and populations, but also to gain a better understanding of how and why education influences HIV for young people. This review provides sufficient evidence to show that education does have an impact on HIV and can be used to improve policies and programs to improve school enrollment, attendance, attainment, and the quality of education in low- and middle- income countries for all young people. In Uganda, school enrollment rose steadily from 1994 to 2013 among adolescents, due largely in part to changes in national policy. Increasing school enrollment in Uganda was associated with a declining risk for HIV and pregnancy among young people ages 15 – 19 years. Data from the Rakai Community Cohort Study (RCCS) were used to examine the association between educational attainment and proximate risk factors of HIV infection for young adults’ ages 20 – 24 years. Results showed that educational attainment was protective against several risk factors for HIV. Compared to those with no education, females with at least a secondary education were less likely to have their first sexual encounter before the age of 18. Compared to those with no education, females with higher educational attainment (attending primary school, secondary school, or beyond secondary school) were more likely to use family planning methods and had fewer sexual partners. Educational attainment was also correlated with riskier behaviors. Females with higher education were more likely to report inconsistent condom use, concurrent sexual partners, and were less likely to know the HIV status of their partners. Similar results were seen in males. Compared to those with no education, males with any education were more likely to use family planning methods. Compared to those with no education, males with higher education (attending primary school, secondary school, or beyond secondary school) were more likely to report concurrent sexual partners. Educational attainment was not significantly associated with HIV incidence in males or females. The association between educational attainment and risk factors for HIV acquisition are varied. Higher educational attainment is associated with delayed initiation of sexual activity and use of family planning methods; however, it is also associated with inconsistent condom use and more concurrent sexual partners. In an era of enhanced focus on education and educational attainment, this data helps explain how schooling can impact the risk behaviors that influence the HIV epidemic in young people. When developing sexual education in the future, researchers, program, and policy developers should utilize these findings to ensure curricula focus on consistent condom use, concurrent partners, and the importance of HIV disclosure. This study also highlights gaps in the current literature – future research questions should more closely examine the quality and content of education, as well as determining the role that education plays in exerting autonomy over behavior and behavior change. The HIV/AIDS epidemic and access to education have seen parallel improvements in recent decades. Nearly 40 years into the HIV/AIDS epidemic, there have been tremendous gains in care, treatment, and prevention of HIV. Yet, the epidemic still impacts millions of people worldwide. Similarly, access to education has improved for many throughout the twentieth and twenty-first centuries, although major disparities and gaps remain. The importance of education for health and development is highlighted by the United Nations (UN) in the Millennium Development Goal campaign (MDG, 2000 – 2015) and in the Sustainable Development Goals effort (SDG, 2015 – 2030)21,22. The UN calls for universal primary education (MDG 2) and inclusive and quality education for all (SDG 4)21,22. In the current post-2015 agenda focusing on eliminating disparities and improving quality in education, now is a pivotal time to review what is known and what remains to be discovered about the relationship between educational attainment and the HIV/AIDS epidemic, two driving domains in policy and program planning. More updated data and research needs to be conducted in a variety of diverse settings in order to understand how education can influence the HIV epidemic in the current environment. Moreover, researchers should ensure that they are looking at the entire context of education and desegregating educational attainment from socioeconomic status measured using alternative measures to better target key entry points for change. Policy makers can utilize this research to evaluate existing policies and implement new polices as needed. The failure to meet the MDG 2 of universal primary education indicates that much work still remains in the policy and program implementation realms of education enrollment and attainment. Beyond primary education, a renewed focus on secondary education, quality education, and gender equality will maximize the benefits of education.

This research is a qualitative study of a short project set up to explore the uses of a visual arts-based approach for addressing HIV and AIDS through teacher development. It was undertaken at the University of KwaZulu-Natal in the face of the HIV and AIDS pandemic. It responds to the suggestions that teachers need to explore their own understanding, attitudes and perceptions of the disease if they are to deal confidently with the demands it places on them as educators in schools. Thirteen preservice teachers, who had enrolled in a guidance course, used photographs and drawing to capture their views of HIV and AIDS and to construct messages for their peers. Methods for the approach were adapted from the work of Ewald and Lightfoot (2001) and from Wang’s (1999) photo-voice. A visual arts-based approach was chosen for its potential to simultaneously engage the mind, body and emotions (Weber & Mitchell, 2004). Drawing on the conceptual work of Banks (2001), Hall (1997) and Fairclough (1995), the photo texts were then analysed by the researcher who saw them as socially and culturally embedded constructions and was interested in how they were affected by and could have an impact on culture and social discourses. Reflections on the photo texts and their associated processes by both the researcher and pre-service teachers lead to suggestions as to the pedagogic possibilities of using a visual arts-based approach in education to address HIV and AIDS. The thesis concludes with discussion of what a visual arts-based approach can contribute to HIV and AIDS in teacher education and comments on the challenges and limitations of such an approach. / Thesis (PhD.)-University of KwaZulu-Natal, 2006.

The purpose of this study was to determine teacher engagement with HIV/AIDS education in primary school. Since the emergence and acknowledgement of the HIV/AIDS epidemic in South Africa, the national education department's policy has advanced HIV/AIDS education as a priority. The new curriculum has opened up opportunities for HIV/AIDS education to be inserted in the curriculum especially in the learning area Life Orientation in the primary school, which previously did not exist. There is a paucity of research documenting teachers' experiences on the implementation of the HIV/AIDS curriculum. The manner in which teachers engage with the HIV/AIDS curriculum is not known. This study focused on 9 teachers in the intermediate and senior phases in a particular primary school in KwaZulu Natal who have had experience in the implementation of the HIV/AIDS curriculum over the past four years in their school. A survey questionnaire was administered to all educators in the study. The three intermediate educators participated in face-to-face interviews as well as a focus group discussion. An interview was conducted with the member of the management team who was part of the sample. The results from the survey, interviews and focus group discussion suggest that teachers were strongly implementing the HIV/AIDS curriculum in their classrooms while experiencing some practical challenges. This study also suggests that the educators found the Department Of Education's implementation plan suppressive. All three intermediate phase teachers used creative methods to assist in the implementation of the curriculum. The respondents claimed that the workshops and meetings that they had attended were invaluable to them. They however preferred seeing the community more closely involved in the fight against HIV/AIDS, as this was not an issue confined to the school exclusively. Teachers would also liked to have had HIV/AIDS education implemented across the curriculum, as the task to empower learners in this regard was a mammoth one. The unique and challenging experiences of teachers implementing the HIV/AIDS curriculum must be documented before any theoretical positions can be articulated about the implementation of HIV/AIDS education in primary schools in South Africa. This study has contributed to research on the implementation of HIV/AIDS education in primary school by providing some insight into a group of educators' experiences. / Thesis (M.Ed.) - University of KwaZulu-Natal, Durban, 2004.

The rapid rate, at which HIV/AIDS is being spread, is changing the face of modern society. The alarming statistics revealed by research, bears testimony to this fact. According to Bennell (2003), the total number of HIV/AIDS maternal and two-parent orphans for subSaharan Africa is expected to increase from 9.85 million in 2001 to 18.67 million in 201 0. Education has a pivotal role to play in effectively dealing with the effects of the pandemic, as well as in creating awareness among learners on HIV/AIDS preventative education. The chief medium through which ideas are conveyed and awareness is raised, is through the use of language. The focus of this dissertation was to critically explore the language used by educators within the context of HIV/AIDS Education , at primary school level. This was done in two ways. The first was conducting an in-depth analysis of documents pertinent to HIV/AIDS Education, in an attempt to ascertain which themes, concepts and terms frequently feature in these various documents. The second was exploring these themes, concepts and terms with regard to how these were perceived and understood by the participants in the study. The translation of the meanings the participants attached to these concepts and terms, and how these translated into learning activities within the classroom context, received attention during classroom and lesson observations. A case-study design within the qualitative mode of inquiry was employed. Document analysis, observation and in-depth interviews were used to obtain data pertaining to the area of study. Three Life Orientation educators, from a suburban, co-educational school in the Kwa - Zulu Natal area, participated in the study. The Critical Discourse Analysis framework informed the study. The study also explored the usage of non-verbal signs and suggestions to convey meaning and understanding among learners. The participants' predispositions, ideologies and pre-conceived notions of what was appropriate, in terms of themes explored within the context of HIV/AIDS education, were also examined in light of any bearing these might have had in the process of facilitating understanding among learners. Due consideration was given to contextual factors, and how these might have influenced the processes of creating meaning and understanding among learners. The findings revealed by this research, provide valuable insights into some of the interpretations of some of the terms and concepts that are commonly associated with HIV/AIDS by educators. In addition, they present the possibility of alternate meanings of these terms and concepts, suggesting that multiple meanings are possible within the context of HIV/AIDS education. The implications of this study for classroom practice are numerous. / Thesis (M.Ed.) - University of Kwazulu-Natal, 2006.

This research presents an understanding of the teaching and learning practices in the context of HIV/AIDS education in the intermediate phase. Against a milieu of change and restructuring in education is the HIV/AIDS education curriculum which teachers are expected to deal with in schools. From an identity perspective, I try to understand how teaching practices which are adopted by teachers in the teaching of HIV/AIDS education either challenges or perpetuates the status of HIV/AIDS in society. Therefore the focus of this study is primarily the teacher. By employing Samuel's Forcefield Model as a structure for this study, I demonstrate how the choices that the teacher makes in teaching practice, are shaped by a range of diverse forces, which are frequently in conflict with each other. In this study I want to understand how teachers are engaging with their new roles and multiple responsibilities (as described in The Norms and Standards for Teacher Educators) when teaching HIV/AIDS education in the intermediate phase - given that this aspect is a relatively new dimension to the curriculum. From a methodological perspective, the collection and analysis of data were consistent with the Hermeneutic research paradigm. For the purpose of this study interviews and questionnaires were used to collect data from educators. Furthermore, in order to present a more holistic picture of the teacher and to ascertain to what extent, what the teacher teaches is actually what the learner learns, data was also collected from learners via observations, conversations and through an analysis of drawings and poems. It must be emphasised that although learners in this study play a pivotal role as sources of data, they are not the unit of analysis for this study. Thus the major part of this thesis focuses on the teacher. The findings of this study indicate that the guiding principles of a teacher's life, such as race, religion and culture are important forces that mould what, why and how teachers teach HIV/AIDS education in the intermediate phase. On the other hand, the forces that mould learners' experiences of HIV/AIDS education is determined by the social environment that the learner lives in. The forces that shape what the teacher does are not the same as the forces that shape what the learner learns. The concept of 'othering' is predominant in the interactions between teachers and learners and teachers are socially distanced from learners, parents and the child's social environment. Hence the 'caring and sharing' as espoused by teachers is not being articulated in practice. / Thesis (M.Ed.)-University of Kwazulu-Natal, 2005.

This study explores the perceptions Indian female youth have of HIV and AIDS in the / Thesis (M.Ed.) - University of Kwazulu-Natal, 2006.

Since HIV and AIDS became a health problem in the world in the early '80s, education has been identified as one of the ways to control the spread of the virus, for the virus is mainly spread through specific risk behaviors. uMgungundlovu district ranks as one of the worst-affected areas in South Africa, with HIV prevalence figures of 40% and above over the past five years The study aimed to establish how people living with HIV acquired knowledge about the disease; to investigate how they responded to the knowledge acquired; and to identify factors that affect their implementation of the knowledge acquired in their daily lives. I hoped that this study would capture some of the realities that we live in, so that HIV education programme developers and implementers can start to grasp the factors that individual HIV positive persons experience, which can play a positive or negative role on how one uses the knowledge they acquire to improve their own health and also be able to protect the next person. The study was a micro qualitative research, with a feminist approach, drawing on both interpretive and critical paradigms. It focused on a particular group of people in a specific area. Through my personal reflections, the semi-structured in-depth interviews, focus group discussions and the review of other existing literature (published and unpublished), the study attempted to investigate perspectives of people infected with HIV on HIV and AIDS education. The study was conducted with consideration of the positions of women and men in the diverse South African cultures. The study findings showed how the intersection of gender, power and culture, the context of reception and implementation of knowledge, the individual‟s habitus and the multi-disciplinary support systems, impact on the reception, receptivity and implementation of HIV and AIDS education. The conclusion, recommendations and suggestions for future studies from the study are presented, positioning the person living with HIV at the centre of responses to slowing down the spread of HIV. / Thesis (M.Ed.)-University of KwaZulu-Natal, Pietermaritzburg, 2010.

The first cases of Acquired Immune Deficiency Syndrome (AIDS) were reported in 1981 and in 1983 the Human Immunodeficiency Virus (HIV) was identified. Today, over 40 million individuals globally are living with HIV/AIDS. As there is currently no cure for the disease, it is projected to reach pandemic proportions in the 21st century. In South Africa at the end of 2006, over 5.3 million individuals were living with HIV/AIDS, with affluent and educated South Africans showing the highest HIVprevalence growth rate. The HIV prevalence amongst 15 to 24 year old South Africans is 10.4 percent. It has become vital that youth receive education about HIV/AIDS as early as possible, to ensure that they do not contract the virus. Psycho-education seeks to teach psychological knowledge and skills to individuals. This is also known as life skills teaching. The National Departments of Health and Education have developed a life skills programme for schools. This programme aims to, amongst others; educate young people about HIV/AIDS. The effectiveness of this programme will be assessed in two schools in the Port Elizabeth area. In this exploratory descriptive, triangulation research study, a quasiexperimental, one group pre- and post-test design was used to assess the effectiveness of the life skills programme amongst 211 Grade nine middle to upper socio-economic group learners. Four focus groups were conducted after the programme to explore the learner’s attitudes and perceptions of HIV/AIDS and their experiences of the programme. Tesch’s model of content analysis and Guba’s model of trustworthiness were used to analyse the data obtained from the focus groups.

Thesis (MPA)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: “My Future is My Choice” (MFMC) is an extra-curricular life skills programme in Na-mibia aimed at minimising the impact of HIV and AIDS among young people. The pro-gramme was introduced fourteen years ago and is believed to have had a significant im-pact on young people who were enrolled in and graduated from it. The programme tar-gets young people from grades 8 to 12. The purpose of this study was to assess how the “My Future is My Choice” Programme imparts knowledge and skills to young people in the Ompundja Circuit of the Oshana Directorate of Education, in Northern Namibia. This was an implementation evaluation study, following a qualitative approach to collect in-depth information. Data was collect-ed by two means: focus group interviews with an interview guide as an instrument, and analysis of documents. Purposeful sampling was used to select twenty young people from the population of young people who graduated from the programme. Young people from three secondary schools and one combined school were interviewed. The outcome of the study indicated that young people who graduated from the pro-gramme were better equipped with knowledge and skills that enable them to protect themselves from HIV infection. The study also indicated that the strategies used to im-plement the programme are crucial to the successful transfer of information to young people enrolled in the programme. However, some challenges which need immediate attention for improvement concern the number of participants, the content, a review of topics and the time allocated to the implementation of the programme. It is therefore recommended that recipients be consulted for input on what their needs are with regard to HIV and AIDS prevention. As the programme began fourteen years ago, its strategies now require updating and revision of the programme has become necessary. The revision of the programme will enable its facilitators to incorporate new ideas and methods of HIV prevention gained from over a decade of experience. It would also allow for the identification of young people’s needs and incorporate relevant topics that are not currently covered in the manual. Hence, collaboration between facilitators, learners, teachers, parents, communities and programme designers is a key element in ensuring the continued success of the “My Future is My Choice” Programme. / AFRIKAANSE OPSOMMING: “My Future is My Choice” (MFMC) is ʼn bykomende lewensvaardigheidsprogram in Namibië wat die impak van MIV en VIGs onder jongmense wil verminder. Die program is 14 jaar gelede ingestel en het na bewering ʼn beduidende uitwerking gehad op jongmense wat daarvoor ingeskryf het en dit voltooi het. Die program is afgestem op jongmense in graad 8 tot 12. Die doel van die studie was om te bepaal in watter mate die MFMC-program die jongmense in die Ompundja-distrik in die Onderwysdirektoraat van Oshana in Noord-Namibië met kennis en vaardighede toerus. Die studie het ʼn implementeringsevaluering behels, en het diepte-inligting met behulp van ʼn kwalitatiewe benadering ingesamel. Data is met behulp van fokusgroeponderhoude aan die hand van ʼn onderhoudsgids sowel as deur middel van dokumentontleding bekom. Twintig jongmense uit die groep wat die program suksesvol voltooi het, is met behulp van doelgerigte steekproewe gekies en onderhoude is met jeugdiges van drie hoërskole en een gekombineerde skool gevoer. Die uitkoms van die studie dui daarop dat jongmense wat die program voltooi het oor beter kennis en vaardighede beskik waarmee hulle hulle teen MIV-besmetting kan beskerm. Die studie het ook getoon dat die strategieë wat gebruik word om die program in werking te stel deurslaggewend is vir die suksesvolle oordrag van inligting aan diegene wat vir die program ingeskryf is. Tog is daar bepaalde uitdagings wat onmiddellike aandag verg, soos die aantal deelnemers, die inhoud, die onderwerpe, en die tyd wat vir die inwerkingstelling van die program beskikbaar gestel word. Daarom word aanbeveel dat, ten einde die MFMC-program te verbeter, diegene wat die program volg oor hulle behoeftes met betrekking tot MIV/vigs-voorkoming geraadpleeg word. Nou, 14 jaar nadat die program die eerste keer in werking gestel is, is dit duidelik dat die strategieë wat gebruik word verouderd is en dat die program dringend hersien moet word. Sodanige hersiening sal die programaanbieders in staat stel om nuwe idees en metodes vir MIV-voorkoming wat nie 14 jaar gelede bekend was nie, by die program in te sluit. Dit sal ook ʼn geleentheid bied om jongmense se werklike behoeftes te bepaal en ander onderwerpe aan te roer wat nie tans in die handleiding verskyn nie dog tersaaklik is. Daarom is samewerking tussen fasiliteerders, leerders, onderwysers, ouers, gemeenskappe en programsamestellers ʼn sleutelelement om die voortgesette sukses van die MFMC-program te verseker.