HIV/AIDS EDUCATION:
SOME PERSPECTIVES FROM THE ASIA-PACIFIC
Paper Prepared for the Fourth Meeting of the Working Group on Education for All,
UNESCO, Paris, 22-23 July 2003
by Usa Duongsaa, ASPBAE
Overview of situation
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Estimated 7.2 million people are believed to be HIV-positive in Asia
Concentrated epidemics among injecting drug users and sex workers have crossed over into
the general population in Cambodia, Myanmar and Thailand, resulting in generalized
epidemics
In Indonesia, Nepal and Vietnam, infection rates are exploding among those two high-risk
groups.
In China, home to a fifth of the world’s population, concentrated epidemics have emerged in
several provinces and HIV is moving so rapidly that many fear the country is on the verge
of a generalized epidemic. According to UN estimates, between 800,000 and 1.5 million
people in China had HIV by December 2001, and the number could reach 10 million by
2010.
With the current estimate of 3.8 million people living with HIV/AIDS (PHA), India is
home to the world's second-largest HIV-positive population, after South Africa. It is
believed HIV is spreading rapidly in the country.
Increasing infection in Pakistan and Malaysia in Asia, and Papua New Guinea, Solomon
Islands, Vanuatu, Samoa and Fiji in the Pacific
Increasing number of children orphaned by AIDS, many of whom still face discrimination at
school and in the community
Although AIDS has affected all age groups, all sexes, and all occupations, overall, the
current face of HIV/AIDS is primarily young, and often female. Almost 12 million young
people (aged 15-24) and 3 million children live with HIV or AIDS. The majority of new
infections are among the young - 6,000 young people and almost 2,000 children become
HIV-positive every day.
Women continue to be more likely than men to be poor and powerless, have less education,
less access to land, credit or cash, and to social services. They are more prone to be victims
of violence and sexual abuses. Therefore, they continue to be more vulnerable to
HIV/AIDS, to have relatively less access to prevention, and to shoulder more
responsibilities in caring for the infected
HIV/AIDS is closely linked to other social and economic problems including poverty,
illiteracy, sexual exploitation including prostitution, trafficking of children and women,
gender inequality, drug use, migration and displacement because of armed conflicts.
Therefore, even in relatively low-prevalence countries, there are increasing vulnerabilities
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Overview of Responses
Positive:
 Increasing national/political commitment to fighting HIV/AIDS, but denial still exists at
national and/or local levels in many countries. Some recent good news at
national/governmental level: the Vietnamese government is establishing a national strategy,
taking tougher measures against prostitution and drug trafficking, producing low-cost AIDS
medicines, working with foreign countries, and raising HIV/AIDS awareness among citizens.
China has launched what is believed to be the first web site aimed at giving young Chinese
people advice on sexual health and encouraging young people to discuss openly their sexual
relations and other sexual matters.
 Increasing involvement of “target groups” and participation of NGOs, faith-based
organizations, and other civil society organizations in HIV/AIDS interventions
 Increasing visibility, acceptance, and participation of PHA, including formation of PHA
groups and networks. But still not in every country.
 Increasing concerns on stigma and discrimination
 Increasing access to voluntary counseling and testing
 Increasing access to care and treatment including prevention of opportunistic infections and
provision of anti-retroviral therapy. Even with support from the Global Fund on AIDS, TB
and Malaria (GFATM), however, provision is still far from adequate.
 Increasing prevention of mother-to-child transmission
 Many efforts made at providing HIV/AIDS education for the public in general as well as for
children in youth in particular, both in and out-of-school. Many IEC materials produced and
distributed; many campaigns organized including World AIDS Day campaigns.
Negative and not-so-positive:
 Complacency and fatigue especially in ‘successful cases’ like Thailand, as reflected in the
recent UNDP Human Development Report
 Inadequate care and support for children and elderly people who are affected by the
epidemic, especially regarding their psychological/emotional/spiritual/social needs
 Donor financial contributions to GFATM not adequate
 As the GFATM focuses on access to care and treatment, only small percentage of funds
supports HIV/AIDS education
 Relatively little local and community responses; interventions still largely centrally planned
 IEC materials still largely mass-produced, so often they do not respond to a specific target
group’s particularity or a community’s cultural sensitivity, therefore many of the materials
are not very effective
 Interventions often planned and implemented in segmented fashion with inadequate multisectoral co-ordination between GO and NGO, between education and development and AIDS
organizations
 Inadequate evaluation of interventions and summarizing lessons learned
 Inadequate learning, sharing, exchanges among communities, sectors, countries, regions.
 Still a great deal of discrimination against others because of sero-status, religion or sexual
orientation, or certain practices such as drug use and sexwork, leading to disabling attitudes
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and practices including regarding PHA, sex workers and drug users as those who committed
social evils, making it difficult to do effective interventions
Still existing taboo against talking about sex and sexuality, especially in the cases of youth
and women, resulting in young women’s vulnerability and inability to effectively protect
themselves against pregnancy and sexually-transmitted infections including HIV/AIDS
(Note, for example, that 10.5 million unsafe abortions take place in Asia each year out of the
approximate 19 million unsafe abortions taking place worldwide).
In general, and even among the teaching professionals, there is inadequate understanding on
behavioural communications and change or behavioural development. Therefore, even when
HIV/AIDS education, drugs education and sex education are included in the school
curriculum, they tend to be lecture-based and knowledge-based, although knowledge does
not lead to awareness and action. Inadequate appreciation of participatory approaches to
HIV/AIDS education and awareness-raising including participatory analysis of personal risk
perception, life skills training and peer education programme, and participatory community
mobilization and planning
Inadequate understanding of linkages between AIDS and other economic and social
problems, therefore attempts made to solve problems are often individually and segmentally
planned, resulting in poor outcomes and impacts
What needs to be done
Certainly more awareness-raising, prevention, and HIV/AIDS education need to be done. And
they need also be done differently, so as to be more effective. In order to achieve this, we need
to do more.
 We need to relinquish our authority. We need to decentralize HIV/AIDS education
planning and implementation, and allow others to take the lead, particularly the ‘target
groups’ themselves who know their contexts, their needs and their potentials much better
than we do. Instead of planning, designing, and conducting more HIV/AIDS education for
children and young people all by ourselves, we should involve more children and youth in so
doing. Better still, we should encourage and promote more youth-initiated, youth-led
activities including awareness-raising, promotion of prevention, promotion of acceptance,
care and support.
 We need to work in a more integrated fashion. It is not sufficient for us to just
concentrate on HIV/AIDS. In order to do HIV/AIDS education effectively, we need to
integrate HIV/AIDS education with drugs education, sexuality education, gender education,
and life skills training. These issues need to be mainstreamed into the curriculum in both
formal education and non-formal education.
 We need to accept that knowledge alone does not lead to awareness or action, so we
need to work in a participatory manner. Hence, participatory HIV/AIDS education,
participatory drugs education, and participatory sexuality education. We cannot just give
facts and tell children and young people to “just say no”, because it does not work; children
and youth do have a mind of their own, regardless of what we adults choose to believe.
Therefore, we need to impart not only knowledge but also skills that translate knowledge
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into action: negotiation, conflict resolution, critical thinking, decision-making and
communication. These skills improve self-confidence and ability to make informed choices.
In order to do the above, we need to become more open, and more accepting. We need
to be comfortable with their own sexuality, and we need to be free of prejudices against
people who are different from us including drug users, sex workers, gays and lesbians, and so
on. Otherwise our own attitudes and prejudices are barriers to change and to solving
problems in the long terms. It is important to bear in mind that the goal is to save life and to
promote quality of life in the community and society, not to moralize or to condemn.
Training, or rather re-training, is certainly important.
We also need to acknowledge our limitations that we cannot know everything, nor can we
do everything. Therefore we need to work with others more closely, and not only preach but
practice genuine multi-sectoral collaboration, networking, and equal partnership.
To make HIV/AIDS education really effective, we also need to focus more on advocacy.
We need to advocate for integration of AIDS education into education not only for children
and youth, but also for adults and communities. We need to advocate comprehensive and
sustained responses to HIV/AIDS and other social problems, because awareness cannot turn
to actual prevention or care and support if necessary services are not made available. And
we need to advocate linking local responses to national policies and strategies, and to
regional and international exchanges, learning, sharing, and collaboration. Of course, for all
these to happen, we need to work with other partners.
We need to focus less on education and focus more on learning. We cannot just
concentrate on providing HIV/AIDS education in the classrooms or in the school, for the
students and teachers and achool administrators, nor can we content ourselves with educating
those who come to us. We need in fact to promote HIV/AIDS learning and reach out to all in
the community and in society, by providing forum for sharing and exchanges and promoting
knowledge management mechanisms/processes/system. We need to show others that
education and learning have no fences or borders, that education and learning are valuable
for all.
Most importantly, we need to educate ourselves. We need to learn, ourselves. We need
to learn to function less as teachers or educators, and more as facilitators of learning. If we
do not succeed at doing this, we will fail at trying all the above.
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