This page features computer generated text of the source audio. It may contain errors or omissions, so always listen back to the original media to confirm content. You can search the text using Ctrl-F, and you can also play the audio by clicking on a desired timestamp.
Let me say just a little bit about me and etr. So you have some idea where I come from and then you'll understand why I'm going to talk to you about young people and how to do HIV prevention with adolescents. I started working with adolescents. Oh, I hate to even tell you in 1968 as a classroom teacher. And as you know, that was before HIV, and I was like, 20 years old or 21 [00:00:30] years old, and I had a student come to me and say, I think I'm pregnant and I had no idea what to say to her. Um, But I talked to her and I called some people in the community and I said, Help, how do I help this young woman? And they gave me some assistance about how to talk with her and how to get her to talk with her parents. And in that one year of teaching, [00:01:00] I had 20 girls come to me and say, I think I'm pregnant now. That sounds like a lot, and it is a lot because there are only about 350 students in the high school, so that was my introduction to working with young people around issues about sexuality. I've been doing it ever since. [00:01:30] About 14 years ago, I had the opportunity to work for an organisation that was just starting. Called ER Associates, ETR stands for education, training and research, and we do education, training and research as it relates to providing good health education to young people. [00:02:00] K through 12 kindergarten through 12th grade in 1987. The centres for Disease Control who was sponsoring this conference, gave us a five year grant money for five years to develop programmes for young people to help them prevent the spread of HIV. [00:02:30] So that's my background. That's how I come to you. In the last few years at ETR and at CDC, we've been asking the question. What really works now? I've been doing pregnancy prevention education since the early seventies, and we haven't stopped teenage pregnancy in [00:03:00] the United States. So I think it's a very important question to ask ourselves what works. What's effective. When a young woman gets pregnant, it doesn't end her life. She still has some options. When a young person gets HIV, it very well may end their life. So from my viewpoint, the stakes are higher when it comes to talking about HIV. [00:03:30] From the survey that Christine shared, it looked like a lot of you did something with HIV education with your young people. And even if you don't, my hunch is you have some beliefs about what works. I certainly did. I still do. But they change [00:04:00] before I tell you what we've found through some studies and research about what works. I'd like to survey you and see what you think works. And I'm going to do that by giving you a little quiz. What I'd like you to do is on a piece of scratch paper, just any piece of paper. Write the numbers one through [00:04:30] five. OK, Yeah. No. I'm going to read five different statements about HIV prevention education for young people. [00:05:00] After I read a statement, I want you to decide whether you think that statement is true. In other words, it's what works or false. It's what about doesn't work, is that clear? Any questions just write. True or false, you can put plus or minus you just nobody's going to correct this. This is kind of a game it's not a real test. OK statement number one. Giving young [00:05:30] people accurate information about the risks of HIV infection significantly reduces their unprotected sex. Let me read it again. Giving young people accurate information about the risks of HIV infection significantly reduces unprotected sex. [00:06:00] Do you think that's true or false? Ready for number two? I'll wait. You mhm? [00:06:30] Yeah, All right. Number two. HIV prevention education that teaches the important steps in decision making and the benefits or risks [00:07:00] of different types of sexual behaviour significantly reduces unprotected sex. Shorter, Fast, faster. You lost it. I'm sorry. The basically it is. If we teach kids about decision making, will that reduce their unprotected sex? [00:07:30] And we teach them about the consequences of unsafe sex? Does that reduce? They're engaging in unprotected sex. Significantly. Yeah. The first one was about information. The second one is about decision making. Yes, if we teach young people about decision making and the risks that are involved [00:08:00] in sexual behaviour, they will not have or significantly, they will reduce the amount of unprotected sex they actually engage in. So again, just to summarise, the first question was, If we give them information, they'll reduce their risks. The second one is if we give them decision making skills, they will reduce their risks. The third one is [00:08:30] if we teach them comprehensively about health and about sexuality that will reduce their risks. We really teach a broad programme that will reduce their risks. A engaging in unprotected sex [00:09:00] Yeah, the fourth one. Most HIV prevention programmes to be effective need to be at least 10 sessions long. In other words, if you were teaching in a classroom, you'd need 10 class periods like, say, [00:09:30] 50 minutes to really change kids' behaviour and the last one not ready? Sure. Um HIV prevention programmes need to last at least [00:10:00] 10 class sessions to change behaviour, Kids' behaviour and the last one HIV prevention programmes have been more effective at getting kids to use condoms than in getting kids to delay having sex. [00:10:30] We've been more successful at getting kids to use condoms than to delay intercourse. Think that's true or false? You doing that? [00:11:00] HIV prevention programmes have been more successful at getting students to use condoms than to delay beginning to have sex or the onset of intercourse. We're more successful getting them to protect themselves than we are getting them to abstain. That's another way to say it. OK, now let's see how you did. [00:11:30] Well, everybody, stand up. Yeah, Bye. OK, look at your piece of paper and count the number of true statements. You have the number of true statements. [00:12:00] If you had five true statements, sit down. If you had five true statements, sit down. If you had four true statements, sit down. OK? If you had three true statements, sit down. [00:12:30] If you have two true statements, sit down. If you have one true statement, sit down and those that are standing have no true statements. You passed. All of those statements were false. Thank you. [00:13:00] All of those statements were false, but so you don't feel stupid? I believed a lot of those statements also, and the last 20 years conducted education programmes based on believing those statements were true. However, in the last five years or so, we've started to do some research [00:13:30] to see what really makes a difference. What works? What changes kids behaviour And what we found out is that information does not change kids' behaviour. In fact, you heard Christina say that kids are getting tired of hearing information about HIV. [00:14:00] They think they know it all. Already. Decision making skills DOESn't CHANGE kids' BEHAVIOUR You had a question. Oh, OK, I, I I'll go on to all of them. I'll tell you, it doesn't. We thought if we taught kids how to make healthy decisions, they would act in their own best interest, right? But look at other [00:14:30] health behaviours like wearing seat belts. Now, I don't know about your country if you're outside the US. But in this country, there's been a big campaign to get people to use seat belts. They finally had to pass laws to make people do it. They didn't voluntarily, even though they had [00:15:00] lots of information that it could save your life. So if we as adults have information about things that will make us more healthy and we don't act on it, why would we think kids would? It doesn't mean they don't need information they do. It's not the only thing they need. And I'll tell you a little bit [00:15:30] more about that in a minute. Also, if we teach things comprehensively, if we teach about sexuality, relationships, decision making assertiveness or saying no kids learn a lot of good things. It doesn't mean they protect themselves. [00:16:00] So those programmes are very important. They just don't protect kids against HIV. I'm going to skip the question about 10 sessions for a few minutes. I'll come back to that. It's false, but I'll come back to that. And in fact, in the United States we've been more successful at getting kids who delay starting to have sex than we have been at getting them to use protection. [00:16:30] That the opposite of what I said is true and more about um so I don't think so. I think what we're finding is that if we can get to kids at a younger age before they start having sex, um, seventh grade, eighth grade 0, 13, 14. Thank you. Sure, [00:17:00] I'm sorry. The question was, what wasn't it a factor of religion, that it's easier to get kids to delay having sex? I don't think that's true. It really has more to do with. It's easier to get somebody not to ever start something like smoking than to get them to stop, and it's the same thing with sex. It's a lot easier to convince somebody to delay starting [00:17:30] to have sex than to stop once they start. There are a couple of questions, um, through me, they [00:18:00] need available. The question is, do I agree that if kids are going to have sex, condoms should be available? And absolutely, I'm not saying we shouldn't teach about protection. I'm just saying we haven't been very successful at getting kids to use it. And I'm going to talk a little bit today about what we know about what may move us to be more successful. There was, yes, [00:18:30] right interaction for many years, and the figures of the serve us and more and more simply, and three years of the terms of and I hope today is that in France the statement is that in France they're finding that kids are more likely to [00:19:00] use condoms and protection than to delay intercourse. That isn't true in the United States. Not it's not true. Where not in Africa. Oh, South Africa. Yeah, What I'm gonna say to you today is really about the United States. I'm going to give you some time at the end of my talk to really talk about what this means for your country. Because [00:19:30] it is different. And if there are any tape recorders on, I'll give you some of my biases about the United States, and that is that we are very what must say. Yes, there is sex education in some of the schools in the United States. What that means can be anything from talking [00:20:00] about puberty, talking about menstrual periods and that kind of thing to talking about using birth control or condoms. But in this country, we give mixed messages about sex. That isn't true. [00:20:30] In some other countries, the mixed message goes, something like this. Sex sells. It sells everything from cars to laundry soap. Kids see sex and advertising about sex everywhere, and they see it's fun. It's something people should want to do. It makes you glamorous. [00:21:00] It makes you desirable. But wait till you're married. That's the mixed message. In the United States, the average age for somebody to get married is 24 years of age. So what we say to kids is here all about this wonderful thing called Sex and start having sexual feelings about 13 or 14. [00:21:30] But wait 10 years. I think people in the United States are confused and we don't give a clear message. And in fact that's a very good into my next piece, which is [00:22:00] what does work and giving a clear, focused message seems to work. Let me back up a minute before I tell you more about that and say how we came to know that about three years ago. The centres for Disease Control was very [00:22:30] interested in this question about what works, and they pulled together a panel of researchers and experts in sexuality education, and they had them search the literature to see what studies have been done [00:23:00] that show we were successful in getting kids to use safe sex practises or not to have sex at all. This panel reviewed all the literature and all the studies, and they identified five characteristics of effective programmes. I've got a slide. [00:23:30] Let's see if I can get this to work. Ah, OK. You've got a packet on your chair with a purple cover. In that packet is a copy of these slides that I will be showing you. Yeah, Yeah. Oh! [00:24:00] In addition, at the back of that packet is the article that was written by the researchers that did this study Basically what they found were there were five characteristics or five things very successful [00:24:30] HIV prevention programme needed to have in order to either delay get kids who delay starting to have sex or to get them to use protection. They looked at both things because we know both things are important in the United States. Most surveys show that for [00:25:00] students who are 13 to 15, somewhere between 30 50% of them are having sex. So even if we want them to delay and we give that message, we can't ignore that a good portion of them are not. We have to talk about protection. So these are the five things now, this don't get too confused by this grid. Let me tell you what the [00:25:30] five things are. I have some more technology here. Let's see if I can use it. Maybe, maybe not. Oh, I have. The first is narrowly focused Goal. That's what I said to you about giving a clear message. We need to have a clear, focused message. I'll tell you about some of those messages might be in a minute. The other thing we've learned [00:26:00] in the United States is that There's this whole behaviour theory called social learning theory that's really about believing you can do something, and programmes need to teach kids that they can do something and get them to believe it. I'll say more about that in a minute. The other one is, and that's these [00:26:30] three things right here is that there needs to be content but not only teaches information. Information is important, but that also looks at the social pressures and pere norms that students have now. This is especially important to your culture. [00:27:00] The information about HIV is the same worldwide. We know how people get it and how they don't get it. That but the types of pressures and the norms. What people believe is going on is true is different in different cultures, whether you're in the United States, in France, in South [00:27:30] Africa, in Thailand, kids experience pressures around sexuality. Some of them may be not to have sex, but they experience pressure both internal, because their hormones are starting to activate and external from their friends and the culture around them. The last content that's important [00:28:00] is that kids get the skills to protect themselves. It's not enough to give him the information or talk about the pressure they need to be able to do something about it, Just like it wouldn't be enough to tell kids. Car accidents kill people, and seatbelts can protect your life [00:28:30] but not show them how to use a seat belt. It's a pretty simple example, but makes sense right. The skills I'm talking about really have to do with first refusal skills, being able to say no to sex when they don't want to have sex. [00:29:00] And secondly, to use protection not only how to use it, but how to talk to your partner about using it when you do have sex. The programmes that have been studied in the United States that have worked have these four elements narrow. Focus, goal. They use the social learning theory [00:29:30] they have. Actually, it's five, these three types of content, and when they deliver this content, they make sure that the message is clear. The message about information, the message about social pressures, the message about skills that it's audience appropriate both age wise and, um, content wise [00:30:00] that the learning is interactive and I'll say a little bit more about that in a minute and that the kids personalise it. Now where does the quilt fit in all of this? You're here to talk about the quilt? Well, I think Christina said it really well. The quilt motivates. It gets kids attention. [00:30:30] It makes them feel vulnerable. Adolescents usually don't feel very vulnerable. Once we get their attention, they are more likely to hear us when we talk about these other things. The Quil can be used to talk about information about risk. It can [00:31:00] be used to talk about the pressures and norms. It can be used to help kids feel vulnerable. It motivates them to use the skills we're teaching them. The last thing that this study found out that was very important was in the bottom bar, and that's teacher training [00:31:30] or educator training. In the United States, teachers, when they go to college usually don't get any training in how to talk about sexuality to their students. And it's hard for them the first time they have to say Penis in front of the classroom. They may die of embarrassment. [00:32:00] They need to understand how to teach this in a way that kids can hear and a lot of teachers need training to help them do that well in the United States, CDC has identified three [00:32:30] programmes right now that work and they're recommending that schools in this country use those programmes. I don't know if these programmes will work in your culture at all but just so you know what they are, I've put them up here on the table. They're all for high school kids right now and they're searching for more. [00:33:00] And a one page information sheet about these three programmes will be on the back table when you leave telling you the name, how much they cost or you can get them if you're interested. The three programmes are get real about AIDS postponing or I'm sorry, reducing the risk and be proud, be responsible. [00:33:30] Another programme that I didn't include because it doesn't address HIV is called postponing sexual involvement. I want to talk about each one of these five characteristics a little bit more and share with you how these programmes carry [00:34:00] out that characteristic. The first characteristic is a narrowly focused goal. It feels like there are three options when we talk about HIV. Postponing sexual involvement focuses on [00:34:30] postponing sexual involvement until you're older. That's its focus. That programme is taught 7th, 8th grade. What did you change to that? Those getting aid are all the question is, what do you say to a kid who says But [00:35:00] it's older people getting AIDS, not us. It's a good question. What do some of you say when you hear that question? Does anybody have? Yeah, and a you tell me there. I'm sorry, I can't hear you. [00:35:30] Uh, this gentleman was suggesting that this is a good place for the quilt to come in that when you show that young people are getting AIDS and are dying like that quilt sample from Dwayne that we saw on the slide, kids start to believe it. Having people come in and talk [00:36:00] about people that are infected with HIV talk about how it's affected their lives and especially if they are people that got infected when they were really young. It's a good way to answer that question. Yeah, America become cover. [00:36:30] And for And where are you from? In Maine, There's a programme called Listen to the students. Actually, I do. I have heard of it. I'm sorry. I have, uh that they're doing in Maine, The state of Maine and it's kids with HIV. It's so dangerous. Ah. Huh. It's a 26 week course that [00:37:00] kids in Maine, or at least in their school system, are required to take one of the problems I find in education. And this goes back to the 10 session question. You need 10 sessions. A lot of teachers say I don't have it. There's so much I have to teach. How can I devote 10 sessions to this class? [00:37:30] OK, OK, ok. Yes. Um, yes. Well, thank you for actually moving. The question is, is there a difference between what the statistics say kids are using and delaying [00:38:00] sex? And what I actually think is happening? I don't really have any way of knowing when we do research. We try to account for all the guess work through statistics and statistical operations on the data. I would just be guessing if I answered. Yeah, um, don't you think that, um you cannot tell kids do not [00:38:30] have sex like you can't say. Do not drink and drive. You have to say this is your choice of choice, HIV. The question is, do I think that we can't say to Kids don't have sex the way we can say don't drink and drive I have two reactions. [00:39:00] One is what I know as a professional, and one is what I feel as a person. What I know as a professional is, in fact, giving that single clear message wait to have sex seems to be effective with some kids, so I don't want to throw that message out. And that's the professional reason that it works. The personal reason [00:39:30] is I don't think 13 year olds should be having sex are in. I know I'm saying that's my personal, Um, personally, I think it's too young for 13 year olds to have sex. I'm not going to deny that they're doing it, and I'm not going to judge them for doing it. But in the United States, I think [00:40:00] they're a large body of adults that would agree with my feeling and because we do know from research that giving that message may protect kids from HIV STD pregnancy, emotional consequences. I don't want to abandon that message. It isn't the only message, though. [00:40:30] And if you look up here at the other programmes like RT R or reducing the risk. The clear message goes beyond delayed sex to delay sex. And when you start to have sex, protect yourself. Yeah. Not assume that is just [00:41:00] hi to do that, Hm. Mhm. Mhm. Mhm. Mhm. The question is, none of these things are these things or assuming that sex is penetration and that why aren't we teaching kids all the other things that we can do that aren't penetration. And in fact, in some places in the United States they [00:41:30] call that out, of course, versus intercourse. We do teach that how much you teach, whether you teach that that's holding hands and kissing or whether you teach that's mutual masturbation is very controversial. Remember the United States? We have this very mixed message. Sex is everywhere, but nobody is supposed to do [00:42:00] it until they get married. And we know that's not true. We know people don't believe everybody believes that, but there are some people we're talking about, the public schools. We have to think about parents and what they want their young people to hear also, and we have to balance that between what we think [00:42:30] is real and what parents the messages parents want? Yeah, stay. Hm asked. Right? Yeah, that thanks. [00:43:00] You have to. The question is, do I think it's the same for people that are having sex with people of the same gender? Or is it different? And that in Guatemala they're just barely beginning to talk about heterosexual sex, let alone sex with same gender partners [00:43:30] in the United States? There is a tremendous amount of homophobia, and it is pretty taboo in a most schools to talk about sex with somebody of the same gender. It is difficult to address that directly so far, what we've done, and I'm not sure it's successful. I'm just talking politics [00:44:00] now with you is that we've tried to come at it indirectly. By that I mean, we try not to say girlfriend boyfriend. We try to say, partner in teacher training. We try to let teachers know that there's a good chance that 10% of the students [00:44:30] in their classroom, maybe gay or lesbian and the teacher trainings that we do at ETR. We often have a panel of young people that are gay and lesbian. Come talk about their experiences in high school, how painful it was to be gay or lesbian, I'd be going to high school [00:45:00] and have nobody acknowledge that was even a possibility. And there are often people with tears in their eyes by the time that panel is over. But it's just a beginning. Most schools are not ready to come out and have open discussions about same sex practises. So [00:45:30] in that way, I'm not sure we're a lot different than Guatemala. Yeah, my that you are your message, but only also, of course. All right. I didn't hear the very first part of what you said. My feeling is that you are for the [00:46:00] Yes, yes, The the statement was that we are accommodating our message not only for the kids, but for the parents and the community surrounding it, and that is true. And I'm not always comfortable with that. But I know that if I say what I'd really like to say, I may never get back in that school. So I compromise and I try to give kids resources [00:46:30] where they may go to get help to talk to some adult outside the school. Now, San Francisco Unified School District is a little bit different where you are just because they're more advanced and they do talk more openly about some of this in San Francisco. It is the exception, not the rule. There was a question. Yeah. Yeah, [00:47:00] Well, uh, 76, when you're talking about sexual relation. Mhm. Did you have and have go? Well, [00:47:30] I agree. The statement was, When you talk about sexuality, you need to talk about pleasure. And personally, I agree professionally. That is very controversial. We don't want to tell kids in the United States. It feels good. They might go do it now. I'm saying that's a joke. I mean, they hear everywhere, it feels good, but we are very two face. Do you know what that means in this culture? About [00:48:00] sex in our culture, in the United States? Now these little boxes, you aren't getting the overall you're not getting what's in the programme. I haven't gotten that far yet. I'm just trying to give you some broad categories here about what works, and I would say we need to talk about the pleasure of sex with kids. But if I'm really looking at preventing HIV, my [00:48:30] hunch is that they already know that message. But it feels good. They hear that enough. What? I want to make sure that I teach the message in a compassionate way about protection and about waiting for sex until it's right for you. I don't need to teach that message in a way that makes them bad for wanting to have sex or [00:49:00] the pleasure of sex in the United States, we say we want to teach HIV prevention in a sex positive way. But it's very difficult for me in an hour to go into great depth about programmes and what that would look like if you're interested. One option is to seek out [00:49:30] one of these three programmes that I talked about and see how they did it. Yes, yes. In the United States, there's been a lot of peer education programmes tried and in fact the postponing sexual involvement programme use piers. Research has not shown that that's been more effective than an compassionate teacher [00:50:00] teaching it. That doesn't mean I wouldn't do it. But what I was asked to talk to you today about what we know works. This is like the bare bones. It doesn't mean you can't do a lot more, but in my 20 years of experience when I spend a lot of time on information and decision making right, [00:50:30] it wasn't changing kids behaviour, and I think that is the bottom line, especially when it comes to HIV. We've got to get kids protecting themselves. I only have about 15 more minutes. Let me just go through a couple of other slides quickly, and then I'll just answer your questions. [00:51:00] That was about narrow focus that it needs to have a narrow focus, and the narrow focus is abstinence or protection or both. Social learning theory says that people have to believe they can act on the information they have, so it isn't enough just to tell kids information. We have to make sure they have the belief in themselves that they can [00:51:30] actually carried out. That belief happens when four things are present. They understand what must be done. They understand they either need to not have sex or use protection or not use drugs. We haven't said a lot about drugs here. They need to be motivated. They need to believe that life is worth living, that in fact they don't [00:52:00] want to get HIV. There's a reason not to get HIV. For some kids in this country where there's a lot of violence, they see people around them being shot. They don't believe they're going to live anyway, So why should they worry about HIV? That may be true in your cultures, too, in your country. So we have to think about that. They have to believe that what you're teaching them is effective, for example, that condoms really [00:52:30] do prevent HIV. And there's been a lot of controversy in this culture about whether they do or not magazines and what we call the tabloid newspapers run big headlines that say condoms don't work, people get afraid, and then they need to believe they can use everything you've taught them. They can put it into action. [00:53:00] And that's where Practise comes in, practise in role plays and play acting, saying No asking your partner to use condoms. Think I'm going to skip over this just because I think it's relatively clear that we need to give information, [00:53:30] talk about the pressures and give kids the skills. I'm gonna skip this, too, just to let you, um, ask questions. I think more. Are there more questions about effective programmes? Yeah, back there? No. Yeah. What do you make this, uh, when we started. [00:54:00] This is the $64,000 question. The question is, at what age is Should kids stop delaying? And is it OK for them to have sex? Um, the reason I don't know if you know that joke. The $64,000 question. There was a quiz show TV programme years ago, and if they got the answer right, they got $64,000. [00:54:30] So that's what I mean when I say this is a $64,000 question, I don't think I'm going to win it, though. It's a hard question. I could tell you what I believe for my Children and my family, but I'm not about to say what everybody else should do. And one of the things in sex education we try to do is involve [00:55:00] parents and get them telling their own Children what their family beliefs are about. That that's the emotional side of it. The medical side is that we know that when young people start having sex at a very early age, they [00:55:30] are more likely to become infected with an STD. Young women are much more likely to get pregnant. Young women are more likely to get cervical cancer in older age, so there are some strong medical reasons. The young people 13 14 15, [00:56:00] should probably not be having sex. What I say to kids is you need to think about what your family believes and what you believe about, what kind of relationship sex belongs in. And and do [00:56:30] you feel better about yourself and the relationship and your partner after you've had sex? Those are questions I pose to kids to get them to look at that question for themselves. Yeah, how do you deal with trust? [00:57:00] The question is, what do I do about with the trust so that we talk to kids about trusting a partner and knowing they're not going out and getting it on the side within the limits of a lot of the sex education that we have time to teach in the United States? We don't do a lot with that. Unfortunately, a lot of what we have time to do [00:57:30] is to deal with facts, to get kids realising the risks. But we don't have a lot of time to talk about good relationships and what that means. And I think that's sad. Yeah, that's the best. I can answer that. At this point. If I were teaching a class and it sounds like maybe in Maine they have the luxury of this [00:58:00] and I had 26 weeks, I would talk about relationships. What are good friendships, then what does romance mean? What does sex mean in the United States? We don't address those things very much in schools. Yes. Are you talking about [00:58:30] a lot of the other things? That is just a general. And so the question is that I keep talking as if I'm talking about sex mean intercourse and genital contact or gentle penetration. And wouldn't it be more effective if I talked about it in the bigger hole? [00:59:00] And you know what the truth is right now? The research shows no. The answer to that is no. Even though philosophically, I believe sex should be taught in that bigger context. It isn't what works. What works is getting down to the specifics about how you get HIV, how to protect yourself, and you get HIV by having genital contact and how to prevent [00:59:30] that contact through condoms or delay of sex now many programmes. If there's time, they'll talk about other ways to feel intimate and to get physical pleasure. And some people have called that out, of course. And I'm saying, If you have time to do that, do that, That's wonderful. We haven't done [01:00:00] any research to see if we taught a class where we talked about outer course as options and we taught a class where we didn't if the kid's behaviour would be different. What we do know is when we give a direct, clear message about delaying sex or using condoms, we seem to be effective in changing kids' behaviour. It is when I say that I'm not [01:00:30] saying forget the other stuff, but I'm focusing on what we know works in the United States because there's such limited time to address this. In my mind, it's important to focus on what works because lives are at stake. Sure, question is, in many places in the world, young people may not have a choice about whether or not they become sexually active. [01:01:00] That somebody makes that decision for them, especially young women, and I agree I don't have good answers for that. It isn't something that I think you can effectively address in a school. I think it's something that has to be addressed in the community and the culture doesn't work. Um, the reason I think you can't address it in the school is [01:01:30] that at least in this culture, when young women are sexually abused, they really don't have a choice. They can't get out of it. So you can't tell the young girl we just do something different. She's already victimised. The only way to make that kind of a change is to begin to change the community and the culture, and you may start with one small group that starts to show that that's abusive. [01:02:00] I don't have easy answers because I don't know your culture, but we can't do victim blaming here. We can't make the problem to fix for the victim. They can't fix it. We, as the adults have to take responsibility to begin to change in that culture. In this culture, we've made some of those changes. They are very slow. Sexual abuse still happens. [01:02:30] It's estimated that one in 10 girls are sexually abused in this culture or 17, depending on the statistics. You're reading. But we're starting to speak out in this culture to say it's not OK. We started to do educational programmes in communities and schools, saying it's not OK. It's a beginning. It's a very difficult problem. I have one more minute. [01:03:00] Um, let's see. Let me take this gentleman here. Oh, good. This has to do with when you're teaching. Oh, the question is, how do I define skill level when it's audience appropriate? You need to know the age group of your kids and the emotional maturity of your kids. And that's what I mean. [01:03:30] Well, thank you. I know that sex education HIV prevention is a tremendous challenge. It's a challenge here in the United States, and it's a challenge in your culture. And I wish you good luck. And hopefully we will be able to continue to share with each other what we know about what works. Thank you.
This page features computer generated text of the source audio. It may contain errors or omissions, so always listen back to the original media to confirm content.
Tags