When the lesson can mean life or death AIDS education failing to change teens' behavior

May 23, 1993|By Holly Selby | Holly Selby,Staff Writer

In Howard County, an eighth-grade class explores the ABCs of whether condoms always prevent the spread of AIDS.

At a student workshop in Baltimore, middle-school girls practice ways of saying "no" that won't cost them their boyfriends.

Elsewhere in the city, children act out scenarios that illustrate the connection between intravenous drug use, sex and HIV infection.

As of March 31, 3,710 people in Maryland have died from AIDS, including 2,302 in the Baltimore metropolitan area. And with the onset of this sexually transmitted epidemic, sexual relations, once talked about only among family or friends, have become a matter of public health.

Obeying a state mandate, Baltimore-area school systems sprinkle units about AIDS prevention into health, science and other courses, beginning in the elementary grades and continuing into high school.

But teaching children about the transmission of a fatal disease is different from teaching anything else.

Unlike history or spelling, AIDS prevention is one of the few subjects in which grades simply do not matter. What matters is whether children take what they learn and use it to change how they behave.

"That is the crux of this issue," says Dr. John Santelli, an epidemiologist for the city Health Department. "Somehow education and knowledge aren't getting translated into behavior changes.

"A lot of kids know about HIV and know how it's transmitted," he says. "But we still see a lot of kids engaging in high-risk behavior."

Even teen-agers, when asked, echo his words. Many would agree that knowing is one thing, doing is another.

"Kids are listening to the information and in the back of their minds, they might be hearing it," says Jason Hines, a senior at Baltimore's Douglass High School. "But at that last, given second when some might say, 'Wait for the condom,' they're not. There's still some with the attitude that, 'It won't happen to me.' "

Indeed, teen-age boys who boast they "got burned" by their girlfriends don't mean they were dumped -- they're talking about the pain of gonorrhea, says Andy Hannon, a social work administrator who coordinates Three for Free, a statewide condom giveaway program. "Things like gonorrhea and chlamydia are almost rites of passage to some kids."

The test of the curricula's success will be given, then, not in class but in private, when these students say "no" to drugs or when they make love -- or don't.

"There's a lot of concern that a lot of adolescents are going to be dying 10 years from now," says Dr. Santelli.


It's review time in an eighth-grade health class at Mayfield Middle School in Howard County. In a brightly colored room, students sit at tables, forming teams with names like "The Jamals," "The Four People" and "The Guys, Girls and Squires."

A wholesome-looking girl with long, dark hair gazes, smiling, at the class from a poster. The words under her say, "She shows all the signs of having HIV."

Pat Johnston, director of the county AIDS curriculum, is refereeing a game designed to make students go over what they've learned about the disease.

A cheerful, no-nonsense woman, dressed today in a denim jumper decorated with a tiny red ribbon, the symbol of AIDS awareness, Ms. Johnston asks the students to rate behaviors that deter HIV.

Abstaining from drugs gets a 100 rating.

Abstaining from sex gets a 100 rating.

Using condoms does not.

Still, Ms. Johnston drills the students by asking questions about the effectiveness of condoms: To provide any protection, what material should they be made of? What if they're too old? What if they have holes? What if they're not used throughout the entire sexual act? What if there's no space at the tip?

The students seem to know the answers. They pay close attention, and there is no snickering during the 15-minute discussion.

According to the federal Centers for Disease Control and Prevention in Atlanta, 40 percent of U.S. teen-agers are sexually active by the ninth grade. And that rises by 10 percentage points each year -- with 70 percent of high school seniors reporting they have had sexual intercourse.

But in many schools, mandatory AIDS instruction tapers off just as students are most likely to be sexually active, says Dr. Lloyd Kolbe, director of adolescent and school health for the CDC.

Paradoxically, 82 percent of schools nationwide require some AIDS material in middle school, but only 38 percent require it in 11th and 12th grades, the CDC has found.

In Maryland, a 1987 bylaw mandates one lesson during each of these intervals: grades three to six, six to nine and nine to 12.

In the metropolitan area, only the city and Baltimore County require 11th- and 12th-graders to take AIDS-prevention lessons.

However, state school officials point out that students get information not only from AIDS instruction but also from required and elective courses that deal with related health issues.

Learning to say 'no'

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