Report from New York City: the turbulent history of HIV/AIDS education

The HIV/AIDS curriculum of public schools in New York State and New York City has been the subject of important debate for much of the 25 years since the start of the AIDS epidemic – and each twist and turn of the debate has reflected wider debates occurring about AIDS.

Since 1987, the New York State Education Commissioner Regulations have required that every board of education in the state provide education on HIV/AIDS to students K-12. The content of that education has varied, since it’s dependent on the current Chancellor and political context. For example, in 1991 Chancellor Joseph A. Fernandez proposed distribution of free condoms in schools. This was the subject of fierce controversy over the next year and finally passed with fear mongers suggesting that there would be a big increase in sexual behavior.

A decade later, movement in the public school curriculum regarding HIV/AIDS education was initiated by Scott Stringer, then NYS Assembly member (now Manhattan Borough President), who, in 2003, wrote a comprehensive report entitled “Failing Grade: Health Education in NYC Schools” (http://www.assembly.state.ny.us/member_files/067/20030622/index.html). In “Failing Grade” Stringer criticizes the vast discrepancy between local mandates for health education and actual practices. The report found that the majority of districts violate New York City’s minimal mandates on health education; often this is simply out of ignorance of the mere existence of regulations.

The need for more sex education is clear—New York City is still the American epicenter of HIV/AIDS (New York City accounts for 15.5 percent of all AIDS cases in the U.S. and more than half of high school students identify as sexually active. The Guttmacher Institute, in a report entitled, “Facts on Sexually Transmitted Infections in the United States” released in August 2006 cited, “although teens and young adults represent only 25% of the sexually active population, 15–24-year-olds account for nearly half of all STI diagnoses each year” (http://www.guttmacher.org/pubs/2006/09/12/USTPstats.pdf).

In November 2005, Chancellor of the NYC Department of Education, Joe Klein, issued a revised curriculum on HIV/AIDS. The new document prioritizes reducing the stigma around people with AIDS, stating as one of its key goals that it will “enable [students] to feel comfortable around people with HIV/AIDS”. To the teachers, it says: “It is important to clarify that it is risk behavior they should avoid, not the people who have AIDS”. It suggests homework to encourage greater parental involvement.

However, it also includes revisions to the health education curriculum that are not necessarily a step in the right direction. The document incorrectly labels abstinence as 100% effective, which does nothing to reduce stigma around sex. The changes include adjustments to the free condom distribution program, instituted in 1991. Now, all parents and guardians have the option of prohibiting their children from the taking advantage of the program: “their children’s identification numbers are placed on a list to ensure that they will not participate”.

This amendment violates the often-stated goal of universal access to prevention that vulnerable teenagers need and will lead only to further delay in effectively addressing HIV/AIDS among adolescents. Plus, really, how hard will it be for a kid whose parents haven’t objected to pick up condoms for a kid whose parents have?