/ 15 April 2008

Making HIV/Aids an issue

In 1953 there was a polio scare in South Africa. Schools, swimming pools and movie houses throughout the country were closed for an extended period. There was no cure. There was no vaccine. And no one was sure how the disease was spread.

I was a teenager in grade 11 at the time. For me, polio was something out there that had nothing to do with me. But my mother was eaten up with anxiety and packed me off to her sister in Groot Marico in the North West.

There I swam dreamily every day with the dragonflies in a school pool no one was using. I whooped for joy each time an extension to school closures was announced on radio.

Similarly, I get the impression that for the teenager of today HIV is not “a big issue” either. Having fun, experimenting and exploring is what being a teenager is about.

Some adults argue that HIV-infected teenagers get what they deserve, but we have to take into account that they lack life experience. Furthermore, neuro-scientists warn us that the adolescent brain is still developing, which makes it difficult for them to exercise emotional control or think effectively in abstract terms.

We tackled this reality recently at a workshop that took place at Emshukantambo Secondary in Soweto. A group of 18 learners participated. We sat in a circle and introduced ourselves.

I did not want to talk at the learners, but I wanted to allow each participant to express their thoughts and feelings instead. In the first round, we spoke about the positive aspects of being a teenager.

They mentioned that it was a period where they had to make choices that would affect their future lives. For many, adolescence was a period of greater freedom, and a time of exploration and experimentation.

Next, they talked about their views on HIV/Aids. Generally, they spoke about living positively. Many of them “preached” abstinence.

A few spoke about people they knew who had HIV/Aids and the support they needed. One of the last speakers challenged the group. If they were all doing the right things, how did it come about that the HIV infection rate was so astronomically high among teenagers? There was a titter of recognition. He had hit a nerve. And we had come full circle.

We then moved into the second stage of the workshop. Here the learners left their seats and joined hands to simulate two different patterns of sexual behaviour. These patterns are illustrated as computer models in the book The Invisible Cure, written by Helen Epstein.

Epstein spoke to countless people about their sexual practices in order to find out why the HIV infection rate in the East and Southern Africa was rampant while in places such as the United States, Europe and Western Africa, it was as low as 1%.

The two models are fairly easy to follow:

  • You need nine girls and nine boys.
  • In the illustrations (Serial Monogamy and Concurrency) the squares represent males and the circles, females.
  • In order to simulate “serial monogamy”, the girls and boys hold hands in pairs. In this model, partners stay together for a fairly lengthy period and relationships outside of this bond are frowned upon. Divorce often intervenes and this entails abandoning one partner for another.
  • For the second pattern, concurrency, insert the numbers one to nine in the squares for boys and one to nine in the circles for girls. Then call out one person at a time to join the network of participants. They all hold hands, but where someone has a number of partners, the extra partners can hold on to a shoulder instead. For instance, boy number two has four girlfriends so two of them can hold on to his shoulders while the other two hold hands with him.

    During this activity the group becomes aware of the impact of the two patterns. Ensure that the learners get to see copies of the two patterns of behavior. Point out that four girls and four boys remain faithful in the concurrency pattern, but this will not protect them from infection. The entire network of partners will be infected.

    Also emphasise that, in the concurrency pattern, new infections occur on an ongoing basis as the virus moves through the whole network. A newly infected person is highly infectious. This is because the anti-bodies have not yet had time to fight the HIV viruses that are rapidly multiplying in the bloodstream.

    Someone who has had the virus for a number of years is less infectious and this means serial monogamy offers greater protection from the virus than concurrency. The virus is also limited to two people only and is less likely to spread further.

    Learners returned to the circle formation for a feedback session where each participant was again given a chance to speak.

    It became apparent that the Emshukantambo Secondary group had shifted from their earlier position. They were incorporating the new information or insights into their personal observations.

    They began to look at the behaviour of their own age group from the outside. One boy stated that young people were “having fun” and following the “modern” patterns of sexual behaviour without considering the risk of HIV infection. One girl observed that if you became infected, you would not know who had infected you.

    I have worked on HIV programmes in several schools in the past. I feel sure that this group of grade 11 learners will generate ideas that will have an impact on their peers.

    Joan Dommisse is an HIV/Aids educator