/ 23 April 2009

Small comfort

In February a shocking article appeared in a daily newspaper. A grade 11 girl from Tembisa High School on Gauteng’s East Rand died after giving birth to a baby girl she named “Comfort”. The article reported that 30 girls from Tembisa High had fallen pregnant last year and 23 from neighbouring Zitikeni Secondary.

Five days later a related article, Pregnancy scarier than HIV, appeared in another newspaper. It dealt with the findings of a recent study of teenage behaviour in South Africa. In the article, two trends of interest to educators came up: few teenagers involved in sexual relationships thrive at school; teenagers enter sexual relationships without giving a second thought to HIV.

These articles were on my mind when I visited Zitikeni Secondary to run an HIV workshop for a group of grade 11 learners.

At the outset it was necessary to break the ice and get each learner to speak freely. Sitting in a circle for the warm-up round we followed an ancient Native American method of communication. A circle of people address a problem as a group and bit by bit. As each person adds a new contribution, a solution becomes evident. A talking stick, which gives you permission to speak, is passed around the circle and everyone has to adhere to the rules: “lean” speech, speak from heart and listen with your whole heart.
There are a number of ways to start but the simple one I chose worked like a charm.

  • What is your name?
  • Does your name have a meaning?
  • Who gave you that name and why?
  • Do you like your name?
  • If you have a nickname how did you get it?

    During the two-hour workshop learners moved from one activity to the next. These were based on insights I have gained from various publications, including The Invisible Cure – Africa, The West And The Fight Against Aids by scientists and public health writer Helen Epstein,

  • Predictablty Irrational by Dan Ariely, a professor of behavioural economics, and Freakonomics by economist Stephen D Levitt.

    For starters, the learners explored two types of sexual behaviour – serial monogamy and concurrency based on the computer models that feature in Epstein’s book. First, girls and boys formed pairs to simulate serial monogamy that leads to few HIV infections.

    Next the whole group formed a network of partners to demonstrate concurrency. They soon realised that within the network there were people with up to three concurrent partners and others who were faithful to one partner only.

    It was at that critical moment that I mentioned that a newly infected person is also a highly infectious one, because your antibodies have not yet kicked in to fight the HIV virus. It became obvious to the learners that in this model, the virus passes like wild fire from one to the other, including faithful partners.

    When I asked which pattern teenagers follow the unanimous and frightening answer was concurrency, a pattern that leaves no one uninfected.

    Next we examined some of writer Dan Ariely’s findings in the field of HIV prevention. Ariely set up an experiment with male students at Berkeley University to prove that we become someone quite different from our usual selves when we are sexually aroused. You might become much more attracted to sexual practices you would never otherwise consider, for example being tied up by a sexual partner.

    You might be more likely to engage in immoral behaviour, for example telling a woman you loved her to increase the chance that she will have sex with you. And there’s more chance of you having sex without a condom.

    Ariely’s experiment makes it easier to understand why teenagers admit in surveys that they use condoms “sometimes”.

    According to Ariely: “Sex education should focus less on physiology and biology of the reproductive system and more on strategies to deal with the emotions that accompany sexual arousal.”

    He insists that both girls and boys should carry condoms.

    Next the whole group took part in a “continuum debate”. They formed one long line. The topic was “pregnancy is scarier than HIV”. Those who
    believed that pregnancy is scarier than HIV stood on the far left, while those who thought HIV was scarier were on the far right. The debate proved to be lively but, because you had to raise your hand to get the chairperson’s permission to speak, it was also well controlled. Here is a sampling of the arguments put forward by the learners:

    Pregnancy is scarier than HIV

  • Pregnant teenagers drop out of school.
  • There is a risk that a pregnant mother can infect her child with the virus.
  • A baby affects your whole life (a girl’s point of view).
  • If you die you leave a child behind.

    HIV is scarier than pregnancy

  • HIV is incurable even if there are antiretrovirals.
  • ARVs have side effects and kill people.
  • To avoid pregnancy you can abstain or use a condom.
  • A girl can protect herself by using a female condom.
  • A poor community loves babies and will raise the child.
  • If you are HIV infected it has to be a secret. No one but you and your parents must know.
  • If you are HIV infected life is no longer free and fun.
  • If you don’t know you have HIV, you can sleep with many girls and infect them.
  • You can terminate a pregnancy but you can’t terminate HIV.

    The belief that unplanned babies would be cared for by the community did not ring true. Stephen Levitt, in his book Freakonomics, paints a more frightening picture of what really happens to such a child, born into poverty. He says: “A single-parent household and childhood poverty are among the strongest predictors that a child will have a criminal future”.

    In the final round almost every learner thanked me for the workshop. Some mentioned they had learned things they had not been aware of before. I believe new ground was broken.

    Joan Dommisse is an educator in the field of HIV/Aids. Contact her on 011 616 8404 or jdommisse@iburst.co.za