12 million young people in the world living with HIV

There are currently nearly 12 million young people in the world living with HIV. More than half of these young
people are female. They also have sexual and reproductive health needs that are seldom addressed in any formal
sex education curricula.11 In this era of expanded access to antiretroviral therapy (ART), the population of children
living with HIV is growing as their life expectancy increases. There are an estimated 2.3 million children (below the
age of 15) living with HIV worldwide.12 With access to treatment, HIV-positive children can expect to develop into
healthy adults who, at some point, will start having sexual relationships. For an HIV-positive young person who has
never benefi ted from education programmes about sex, relationships and HIV, these kinds of programmes – which
assume all students are HIV-negative – will not suffi ce. Furthermore, the implicit and pervasive assumption that
all students are HIV-negative can render invisible those who are living with HIV or AIDS. It may also inadvertently
increase stigma through the creation of an ‘us’ and ‘them’ mentality.
Debate also exists regarding the intended focus and outcomes of sex, relationships and HIV education. Should sex,
relationships and HIV education focus narrowly on specifi c measurable outcomes such as condom use or delayed
sexual initiation? Or should its focus be expanded to address the broader underlying issues, such as poverty,
gender inequality and discrimination, which make people vulnerable to HIV, STIs and unintended pregnancy?
This review considers sex education and HIV education in schools (with a focus on the prevention of the sexual
transmission of HIV). Effective delivery of each is unimaginable without discussion of the other. Clearly, sex education
must address the prevention of HIV infection, given that the overwhelming majority of HIV infections in the
world are sexually acquired. Effective prevention of HIV, of necessity, will also involve discussion of sex.