best placed to deliver sex, relationships and HIV education.

Teachers
Given their number and proximity to students, teachers are best placed to deliver sex, relationships and HIV education.
Pre-service training provides an opportunity to familiarise all teachers with the basic concepts and elements
of a sex, relationships and HIV education curriculum and to ‘mainstream’ its delivery across the curricula. In addition,
targeting trainee teachers (in pre-service teacher training) is likely to be more successful, not only in terms
of scaling-up, but also because young teachers are probably more likely to be open to teaching sex, relationships
and HIV education, with older more experienced teachers being more resistant. The same applies for introducing
some of the participatory teaching methodologies that are expected of many sex education programmes. However,
teachers will not be equally interested or adept at teaching the subject. Their interest and aptitude may only emerge
after some time spent in the classroom, making the provision of in-service training a likely necessity.
Teacher training should be supported by national ministries, local school management and communities.34 Curricula
should include content on sexual and reproductive health and HIV, teaching methodologies and teacher skills, personal
attitudes, and teachers’ own HIV-risk behaviours. Attention should also be paid in such curricula to policies,
administrative practices and cultural norms that can affect teaching. Those involved in teaching sex, relationships
and HIV curricula should include both men and women who are motivated and willing and perceived as trustworthy
by students. Finally, they argue that there should be a policy of zero tolerance of exploitation of students.
Experience in Tanzania35 suggests that problematic teacher–pupil relationships create one of the most signifi cant
barriers to potential programme success. In many settings in sub-Saharan Africa, established teaching culture and
practice are authoritarian and didactic and hardly conducive to the trusting relations and participatory approach
required by many sex and HIV education programmes.
Effective delivery of sex, relationships and HIV education is also hampered in some settings by sexual harassment
or abuse of schoolgirls,36, 37 a phenomenon that has been reported in a number of sub-Saharan African countries.38
This is a signifi cant problem that seriously undermines the potential credibility of sex, relationships and HIV education
in schools. In addition, mandatory pregnancy examinations and the punishments imposed on those who fail
them can undermine the success of such programmes.
Despite these barriers, school-based programmes have potential if they can be adapted to the realities of the local
educational system by such means as simplifi cation of subject matter, pre- and in-service training on teaching
methods, improvement of teacher-pupil and teacher-community relationships, and close supervision and appropriate
responses to abusive or exploitative practices.
Implementation of sex, relationships and HIV education can be promoted through provision of teacher training;
appropriate screening and selection of teachers charged with delivery of the programme; supporting schools in the
development of an HIV and AIDS policy, and developing school-based health programmes that go beyond HIV or
sexual health and are embedded in broader school development programmes that improve school functioning. थे organizational characteristics of schools and a supportive community are important determinants of the success of
HIV prevention programmes.38
As well as having to compete in a crowded curriculum, sex, relationships and HIV education does not have the
same status as other subjects, either for students or teachers. In part this is because it is usually non-examinable,
but also because of the sensitive nature of the content, despite its potential importance to students’ well-being. For
teachers of sex, relationships and HIV education there is rarely, if ever, a tradition of advanced training. Teachers are
sometimes instructed to teach sex, relationships and HIV education despite lack of training, experience or interest.
Taken together, these issues raise a question as to whether or not sex, relationships and HIV education is in need
of professionalisation.