physical and emotional development and STIs and HIV and AIDS.

Evidence-based Sex and Relationships Education
Experts suggest that a good curriculum for sex and relationships education covers three areas: facts and information,relationship and interpersonal skills and values.23 Others add that it should also address perceptions of peernorms, attitudes and intentions.24 While some programmes continue to focus on human biology, reproduction,
hygiene and marriage, others have expanded to include information on physical and emotional development and STIs and HIV and AIDS. More broad-based curricula also cover contraception, abortion and sexual abuse.Some programmes give young people the opportunity to consider diversity, marriage and partnership, love and
commitment, and the law as it relates to sexual behaviour and relationships, together with consideration of social,
religious and cultural aspects of sexuality.25 The development of critical thinking, for example about rights and
gender, is also often encouraged, and skills developed in communication and decision-making. However, it is important
that the content remains focused on sexual relationships and the sexual transmission of HIV if the programme
is to have measurable impact on HIV infections.
All sex and relationships education programmes are values-based. The key questions concern which (or whose)
specifi c values, the extent to which these are made explicit, and whether or not they are open to scrutiny. Processes
that clarify values about sex and relationships can be useful not only for students but also for teachers, school
authorities, parents and communities.
Sex and relationships education is delivered through a range of named programmes, including: sex education,
family life education, population education, sex and relationships education, sexuality education and life skills education.
The title of the programme may be a refl ection of political or cultural sensitivity, indicative of the emphasis
of its content, or a combination of the two.
Experience in Kenya and Tanzania suggest that, even in contexts of severe resource constraints, it is possible to
implement good quality sex and relationships education within primary school curricula. The Mema Kwa Vijana
(‘Good Things for Young People’) programme in Tanzania touched on community-based activities including condom
distribution, health service and in- and inter-school elements. The most intensive component was a participatory,
teacher-led, peer-assisted, in-school programme, comprising an average of twelve forty-minute sessions per year,
held during school hours in Years Five to Seven of primary school.
In Kenya,26 groups comprising head teachers, resource or senior teachers and community representatives were
trained to deliver HIV and AIDS education with a particular focus on prevention and care for those affected by HIV
by infusing and integrating lessons across the entire school curriculum, with a focus on students aged between 12
and 14. Upon their return to school, graduates of the training provided training for their colleagues, delivered HIV
and AIDS education in the classroom and implemented co-curricular activities, such as drama, music, art, public
speaking, writing, sports and exhibitions, within and across local schools.
The HIV epidemic has signifi cantly raised the profi le of the condom, which has become the most popular method
of contraception for sexually active people. However, some argue the association between condoms and HIV also
stigmatises condoms (and their users).27 Given that two-thirds of young women whose partners use condoms are
motivated by the desire to avoid pregnancy, and that it is more socially acceptable to raise the issue of condom use
with a sexual partner in relation to pregnancy rather than HIV, more attention needs to be paid to highlighting the
contraceptive benefi ts of condoms.
The issue of condoms highlights some of the key tensions that can compromise the effectiveness of sex and relationships
education, including community and religious sensitivities and teacher discomfort.
A study of the condom component of the Primary School Action for Better Health (PSABH) programme in Kenya28
highlighted how inconsistent information about condoms was provided to young people. Teachers and community
and church leaders believed in and presented abstinence as the only effective way to prevent sexual transmission
of HIV. As a result, they had diffi culty developing a clear position on the use of condoms, a situation exacerbated
by government silence on the topic and the confl icting positions taken respectively by social marketing campaigns
and churches and leaders. This led teachers to often repeat negative and inaccurate messages on condoms.
Students recognised the contradictions in what they heard from teachers and other adults in their communities and
turned towards peers with sexual experience and particular teachers who were more comfortable with the subject.
Following training, there was evidence that an increasing number of young people were receiving information about