According to the 1997 Massachusetts Youth Risk Behavior Survey, large numbers of Massachusetts’ students are engaged in behaviors that put them at high risk for HIV infection and other sexually transmitted diseases. The Massachusetts Department of Education’s AIDS/HIV Program has developed a strong network of collaborations with other state-level Departments and with a broad spectrum of community-based agencies to provide HIV/STD prevention education, policy and curriculum development, technical assistance and training to local school districts.
 

The purpose of the AIDS/HIV program is to expand and strengthen the capacity of school districts to plan, implement and evaluate the effectiveness of HIV/STD prevention as a component of a coordinated school health program. The AIDS/HIV Program promotes, sustains, and improves school-based HIV/STD prevention activities by providing direction, resources, technical assistance, training and policy support.  Program staff is integrated into and provides technical assistance on HIV-related matters and sexuality education to the Learning Support Services Cluster staff who serve as liaisons to local schools around the Health Protection and Safe and Drug Schools grant programs. The Youth Risk Behavior survey, administered every other school year through this program, collects, analyzes and disseminates information about the risk behaviors of high school students to the local level in formats that are accessible and useful to educators and public health officials alike.  Funding for the AIDS/HIV Program is provided through a Cooperative Agreement with the United States Centers for Disease Control and Prevention’s (CDC) Division of Adolescent and School Health (DASH). This program has been continuously funded at the Department since 1988. 
 

The goals of the AIDS/HIV Program are:

Goal I:   Massachusetts public schools will increase their capacity to provide effective HIV/STD prevention education as part of a Coordinated School Health Program for the purpose of increasing students’ knowledge, skills, motivation and supports necessary to prevent HIV/STD infection. 

Goal II:  Massachusetts public schools and youth-serving community agencies will increase their capacity for providing effective HIV/STD prevention education programs which address the needs of selected populations of  youth in high risk situations. 

Goal III:  Massachusetts public schools will increase their capacity to respond appropriately to students and staff infected or affected by  HIV/AIDS.

Goal IV:  The Massachusetts Department of Education will have collected statewide data on the status of comprehensive school health education, HIV/STD prevention education and student risk behaviors, and will have increased the capacity of LEAs to collect and utilize local data for the purpose of program improvement.

The Massachusetts Training and Demonstration Center (MT&D) was established in 1994 with federal funding received from the Centers for Disease Control and Prevention’s Division of Adolescent and School Health (CDC – DASH). The MT&D provides professional development opportunities and technical assistance for DASH-funded HIV education coordinators in state, territorial and local education agencies across the country. MT&D staff plan and conduct two to three three-day trainings per year for teams of HIV education coordinators and their colleagues on preventing HIV infection in school-aged youth. 

Training topics include:

• Beyond the Magic Bullet: Building Support for HIV Prevention and Education for Youth (1999)
• Thinking About Gender: Girls, Boys and Effective HIV Prevention Programs (1998)
• Working Together: Collaboration for Statewide Planning to Prevent HIV Infection Among Youth (1997)
• Building RESPECT in HIV/STD Prevention Education: Revisiting Educational Strategies with Pacific Entity Cultural Traditions (1996)
• Starting Early: HIV/STD Prevention for Early Adolescence (1996)
• High-Risk Youth: Addressing HIV/STD Prevention for Target Populations (1995)
• Applying PRECEDE/PROCEED to the Prevention of HIV Infection/STDs Among Youth (1994)

In1998, the MT&D, the West Virginia Department of Education, the San Francisco Unified School District, the Education Development Center and CDC – DASH collectively formed the Training and Development Consortium (TDC). TDC members work collaboratively to more effectively plan and implement trainings for HIV education coordinators.

NINE COMMON CHARACTERISTICS OF EFFECTIVE HIV/AIDS PREVENTION CURRICULA (BASED ON THE WORK OF DOUGLAS KIRBY):
 

1) Focus clearly on sexual risk-taking behaviors 

2) Incorporate behavioral goals, teaching methods, and materials that are appropriate to the age, sexual experience & culture of the students. Reinforce clear values that strengthen individual and group norms against unprotected sex. 

3) Based on social learning and behavior change theory

4) Long enough to allow participants to complete important activities. Short programs can’t do enough; small groups are more effective/increase involvement. (10 – 14 sessions minimum, unless in small group setting)

5) Provides basic accurate information that is relevant to the goal of prevention. 

6) Use teaching methods to involve students and help them personalize information, including encouraging open discussion.

7) Include activities that address social or media influences, including what are social messages & how to respond to pressures to have sex. 

8) Provide modeling and practice in negotiation & communication skills

9) Select teachers or peers who believe in the program and then provide them with training, which often includes practice sessions, content and increasing comfort
 

BACKGROUND INFORMATION  - HIV & SEXUALITY EDUCATION PROGRAMS
 

There is a large body of research outlining approaches to HIV prevention and sexuality education and showing us what is effective in reducing sexual risk taking behavior.  In addition, there is anecdotal and experiential evidence about what does and does not work.  The lists below are based on a compilation of these sources. 
 

SOME COMPONENTS OF A COMPREHENSIVE PROGRAM INCLUDE:

• Classroom instruction on HIV in the context of comprehensive sexuality education (This needs to include information and skills to prevent sexually transmitted diseases and pregnancy.  See characteristics of effective curricula below.)
• Peer education
• Special events
• Condom availability (Research tells us this is a low-cost and effective intervention which can result in higher rates of condom use without increasing sexual activity.  Massachusetts is the only state with a Board of Education policy encouraging districts to consider making condoms available and has the most districts with such programs (23).  Unfortunately, as far as we know, no new programs have been established in the past few years and two have been dismantled.)
• Parent activities & education (Research has shown the young people who talk to their parents about HIV and/or sexuality have lower rates of sexual risk taking.)
• Counseling and referrals (School-based counselors have a critical role to play in working one-on-one with students on a range of related issues. In Massachusetts teenagers have the right to access testing and treatment without parental consent.)
• School health services
• Comprehensive policies (Policies should support prevention education and programming, promote ongoing staff development, and preserve the confidentiality and legal rights of HIV-infected students and staff.  See attached "Components of an effective HIV policy".  Massachusetts is also considered to have model Board of Education HIV policy recommendations.)

EFFECTIVE PROGRAMS ALSO:

• Involve youth in planning and implementation
• Are based on research and data
• Adapt prevention education and activities to meet the unique needs of students at high risk, such as gay, lesbian and bisexual youth,  young girls,  youth of color, students with disabilities, students with a history of sexual abuse and students with limited English proficiency
• Coordinate and integrate HIV content within all components of a comprehensive school health program, across all grade levels and curriculum areas such as science, social studies, language arts, etc. (Board policy recommends that HIV prevention be taught in EVERY grade level.)
• Provide linkages with community based agencies and services
•  Focus on fostering sexual health and positive sexuality, rather than using fear-based messages