Rent: teaching and learning about HIV

Last night I went to see the 20th Anniversary concert of Rent @rentinconcert with my co-Rent addict @smunnings01.  Rent is a musical set in the East Village of New York in the early 90s. It is about love, life and HIV.  I first saw the musical almost 16 years ago when I had only been working in HIV and sexual health for a couple of years.  At that time many more people - friends and colleagues - were still dying from AIDS related illnesses with horrifying frequency.

Each year the Health Protection Agency publishes statistics on HIV.  By the end of 2011 an estimated 96,000 people were living with HIV in the UK.  It is estimated that about a quarter of those do not know they are infected.

The first time I saw Rent was the day my Grandad died.  He was old and he had been ill.  I understood his death and although of course I was upset, it made sense to me.  As a young gay man in my early 20s I was still struggling to make sense of the assault of HIV on the gay community.  In my professional life I was learning about the UK policy response to the epidemic. I was also trying to make sense of what HIV meant for me having newly arrived in London. I remember very clearly sitting in the theatre and being overwhelmed and angry by the devastation AIDS was causing in individuals, families and communities, and simultaneously uplifted by the optimism of the play.

In 1987 FPA published an excellent training handbook on HIV and AIDS by Hilary Dixon and Peter Gordon called Working with Uncertainty.  In their introductory chapter they say because HIV infection is still shrouded in fear, myth, exaggeration and confusion.... Fast forward 25 years or show and that fear, myth, exaggeration and confusion about HIV still exists especially, but not exclusively, amongst the young.  Over a decade ago Ofsted reported that teaching about HIV was inadequate in too many schools.

At that time the DfEE was demonstrating clear leadership on PSHE and responded positively to Ofsted's report.  They funded National Children's Bureau and Sex Education Forum to produce a teaching resource to help schools.  Teaching and Learning about HIV updated and brought together all of the excellent materials that had been produced to help teachers and others working with young people to educate them about HIV.  It is available here http://www.ncb.org.uk/hiv/resources-for-professionals/teaching-learning-about-hiv.

Fast forward another ten years - bringing us right up to now in the 21st Century - and the Sex Education Forum carries out research that tells us 1 in 4 young people learnt nothing about HIV and AIDS in schools.  The research also shows significant gaps in knowledge and information.

As one young person in the SEF research said "Just because we are afraid of the way AIDS can affect our lives doesn't mean we hide it under the rug.  Speaking about it will keep knowledge up.  And with that knowledge comes the power to help ourselves."

Wise words indeed. Combine this insight with the fact the report also identified almost half said they did not think they had learnt what they needed about HIV at school and we should all be worried - parents, education and health professionals and politicians alike.

Policy and decision makers in school, local, regional and national level would do well to heed this information when making decisions about school and community based sex and relationships education and services for young people.  Here is the report www.ncb.org.uk/media/333229/young_people_experiences_of_hiv_and_aids.pdf

Tackling HIV requires a multi-faceted universal and targeted approach and there are many excellent organisations with detailed information and advice about HIV including Terence Higgins Trust www.tht.org.uk, National AIDS Monitor www.nam.org.uk, National AIDS Trust www.nat.org.uk.

PSHE along with good teaching about HIV in science is one critical and important part of our response to tackling HIV.  Whilst many teachers in schools and professionals in community settings are providing incredibly good learning experiences about HIV, too many young people have been let down by inadequate education about HIV in the past.  Many of us hoped that would change with the outcomes of the Government's PSHE review.

Last month Gove published that Review and essentially left it to schools to decide what to do.  This decision lets down another generation of young people.  Brook and other expert organisations, teachers, parents and young people agree that the status quo isn't good enough.  It has failed too many young people.  Our job now is to work together to improve teaching about HIV as part of a comprehensive package of PSHE and education about sexually transmitted infections in science.

As Professor Jane Anderson, Chair of the British HIV Association tweeted in response to an earlier version of this blog biomedical and scientific advances aplenty, but without teaching and learning their power just evaporates. Education key.  We cannot and must not allow another commentator to be writing in ten years time that we still haven't got a grip on teaching children and young  people about HIV education once and for all.

To help us there are many excellent resources including this online resource for schools and others to address the issues with young people: Positive? Awareness of and Attitudes to HIV www.learningpositive.com.  

Responding to the Publication of the Government's PSHE Education Review

Personal, Social Health and Economic (PSHE) education is vital for children and young people. It is as important as reading, writing and arithmetic (and IT) yet it continues to be the 'Cinderella subject' of the school curriculum; neglected and ignored. Last month, the Government announced it would not be making PSHE education statutory in primary or secondary schools. Brook, like many organisations, believes this undermines children's rights, their health and their safety.

Young people are talented, resourceful, resilient and creative and even though many of them navigate life's path with few serious problems, everyone; parents, politicians, professionals and young people themselves, worry about them. We see the headlines: teenage pregnancy, smoking, obesity, substance misuse, sexual exploitation, female genital mutilation, HIV and other sexually transmitted infections, domestic violence and violence against girls and women, bullying including homophobic and sexual bullying and gangs. These are real and valid health and social concerns that require public and political attention, particularly in the context of the unprecedented economic and social change we are facing.

When they get excellent PSHE education, children and young people can learn about many of the issues that might affect their health and happiness. Things like relationships, sex, alcohol and other drugs, eating and fitness. Good PSHE education helps to develop vital personal and social skills, positive values, an understanding of equality and diversity and the importance of individual rights and responsibilities. PSHE education is not a magic bullet but where it is done well in primary and secondary schools it is proven to make a difference to young lives.

Last month, the Government had the chance to make sure all young people got good quality PSHE education with the publication of their long overdue PSHE education review. They could have made a simple, cost effective, workable change. Instead the Department for Education (DfE) chose the status quo.

The decision not to make PSHE education statutory flies in the face of children's rights as set out in the UN Convention of the Rights of the Child, ratified in the UK in 1989 and works against other government departments' aspirations to improve PSHE education. The Department of Health (DH) thinks children and young people should have good Sex and Relationships Education (SRE), so does the Home office. DfE itself has stressed the importance of PSHE education and said it wanted young people to have good SRE (though obviously not enough to make sure that actually happens).

And it gets worse. Not only has the Government ruled out statutory PSHE education, its consultation on the national curriculum proposes watering down the minimal (but important) content in the science curriculum that contributes to good PSHE education. The review proposes;

• At key stage one, the names of genitals are not included in the requirements to teach 'basic parts of the body'. This matters because children need a language to describe their bodies if they need to ask for help.
• An unnecessary note tells teachers that pupils in key stage 2 'should not be expected to understand how human reproduction occurs' and there is no mention of puberty for children who need support and preparation for a huge change in their lives.
• The specific reference to 'sexual health' has been removed from the proposed new Key Stage 3 science curriculum and there is advice in the new Key Stage 3 content that learning about the structure and function of the male and female reproductive system should not include hormones.

The new proposals make a fudge of teaching children essential aspects of the science of their bodies, simply because some people feel a bit icky about sex and relationships.

We know that some schools take their responsibilities to young people seriously. Some schools deliver all of PSHE education well and some schools deliver parts of it well. But it's not required in law that every school teaches a minimum content or to a required standard. Teachers cannot train to be PSHE education specialists in their initial teacher training. As a result some children get very good PSHE education, and others get the absolute bare minimum required by law - the science of reproduction and infections (now under threat).

It is clear then why so many parents, professionals and organisations, including teaching unions, are deeply concerned that the Government has opted for more of the same rather than facilitate systemic changes in teacher training, curriculum planning and delivery.

Introducing PSHE education as a statutory subject in schools would be relatively low cost and high impact. It would reach the majority of children and young people with the core information and skills to help them manage their lives now and in the future. It would provide teachers with the essential training and skills they need to teach the subject well and it would make a proper difference to many of the problems that young people face today.

To refuse to take this opportunity and to propose the watering down of the science curriculum at a time when other sources of information and advice in the youth and community are being cut is short sighted and ill considered.

This decision fails children and young people. It ignores the consensus in this country in support of PSHE education and it ignores the evidence. It also overlooks the fact that the status quo does not work. Now it's time to work with schools and their community partners to support them to do the right and moral thing by children and ensure that PSHE education gets the time, attention and position it requires in school life.

Looking in and beyond the Brook gates

Over recent weeks I have been travelling around the country visiting Brook services and meeting/seeing again the Brook staff teams working across Brook's clinical and support services, education and our advocacy and lobbying work. It is a true pleasure spending time with my colleagues who are working with young people day in day out; and from each and every session I have left energised, inspired by their creativity and passion, and with further clear ideas about what they want from their Chief Executive and their experience of the new Brook organisation.

As one person said, 'I come to work each day not quite knowing what I am going to find, and I always go home knowing that if I have helped at least one young person even just a little bit then it has been a good day'. And this sentiment was echoed often and I was particularly struck by one colleague who said 'in my work I do a lot of work with young women - lots of them are being hurt or not enjoying their relationships and through the work we do I try to help them see that is not good enough for them and they deserve me, and when someone comes back and says I've had enough, or I tried this instead today and it worked, that gives me a real buzz.'

Meanwhile in the national team in Kentish Town our cohort 3 volunteers left us last week - this cohort devised and developed the sex: positive campaign and worked hard and tirelessly to convince many stakeholders of its value. I am immensely proud of their work, and of their individual and group achievements. They brought their own buzz into the office and whilst we will miss them, of course most of all we wish them well and welcome the new volunteers working in both our Kentish Town and Oldham offices.

Whilst spending my hours on the train I am trying to both keep away from too many sandwiches, and keep on top of the policy documents and what is happening. Most notably Positive for Youth, and the PSHE Education review, both from Department for Education.

Positive for Youth is important because it sets the framework for a positive approach to working with young people. There is much to be liked about the tone and content of some of the discussion papers, and I am delighted the health and well being paper emphasises the importance of sex and relationships education and services, and highlights the Brook @besexpositive campaign (www.sexpositive.org.uk). Like many others I am keen to really understand further how this translates to action and dovetails with other initiatives.

The PSHE review was launched by DfE at the end of July and this is an important opportunity to influence the future of PSHE Education including sex and relationships education. In the scope of the document it states that sex education is statutory and that schools must have regard for the sex and relationship education guidance therefore no further changes are needed to legislation. It is absolutely true science contains some 'sex education' and that 'secondary schools must provide a programme which includes as a minimum teaching about STDs including HIV and AIDS' and it is true they must have regard to the sex and relationships education guidance. The unspoken bit here though is they must pay regard to the guidance IF they deliver SRE outside of the statutory minimum which we know so many many schools don't. And young people tell us they suffer from poor quality SRE as a result.

Brook is also concerned the review document does not include consideration of withdrawing the parental right of withdrawal. The UK is signed up to the UN Convention on the Rights of the Child and there is evidence of this government listening to young people - so I fail to understand a) how we will ensure the entitlement of all children and young people and b) why when there are so many young people telling us their sex and relationships education is not good enough decade after decade, and there is a huge majority consensus from parents and professionals about the need for SRE that it continues to be played a curriculum subject that gets politicised. Only when it becomes as normal and everyday as maths and english will children and young people get the education about relationships, emotions, sexuality and sex education they want and deserve to help them navigate their way through the complexity of the 21st Century.

We will be working with FPA to prepare a full submission to the PSHE Education Review consultation.

And whilst the Positive for Youth discussion papers and the PSHE Education review are in the public domain, we also know that proposals are being considered with regard provision of pregnancy choices counselling, and whether abortion providers will be able to provide this counselling in the future. You can see Brook and FPA briefing and advice about what you can do to let your views be known here http://bit.ly/owp9pG

Finally in the Westminster village, we await the Lords Select Committee report on HIV in early September which I am hopeful will provide strong support for improving the quality and quantity of SRE.

Tonight I am going to the Edinburgh Fringe Festival which I am looking forward to, and am taking the opportunity to visit the new integrated sexual health service recently launched in Edinburgh. To pack my shorts or my raincoat was a dilemma last night, but this morning I think it is definitely raincoat.

Have you pledged to be sex: positive? Its free, its easy and it takes two minutes, just click here http://bit.ly/nOphPt