Navigating the gap between inadequate sexual education and the health needs of young people in the fight against HIV is more crucial than ever.
Peggy Owusu-Ansah
Youth Activist, Advocates for Youth
The first time I heard HIV mentioned in a classroom, I was in elementary school history class as my teacher discussed illnesses through the ages. Moving from smallpox to the Spanish flu, we brushed over the topic of HIV as something that we “used to get but now only affects people in Africa.” As a Ghanaian living in America, I thought that meant that I was somehow lucky to have come from a place where this perceived danger still existed and to have ended up somewhere where it did not.
In sex education classes, called “family life education” in my Virginia county, teachers did everything they could to avoid talking about HIV. Our teachers would say its name and something along the lines of “HIV is deadly; if you get it, there is no cure.” These early conversations sent a dangerous message steeped in stigma and misinformation. HIV was something to fear and to ignore.
In my last year of family life education, I finally had a teacher that went against the grain and not only brought up HIV, but explained what it was, how it could be treated, the importance of testing, and how to prevent its spread. It was my first – and only – sex education class at school that actually addressed prevention and care. I will always feel grateful to that teacher for providing what many young people never receive: comprehensive sex ed that incorporates HIV.
The education gap
For young people, school programs such as sex ed, family life education, or health may be the only introduction that they have to HIV, STIs, or sexual health practices. However, in 2020, only 39 states and the District of Columbia required sex ed be taught in schools. Of those 39 states, just 22 require that the instruction is medically or factually accurate, and the definition of what is medically accurate varies by state.
I started to really understand the differences between the sex ed I received and the curriculum in other states when I started college in Tennessee, where sex ed, or “family life education,” is only taught in counties where the teen pregnancy rate is considered high. Even then, the curriculum is not allowed to promote anything that could be seen as a “gateway” to sex. This includes giving out condoms in sex ed courses, showing demonstrations of how to use condoms, or descriptions of any sexual acts. Tennessee is not unique: as of 2014, only 7.2% of high schools in the United States offered condoms to students as a part of their sexual health programs. By banning condom availability programs, states are restricting proven approaches to promoting safer sexual health practices.
Barriers to care
Insufficient sex education has a real impact on young people’s ability to seek healthcare and prevent HIV. In 2021, 19% of all new HIV diagnoses in the United States were among young people aged 13-24, and Black youth made up 53% of those diagnoses. Today, almost half of young people in that age range living with HIV in America are unaware they are living with HIV.
Young people face unique barriers to accessing health care, resulting in low HIV testing rates.
In 2021, only about a quarter of individuals aged 18-24 years old had ever been tested for HIV (27%). Many of us don’t have parental support, medical insurance, reliable transportation, or even flexible schedules that allow us to make appointments. These barriers are even harsher for Black youth, who are more likely to contract HIV but often encounter misinformation, stigma and medical mistrust.
Focus on accessibility
The health needs of young people have to be taken into account when we consider creating inclusive care for all people. We need more programs like TakeMeHome.org, which provides HIV self-tests for free, health centers that provide free condoms, and promotion of PrEP access at schools and community centers could help reduce stigma and expand prevention and care. With only 81% of youth being linked to HIV-related care, we must meet young people where they are to ensure their needs are met. When we consider Black young people, the push needs to be greater.
Young people deserve access to the education and resources they need to thrive, and that includes sex education that breaks down stigma about HIV. Together, we can create a society that not only responds to the needs of today but works hard to create a better future for every young person living with HIV.
