Montenegro

HIV in school curriculum

 

There are many taboos in every society, of course, but there are many more taboos in societies that have been more traditional. Exposure to other societies emboldens people to dare to question the wisdom and validity of widely accepted taboos within their own societies. The dawning of the age of information, with the 500 TV channel universe and the Internet, has opened formerly isolated societies to the rest of the world and a lot of people are asking a lot of questions about a lot of things, including social taboos, now.

 

However, for every individual who dares to ask questions, there are legions who are content to accept the status quo. Maintaining the status quo can be a good thing, a harmless thing, or, in some cases, a very dangerous thing. If ignorance about HIV/AIDS is wide spread in a society, maintaining the status quo is a very dangerous thing.

Montenegro has a low prevalence of HIV. Although the Institute for Public Health estimates that there may be as many as 300 - 500 cases of HIV in Montenegro there have only been 89 confirmed cases from a population of just over 600,000. Health authorities (and everyone else in the country) would like to keep it that way.

The old saying that an ounce of prevention is worth a pound of cure has survived over the years because it is true. The ounce of prevention needed to immunize people from all manner of harmful things is almost always a cocktail of numerous elements, of which education is often the dominant ingredient. But, because the most common ways to contract HIV – men having sex with men, having sex with sex workers and intravenous drug use – are severely frowned upon in the socially conservative country, HIV is a taboo subject in Montenegro.

Montenegrins, of course, are not oblivious to the reality of HIV but reality is not for the squeamish and because HIV is a taboo subject, discourse about the disease makes many in this small country very squeamish. So, how do you educate people about things they would rather not think about, never mind talk about? Well, you do the logical thing. Star at the beginning. With the kids.

The United Nations Development Programme (UNDP) in Montenegro has targeted high risk demographic groups in its educational efforts to prevent HIV, namely: sex workers, injection drugs users, men who have sex with men, sailors, prisoners, Roma youth, workers in the tourism industry and young people. Efforts to reach the larger general public are also part of the programme but the goal of long term prevention necessitates outreach efforts aimed at youth.

There are an estimated 200,000 young people in Montenegro. The biggest success since the programme’s inception has been the design and implementation of a ‘healthy lifestyles’ course for grade 8 and 9 students (13 – 15 years of age). The pilot course, - which includes a section on HIV, other sexually transmitted infections (STIs) and safe sex practices - has reached 2700 students in the 2008 – 2009 school year. The pilot has been universally hailed as a success and will be part of the curriculum of all Montenegrin elementary schools in the 2009 – 2010 school year. Unfortunately, there is currently no room within the compulsory curriculum for the course and it will only be offered as an option.

The course is unique in Montenegro for two reasons: education professionals were not solely responsible for its design (physicians, psychologists, sociologists and other professionals were all instrumental in the effort); and it is the first time in Montenegro that preventative measures health planning has been institutionalized within the education sector.

Contributors to the course’s content first designed a syllabus (which included sections on the concept of healthy life style, illicit drug use and abuse, violence and bullying, health and fitness, nutrition and hygiene, recreation and sports, body defense system and infectious diseases, reproductive health and sexual education, mental and emotional health, psychoactive substances and smoking, prevention of violence and environment, etc.) and then got down to the hard work of detailing exactly what would be taught. A text book was produced and more than 100 teachers across the country were trained to teach the course.

Despite the fact that people who engage in any activity that is commonly associated with HIV are highly stigmatized in Montenegro, educational authorities report that there was no resistance to the inclusion of a section on HIV/AIDS in the course. Although the people behind the effort had no doubt that an HIV/AIDS section was essential, they were not so sure that there would be no public hysteria and believe that such would not have been the case a mere ten years ago.

Confident that they had crafted an important and interesting course, education authorities embarked on a mission to ‘sell’ it to Montenegrin students and, perhaps more importantly, their parents. Television spots were produced and put into high rotation on domestic TV stations with programming aimed at the 13 – 15 demographic. Knowing that Montenegro, like every other European country, is football crazy, the spots were also aired during televised matches which attracted both young viewers and their parents.

A survey of the students who have enrolled in the course showed that 90% of them believed that it would be beneficial to them immediately and for the rest of their lives.

Those involved in the effort to make the course a reality are rightly proud of their work so far and are very curious to see how much more fruit their labour will produce in the 2009 – 2010 school year. They are hopeful that students presently enrolled in the course will ‘sell’ their friends on it, who will ‘sell’ their friends on it, who will… resulting in high demand for years to come.

In addition to safeguarding against an increased prevalence of HIV/AIDS in Montenegro, the course should also lead to increased tolerance with Montenegrin society. Social evolution can be a painfully slow process, especially for minorities who suffer under age old prejudices. Tolerance for gays in Montenegro is so bad that there is not a single ‘out’ gay man, lesbian or bisexual in the country. One section in one optional healthy lifestyles course will not, in and of itself, eradicate prejudice against individuals based on their sexual preferences but it is a start and one day, maybe in the not-too-distant future, the prevalence of homophobia will be as low as the prevalence of HIV/AIDS in Montenegro.