The impact of HIV/AIDS on society

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CHAPTER 2 :LITERATURE STUDY AND CONCEPTUAL FRAMEWORK

Introduction

The HIV/AIDS epidemic has left no part of the world untouched. The problem exists worldwide, although the greatest concentration of HIV infections and AIDS related deaths is in developing countries (Juma, 2001). Education is at the core of one of the great challenges facing humanity: winning the fight against HIV/AIDS (UNESCO 2002). In terms of the realisation of children’s rights HIV/AIDS is fast becoming a critical challenge in South Africa (Smart, 2003). As will become evident in this chapter, a reciprocal relationship exists between HIV/AIDS and education, which goes beyond the formal education sector and embraces society and other areas.
The proposed study will focus on the experiences of learners in three schools implementing HIV/AIDS programmes as suggested by the Gauteng Department of Education, and within the framework of the proposed programme of the National Department of Education. The conceptual framework within which these experiences will be studied is sketched in this chapter.
The purpose of this chapter is to investigate the two major fields of knowledge that play a leading role in defining this study. The complexity of HIV/AIDS and the impact it has on the adolescent, society and the education system has an important role to play as one field of knowledge in this study. Theories on adolescent development form part of this field. Policies, plans, curricula and programmes of the National Department of Education and how these are envisaged also need to be investigated as a second field of knowledge. Research into HIV/AIDS programmes at national and international level is included in this field.
I am thus compelled to consider these vast arenas in my attempt to frame this study theoretically. I will structure my discussion in terms of looking at the “whole” of the impact of HIV/AIDS. I will approach this framing process logically, by first looking at the macro level impact of HIV/AIDS on society. Then I will narrow it down to meso level with the impact of HIV/AIDS on the adolescent and the education system and lastly I will focus at micro level in terms of HIV/AIDS and the curriculum, with a constant focus on the adolescent and his/her experiences. In this way I will construct the conceptual framework of my study.
The African continent is diverse in terms of its economics, cultural heritage and the level of education of its people (Kaaya and Smith Fawzi, 1999). In a recent report compiled by UNESCO (2002) some of the current known facts regarding HIV/AIDS and education are listed:

HIV affects all continents and regions
HIV prevalence among young people is high and rising rapidly
The full impact of HIV/AIDS on educational institutions is yet to come
HIV/AIDS is undermining institutional capacity
The number of children orphaned by AIDS is rising rapidly
Student enrolment and achievement are likely to fall
HIV/AIDS-related risks and vulnerability are present in the majority of schools

It has become clear to me that in order to understand and describe the experiences of learners in terms of an HIV/AIDS programme, it is important to investigate the facts listed above. Once an understanding of the impact of these facts on the adolescent is reached, the findings of this literature investigation will provide a framework for the research.
In the face of HIV/AIDS the adolescent is of critical importance. Statistics, as revealed in the literature, indicate the scope of the catastrophe affecting the youth (Issues in World Health, 2001; Shisana, 2002; McKay, 2004; Smart, 2003):

In 1998 over 2.5 million young people between the ages of 15 and 24 became infected with HIV – half of all new HIV infections that year
In 2001 an estimated 11.4% of people aged two years and older were HIV positive, with an estimated 2000 more South Africans contracting the disease daily
In 2001 an estimated 28.4% of pregnant women in South Africa aged between 20 and 24 years attending antenatal clinics were infected with HIV
In 2004 nearly 25% of all new infections are among the youth

Other researchers support the above-mentioned statistics (Blanchett, 2000; Coyle, Kirby and Parcel, 1999; Department of Education, 2001(a)). Furthermore, available research examining the risk behaviours of young adults illustrates that even more young people are engaging in behaviours that place them at risk of HIV infection in the future (Blanchett, 2000). We have to come to terms with the reality of sexual activity among the youth, and as such HIV/AIDS education calls for a progressive understanding of both social and sexuality issues which are vital components in the growth and developmental health of youths and adolescents (Nyachuru-Sihlangu, 1992:225).
This chapter will thus firstly focus on the broader impact of HIV/AIDS on society and on the education system. The development of the adolescent will be studied in detail in order to understand and describe his/her experiences. Other studies and educational programmes related to HIV/AIDS at international and national level will be investigated and discussed in order to make comparisons in terms of this study. Lastly, strategies applied in other countries for the prevention of HIV/AIDS will also be compared to our National strategy to set the stage for the curriculum the learners are exposed to and from which they gain experiences.
This introductory discussion has set the stage for the description and development of the conceptual framework of this study. Next I will discuss this framework to locate my enquiry, as illustrated in Diagram 2.

The impact of HIV/AIDS has already been felt in every aspect of socio-economic life including formal education (Juma, 2001). According to Juma (2001), insufficient research exists to support an objective assessment of the extent of this impact, but various indicators show it to be considerable. HIV/AIDS is affecting learners, educators, parents and communities, organisations and management, the curriculum as well as resources (Smart, 2003).
South Africa is considered to have one of the fastest growing HIV epidemics in the world, with approximately 1600 people being infected every day. Currently in South Africa alone, 3.5 million people are infected with HIV (approximately 10% of the population), and this number is expected to rise to between 6 and 10 million people within 15 years (Call, Riedel and Hein, 2002). The need for urgent steps focussing on the youth to address this enormous problem is evident from the following statistics. The level of HIV infection amongst pregnant adolescents younger than 20 years was 6,7% in 1994 and rose to 12,7% in 1997, and to an alarming 21% in 1998, an increase of 65% within one year (Department of Education, 2001(a)). These statistics are disturbing in terms of adolescent risk behaviour in the face of HIV/AIDS and the challenge it poses to the education system.
In South Africa, more than 60% of new HIV infections occur among 15- to 25-year olds, with adolescent girls being among the most frequently diagnosed (Call et al., 2002). The latest statistics released on teenage pregnancies and abortions clearly indicate that a large number of school-going adolescents are engaged in unprotected sexual activities, which increases their chances of contracting and spreading a sexually transmitted disease or infection and ultimately HIV/AIDS (Department of Education, 2001(a)).
Of the more than fifteen thousand new cases of AIDS reported daily in South Africa, it is estimated that 10% are children (UNAIDS, 1998(b)). In 2004 almost 25% of all new infections in South Africa are among the youth (McKay, 2004). Unfortunately, statistics alone do not fully present the grim reality of HIV/AIDS. Even well written carefully considered prevention programmes cannot anticipate the contextual factors in which they will be presented.
HIV spreads fastest and farthest in conditions of poverty, powerlessness and lack of information (Issues in World Health, 2001). There are almost 18 million children under the age of 18 in South Africa of which an estimated 60% live in poverty and are nutritionally vulnerable (Smart, 2003). Worldwide, the AIDS epidemic is most severe in the poorest countries, where the disadvantaged and people with few opportunities, services and support systems, are at greatest risk.
In industrialised countries, living in impoverished family and neighbourhood environments is associated with high-risk behaviours, such as substance abuse and delinquency, early pregnancy, poor nutrition, school failure and feelings of despair (Call et al., 2002). It is thus important to keep in mind that poverty has an effect on adolescents’ mental health and risk-taking behaviour when investigating their experiences of an HIV/AIDS programme presented at school.
The health of adolescents is shaped by the daily contexts in which they grow and develop. Transformations in world economics, government, families and technology, among other things, are altering societies around the world, and, in turn, reshaping the contexts of adolescents’ lives (Call et al., 2002; Giese, Meintjies, Croke and Chamberlain, 2003). Taking a closer look at how the impact of HIV/AIDS influences families and communities will thus shed light on how adolescents are affected within their daily contexts.
HIV/AIDS is causing devastation all over the world – destroying communities and families and destroying hope for the future (UNESCO, 2002). In a report compiled by Hunter and Williamson (2001) the tremendous impact of HIV/AIDS on the macro systems of a society is captured. Some of the issues raised in this report will be highlighted here to show the impact of HIV/AIDS on the broader systems of society.
Countries may only experience the demographic effects of HIV/AIDS years after the height of the epidemic. According to a UNESCO report published in April 2001 (UNESCO, 2001), the HIV/AIDS epidemic will have a greater impact on the size of the population of several developing countries than the Second World War had on any society. Robertson and Ensink (1992) seem to support this report by saying that in South Africa the increasing prevalence of HIV seropositivity in woman and children indicates that we are on the brink of an AIDS epidemic of the proportion of that which has swept through other African countries. The increased demand for care stretches already overburdened health and education systems. With infection rates reaching a third of the population, and as many as half of the young in some countries, no institution will remain untouched.

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CHAPTER 1 INTRODUCING THE STUDY
1.1 Introduction
1.1.1 What were my motivations in this study?
1.1.2 Background of the study
1.2 Statement of intent and aims
1.2.1 Research question
1.2.1.1 Primary research question
1.2.1.2 Secondary research questions
1.2.2 Research aims
1.3 Paradigmatic perspective
1.4 Conceptualisation
1.4.1 Case study
1.4.2 Exploring
1.4.3 Experiences
1.4.4 Learners
1.4.5 HIV/AIDS Programmes
1.5 Research Design and Methodology
1.5.1 Research Design
1.5.2 Data Collection
1.5.2.1 Selection of Data Source
1.5.2.2 Selection of cases (sampling)
1.5.2.3 Methods of Data Collection
a. Mode of observation
b. Data documentation
c. Data capturing and editing
1.5.2.4 Data analysis and interpretation
1.5.3 Ethical Strategies
1.5.4 Trustworthiness
1.6 Limitations of the study
1.7 Conclusion
1.8 Organisation of the thesis
CHAPTER 2 LITERATURE STUDY AND CONCEPTUAL FRAMEWORK
2.1 Introduction
2.2 The impact of HIV/AIDS on society
2.3 The impact of HIV/AIDS on the education system
2.3.1 The importance of HIV/AIDS education
2.4 The adolescent and HIV/AIDS
2.4.1 Introduction
2.4.2 Exploring learners’ experiences in terms of adolescent development
2.4.3 Why adolescents are so vulnerable in terms of HIV/AIDS
2.5 Programmes in HIV/AIDS education
2.5.1 Introduction
2.5.2 Programmes implemented at international level
2.5.3 Programmes implemented at national level
2.6 Conclusion
CHAPTER 3RESEARCH DESIGN
3.1 Introduction
3.2 Context and setting
3.3 Research Design
3.3.1 Data collection
3.3.1.1 Selection of data sources
3.3.1.2 Selection of Cases (sampling)
3.3.1.3 Methods of data collection
a. Mode of observation
b. Data documentation
c. Data capturing and editing
3.3.2 Data analysis and interpretation
3.3.2.1 Method of analysis and interpretation
3.3.2.1.1 Data analysis steps
3.3.2.1.2 Data discussion and interpretation
3.3.3 Ethical Strategies
3.3.4 Trustworthiness strategies
3.4 The role of the researcher
3.5 Conclusion
CHAPTER 4 INTERPRETATION OF LEARNERS’ EXPERIENCES OF HIV/AIDS PROGRAMMES
4.1 Introduction
4.2 The context within which understandings emerged
4.3 Discussion of the data
Theme 1: Knowledge that changed me positively
Category 1.1: “The programme opened it up for me”
Category 1.2: “I am more comfortable with issues”
Category 1.3: “The programme changed my lifestyle”
Theme 2: Knowledge that impacted me negatively
Category 2.1: “I am fed up with talk about AIDS”
Category 2.2: “It was like a big shock to me”
Theme 3: Persisting Misconceptions and Stereotyping
Category 3.1: “Some white people…But black people”
Category 3.2: “I do think poverty plays a major role in HIV”
Category 3.3: “You go on the rumours you pick up”
Theme 4: My parents, the HIV/AIDS programme and me
Category 4.1: “It has paved the way for communication”
Category 4.2: “My parents are too scared to talk about sex”
Category 4.3: “These things should start at home”
Category 4.4: “Even my parents are more open to HIV/AIDS issues”
Theme 5: My friends, the HIV/AIDS programme and me
Category 5.1: “An opportunity to open up to our friends and peers”
Category 5.2: “You just do what your friends do”
Category 5.3: “ It was a shock to my system”
Theme 6: “We need something different now”
Category 6.1: HIV/AIDS Programme format: “There must be new ways”
Category 6.2: “We need to know…”
Category 6.3: “You have to be scared to get it”
CHAPTER 5 TRANSCENDING FINDINGS
5.1 Introduction
5.2 Overview of study
5.3 Conclusions and addressed aims
5.4 Transcending Findings
5.5 Limitations of the study
5.6 Quality Criteria
5.7 Implications for research, practice and HIV/AIDS programme development
5.8 Contributions of the study
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