HIV is a massive problem in Lesotho. Massive almost seems like an understatement – based on the latest data, a solid ¼ of people in Lesotho are HIV positive. This potentially makes Lesotho the highest rate in the world – it’s definitely in the top two. The virus affects all parts of life here, so it naturally follows that HIV/AIDS education and prevention is a huge part of my (and all teachers’) job at school.
I want to start with some basics about the epidemic. Most of this information comes from the Lesotho Demographic and Health Survey (2014 is the most recent) as well as from various HIV/AIDS trainings I’ve attended since starting my Peace Corps service.
- Globally, 36.9 million people are living with HIV.
- In Lesotho, 25% of adults are infected with HIV.
- In Thaba-Tseka, the district of Lesotho where I live, 24.7% of adults are HIV positive.
- HIV is more prevalent in urban than rural areas of Lesotho.
- HIV is more prevalent among Basotho women (30%) than men (19%). This discrepancy is due to the female body’s increased susceptibility to the virus, as well as social factors that make women in Lesotho more vulnerable.
- 25% of pregnant women in Lesotho are HIV positive. Note that with proper care, it is possible for children of HIV positive mothers to be HIV-free!
- There are many factors that increase the risk of HIV, including (but definitely not limited to): intergenerational sex, multiple concurrent sexual partners, migrant labor, and gender-based violence.
- Lesotho has adopted a global goal for epidemic control called 90/90/90, which aims to do 3 things: ensure that 90% of people know their HIV status, ensure that 90% of HIV positive people are receiving antiretroviral (ARV) therapy, and ensure that 90% of people on ARVs have demonstrated viral suppression. This sounds complicated, but it basically just recognizes the importance of testing, treatment access, and treatment effectiveness.
The scale of the problem often feels disheartening. What can one person do in the face of such an epidemic? It’s obvious that I’m not going to change the state of Lesotho as a whole. Nobody is.
But to be fair, I’m not working alone – I have a team of counterparts and friends in my community who are committed to finding small scale interventions that work. I also have Peace Corps, PEPFAR, as well as a slew of NGOs and government agencies that are already working in Lesotho and looking for new partners.
That said, I’m currently involved in 3 projects at my school that are HIV/AIDS related. The idea is that through education, individual students will learn to make safer choices and thus protect themselves and those around them.
1. Life Skills Education: The Lesotho Ministry of Education is currently rolling out new curriculum for primary schools. This new curriculum emphasizes (and evaluates – which is a huge incentivize for teaching here, as classes that aren’t evaluated are often skipped altogether) Life Skills class. I’ve blogged about Life Skills before – I co-teach it to Grade 6 and 7 with my Basotho colleagues – but it’s essentially a hybrid of sexual education and abstract topics like self-esteem and goal setting.
In teaching Life Skills, I’ve been surprised at how little students know about their own bodies. After going over the basics of the reproductive systems, we spent most of the year learning about safe sex and HIV/AIDS. There are a lot of myths to dispel, and most of my students don’t feel comfortable asking adults in their life what’s true due to the taboo surrounding talking about sex.
At the end of the year, they’ll leave this class knowing tangible facts like how HIV is spread (through 4 body fluids, but not saliva!), the 3 best ways to protect yourself against HIV (abstain, be faithful, condomize!), and the steps to correctly using a condom (including participating in a condom relay race!).
2. Girls’ and Boys’ Forums: I inherited this project from the PCV who taught at my school before me, and I love it. Once a week, boys and girls meet separately in forums. There, led by Basotho teachers, they choose topics to discuss in Sesotho. For example, at the next meetings the girls have agreed to talk about safe sex, and the boys want to go over drugs and alcohol.
The idea of forums is that in addition to Life Skills class, it can be helpful to discuss HIV/AIDS-related issues in a single-gender space using the local language. These conditions make for a more relaxed, comfortable environment for students to speak their minds and ask questions without fear of judgement. I’m all for any way we can reinforce these important topics!
3. Grassroot Soccer: GRS is a South-African based NGO that trains Peace Corps volunteers in 50+ countries to use their curriculum. I was recently trained, along with a local co-teacher, to teach the “Skillz” curriculum – a set of 11 classes that uses football (soccer!) to teach lessons about HIV/AIDS. We’re currently about halfway through an intervention with Grade 7 students, and we have plans to work with other groups in the future.
I had heard from several PCVs that this program was their favorite aspect of service, and I can see why. It’s just so FUN. When it’s time for GRS, my kids get to go outside and run around, play with a ball, and sometimes even do limbo. The lessons progress in a logical order and each end in one or more “key messages.” Out of all the HIV work I’ve done at school, this program engages children the most and has prompted the most honest and in-depth conversations.
So, there you have it – my HIV/AIDS work at school! Stigma is an enormous obstacle to tackling this disease – so many people reject testing, aren’t properly medicated, or lack an effective support system because of the culture of fear and shame that prevents honest conversations about HIV. If nothing else, my school has become a place where teachers and learners have frank conversations, and that’s a great place to start.