Age-appropriate sex education, A must in schools | Sunday Observer

Age-appropriate sex education, A must in schools

The statistics of the National STD/AIDS Control Program in Sri Lanka Show that the cumulative HIV cases of children, reported in the country by end 2016, is 80% of which 60% of children go to school without any issues. The total number infected in Sri Lanka by the end of 2016 is 2,557.

In 2016, 20 youth (15-24 years) were reported with HIV (two females and 18 males), in the previous year 91/249 (36%) were due to male to male sex. Every week about 4-5 new HIV cases are reported to the National STD/AIDS Control Program in Sri Lanka. It is a pathetic situation that 4-5 new patients are added to the prevailing population living with HIV (PLHIV), per week. The HIV case rate in the country is 1.2 per 100,000 population, per year.

The United Nations Population Fund (UNFPA) Consultant, Attorney-at-Law Kamani Jinadasa said at a recent workshop on ‘Reproductive Health and Rights’, men having sex with men (MSM) have become one of the leading causes for the rapid increase of HIV infected persons..

There were two incidents reported regarding HIV recently. One, about a child from Ganemulla who was denied admission to school because the mother had HIV, and the other about two boys aged 14 and 16 from Alutgama who were abused by the owner of a beauty salon suffering from HIV and taking treatment from the Kalutara STD clinic. The two boys had contacted HIV afterwards according to police reports and the Alutgama police had arrested the beauty salon owner. “It is an offence under the Penal Code and is considered as child abuse,” said Dr Ajith Karawita.

Dr Ajith Karawita

Dr Ajith Karawita, Consultant, STDs and HIV Medicine, Anuradhapura Teaching Hospital spoke to the Sunday Observer about the reason for the rise of HIV among the youth and suggested some programs which could be carried out to decrease the number of HIV infected in Sri Lanka. Dr. Karawita said, the rise in the number of cases in any age group can be described as an increase in the number of actual cases or an increase in the detection of new cases, by screening programs. “I think, at present, both are happening. In 2016, of the total reported (249), 8% were among youth (15-24 years), youth infections are considered as new infections. Therefore, if this group is increasingly affected, it means new infections are on the rise in the country,” he said.

“On the other hand, the Ministry of Health is targeting over 1 million HIV tests per year with increasing effort and resources. This could also bring more and more new cases. Among the 20 cases of youth reported in the year 2016, the majority were males (18) of whom the majority has acquired the infection through male-to-male sex. Schoolchildren less than 15 years are generally getting infected before birth from an infected mother. Most of them face problems at school entry, while other children who are not infected but if the mother/father or a household member is infected they too get ostracized from society or school,” Dr. Karawita said.

He said, “The parents of other children threatened the school management that they would take their child out of school in Ganemulla. It is a threat to the school because if the number of children are less, the school would have to be closed. Whether the child is infected or not, the child has the right to go to school. People make logical statements such as an HIV child could get injured and another child who touches his blood could be infected. These probabilities of infection in schools is low. There should be a cut, blood spill,and touching a cut injury for this probability to happen. This does not practically happen and has not happened anywhere in the world unless they have penetrative type of sexual intercourse or mixing of blood. This should be explained to the parents and they should be made aware of this.”

According to Dr. Karawita, the reasons of new infections in the youth are mainly due to unprotected sexual behaviour, especially, increasing engagement in male-to-male sex.

“This is tightly controlled by society and therefore, it is a hidden behaviour, not a talking subject in many print or electronic media. Therefore, the epidemic is hidden and the disease spread underneath. Youth are hardly exposed to any education or edutainment on these subjects through the media,” he said.

“The other reason is the lack of education on reproductive health and sexually transmitted infections and their prevention.

“I would like to emphasize the word “education”, awareness is not enough, just knowing things will not change behaviour. For children to be protected at the 15-24 age period, they should be educated on these at least before 15 years of age. So, the introduction of age-appropriate sex education is a must and we need to mainstream education to cover all the children,” he said.

Dr. Karawita said, the current school curriculum covers the introduction of reproductive health in Grades 7, 8, 9 with little on sexually transmitted infections and never on condoms. After Grade 9, reproductive health becomes an alternative subject which only some students select. Unless they select Biology, schoolchildren are not exposed to learn reproductive health, sexually transmitted infections and their protection.

Dr. Karawita suggests some programs which can be done to decrease the number of HIV infected in Sri Lanka.

He said, “To decrease the number of HIV infections, simply we need to halt and reverse the modes of possible transmission of HIV. When already infected people are analysed, over 95% of cases are due to sexual transmission. These are through homosexual receptive or insertive penetrative sex (receptive or insertive anal sex among males) or heterosexual vaginal or anal sex or bisexuals.”

He said, the current trend is that out of the total sexual transmissions, the proportion of male to male sex has been on the rise during the previous years. If we are to control the disease we need to reduce partner change rate to a mutually faithful one partner or complete condomization of all other sexual behaviours.

The ABCD of prevention or decrease of possible infections are:

A-Abstinence; abstain penetrative sex till marriage, or abstain from sex when the marital partner is away

B-Be mutually faithful to one partner

C-Condom; If one cannot stick to A and B above, the use of a condom is a must

D-Diagnose; someone exposed to a risk must take an HIV test

Programs to decrease the number of HIV cases:

Increase testing Reproductive health and sex education Identify all the infected people and put them on HIV treatment Social marketing of condom and HIV test Financing for the media, for HIV prevention messages and sustainability

Targeted interventions for most at risk populations:

100% condom programs Modification of school


“Most of the above mentioned programs are happening but, we need to scale and intensify prevention interventions,” he said.

Mohan Liyanage from Colombo spoke about the pathetic situation which prevails in the country. He said, “It is time for Health Authorities to take action to prevent and decrease the number of HIV patients. What if the number of HIV infected increase in Sri Lanka? The local PHI and Public Health Nurses should address the Parent Teachers’ Association on this issue.

They should make the people aware of the precautions that can be taken. Educating the people is very important.”

“Action should be taken by the Health Authorities before it goes out of control. The doctors can address the patients in clinics. At the same time I think there are more negatives of changing the school curriculum with much on reproductive health, as children will want to experiment it after they learn.

Children suffering from HIV should not be isolated.

They should be given the right to education. People in rural areas, especially, should be educated about HIV and explained that it is not a communicable disease. In the case of the Alutgama boys, their parents or guardians should be more alert about their children. Parents should have control over their children,” he said.