The article was published in Eesti Päevaleht on September 23, 2008

Education Key to Defeating HIV

Jessica Adkins
Political/Economic Section Chief
U.S. Embassy

In the global struggle to prevent the spread of HIV, it is very clear that information is one of the most critical tools we have. Increasing people's understanding of how the disease spreads and giving them the tools to protect themselves literally saves lives. Disseminating information about HIV also helps address and reduce the stigma that is still attached to people living with HIV/AIDS.

Providing information to young people is particularly important. According to the United Nations, approximately 45 percent of all new HIV infections worldwide occur in young people aged 15-24. In 2006, Estonia had the highest rate of new HIV infections in Europe with 497 registered cases per million people – a figure that is significantly higher than the EU average of 87 cases. 44% of the new Estonian cases were among people aged 15-24.

Experts agree that, to be successful, HIV prevention programs must include a focus on youth. Teenagers around the world – including in Estonia and in the United States – are at risk. Young people are vulnerable to participating in activities which can dramatically increase their risk of HIV infection – particularly unprotected sex and injecting drug use. Adolescents need accurate, age-appropriate information about HIV/AIDS that will empower them with the knowledge and skills on how to protect themselves. The less information our children have, the more vulnerable they are to contracting HIV. Thus, it is essential to provide young people with a basic understanding of HIV, help them personalize risk, and support them in developing the self-esteem, communication and decision-making skills they need to make healthy life choices.

School HIV prevention programs are the key in this effort. Schools provide an organized and cost-effective vehicle for getting accurate information about HIV to large numbers of children before they decide to engage in high-risk behaviors. The Global Fund to Fight AIDS, Tuberculosis and Malaria, to which the U.S. Government is the largest contributor, provided $10 million for HIV/AIDS programs in Estonia – of which more than $1.5 million was dedicated specifically for educational programs. From 2004 to 2007, with support from the Global Fund, more than 88,000 students attended special HIV prevention courses and 28,000 participated in peer-to-peer programs. During this time period, the number of registered new cases of HIV among young people ages 15-24 fell significantly. However, this does not necessarily reflect a drop in incidence among this age group. Continued focus on education programs remains a crucial component of the strategy to stem the epidemic.

The key now is to maintain this positive momentum. Although HIV prevention courses were provided to students with support from the Global Fund, comprehensive HIV prevention is not currently part of Estonia's national school curriculum. This means – right now – Estonian children may not be getting enough information to protect themselves from HIV. At the end of July, the Minister of Education allocated 1.4 million eeks for peer-to-peer HIV programs for Estonian youth. This is a significant step that will help fill the gap in the short term. But, Estonia needs to mainstream HIV prevention as part of the national curriculum as soon as possible. The Ministry of Education is revising the school curriculum now and has committed to include HIV prevention information as part of the health education program. Rapid implementation of the new curriculum, as well as comprehensive training for teachers, will be essential for the long-term success of Estonia's HIV prevention efforts.

HIV is one of the most important social issues of our time. It is not however, only a social issue. When the Prime Minister spoke at the World Health Ministerial in Tallinn in June, he highlighted the importance of raising awareness about healthy life styles as a preventative measure for health care systems. He noted that investment in healthy life styles now will save on medical costs down the road. This is particularly true in the case of HIV/AIDS, which can involve significant long-term treatment costs. Prevention programs represent the most promising way to reduce the burden and cost of long-term treatment and care.

Investing in HIV education programs for all students is investing in the healthy future of Estonia.