Introduction

This curriculum provides lessons for five hours of acquired immunodeficiency syndrome (AIDS) education instruction for high school aged and young adult students of English as a Second Language (ESL). The curriculum helps students develop English language skills as it helps them understand AIDS risk factors. It helps them develop skills to cope with social pressures that might lead to behaviors that would put them at risk for HIV infection, and it helps them make decisions that will preserve their health and the health of their families and communities. Each lesson incorporates specific AIDS education and ESL objectives and develops the critical thinking, reading, writing, listening, and speaking skills at the core of every sound ESL program. Copy-ready background materials, exercises, and activities are provided for each lesson.

According to the World Health Organization, half of the people with human immunodeficiency virus (HIV) worldwide were infected between the ages of 15 and 24, the majority through unprotected heterosexual intercourse (Pediatrics, January 1995). In the U.S., teenagers have the highest rates of sexually transmitted diseases (STDs), with females between 15 and 19 years of age having a rate of gonorrhea 22 times that of women 30 and over (Morbidity and Mortality Weekly Report, August 13, 1993). As HIV becomes more widespread among teenagers and young adults, the chances of a person in this age group having an infected sexual partner from whom the virus may be transmitted will continue to increase.

The need for an AIDS education curriculum for ESL students in this age group is recognized by the international organization of Teachers of English as a Second or Other Language (TESOL). The TESOL organization declared at a recent conference that, 1) "language minority people in countries where English is the dominant language are less well-informed about and more vulnerable to AIDS because they are linguistically and economically more removed from mainstream AIDS education programs, 2) education is presently the only defense against HIV infection, and 3) integration of AIDS education into the ESOL curriculum can enhance our students’ language learning experience by providing them content-rich language instruction essential to the preservation of their health and the health of their communities." Therefore, the TESOL organization has resolved to make integration of AIDS education into the ESOL curriculum an organizational priority (TESOL Resolution to Promote AIDS Education Through Content-Based ESOL Instruction, Appendix II).

Whenever possible, AIDS education is best presented in a student’s native language by specially trained health education instructors. However, very often, ESL learners don’t have the opportunity to receive AIDS education in a setting that can provide them this health education in their native language. Only a handful of HIV curricula used in public schools in English dominant countries have been translated into ESL students’ native languages. Adult education students, out of school youth, employees receiving work-site instruction, and many students in settings with limited instructional resources may find in their ESL instruction the only opportunity for any kind of intelligible AIDS prevention education.

Dating back to the TB epidemic in the U.S. at the beginning of the twentieth century, the ESL program has been the medium for orienting immigrant students to their new country and to solutions to the health problems they encounter in their new surroundings (Singh, College ESL, May, 1992). ESL students see their teacher as a major source of information about life in their new country. The ESL teacher is a trusted guide to the unfamiliar territory of the new country’s values, customs, and health hazards, as well as to its language.

The integration of AIDS education into the ESL program can provide an empowering experience. AIDS education enables our students to understand and to exercise control over a part of their world that would otherwise remain dangerous and frightening. To the extent this understanding is achieved through ESL instruction, this instruction assumes greater value.

Many forces exist beyond the reach of the ESL classroom that influence the individual behavior by which HIV is spread, such as biological drives, religious beliefs, community norms, and socioeconomic forces. Underdevelopment, unemployment, poverty, and illiteracy are directly associated with lack of access to adequate health education and health care, which in turn contributes to greater incidence of disease. Political leaders, whether because of simple indifference or fear that acknowledging the existence of the AIDS epidemic among their constituents might damage their image or that of their community, are often slow to speak out in the fight against AIDS. The people most vulnerable to HIV are usually the people whose voices are most often inaudible in the debate over how society’s resources should be appropriated. Television bombards us with hundreds of images throughout the day which promote sex with every soap opera and beer commercial, while in the two countries in the western hemisphere where the AIDS epidemic is most devastating, the U.S. and Brazil, there has been, until recently, a total ban on network television advertising of condoms. These factors have a powerful influence on individual behavior and on the overall shape of the AIDS epidemic worldwide and may not be immediately or significantly altered by our work in the ESL classroom.

However, we can help our students better understand the ways in which these larger forces influence the AIDS epidemic and its impact on our communities. The curriculum suggests strategies and provides activities that enable students to address these forces and to exercise some degree of control over some of them.

The ESL instructor does not need to be an AIDS expert. The curriculum focuses on a very few simple concepts necessary to an understanding of HIV/AIDS and the safe behaviors that protect us from HIV infection:

HIV is only transmitted through bodily fluids exchanged in

a) sexual intercourse (vaginal, anal, and oral)

b) sharing needles that come in contact with blood, as in injecting drug use;

c) the birth process, breast feeding, or during pregnancy -- if the mother is infected, the virus may be passed to her fetus or infant;

d) by transfusion of infected blood (though this is highly unlikely since screening of the blood supply began).

AIDS is not a gay disease

Any person exposed to contaminated bodily fluids may become infected. (The largest group of people in the world infected with HIV are married women.)

Because AIDS has a long incubation period sometimes 5 to 10 years or more after infection with HIV

a) most people presently infected with the virus look and feel perfectly healthy;

b) you can not tell they are infected by looking at them;

c) they don’t know that they are infected, unless they have been tested;

d) but they can infect others.

You can protect yourself from HIV infection if you avoid risky behavior:

a) avoid unprotected sexual intercourse -- the safest way is to abstain , but if you have intercourse;

b) practice safer sex, including the correct use of latex condoms every time you have intercourse;

c) don’t use drugs in risky situations -- all drugs, including alcohol, reduce good judgment needed to avoid risky behavior;

d) don’t inject drugs -- if you do, don’t share needles, or, if you must share needles, clean them thoroughly with bleach and water.

The most important lesson students will learn from the curriculum is that avoiding HIV infection can be much more within their control, once they learn the simple facts about HIV transmission and acquire the basic skills needed to practice healthy behavior. The curriculum helps students understand what they must personally do to protect their own health, and helps them develop the skills necessary to translate such understanding into healthy behavior. While individual behavior may be influenced by many outside forces, it is each individual’s decision whether he or she chooses behavior which is healthy or life endangering.

The curriculum relies heavily on small group learning strategies. Role playing, small group discussions, and problem solving activities give students the opportunity to anticipate and analyze the high risk situations that they face beyond the classroom. They are able to formulate decisions and practice responses that they will use in real life situations. No student who is exposed to this curriculum should become involved in high risk behavior because of a lack of preparedness.

Students develop greater confidence and self esteem as part of a small group where their input is respected and valued, and where they are able to develop effective responses to challenging circumstances. The small group is well suited for ESL students, who will be less intimidated using their new language in such a setting than they would be speaking with a larger audience. It is particularly appropriate for the discussion of sensitive, AIDS-related topics like sex and drug use.

It is important to treat AIDS-related issues with an explicitness that was, before AIDS, considered inappropriate. Family planners tell the story about the young woman who was being interviewed by a counselor: "Are you sexually active?" the counselor asked. "No," she replied. Two months later, the woman was pregnant. "I don’t understand," said the counselor, "You told me you weren’t sexually active." "I’m not!," she sobbed. "All I do is just lie there!" The need to be direct and specific and to avoid euphemisms is even greater when presenting AIDS prevention instruction to ESL students.

When we talk about sexuality and drug use in class, we must pay particular attention to some guidelines that help to make any class work better. Personal boundaries should be respected. Students and teachers should be free to withhold personal opinions about sexuality and their own personal experiences. The topic is potentially embarrassing. Embarrassment can be minimized if we maintain good classroom decorum and display mutual respect. People must feel free to express themselves and ask questions without fear of ridicule. Our experience presenting this material suggests that it is better to approach the rather sensitive issues addressed in this curriculum after a period of several weeks of more traditional ESL instruction during which classroom rapport and trust have been established.

The five lessons that follow begin with an exercise game that illustrates the exponential manner in which HIV is spread. The lesson then examines the scope of the AIDS epidemic, the nature of the disease, the ways it is transmitted, and the ways it can be prevented. The next three lessons present activities and exercises that clarify students’ understanding of the relative risks of various behaviors, examine their attitudes toward risk reduction behaviors, describe the value of testing, counseling, and treatment, develop students’ ability to respond appropriately to specific HIV risk situations by analyzing each step of the decision making process, identify social pressures and barriers to effective communication that place them at risk, and develop strategies for resisting these pressures and overcoming these barriers. The final lesson enables students to utilize their newly acquired knowledge and skills to extend AIDS education from the classroom into their communities.

Each lesson includes reading, writing, and discussion activities designed for use with high school-aged and young adult ESL students.

An appendix includes materials and exercises which can be used to supplement the five basic lessons or used as free standing activities. A list of agencies and additional sources of information and services is also included. The curriculum has been prepared with the view of making the integration of AIDS education into the ESL program as useful as possible in preserving the health of our students and our communities and in developing students’ English language skills. Now it’s up to us.

|Next||Previous| |Table of Contents|