HIV Awareness: PSHE Lessons

Stephen Doughty Excerpts

Friday 24th February 2017 Commons Chamber

[Mike Freer (Finchley and Golders Green) (Con)]

The issue that I wish to raise today with my hon. Friend the Minister is sex education in our schools. For once, however, I do not want to stray near the issue of statutory sex education; I wish to focus on HIV awareness in the teaching of health and sex education to pupils. Before I touch on the issue of how the subject is taught, I think it is important that we understand the ongoing public health issues that need to be addressed, in part through improved sex education.

As chair of the all-party group on HIV and AIDS, I am conscious of the work we still have to do to eradicate HIV/AIDS. Despite the groundbreaking public health initiatives of the 1980s—for which much credit must go to the leadership and tenacity of the then Secretary of State for Health and Social Security, Norman Fowler, who is now Lord Speaker—HIV/AIDS continues to be a health issue in the UK. There are now more people living with HIV in the UK than ever before. In 2015, an estimated 101,200 people in the UK were living with HIV, 13% of whom were unaware of their infection. Infections used to occur predominantly among men who have sex with men—MSM—but that has changed over the past 10 years. The majority now occur through heterosexual transmission: in 2015, 57% of new infections were among heterosexuals. Most telling is the fact that 90% of those new infections came through unprotected sex—sex without condoms.

We continue to have a public health issue and a problem with sexual behaviour. I believe that we must therefore redouble our efforts not just to change, but to ingrain behaviour. We need to ingrain the safe sex message at the time in people’s lives when it can have the biggest impact—in our schools, with the 15-to-18 age group. I do not propose to touch on the arguments about statutory sex education—as I said, that is a debate for another day. Instead, I want to touch on why targeting 15 to 18-year-olds is important and, crucially, on why we need to look at a different approach to teaching this important topic.

Overall infection rates were on a steady downward trend until recently, but we have seen a slight increase in infection rates in the 15-to-24 cohort. There could be many factors behind that increase. HIV/AIDS is less visible in the media than it used to be; it receives less attention from celebrities, who have been invaluable in raising awareness. Major breakthroughs in treatments and in the accessibility of anti-retroviral drugs—ARVs—mean that HIV/AIDS is no longer life-threatening, although it is certainly life-changing. The fact that it is no longer deemed a terminal illness might be a factor in why people are becoming a little complacent: because living with HIV is manageable, people think that they can cope by just taking a daily pill.

You will remember, Madam Deputy Speaker, and so will other hon. Members, that when we were under the age of 24 we felt invincible—nothing could touch us. Now, when we drive past a club at 3 in the morning, it might be minus 6° outside, but under-24s are scantily clad because they think they are invincible. They think that nothing will happen to them, or that if it does they do not have to worry, because there is a pill or because by the time it becomes a problem there will be a cure. Importantly, the safe sex message about the use of condoms has been lost or diluted. It is important to remember that condom use protects against not just HIV, but a range of other sexually transmitted infections.

How do our teenagers learn about sex? We know that access to the internet has changed how many teenagers view sex, and that online pornography can provide a distorted and unrealistic view of sex. The ability to find a date or sexual partner via phone apps has changed how teenagers learn to have sex and the frequency with which they can have it, but sadly online pornography and hook-up apps rarely teach or stress safe sex. Too many provide no sexual health messages at all.

That, of course, is not a matter for the Department for Education, but how we combat that distorted view of sex and address the lack of safe sex messages is a matter of education. We have to be honest and accept that few teachers relish delivering sex education, and it is probably true that few pupils relish discussing sex with a teacher. It is embarrassing for both. There is likely to be a credibility gap. Even a teacher in their 30s will be deemed old by teenagers in school and being taught about sex by them is likely to be viewed as being taught by their mum or dad. That is how cringe-worthy much sex education can become.

I believe, therefore, that we need to use people closer to the age range of the students, especially those I would call young advocates—those with personal experience of living with HIV or chlamydia, of having a cervical cancer test or of the implications of losing a parent to HIV/AIDS. If sex education is delivered by people closer to the age range of the audience, it becomes personally relevant and much more powerful in getting the audience to listen. Young advocates can explain sex beyond the mechanics without embarrassment—I realise it was a long time ago, but my sex education was very mechanical and quite rudimentary.

If we can update how we teach teenagers about sex, we can have a significant impact on their sexual health. We need to show how life-changing illnesses such as HIV can be, and that message is much more powerful if taught by somebody going through that experience. It is important to stress not just the implications of dealing with an infection or life-changing illness but—most importantly—how teenagers can protect themselves from HIV/AIDS and a range of other sexual health issues. Young advocates can deliver a more powerful and personal message—one that students can relate to and are more likely to take notice of. We need a radical change in how we approach sex education, especially HIV awareness.

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

I thank the chair of the all-party group on HIV and AIDS for giving way. As a vice chair of that group, I wholeheartedly agree with his comments. Will he join me in praising the work of people such as the Student Stop AIDS campaigners, who are raising awareness of the epidemic not only in this country but of its impact globally, and setting an example for their peers?

[Mike Freer]

The hon. Gentleman makes a very good point. The all-party group often invites young advocates and voices to come in and talk to parliamentarians and others, and we have seen at first hand the impact that a young person can have talking about the impact of an HIV infection on their life and their family. It is much more powerful than middle-aged men or women talking to teenagers—not that he is a middle-aged man yet.

I shall provide just three examples of people and organisations that I would ask the Department to consider meeting and using. One of the most inspirational young men I have met is Robbie Lawlor. He is an HIV advocate based in Ireland and the UK. He was diagnosed as HIV positive at 21. He was taught little about sex in school, let alone safe sex. His diagnosis sent him into depression and he abandoned the university place he was about to take up, but he has now become an inspirational advocate for HIV awareness. He tours and speaks passionately about the need to talk more openly about sex and safe sex and about how to challenge stigmas and ensure that people are more aware of risky behaviour and the importance of testing. He says:

“If we can’t talk openly about sex with our friends and family, how are we going to negotiate safer sex with people we may potentially sleep with? Shame inhibits people from going to get tested, and prevents people from getting the information they need.”

Robbie has also advocated for people living with HIV to be at the heart of education on HIV to ensure that individual stories are heard and some of the most damaging misconceptions about what it is to live with HIV are confronted by people who know how their diagnosis has affected their day-to-day lives. I urge my hon. Friend the Minister to meet Robbie and hear at first hand how we need to change the way in which we approach HIV in sex education.

There is also a group called Positive Voices, whose speakers are fully trained to deliver sexual health presentations to diverse audiences in a range of settings including schools, colleges, faith-based groups and community organisations. They cover HIV prevention and safer sex messages, as well as sharing their own experiences of living with HIV. Those presentations are very powerful. They are tailored for young people and adults, and the speakers work with organisations in advance to ensure that they are both appropriate and engaging.

I recently came across the Elizabeth Taylor AIDS Foundation, which is now doing work in the UK. It has launched an initiative called the sex squad. I must say that I became rather excited by the idea of a sex squad: it is certainly a catchy title for a sexual health education initiative. Imagine the sex squad coming into your school! It would certainly catch the imagination of the pupils.

The sex squad initiative is part of an arts-activist movement to improve sexual health education. It started in Los Angeles, and, interestingly, in the very traditional, conservative southern states of the United States, and it involves a multiple-component presentation and peer education. It is a new model for community-based sexual health education, which targets young people in communities that are at risk of HIV and other sexually transmitted infections. As well as organising live and digital interventions, it is inspiring the creation of youth-led high school sex squads at four state high schools in Los Angeles. It harnesses the power of humour and story-telling to create performances for teens that are memorable, inclusive, and fun. I can only recommend the work done by the foundation, which is driven by Elizabeth Taylor’s grandchildren. They are still heavily involved, which is to their enormous credit.

HIV continues to be a problem in the 15-to-24 age group, accounting for 11% of new infections, while 33% of new infections are in the 25-to-34 age range. It therefore accounts for 44% of new infections in people under 34. We need to reach people when they are most susceptible to behaviour change. We need to stop the conveyor belt towards inappropriate behaviour that puts their health at risk. We need to change the way we deliver sex education, especially HIV education, so that we can protect the next generation. The current sex education system is not ingraining the message on safe sex. It is time for a more innovative approach. It is time to introduce youth ambassadors where they will be listened to, and where we stand the best chance of changing behaviour and changing lives. Let us change the teaching, and let us change our approach.