As discussed in Chapter One, meaning-making refers “to the ways in which people conceptualise, understand or make sense of life events, relationships, situations and the self. It is the ability to integrate challenging or ambiguous situations into a framework of personal meaning using conscious and value-based reflections” (Ignezi, 2000, p. 5). In the context of this study, meaning-making is used to refer to the ways in which young people make sense of the HIV and AIDS knowledge that they are exposed to from different sources of information. Specifically, meaning making is a complex process involving various social institutions and influenced by a variety of values, beliefs, attitudes, practices, discourses and norms of society (Bull, 2010). These factors interact to shape and reshape the meaning-making process and to influence the organisation of behaviours towards particular situations (Charon, 2009). Informed by this understanding, this thesis proposes that the meaning that young people attach to the messages that they receive about HIV and AIDS has a significant influence on how they respond to the epidemic, including how they prevent HIV infection. Such meaning has implications for how social institutions work towards improving their strategies to help young people in the fight against the HIV and AIDS epidemic. In the context of a plethora of educational campaigns and interventions aimed at curbing and managing the epidemic on the one hand, and little success in curbing the spread of HIV in Lesotho, particularly among young people, on the other, this study aimed to understand the reasons for the paradox. In particular, the study addressed the question: What meaning do young people make of the messages that they receive from the school HIV and AIDS
67
programmes, and what factors inform the meaning that they make? To address the key research question, the study addressed three sub-questions:
• What is the curriculum policy informing the teaching of HIV and AIDS education in Lesotho secondary schools?
• How are teachers trained for their role as HIV and AIDS educators in schools? How do they understand and enact their roles?
• How do young people in schools experience the HIV and AIDS education programmes?
In the previous chapter, I reviewed the literature, local and international, related to HIV prevalence rates among young people of school going age, HIV and AIDS interventions in schools as well as young people’s experiences and meaning-making in the context of these interventions. From this review, a conceptual framework for understanding meaning-making among young people in the context of HIV and AIDS education in a rural secondary school in Lesotho emerged. The review suggests that such meaning-making is largely influenced by three factors: socio-cultural factors (unequal gender norms, and gender-based violence; HIV and AIDS stigma and discrimination), socio- economic factors (rurality and poverty) and factors within the education system (inadequate and inappropriate educational programming). This chapter outlines the theoretical framework which informed data collection and the analyses of the data. Informed by the conceptual and theoretical framework discussed in this chapter, I conclude by presenting a number of propositions for examining the meaning that young people in one secondary school might attach to HIV and AIDS education messages that they are exposed to in the HIV and AIDS curriculum and the factors that inform this meaning.
68
3. 2 Summary of the Findings from the Literature
Firstly, literature reviewed in this thesis suggests that there remain high HIV prevalence rates among young people, including those still of school-going age, in Lesotho. It suggests that the HIV and AIDS epidemic continues to be a major public health issue globally, and in Lesotho in particular, a country that ranks second with the highest HIV prevalence (UNICEF, 2013; Lesotho Ministry of Health and Social Welfare, 2014; Lesotho Demographic and Health Survey 2014; Lesotho Ministry of Health, 2016, UNAIDS, 2016). Prevalence rates in the country tend to be negatively skewed against girls and young women. This is in spite of a plethora of interventions that have been implemented to curb the spread of the virus since the first person was diagnosed in the late 1980s.
This suggests that these interventions do not succeed in helping young people, particularly girls and young women, in the fight against HIV infections.
Secondly, the literature suggests that addressing young people’s vulnerability to HIV infection will only be possible when they are in a position to make informed decisions about their own bodies and sexualities, when they are supported by all those around them and when they have adequate and appropriate knowledge and skills from well conversant and competent educators about HIV and AIDS. The literature suggests that a number of factors act as barriers to these conditions and contribute to young people’s continuing vulnerability to HIV infection. These factors include unequal gender norms, gender-based violence, HIV and AIDS stigma and discrimination and ecology (e.g., rurality). Further, factors such as inadequate and inappropriate curriculum in the education system and poor teacher preparation make it difficult to address young people’s vulnerability to HIV infection. Of particular relevance to this study is the literature which suggests that an inadequate and inappropriate curriculum often leads to silence about issues of importance to young people, thereby creating a gap in their knowledge about HIV and AIDS (Miller, 2010; Walcott et. al., 2011; Jackson,
69
2012; Francis et al., 2008; Motalingoane-Khau, 2010; Masinga, 2013) and denying them opportunities to make informed decisions about their sexuality. This puts young people at risk of HIV infection. That teachers tend to be poorly trained to teach HIV and AIDS means that they tend to teach it poorly, to avoid certain difficult or controversial or taboo topics and to use inappropriate pedagogies or teaching strategies for the content and the target population (young people). This contributes to the vulnerability of young people to HIV and AIDS.
Finally, the literature suggests that young people’s experience of HIV and AIDS education in schools is varied and paradoxical. On one hand, young people find the curricula informative while on the other they find it inadequate, uncomfortable, unrealistic and not meeting their needs. Research suggests that as a result of the inadequacy and confusing nature of the HIV and AIDS curriculum and of the stigma attached to it and to those who are infected, young people not only have varying levels of knowledge but they also hold problematic myths about the virus that contributes to their vulnerability to HIV infection (Burgoyne and Drummond, 2008; Sukati et. al., 2010; Martha Kempner, 2014). Related to this situation is the fact that young people often use metaphors to talk about HIV and AIDS and by so doing they avoid talking about the pertinent issues, including sex and sexuality, that would contribute towards reducing their vulnerability to the infection. These trends, coupled with the high rates of infection among young people, suggest that the interventions, including those within the school curricula, implemented to curb the spread of HIV among this population, are not successful. This thesis focuses on the reasons for their lack of success.
Informed by the literature reviewed in Chapter Two, the study reported in this thesis is premised on the understanding that key to informing the meaning that young people make of the messages that
70
they receive from the school programmes in order to reduce their vulnerability to HIV and AIDS are influenced by three factors: socio-cultural factors (unequal gender norms, and gender-based violence;
HIV and AIDS stigma and discrimination), socio- economic factors (rurality and poverty) and factors within the education system (inadequate and inappropriate educational programming).