A review of secondary schools as supportive environments for HIV prevention and sexuality education amongst secondary school learners in Durban and surrounding areas, KwaZulu-Natal, South Africa.

Abstract

Background: The study investigated whether the current provision of sexuality education made available through the Life Orientation Curriculum (LO) in South African secondary schools is supported by their school environments. Given the high prevalence rates of HIV, STIs and teenage pregnancy amongst youth in South Africa, the impact of the school environment on how and what is learnt, received and applied to school life and learners’ daily lives needs to be taken into account for the future prevention of learner engagement in risky sexual behaviours. More specifically, the importance of the school environment in impacting on the outcomes of sexuality education needs to be emphasised in schools in KwaZulu-Natal (KZN), given the fact that KZN is the province with the highest prevalence of HIV, STIs and teenage pregnancy in South Africa. It also possesses the highest number of youth in the age range of 15-24 years; which is the population age demographic indicated to be at the highest risk for sexually transmitted diseases. Although much research has been undertaken into the effectiveness of the content of sexuality education worldwide and into its, implementation in classrooms and schools, there is a paucity of research on the role of the school climate, culture and school connectedness in Life skills teaching. Research involving Life skills curricula have indicated varied results in improving youths’ sexual behaviours and HIV, STI and teenage pregnancy prevention. Limited research has been carried out in terms of school connectedness, school climate and culture in general within SA but, in particular, there is limited research directly to the connectedness of the learner to the school and to the HIV prevention and sexuality component of the Life skills programme. Further research is therefore required into the role of the school environment and sexuality education as an influential factor in learners’ own sexual practices. Providing a holistic understanding of the surrounding factors within the school environment that create an influence on the way in which sexuality education is delivered via the LO curriculum within South African schools, is critical to the overall effectiveness of sexuality education. It is also important to gain an accurate understanding of the environment that best supports learners, educators and caregivers to engage with the revised curriculum. The study therefore explores whether the school environment stands in contrast to or promotes the values taught in sexuality education and whether the school environment is supportive and conducive to teaching sexuality education. Furthermore, it aims to understand how learners, educators and caregivers perceived and experienced their school environment to determine whether or not these external conditions were conducive to the aims of sexuality education. The study aims to achieve this via investigation/exploration of the following seven objectives: 1) To investigate and understand the extent to which learners feel safe, cared for and respected by peers, educators and support staff within their school; 2) To determine and explore if learners have networks of social support that they can access within their schools; 3) To examine and explore if learners feel they have positive role models at the school from which they can learn positive behaviour; 4) To study and understand learners’ perceptions of the discipline and order within the school environment; 5) To examine and gain an understanding of the overall school climate and values in terms of discrimination, stigma, acceptance, and tolerance as well as how learners feel about being able to apply what they have learnt during LO, in the context of their school environment; 6) To explore caregiver-school connectedness in terms of perceptions and experiences of the school environment in relation to it being conducive to sexuality education, sexuality and the overall health and well-being aims; and 7) To develop guidelines for improving school climate/culture and caregiver involvement. Method: The study is pragmatic, employing a Post-Positivist paradigm which uses a concurrent mixed methodology research design with the aim of triangulation of the data. The research design consists of: Phase one which was a pilot study to assess the feasibility of the instruments and refinement thereof; and Phase two, which consists of the main study, that comprises the researcher’s observations of the school, cross-sectional surveys with learners, qualitative in-depth interviews with educators and focus group discussions with caregivers. The samples were from four different poverty quintile level schools (poverty quintile two, three, four and five schools) in the Umlazi district of the Ethekwini region, KwaZulu-Natal, South Africa. Stratified purposive sampling was used and principals of randomly selected schools within the stratification by poverty quintile were consulted for access. Grades selected for the study were Grade nine and 11 learners and the study also involved the LO educators of learners and caregivers of learners. Ethical approval was obtained through the Regional Department of Education and the Humanities and Social Science Research Ethics Committee of the University of KwaZulu-Natal, South Africa. A proposed theoretical framework for school connectedness (Waters, Cross & Runions, 2009) was used as a guide. Principal component analysis, chi-square tests, t-tests, Pearson product-moment correlation coefficients, Two-Way ANOVAs and standard Multiple Regression Analysis were conducted to analyse the quantitative data. Thematic content analysis was used to analyse the qualitative data.

Results: The results indicate that a number of challenges faced by the school, which affect learners, educators, caregivers and the school as a whole; are negatively impacting learners’ practice of sexuality education in their own lives. The quantitative and qualitative aspects of the study’s findings indicate that schools in KwaZulu-Natal are largely falling short in the implementation of best practices for optimal outcomes of sexuality education for learners. Furthermore, the study’s findings suggest that schools are likely to require more awareness and resources in order to create enabling school environments for the influence and practice of sexuality education messages in learners’ own lives. Of the total sample (N=600), 24.2% of the learners (N=145) indicated having had sexual intercourse. Learners’ perceived ability to apply sexuality education lessons in their personal lives was the best overall predictive factor for sexual activity engagement. The study’s findings indicate significant correlations between the various elements of the school environment and sexual activity engagement. School engagement was found to be the strongest predictor of sexual activity engagement (ß = .834; t = 5.316; p < .001). The results of the Sexual Activity Scale had a significant negative correlation with the results of the School Discipline Scale (r = -.223, p < .01), Sense of Belonging (r = -.145, p < .01) and Comprehensive School Climate Inventory (r = -.223, p < .01). The Sexual Activity Scale and Caring Environment scale were also negatively correlated (r = -.104, p < .01) as was the Psychological Sense of School Membership scale (r = -.101, p < .01). This suggests that high levels of sexual behaviour engagement were associated with low levels of positive school environment components. Further, quantitative findings indicate that learners regard the school climate, sense of belonging, psychological sense of school membership and school engagement as being beneficial impact factors to sexuality education’s influence and practice in their personal lives. However, the study’s findings also demonstrate that most learners do not attach adequate importance or give priority to sexuality education or LO. Regarding the study’s findings on educators, it was indicated that educators are aware of and are making a good effort to encourage the best practices of sexuality education which will influence personal practice by learners. However, the school environment presents various challenges to the implementation thereof. The study also indicates that caregivers are not as involved in learners’ lives as they could be for best reinforcement of sexuality education in their children’s lives. Conclusion: In addition to the provision of sexuality education through the LO curriculum; supportive factors such as the awareness, promotion and implementation of best practices for school environments should be improved in schools in KwaZulu-Natal. Learners are recommended to participate in sexuality education lessons, to understand the objectives of this component of the curriculum and to practice these messages in their personal lives. Educators are recommended to continue implementing the best practices for pedagogy. It is also recommended that that they maintain the good quality of learner-educator relationships they currently have. Caregivers are encouraged to become more aware of sexuality education as taught via the LO curriculum and to become more involved in their child’s schooling. Schools are recommended to create caring and supportive climates for all key stakeholders (learners, educators and caregivers) as well as to foster closer relationships with caregivers of learners. It is also of importance to call on national and local government to address the structural challenges of poverty and hopelessness as well as degradation and social ills in disadvantaged environments since it is apparent that the environment within which the school is situated has an impact on risk behaviours. Therefore, all stakeholders have a role to play in creating a more supportive school environment which will enable better achievement of sexuality education’s aims.