Health and Sexuality Education in Schools: The Process of Social Change. - Review - book review

Journal of Sex Research, Feb, 2000 by Jean Levitan

Health and Sexuality Education in Schools: The Process of Social Change. By Steven P. Ridini. Westport, CT: Bergin & Garvey, 1998, 224 pages. Cloth, $59.95.

Stephen Ridini's book represents what undoubtedly had been a graduate thesis converted into material designed for a broader audience. Studying at Harvard's Graduate School of Education and School of Public Health, Ridini examined the attempts of two communities to adopt HIV/AIDS curricula into their public schools. In the forward written by Charles Willie (Ridini's mentor at Harvard), Ridini is praised for revealing that "success in public health or public education programs is attributed to interaction between individuals and groups or institutions" (p. xi). The two key findings from the study are that "(a) teaching and learning experiences about health and human sexuality are difficult to implement in public school systems and (b) teaching and learning experiences about health and human sexuality are possible in public education, if appropriate attention is given to the process of community decision-making" (p. x).

As an experienced health educator and sexuality educator, I knew that I would be fighting feelings of frustration from Willie's comments onward. I was initially struck by Willie's and Ridini's lack of historical perspective, although Ridini redeemed himself later in the book. Implementing quality sexuality education in the public schools has been a struggle for decades. Written guidelines and other support services have long been available to communities through The Sexuality Information and Education Council of the United States (SIECUS), formed in the mid-1960s. To read a book with a 1998 copyright "revealing" that the implementation of such programs would be difficult seems rather surprising, to say the least.

Furthermore, as a health educator I am concerned and, frankly, rather angry when the terms health education, sexuality education, and HIV/AIDS education are used interchangeably. The title of the book had prepared me to read about health education and sexuality education. What Ridini primarily focused on was HIV/AIDS education. Unfortunately, in the early 1990s many school systems around the United States were doing the very same thing--interchanging HIV/AIDS education efforts for health and/or sexuality education. Few school systems have ever truly implemented comprehensive health education for grades K-12, where students not only get information but also have the opportunity to examine how their belief systems impact their behavior. And what has been labeled sexuality education has too often been heavily skewed toward the safe topics of anatomy and physiology of the reproductive system, pregnancy and childbirth, and sexually transmitted diseases. With school systems (as in those communities Ridini studied) being encouraged and, in some cases, mandated to educate students about HIV/AIDS, curriculum efforts took on that more singular focus. It is important to distinguish clearly, however, between sexuality education, health education, and HIV/AIDS education. Ridini's title set up misleading expectations.

As I read further into Ridini's work, however, my fears that he did not understand the broader issues were somewhat allayed. Ridini, as a public health educator, was familiar with the U.S. Department of Health and Human Services' Healthy People 2000: National Health Promotion and Disease Prevention Objectives (1991). He had researched the factors that often interfered with the implementation of sexuality programs, namely fears that information led to earlier sexual behavior, concerns over open discussion of homosexuality, conflicts over religious teaching, and the belief that such education was the responsibility of parents. His study also followed the 1990 Massachusetts Departments of Education and Public Health directive to all school districts to create programs to teach about HIV/AIDS at all grade levels. The state had produced and distributed a resource Comprehensive Curriculum Guidelines on HIV/AIDS: Grades K-12 (Massachusetts Department of Public Health, 1991).

Ridini's research was designed to explore how and why community members worked to support or oppose the implementation of HIV/AIDS programs. His meticulous research and immersion in the two communities studied is commendable. He interviewed over 50 individuals in the two towns--referred to as Alpha and Beta--and read numerous books, journal articles, and newspaper accounts of the efforts to integrate new programs into the schools. What strikes me as extremely odd, however, is that anonymity is initiated by referring to the two communities as Alpha and Beta, but the names and titles of all those interviewed are provided. In addition, each town is described in such demographic detail that preserving its anonymity seems close to impossible, with the token gesture comical.

Alpha is described in detail in Chapter 2 as a city of 83,000 residents six miles from Boston. Ridini characterizes it as racially and culturally diverse, generally viewed as affluent with approximately one third of the residents having household incomes above $75,000. A student-initiated effort to expand what was accepted as an inadequate HIV/AIDS program, along with a desire to have condoms distributed in the high school, led to the development of the Health Education Task Force. Despite well-organized opposition to an expanded program, the Task Force succeeded in designing a comprehensive curriculum on sexuality (including HIV/AIDS) and having it implemented.