Sexual attitudes and behaviors of school students in India - grades 6-12

Journal of Sex Research, Wntr, 1997 by Minakshi Tikoo

As of January 1994, the World Health Organization (WHO) had reports from 206 nations of approximately 851,000 cases of ADDS and an estimated 8-14 million cases of HIV infection. In most countries the number of people reported with AIDS doubles every 6-12 months (Cox, 1994). By the end of 1995, WHO estimated there would be more than 6 million AIDS cases and approximately 20 million people infected with the virus. By 2000 it is projected that 10 million children and 30 million adults will be infected with HIV Michael Merson, director of the Global Program on AIDS, added that the global balance of HIV infection is rapidly tipping toward the developing countries. Of the world's total cases, it is estimated that, by 1985, 50% were in the developing countries, by 2000, 75430% will be in the developing countries; and by 2010, as many as 90% of cases will be in developing countries (Stine, 1995). WHO predicts that by 2000 the Asian continent will lead the world in the number of AIDS cases.

The third world countries where AIDS cases are going to increase are the ones that cannot match the technical, physical, and support resources of the developed nations to deal with AIDS. The social impact of HIV/AIDS in the developing countries will be felt differently; the areas of impact are the economy, demographics, labor productivity, agricultural production and development, pressures on the health care sector, families and households, children, women, HIV/AIDS discrimination, and the impact of AIDS on the individual (Danziger, 1994). Education and behavioral risk reduction will be the only route of survival in third world countries for many years to come. This does not bode well for the developing nations and especially India, the most densely populated country in Asia and the second most populous country in the world.

India's population of 900 million people is growing at an annual rate of 2.1%. The goal of the Family Planning Association of India WAD, a nongovernmental organization that formulates national plans for family planning and reproductive health, is to reduce the population growth rate to 1.25% annually by 2000 (FPAI, 1992). If AIDS and HIV transmission continue to spread at present rates, the ramifications will be global, which very few people seem to realize.

The first cam of AIDS in India was reported in 1986; as of 1993 there were 1,032 documented cases of AIDS [National AIDS Control Organization (NACO), 19931. However, WHO estimates that 1.6 million people already are infected with HIV (Bollinger, Tripathy, & Quinn, 1995). It is estimated that about 5 million people will be infected with HIV, and by 2000 the number of AIDS cases will exceed 1 million in India (NACO, 1993). The primary mode of HIV transmission in India is heterosexual contact, except in the northeastern region, where in travenous drug use is the primary cause of transmission. Ninety percent of the cases reported to date were among those below the age of 50, and more than two thuds of these persons were between 20 and 40 years of age. Given HIV's incubation period of 10 years, it seems likely that these people were infected as teenagers. Hence, to prevent infection from spreading, younger age groups need to be targeted for educational programs.

The Indian government, through the Ministry of Health and Family Welfare, in collaboration with WHO, established NACO, which formulated an action plan to deal with the burgeoning AIDS epidemic. NACO has been operational since 1987 but first developed strategic plans to combat AIDS in 1992. One of NACO's strategies to control the spread of the disease is to mandate sexuality education programs nationally. To implement the proposed plans and strategies, there is a need for baseline data against which progress can be measured. To bridge this gap in information regarding sexual behaviors and practices, NACO has funded 65 risk-behavior studies, mainly through local initiatives, Non Government Organizations (NGO), and social institutions (personal communication with Dr. P. R. Dasgupta, 1994).

In the United States, little is known about the sexual attitudes and behaviors of boys and girls aged 10-17 years [Sexuality Information Education Council of Sexuality (SIECUS), 1994]. AIDS continues to be the number one killer of young people ages 25-44 years [Center for Disease Control (CDC), 1995]. Ndeki, Klepp, Seha, and Leshabari (1994) surveyed 2,026 6to and 7to grade students aged 10-17 years in Northern Tanzania and reported low levels of knowledge, particularly with respect to risk associated with casual contact. Bertrand, Makani, Hassig, and Niwembo (1991) surveyed 3,140 men aged 20-49 years and 3,485 women aged 15-49 years in Zaire. They reported universal awareness of AIDS, although some misconceptions did exist regarding the mode of transmission. There is a similar lack of data on the sexual behavior of the Indian population, especially adolescents. The paucity of information regarding the spread and progression of HIV, level of knowledge, attitudes, and behaviors of the Indian people is mentioned by several researchers working with the Indian population (Bollinger et al., 1995; Porter, 1993; Tikoo, Bollman, & Bergen. 1995 Most research, to date, has been clinical and has been concentrated on at-risk populations--commercial sex workers, sexually transmitted disease (STD) clinic patients, intravenous drug users, and commercial blood donors (Bollinger et al.. 1995: Jacob, Jayakumari, John, & John, 1989; Jain, John, & Keusch, 1994.) Very few researchers have explored sexual behaviors, attitudes, and knowledge of Indian adolescents. This information is crucial to policy planners, teachers, and other professionals working in education, as India is just starting to plan a comprehensive sexuality education program, which will be mandated in schools nationally.