Abstract

One major issue affecting   research policy on women's health  is the inadequate attention towards gender differences and gender analysis in medical and medical-related research.  This research aims  to fill  the gap through an experimental study evaluating educational strategies in AIDS education addressing eleven to thirteen year old adolescents in Thailand.  The report provides gender analysis by examining the subject's understanding and perception of the problem and its presentation.

The research begins by measuring the gravity of its subject through the current landscape of HIV infection and AIDS cases in Thailand.  HIV infection rose from 3.1% in 1989 to 20.6% in December 1990.  In 1991, WHO reported 1,095 PWAs (Person with AIDS) in Asia.  By July 1995, Thailand alone, admitted 23,098 AIDS patients in its private and public hospitals with a reported  death toll of 6,579.   The implication of these statistics are all the more staggering considering the figure does not include those who were not admitted to hospitals.  It becomes even more alarming when the 1992 Thai Red Cross Annual Report revealed that 84.7% of HIV infections were males between the ages of 20 to 39.  What then, are its implication to women and their health?  One province in the northern part of Thailand reported that out of 100 women who underwent pregnancy check-up, seven were found to be HIV   positive; and out of 100 men who had STD diagnosis, 43 were HIV positive.   Hypothetically, if these men were married, the  plausibility of transmitting them to their wives are very high.

WHO reported in 1991 that, more than any other country in Southeast Asia, Thailand led the most intensive campaign against AIDS.  With 488 radio and five television stations put into optimum use, current statistics calls for an evaluation of strategies.  Unfortunately, out of the 248 million baht  the country spent on AIDS campaign, very limited budget was allocated for evaluating educational strategies.

The past decade, AIDS prevention in Thailand targeted sex workers and young adults, specifically labourers and factory workers.  However, the Thai Red Cross Annual Report implies that the age factor is just as critical in determining the right group to address.  Sittitrai, W and Associates (1992) revealed that Thai males in the rural area start to be sexually active at the age of 13 and in the urban areas at the age of 11.  The research suggests that the right time to deliver AIDS education to children should be prior to the onset of sexual activities and other related high-risk behaviour.

Research findings indicate that television is the most widely used medium for AIDS Education campaign in Thailand.  The research conducted an experiment by evaluating videotape formats and the learning methods used in AIDS education in the classroom for young adolescents (11-13 years old).  The study was conducted in a public elementary school located in a lower middle-class neighbourhood along an expanding   industrial province near Bangkok.  Most of the parents of the sixth grade students work in the factories.  All submitted parental consent before participating in the research.

Two formats were used for presentation, factual and fictional.  The former included footage selected from talk shows and documentaries produced by the Thai Red Cross.  Pictures of PWAs progressing on different stages of the disease were shown while a doctor discusses HIV and AIDS.  For the fictional format, footage was selected from the cartoon Karate Kids.  The cartoon was a part of a cross-cultural health education programme, originally co-produced by Street Kids International and the National Film Board of Canada.  It was designed to provoke discussion on sexual health issues including HIV/AIDS and the sexual exploitation of children.

The Thai version was edited in Thai language by the Programme on AIDS, Thai Red Cross Society, Ministry of Public Health and the Bangkok Metropolitan Administration.  The edited tape lasted 17 minutes.  The series consisted of the following segments: What is HIV?  What is AIDS? What are the causes of AIDS diseases?  What are the symptoms and physical appearance of the people who contract HIV and AIDS patients in progressing stages?  How is HIV transmitted?   What preventive measures can be taken?

Group discussions followed after watching the videotapes.   112 boys and 112 girls were divided randomly into four groups: 1) those who watched the documentary and participated in a group discussion; 2) those who watched the documentary with no group discussion; 3) those who watched the cartoon and participated in a group discussion; and 4) those who watched the cartoon with no group discussion.

The research reveal that the factual videotape was a more effective strategy for AIDS education along the young adolescents.  When people and events are portrayed as factual, students are more cognitively involved.

The teacher's role as group discussion leader is crucial in distinguishing between fact and fiction.  He or she leads them to analyze the relevance and accuracy of the information.  Both classmates and teacher provide techniques in incorporating the information as knowledge.  As a result, they tend to be more selective in viewing what accurately reflects real life within their community.

The  students who saw footage of real AIDS patients reported that they felt sad.  They informed parents, cousins and neighbours about what they have seen.  The children understandably have difficulty expressing how they feel.  To provide support, the family, teacher and the people in the community can serve as resource persons.  In this regard, AIDS education should focus on strengthening community action to create a supportive environment in developing children's attitude, knowledge, belief and life skills.

Regardless of the videotape formats used and the learning methods employed, the researcher identified  notable gender differences in the study.  Girls had better recall of the AIDS information than boys did.  Girls, who felt little fear from what they saw, reportedly became less passive and tend to actively participate in games or sports after watching the footage.  The researcher suggests that the girls were more responsive to the information from the video and the discussion and therefore more open to AIDS prevention.  The fear they felt did not in any way interfere with the  cognitive processing of the information.  It may have provoked health concerns since fear is a self-oriented emotion.

The boys felt a similar concern over their own health.   The viewing and the discussion roused interest among the boys who reportedly watched and kept track of news stories on the subject.  Findings confirmed that children could differentiate the self and others in the film.  Even when the boys claimed that what they saw on the screen were not useful to them, they nevertheless followed up news stories about AIDS.

The research proposes an AIDS education programme whose gender orientation differ in terms of content and learning process.  Boys need to be educated to be more other-oriented whereas girls need to be more self-oriented.

The research recommend that policy-makers set up an agenda to discuss the following issues: 1) the emotion evoked, such as fear and sadness in AIDS information campaign, with emphasis on its effect to either gender; 2) the factual or fictional format appropriate to a specific target group or gender; 3) the use of television as a medium vis a vis print and other media; 4) the audience of AIDs information campaign with reference to gender and age; and 5) strengthening school-based HIV prevention programme with reference to rural and urban communities.

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