Conflicting HIV/AIDS Sex Education Policies and Mixed Messaging among Educators and Students in the Lower Manya Krobo Municipality, Ghana.

While school-based comprehensive sex education (CSE) is effective in HIV prevention among young people ages 10-24 years, Ghana's national sexual and reproductive health education policy promotes abstinence. Meanwhile, the Ministry of Health's HIV prevention programs provide more comprehensive school-based education. This qualitative study evaluated the HIV/AIDS education program in the Lower Manya Krobo Municipality to assess the perspectives of students and educators in 10 schools on school-based sexual and reproductive health programs, including HIV/AIDS education and conflicting HIV/AIDS sex education policies. HIV prevalence in the Lower Manya Krobo Municipality of Ghana was more than twice the national average at 5.64% in 2018, and prevalence among youth in the municipality aged 15-24 was the highest in the nation at 0.8%. Educators have mixed feelings regarding abstinence-based and CSE approaches. However, students generally endorse abstinence and describe the limitations of condom use. Ambiguity in overarching policies is identified as a factor that could influence the orientation of school-based health educators, create disharmony in sex education interventions, introduce confusing sex education messages to young people, and create a potentially narrow curriculum that limits the gamut of HIV/AIDS sex education to exclude young people's risky sexual behaviours and diverse teaching and implementation strategies. Policies and the scope of sex education should be realigned to ensure the transparent implementation of HIV/AIDS sex education programs in Ghana.

Teacher approaches, attitudes, and challenges to sexuality education: A case study of three junior high schools in Ghana.

While school-based sexuality education programs are established to reduce risky sexual behaviour among young people, teachers who play a central role are challenged by social factors which affect program outcomes. This study aimed to investigate the training and support offered to teachers on the delivery of sex education in three contrasting Junior High Schools in Ghana, the attitudes and approaches to the delivery of sex education, and the response of students to teacher delivery of sex education. A qualitative study design was employed with 13 in-depth interviews with head teachers, teachers, and students. Although teachers received similar training, teachers adopted different attitudes and approaches which resulted in student accounts of disinterest in sex education programs. Applying the health-promoting schools framework, the study concluded that the individual values and attitudes, as well as the type of school support, affects teacher modes of delivery and influences student interest in sex education, and should be considered in the design of in-school sex education programs.