“Sex…is a good thing”: Creating a space for the voices of young Zimbabweans to shape school-based HIV prevention-orientated sexuality education
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There are gaps in research exploring young people’s strategies for school-based HIV prevention-oriented sexuality education (herein referred to as sexuality education), including in African contexts like that of Zimbabwe. Such sexuality education is a fundamental component in the control of the Human Immunodeficiency Virus (HIV) epidemic. HIV is a sexually transmitted infection that incurs lifelong health problems and, if untreated, leads to death. The issue of young people living with HIV is of global and regional concern, especially for Sub-Saharan Africa. A focus on HIV prevention strategies prioritising young people is paramount. In 2017, individuals aged 15-24 years accounted for approximately 33% of new global HIV infections. In Zimbabwe, of those newly infected in 2017, nearly 32% were young people aged 15-24 years. Sexuality education is a vital policy and societal response that aims to provide health knowledge and advice focused on influencing youth behaviour by encouraging practices and advocacy aimed at safer sex. Despite the high proportion of young Zimbabweans becoming newly infected, there are few examples of young Zimbabweans shaping sexuality education design and delivery. This study focused on sexuality education in secondary schools as this is the main domain for delivery. The study used participatory action research (PAR), an action-driven methodology suited for collaborating with young people by creating a space for the expression of their experiences and strategies. PAR sought to explore young Zimbabwean designs for a ‘perfect’ school-based sexuality education lesson. The research involved collaboration with eight women and eight men aged 18-24 years from Bulawayo city. Students from Amakhosi Performing Arts Academy were recruited given that they had recent experience of school-based sexuality education, were articulate and expressive. As co-researchers, they took part in shaping the activities, and 10 action-orientated focus group discussions. PAR methods, including drama, poster creation and poetry, were used for self and collective expression. As young people were recruited from a performing arts background they particularly responded to the use of the drama method. Drama created a collaborative space for animating and making visible the daily realities of their sexual lives in the context of their proposals for school-based sexuality education. Young Zimbabweans recalled experiences of sexuality education lessons as mainly involving authoritarian teaching, especially when talking about sex. This stemmed from a standardised curriculum focused on sexual abstinence and the disease dangers of sex. Yet, co-researchers dramatised sex as “a good thing”, and “natural” to development into adulthood. Using dramatic exaggeration, shock and humour, young people critiqued pro-abstinence teaching as euphemistic, contradictory, and endangering their sexual health as it encouraged “youth [to] do sex [in] hiding”, as “afraid” of being found out, given that their premarital sexual lives are regarded as socially deviant. Co-researchers proposed a perfect sexuality education lesson as one designed by young people, making students feel safe and confident to talk about sex as “good”, pleasurable, and intimate. Harnessing the real-world and highly contextualised nature of the dramas, a theatre like framework of characters, setting, words, and actions around ‘teacher, student, and lesson content’ was used to structure the data analysis. The study findings, and methodological framework used, have implications for new models of school-based sexuality education in African contexts like that of Zimbabwe. This study joins an emerging impetus of innovative research using PAR to partner with young people to shape sexuality education and other important mechanisms for enhancing health and wellbeing. Findings highlighted the capacity of drama as a youth-driven critical learning tool to reflect on and shape sexuality education. Drama enabled youth voices and provided a space to demonstrate their complex daily realities relevant to sexual health promotion. Given the significant growth in cheap and accessible internet enabled mobile phones in Africa, young people will be in a better position to proactively learn, share, and create sexuality knowledge outside the classroom. As user-driven digital spaces gain prominence, formal institutions like that of schools need to explore new opportunities for partnering with young people, blending digital and new style classroom methods, such as drama for sexuality education. Future policy response should be guided by an African youth-centred model of sexuality education as important to HIV prevention.