MIAMI The Graduate School

Certificate for Approving the Dissertation

We hereby approve the Dissertation

of

MOSES B. RUMANO

Candidate for the Degree:

Doctor of Philosophy

Director Dr. Frances C. Fowler

Reader Dr. Michael E. Dantley

Reader Dr. Richard Quantz

Graduate School Representative Dr. Abdoulaye S. Saine

ABSTRACT

Africa University‟s Approach to ‟s HIV/AIDS Epidemic: A Case Study of Preparation

by Moses B. Rumano

This study investigated the causes of the HIV/AIDS epidemic in Zimbabwe as perceived by students and faculty at University, a pan African international private institution situated in , the third-largest city in Zimbabwe. The main purpose of the study was three- fold; 1) to investigate the perceived causes of the high prevalence of HIV/AIDS in Zimbabwe, the worst affected country in Southern Africa; 2) to examine the role of teacher preparation programs in dealing with the HIV/AIDS in Zimbabwe; and 3) to explore the role of sex in combating the HIV/AIDS epidemic in Zimbabwe. A phenomenological theoretical framework provided the scope and dimension of a qualitative research approach formulated to collect data on the perceived causes of the HIV/AIDS in Zimbabwe among students and faculty at . The case study design chosen used detailed semi-structured interviews, observations and documentary evidence and employed questioning strategies of a “how” and “why” nature. It did not require control over behavioral events and is a commonly used approach among studies focusing on present-day events in their real-life context. The case study design was chosen as a particularly good means of educational investigation because of its ability to explain the causal links in real-life interventions that are too complex for survey or experimental strategies. I observed a total of eight two-hour lessons in a range of classes made up of senior students preparing to be either high school or health educators. All the classes that I observed were large and ranged from forty students to one hundred. In none of the classes that I observed were there HIV/AIDS materials displayed in the classrooms or lecture halls. However, well-illustrated billboards about HIV/AIDS were erected on all the entrances to the university campus. I interviewed eight senior students and eight faculty members. Initial data analysis took place through analyzing responses on observation notes that I compiled in the eight lessons that I observed. Different colors of markings were used

to identify common themes. The themes that emerged from the observations were basically similar to those that came from the analysis of the semi-structured interviews.

AFRICA UNIVERSITY‟S APPROACH TO ZIMBABWE‟S HIV/AIDS EPIDEMIC: A CASE STUDY OF TEACHER PREPARATION

A DISSERTATION

Submitted to the Faculty of

Miami University in partial

fulfillment of the requirements

for the degree of

Doctor of Philosophy

Department of

by

Moses B. Rumano

Miami University

Oxford, Ohio

2009

Dissertation Director: Dr. Frances Fowler

TABLE OF CONTENTS

Table of Contents ...... ii Acknowledgements ...... v Dedication ...... vii

Map of Zimbabwe ...... 1 Chapter 1 – Overview of the Study ...... 2 Introduction ...... 2 Theoretical Framework ...... 2 The HIV/AIDS Epidemic in Zimbabwe ...... 3 Current Student Teacher Training in HIV/AIDS Education in Zimbabwe ...... 6 HIV/AIDS Action Programs for Schools ...... 7 The Problem and the Purpose of the Study ...... 10 Limitations and Delimitations of the Study ...... 11 Definitions of Key Terms ...... 12 Research Questions ...... 12 Methods and Procedures ...... 13 The Research Design ...... 15 Interviews ...... 15 Observation ...... 17 Documents ...... 18 The Organizational Plan of the Dissertation ...... 19

Chapter 2 – Literature Review ...... 19 Introduction ...... 19 A Brief Historical Context of Zimbabwe since the Attainment of Independence ...... 19 The Economic Impact on Sexuality ...... 20 Theoretical Framework ...... 21 Preparation of Teachers to Teach in Zimbabwe ...... 24 In-Service Training ...... 26 Broad View of Training Importance ...... 27 Challenges of Teaching Sexuality in an African Context...... 27 Policies, Practices and Community Norms ...... 28 Teacher Attrition Due to AIDS ...... 28 Sex Education Programs in the United States ...... 29 The Kinsey Reports ...... 29 Selected Case Studies of Effective Sex Education Programs ...... 30 Sex Education Programs in Asia ...... 36 The Effectiveness of Sex Education in Thailand ...... 36 Sub-Saharan Africa in the Context of HIV/AIDS ...... 39 A Brief Historical Context of Uganda and HIV/AIDS...... 39 Sexuality Research Studies Conducted in Uganda...... 43 Effectiveness of the, “Let‟s Talk About Sex, Baby” Program in Zimbabwe ...... 42 Sources of Information about HIV/AIDS ...... 43

ii Selected Ineffective Sex Education Programs ...... 43 Translations into Behavior ...... 43 An Abstinence-Only Sex Education Curriculum ...... 45 The Failure of Sexuality Education Programs in Sub-Saharan Africa ...... 46 HIV-Related Stigmatization and in Sub-Saharan Africa ...... 47 The Concept of Stigma in the Context of HIV/AIDS ...... 48 Sources of Stigmatization, Discrimination and Denial in the Context of HIV ...... 50 HIV-Related Stigmatization, Discrimination and Denial at a Societal Level………………51 The Individual Experience of HIV-Related Stigma and Discrimination in Zimbabwe...... 50 Denial Associated with the HIV/AIDS Epidemic in Zimbabwe...... 51 Stigmatization, Discrimination in Families and the Community ...... 53 HIV/AIDS and Property Grabbing in Zimbabwe ...... 54 Conclusion ...... 55

Chapter 3 – Methods and Procedures...... 55 Introduction ...... 55 Setting ...... 56 Education Programs Offered at Africa University ...... 58 Case Study Research ...... 59 Challenges of Doing Research at Africa University ...... 62 Design of This Study ...... 64 Interview ...... 64 Table 3.1 ...... 68 Observation ...... 68 Documentary Sources ...... 69 Data Analysis ...... 69 Validity and Reliability ...... 70 Conclusion ...... 70

Chapter 4 - Discussion of Findings of the Study……………………………………………….71 The Setting ...... 71 The Jokomo/Yamada Library ...... 72 Halls of Residence ...... 72 Private Accommodation ...... 73 Entertainment ...... 73 The Cafeteria and Food Services...... 74 The Chapel ...... 75 Information Technology Training Center ...... 75 HIV/AIDS Billboards on the Campus ...... 75 Perceived Causes of HIV/AIDS Epidemic in Zimbabwe ...... 76 Table 4.1 ...... 77 Table 4.2 ...... 81 Impact of Government HIV/AIDS Policies on Teacher Preparation ...... 85 Table 4.3 ...... 86 Table 4.4 ...... 90

iii Measures that Students and Faculty Think Should Be Put in Place ...... 90 Table 4.5 ...... 92 How Faculty and Students Think the Community Can Help...... 92 Observations ...... 93 Documentary Analysis...... 97 Table 4.6 ...... 98 Africa University Policy on HIV/AIDS ...... 98 University Efforts to Prevent HIV/AIDS...... 98 Non-Discrimination ...... 100 Accommodation ...... 101 HIV/AIDS Education ...... 102 Admission and Discontinuation ...... 103 Peer Education …………………………………………………………………………………………………. 104 Confidentiality………………………………………………………………………………………………….. 104 Other Possible Causes of HIV/AIDS Epidemic in Zimbabwe…………………………………. 105 Resistance and Contradiction to the Hegemonic Powers………………………………………….105 The Inequitable Distribution of Land…………………………………………………………………....107 HIV/AIDS and Migration of Skilled Health Professionals……………………………………….108 Conclusion……………………………………………………………………………………………………….. 109

Chapter 5 - Summary, Discussion and Recommendations ...... 111 Introductory Statement ...... 111 The Problem and the Purpose of the Study ...... 111 Summary of the Dissertation ...... 112 Methods and Procedures ...... 113 The Research Design ...... 115 Findings ...... 115 Discussion ...... 119 Africa University‟s Surrounding Communities ...... 123 Recommendations ...... 124 Recommendations for Africa University ...... 124 Recommendations for Further Research...... 126 Recommendations for Practitioners ...... 127 Recommendations for Community Leaders, Zimbabwean Government and Nongovernmental Organizations ………………………………………………………………………….129 Recommendations For the Future Government of Zimbabwe…………………………………. 130 Conclusion ………………………………………………………………………………………………………..130

APPENDIX A ...... 133 APPENDIX B ...... 136 APPENDIX C ...... 139 APPENDIX D ...... 141 Letter of Permission ...... 142 References ...... 143

iv Acknowledgements

I would like to acknowledge many people on both sides of the Atlantic Ocean for helping me during my doctoral work. I would especially like to thank my advisor, Dr. Frances Fowler, for her unwavering academic support and commitment to my progress. Throughout my doctoral work she encouraged me to develop critical independent and research skills. She continually stimulated my analytical thinking and greatly challenged me to broaden my vision. I am also very grateful for having an exceptional doctoral committee and wish to sincerely thank Dr. Richard Quantz, Dr. Michael Dantley and Dr. Saine, who all in their different capacities were interested in my work. I had confidence and faith in this „academic dream team committee‟ that helped me to explore different theoretical frameworks for my work. All of them gave me an unprecedented and solid support during trying times. Special thanks to Dr. Kate Rousmaniere, Educational Leadership Department Chair, for her interest in my academic endeavors and her generosity in funding my research trip to Zimbabwe. This dissertation would not have been realized without the participants in this study in Zimbabwe, who had to spare their precious time from work, school and family to take part in the interviews and sustained informal discussions. A special acknowledgement goes to Rev. Dr. Philemon Chikafu, the Chaplain at Africa University for his hospitality and guidance. I also thank Professor Fannuel Tagwira, the interim Vice Chancellor at Africa University for making it possible for me to carry out my research at his institution. I would like to express my heartfelt gratitude and thanks to Ken Baker and his wife Lois of the Oxford Bible Fellowship for their financial and social support during my course of study here at Miami University. Their generosity made it possible for me to travel to Zimbabwe to carry out my research work. I owe a special note of thanks to Oxford Bible Fellowship former and current lead Pastors, Win Clark and Jeremy Carr respectively for their unparalleled commitment to their work that brought my family over to the United States. Spiritual, social and financial support from this church made it possible for me to accomplish my academic work. I extend many thanks to my colleagues and friends, especially Hitesh Naik, Chris Mazivanhanga, Dr. Douglas Mpondi, Israel Tashinga Muzuwa, Dr. Lillian Hawkins, Elliot Masocha, Gideon Kanyongo, Dr. Ephias Makauzde, Lameesa Muhammad, Leroy Foster and Willis Agutu. I would like to thank Keith and Jenny, my host family in Oxford for their unfailing

v support and commitment to my academic success. I am also thankful to Nicolas Fondom, a friend who was in charge of organizing a party to welcome my family from Zimbabwe. I also appreciate the inspiration that I got from my (big boys) Edson, Fine, More, Norman, Justice, Nevait and Raymond. I am grateful to my late parents Mr. and Mrs. Rumano, for their vision and dream that I could stand up and be counted. My late brother Ray Fisher deserves special mention in this study as a role model whose wisdom and philosophical insights made it possible for me to aim higher. My three special brothers, Nevait, Jacob and Edmond encouraged and challenged me to be the ambassador of our poor family. My late sister Mildred‟s inspiration helped me to aim higher. My sisters Juliet and Memory urged me to become the academic champion of the family. My late in-laws Mr. and Mrs. Maruma provided social and emotional therapy for my family when I was away for a long time. I would like to express my sincere gratitude and heartfelt thanks to my wife Naomi for her strong and unparalleled support, my son Prosper “Dudes” Tatenda and my daughter Ruvarashe Precious for their enduring tolerance and resilience during our five-year period of separation. Coming to the United States was not easy for you, as you could not get visas.

vi Dedication I dedicate this work to my wife, Naomi and my son Prosper Tatenda and my daughter Ruvarashe Precious for their patience and unshakable faith in me. Let the sky be the limit in your academic pursuits.

vii Map of Zimbabwe, Showing Mutare City with a Red Arrow, Area of Research

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Chapter 1 Overview of the Study Introduction Zimbabwe, a Southern African former British colony, is facing a serious HIV/AIDS epidemic. In its quarterly report, the World Health Organization (WHO) (2007) noted that since 1990, HIV/AIDS has slashed the average life expectancy in Zimbabwe from 61 to 33 years, the lowest anywhere in the world. It is estimated that there are now over one million children in Zimbabwe who have been orphaned due to HIV/AIDS-related deaths. Expressed in simple statistics, one in every five Zimbabwean children is an orphan as a result of the HIV/AIDS epidemic. Currently, there are a number of both government-sponsored and nongovernmental HIV/AIDS programs in the country that are seeking to address this epidemic. However, research studies conducted on their effectiveness have exposed some gaps and weaknesses in dealing with the epidemic. Therefore, the purpose of this study was to investigate a Zimbabwean university to determine in what ways its teacher preparation program is addressing this problem. Teachers in Zimbabwe are strategically positioned to deal with this epidemic by passing information to both in-school youth and out-of school youth so that they can protect themselves from an HIV infection and other sexually transmitted infections. Young people are at particular risk of HIV infection due to the frequency with which they change sexual partners and their physical immaturity. An effective and reflective sex education program might provide young people with an opportunity to make informed decisions about their sexual life and thus help to control and combat the further spread of the HIV/AIDS epidemic. The (WHO) (2007) further observed that between 2002 and 2006, the Zimbabwean population is estimated to have decreased by 4 million people. The need for adequately trained teachers to help address HIV/AIDS education cannot be overemphasized. A Brief Overview of the Literature Theoretical Framework This research study draws its theoretical framework from a phenomenological approach. The phenomenological framework allows the researcher to understand and describe experiences as they are lived. The HIV/AIDS epidemic in Zimbabwe has be understood from the social, economic and historic context shaping the lifestyles of the population. In support, Farber (1998) plausibly expressed the idea that the phenomenological method is intended to be free from all

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prejudgments and dogmas. According to Darroch and Silvers (1997), “Phenomenology is a theoretical orientation, but does not generate deductions from propositions that can be empirically tested. It operates more on a metasociological level, demonstrating its premises through descriptive analyses of the procedures of self, situational, and social constitution. Through its demonstrations, audiences apprehend the means by which phenomena, originating in human consciousness, come to be experienced as features of the world” (p. 213). For phenomenology, society, social reality, social order, institutions, organizations, situations, interactions, and individual actions are constructions that appear as suprahuman entities. The HIV/AIDS epidemic in Zimbabwe has to be historically traced and understood in the context of the intervention strategies that have been instituted by the HIV/AIDS experts since the emergence of the disease in 1985. The nongovernmental Western models prescribed to deal with the HIV/AIDS epidemic in Zimbabwe will be studied in light of the cultural and social context on the ground. Power structures in the society that can help to deal with the HIV/AIDS epidemic should be encouraged to participate fully in the programs that can help to disseminate more and more accurate information on this epidemic. Even more importantly, it shows the continuing of these power relations in cultural, economic, political and intellectual production. The majority of Zimbabweans cannot participate in setting the HIV/AIDS national research agenda. They also have become irrelevant because what falls outside the of the HIV/AIDS research is stigmatized, made invisible and labeled false or of less value or of a handicap in addressing the spread of HIV/AIDS. The HIV/AIDS Epidemic in Zimbabwe In his historical research studies of the HIV/AIDS epidemic in Southern Africa, Kelley (2006) asserted that the first reported case of AIDS in Zimbabwe occurred in 1985. By the end of the 1980s around 10% of the adult population was thought to be infected with HIV. This figure rose dramatically in the first half of the 1990s, peaking and stabilizing at 29% between 1995 and 1997. But after this point the prevalence of HIV/AIDS is thought to have declined, making Zimbabwe one of the first African nations to witness such a trend. The research findings clearly pointed out that a rise in the number of people dying from HIV/AIDS is thought to have played a role in the decline, as well as an increase in the number of people (HIV positive or otherwise) who might have migrated to other countries due to excruciating economic constraints.

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A deep sense of hopelessness and despair has engulfed the nation, and many practitioners and policy makers believe that Zimbabwe needs comprehensive HIV/AIDS intervention programs to ameliorate the unprecedented suffering of the people. Finger (2005) expressed the view that teachers need to be trained and that sex education programs should involve the community, parents, administrators and religious leaders. Sound, concerted efforts from community leaders, religious groups, and educational administrators among other stakeholders might achieve tremendous results in the fight against the HIV/AIDS epidemic. Finger further suggested that the curriculum should include information on human development, reproductive anatomy, relationships, personal skills, sexual behavior and health, and gender roles. A major way that the Zimbabwean population can emerge from this epidemic is to offer comprehensive sex education programs that can address specific cultural issues, human development, and sexual behavior. Effective sex education programs include adequate teacher training and resources for implementing the program. Masland (2005) plausibly argued that the training has to desensitize teachers from feeling discomfort in talking about subjects that were taboo when they grew up. And once teachers start talking about sexual health with youth, they should listen to the youth attentively and try to answer their questions. Teachers have to deal with questions raised by the youth and often that is not comfortable for teachers. Finger (2005) emphasized that the need for good training goes beyond developing school-based curricula. Community initiated programs should be used to complement the school-based sex education programs. Kelley (2006) succinctly expressed the view that for a long time HIV/AIDS was considered to be essentially a medical problem. However, the magnitude and breadth of suffering in Zimbabwe has made it clear that prevention is essential and that education might potentially be used as an alternative approach to the HIV/AIDS epidemic in Zimbabwe. Kelley further noted that this recognition is an invitation for educational leaders to become more involved in the prevention campaigns, in curriculum renewal and in the search for appropriate delivery strategies, not leaving curriculum planners to do this alone. Another major concern of educational leaders should be to protect the education system itself from the ravages of the epidemic. In addition, Kelley remarked that HIV/AIDS affects the education system just as it affects the body, but for years the effects of the sickness remained unnoticed. It was business as usual. To illustrate the gravity of the epidemic, Chikombah (2005) argued that there are slightly more teachers absent, leaving the educational system, or dying than previously but the causes are so manifold that it

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seems unnecessary to really talk about it. HIV/AIDS affects the demand for education as there are fewer children to educate, fewer wanting to be educated, and fewer who can afford to be educated. The epidemic affects the supply of education and the quality of the educational process. It affects management with the fear that the whole system may become disorganized, paralyzed by fear and the lack of guidance about what is to be done. It may also reduce the resources available for education. Kelley (2006) rightly expressed the view that a significant number of HIV/AIDS cases also occur among children below the age of five. Though found in children of age, HIV/AIDS is comparatively rare in children in the 5-14 age group. This age group is referred to as the „window of hope‟. They are the young people who are least likely to be HIV- infected. If they remain so, they constitute a hope that the future will be less ravaged by the effects of the HIV/AIDS epidemic. Chikombah (2005) argued that the developmental stage of children in primary school, combined with their virtual HIV/AIDS-free status, imposes on schools the twofold responsibility of enabling them to remain uninfected while at school and of promoting their adoption of behavior patterns that will keep them uninfected throughout life. Several factors combine to heighten the challenges of these tasks as the majority of children reach puberty during their primary school years. Although school grades are age-related, a significant number of children are older than the officially recognized age for their class and are already sexually active. Kelley (2006) clearly expressed that this situation is aggravated in many Southern African countries by the late age of starting school. In support, Chikombah (2005) observed that in many communities in Zimbabwe, parents do not provide information on or discuss sexual issues with their children, resulting in the children being vulnerable to negative influences in and outside the school. Kelley (2006) remarked that traditionally schools give little help to children on sexual and reproductive health issues and do little to assist them in understanding their sexual identity and coping with its demands. The values and behavioral standards communicated to children by what they gather from the media, society around them, and sometimes from school personnel, weaken their ability to deal in a mature way with their emerging sexuality. Children belong to the group which is most likely to be HIV/AIDS-free; however, young girls and sometimes young boys may be subjected to sexual attention from adults who are HIV-infected. Coping with the epidemic and stemming its advance is made more difficult in educational situations and

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elsewhere by people‟s reluctance to acknowledge the existence of the disease at the personal level. The silence within society brings in its train two further effects, which have repercussions on the education system. One is a sense of stigma and shame that has become attached to the disease. The other is the infringement of the of persons living with HIV or AIDS, and their dependents. Current Student Teacher Training in HIV/AIDS Education in Zimbabwe Chifunyise, et al. (2002) noted that Zimbabwe introduced a nation-wide program to teach AIDS education in 1994. A joint project was started between the Children‟s Emergency Fund (UNICEF) and the Zimbabwean Ministry of Higher Education and Technology (MOHET) after it was established that many teachers were ill equipped to provide accurate and effective information. This joint program aimed to prepare student teachers to distribute accurate and effective HIV/AIDS prevention information to students throughout the country. Chifunyise et al. elaborated that the program was nation-wide and 20 tertiary colleges participated. Four years after implementing the program, an impact evaluation was conducted. In their analysis Chifunyise et al. (2002) expressed the view that the evaluators aimed to assess the extent to which the course had increased the students‟ knowledge about the transmission, symptoms and prevention of sexually transmitted infections and HIV/AIDS. They also intended to determine the degree to which the students had developed positive attitudes towards healthy relationships with the opposite sex and people living with AIDS. Lastly, they proposed to evaluate the extent to which the program had created capacity among student teachers to support the AIDS and Life Skills Education program in primary and secondary schools in Zimbabwe. In addition, Chifunyise et al. observed that in each college, the AIDS education program is organized by the co-coordinator, who is one of the two counselors per college trained under the initial AIDS education program in 1994. These co-coordinators are assisted by one or two other members of staff, under the general supervision of the Vice-Principal. In some colleges, as noted by Chifunyise et al. (2002), group activities led by lecturers or peer educators supplemented the weekly mass lecture, though this was not done on a regular basis. The group activities included drama, poster poetry and play-writing competitions, the production of a newsletter, and organizing exhibitions at agricultural and commercial shows. At the shows student teachers handed out pamphlets explaining STD/HIV/AIDS information to the

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public. Chikombah (2005) further asserted the view that in most of the colleges, during the first year, the student teachers acquire the basic facts about STDs and HIV/AIDS. Chifunyise et al. (2002) explained that in most of the colleges, during the first year, the student teachers are taught basic facts about STDs and HIV/AIDS. They also learn about participatory methods of teaching. For practical sessions, the student teachers work in groups after a mass lecture to prepare lessons that they have to present to each other. This session is followed by peer assessment. Chifunyise et al. further remarked that during the second year, the student teachers are in the field for teaching practice and they are required to teach HIV/AIDS education wherever they are located. During the third year, the student teachers are given the opportunity to build on the information that they had received in the first year. They are also given the chance to address the problems that they faced while teaching HIV/AIDS education during their teaching practice. Student teachers also spend a lot of time preparing resource files. These are compiled by collecting information from their lectures, publications, libraries, health officials in the field, people involved in HIV/AIDS service organizations, and any other sources they may find. To demonstrate the importance of the program, Chikombah (2005) remarked that these resource files are a compulsory component of the course and so the students spend quite a lot of time and effort making sure that the resource file is complete on time. HIV/AIDS Action Programs for Schools According to O‟Donoghue (2002), when the AIDS Action Program for schools was started in 1991-1992, it was based on the assumption that AIDS would soon become the leading cause of death amongst Zimbabwean adults and the driving force behind rising rates of infant, child and maternal mortality, and of orphanhood (p. 25). It was further assumed that education and breaking the silence would form part of the solution to the HIV/AIDS epidemic. O‟Donoghue further remarked that in 1991, Zimbabwe‟s Ministry of Health requested the United Nations Children‟s Emergency Fund (UNICEF) to become involved in HIV/AIDS work. Following a situation analysis and extensive negotiations with several ministries, it was decided that UNICEF would focus on HIV/AIDS prevention, concentrate mostly on youth, and work primarily with the Ministry of Education and Culture (MOEC). That was decided because the largest component of the new HIV/AIDS Prevention Program was introduced as HIV/AIDS Education in schools and colleges. O‟Donoghue further plausibly acknowledged that an in- school AIDS education program was chosen for two reasons. First, in-school youth were still

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largely uninfected by HIV. Secondly, the educational infrastructure was good and school attendance rates high and almost all children attend some primary school. In his observation O‟Donoghue expressed the notion that the AIDS Action Program for Schools is taught from Grade 4 in primary school (9-10 year olds) to Form 6 in (18-19 year olds), as well as in tertiary colleges. A weekly HIV/AIDS lesson is compulsory in all schools and tertiary colleges and is taught as a separate subject. Comprehensive sex education is hereby projected as an effective way to protect teen health in Zimbabwe where the infection rate is soaring and a cause for great concern for an economy that is not performing well. According to Elia (2005), being well educated about sex education can help teens avoid pregnancy and sexually transmitted infections, foster healthy relationships, and be prepared for problems such as sexual harassment, rape and the HIV/AIDS epidemic (p. 49). Age-appropriate lessons in sexuality should occur early in the primary grades and become more specific and sophisticated as students reach middle and high school. Of significant importance also is the adequate preparation of teachers to discuss sexual topics openly with students and treat sexual diversity respectfully. Sexuality education has never enjoyed much prominence in the Zimbabwean primary and secondary schools. Neither has it reflected the complexity of human sexuality even with the advent of HIV/AIDS epidemic that is wreaking havoc and untold misery in Zimbabwe. Nor have cultural and traditional religious beliefs ever been tolerant of the introduction of sexuality education programs as they are misconstrued as promoting promiscuity among teens and young adults. In support of this position Foucault (1978) genealogically traced the of sexuality from the seventeenth century when it was carefully confined and moved into the home environments only. The HIV/AIDS epidemic in Zimbabwe has had a devastating effect comparable to no other modern medical calamity. Different settings provide different contexts and opportunities for sex education. At home, young people can easily have one-to-one discussions with parents or caregivers that focus on specific issues, questions or concerns. They can have a dialogue about their attitudes and views. Sex education at home also tends to take place over a long time and to involve lots of short interactions between parents and children. Due to some cultural beliefs in Zimbabwe, there may be times when young people seem reluctant to talk, but it is important not to interpret this as meaning that there is nothing left to talk about. According to Elia (2005):

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Comprehensive school-based sexuality education that is appropriate to the students‟ age, developmental level, and cultural background should be an important part of the education program at every age. A comprehensive sex education program respects the diversity of values and beliefs represented in the community and will complement and augment the sexuality education children receive from their families (p. 52). In the Zimbabwean context this approach more faithfully reflects the complexity and multidimensionality of sexuality. In close follow up, Elia (2005) noted that perhaps one of the most salient features of comprehensive sex education is its commitment to the needs and concerns of students. Because of the myriad aspects of sexuality, it is impossible to address them all in one class. It should be taught across the curriculum and not only in health and biological studies. As Masland (2005) argued, sex education must become critical and analytical and thus more personally and socially empowering. Students should have the knowledge to make informed decisions when it comes to sex and sexual related issues. Gone are the days when the females had to take unilateral decisions passed on their behalf by their parents or guardians. The need for comprehensive and reflective HIV/AIDS education in Zimbabwe has been sufficiently demonstrated by the disheartening and devastating statistics heavily taking toll on the population. Bogden and Fraser (1996) argued that pre-service teacher preparation is critical as children with HIV disease are living longer, and the number of children with HIV/AIDS who are attending school is expected to steadily grow. In strong support, Quackenbush and Villarreal (1996) asserted that since the 1990s HIV/AIDS has been the leading cause of death among 25- 44-year-olds in Zimbabwe. Therefore, teachers may expect to confront educational and psychosocial issues among children whose parents have HIV/AIDS disease. Teachers need an understanding of the special educational, social, psychological, and medical needs of these students. In their findings, Bogden and Fraser (2005) noted that in some instances the teacher may be entrusted with information about a student‟s, parent‟s, or staff member‟s HIV/AIDS status and must understand ethical and legal requirements for respecting confidentiality. According to Elia (2005), teachers may be expected to provide HIV/AIDS education and to answer students‟ questions about the deadly disease in a manner that is developmentally and culturally appropriate to their students (p. 57). Song, et al. (2000) expressed the view that studies over the past 25 years were conducted to examine the effects of sexuality education programs that were not comprehensive and

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culturally relevant. Some studies indicated that sexuality education programs were not effective, while others provided evidence of valuable and effective results. In support of the latter position, Kirby (2001) noted that numerous studies of junior high school and especially high school sexuality education classes have measured the impact of these courses on students‟ knowledge. The findings are nearly unanimous that instruction in sex education does increase factual knowledge about sexuality. Kirby further observed that there is some evidence that younger students with less knowledge about sexuality learn more than older students who may already be more informed. Sexuality education has an impact on a wide range of issues, such as attitudes toward premarital sexual activities, getting pregnant, the cost of having a child, birth control, sexually transmitted infections, masturbation, personal sexual values, and sexual practices of others. However, these studies provided mixed results. Kirby further pointed out that some of them indicated that certain courses had a small impact on the students‟ attitudes when the courses explicitly tried to change those attitudes while other courses had no impact. Research studies conducted in Zimbabwe on the effectiveness of teacher preparation and the dissemination of HIV/AIDS epidemic information by Chufunyise et al. (2002) showed that teachers have a crucial role in the fight against HIV/AIDS. However, Dzvimbo (2005) asserted that in Zimbabwe several piece-meal programs and curriculum innovations have been introduced to promote HIV/AIDS awareness and prevention among young people. Many of these programs have not yet had the expected results. This, however, is not a reason for not pursuing the programs; on the contrary, it is a signal that approaches need to be improved and that activities need to be better targeted, more flexible, prolonged, consistent and above all made intersectoral, combining formal and non-formal education, education with health, education with strategies to fight , and education with mass media campaigns. The Problem and the Purpose of the Study The problem of the study was to investigate the causes of HIV/AIDS epidemic in Zimbabwe as perceived by students and faculty at Africa University, a pan African international private institution of higher learning. The main purpose of the study were three-fold; 1) to investigate the causes of HIV/AIDS epidemic in Zimbabwe, the worst affected in Southern Africa; 2) to examine the role of teacher preparation programs in dealing with HIV/AIDS in Zimbabwe; 3) to explore the role of sex education in combating high HIV/AIDS prevalence in Zimbabwe.

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HIV/AIDS education should target the population that is most vulnerable to the epidemic. Education, either formal or informal, is an essential component in the fight against the HIV/AIDS epidemic. The social and cultural context in which the children and young people are growing up in Zimbabwe requires openness and the dissemination of correct information on HIV/AIDS epidemic. A teacher preparation program that is specifically dovetailed to address social problems such as HIV/AIDS epidemic is such an example that can pass vital information that may at least reach the majority of the vulnerable population in Zimbabwe. Limitations and Delimitations of the Study The major limitation of this study is inherent in any case study research in that its findings cannot be generalized to all situations. The focus of the study was on Africa University, a United Methodist-related private institution in Zimbabwe. Moreover, time constraints definitely limited the scope of the study. I traveled to Zimbabwe to carry out my research within the specific time period that I have at my disposal. The tense political situation at the time of the study restricted my focus to economic, cultural and social contexts only. My research questions were restricted to social, cultural and economic issues only since the political landscape during the time of the study was tense and volatile. Any political questions that could have made the study richer in both content and perspective were intentionally left out of the research to protect both the interviewer and the interviewees from the infamous state security agents. Questions that could have held the Zimbabwean Government accountable for the worsening problem of the HIV/AIDS were not explored. The failure of the government policies in Zimbabwe were deliberately omitted in the study as that could have considerably compromised my safety at that time. In the social sciences case studies often rely on descriptive information provided by different people. The other limitation of the study was that it was centered on a single religious institution that might not be representative of the entire nation. This leaves room for important details to be left out. Also, much of the information collected is retrospective data, recollections of past events, and is therefore subject to the problems inherent to memory. This study has been delimited to one private university in Zimbabwe, and the focus is only on teacher preparation, policy and HIV/AIDS education as opposed to the more general role of in . The study has been further delimited to teacher preparation at the university level only, leaving out teachers‟ colleges that train primary and a few secondary

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teachers in Zimbabwe. Efforts and initiatives by nongovernmental organizations such as (UNICEF) are not accounted for in this study as it is delimited to teacher preparation at one institution only. Definitions of Key Terms AIDS: acquired immuno deficiency syndrome Case study: “an empirical inquiry that investigates a contemporary phenomenon within its real- life context, especially when the boundaries between phenomenon and context are not clearly evident” (Yin, 2003, p. 123.) Curriculum: an integrated course of academic studies. Epidemic: a disease phenomenon, spreading rapidly and extensively by infection and affecting many individuals in area or a population at the same time. HIV: human immuno virus Public policy: the dynamic value-laden process through which a political system handles a public problem. It includes a government‟s expressed intentions and official enactments as well as its consistent patterns of activity and inactivity. (Fowler, 2004, p. 9.) Sex education: the process of acquiring information and forming attitudes and beliefs about sex, sexual identity, relationships and intimacy. It is also about developing young people‟s skills so that they can make informed choices about their behavior and feel confident and competent about acting on these choices. (Masland, 2005, p. 171.) Research Questions This study will attempt to answer the following overarching question: How do faculty and students at Africa University interpret or understand the causes of HIV/AIDS epidemic and their role in helping to reduce the severity of the epidemic? Subsidiary questions: 1. What do the faculty and students at Africa University think has caused this epidemic in Zimbabwe? 2. To what extent do government policies regarding HIV/AIDS education shape the teacher preparation program at Africa University? 3. What measures do faculty and students at Africa University think can be put in place to help control and prevent the spread of the HIV/AIDS epidemic?

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4. How do faculty and students at Africa University think the schools in Zimbabwe can help in the dissemination of HIV/AIDS education programs? 5. How do faculty and students at Africa University think the Zimbabwean community can help in the fight against HIV/AIDS epidemic? Methods and Procedures This study used a case study approach as the heart of its methodology to take a focused look at how teacher preparation programs might help in reducing and/or preventing the prevalence of the HIV/AIDS epidemic in Zimbabwe. The site of this case study is Africa University. The case study methodology was determined to be the best qualitative research technique to investigate students and faculty perception about the causes of HIV/AIDS epidemic in Zimbabwe. Merriam (1991) defined a case study approach as one involving description, explanation, and judgment. I chose case study as I was convinced that it was particularly a good means of educational investigation because of its ability to explain the causal links in real-life interventions that are too complex for the survey or experimental strategies. In addition, Merriam asserted that a case study strategy might be used to explore those situations in which the intervention being evaluated has no clear, single set of outcomes. According to Yin (2003), the case study is a desirable method of qualitative research when the study focuses on an organization (p. 84). The case study often uses survey and interview questioning strategies of a “how” and “why” nature. It does not require control over behavioral events and is commonly used for studies focusing on present-day events in their real-life context. Africa University opened its doors in March 1992 as the first private, international university in Zimbabwe. The pioneer group of 40 students came from a dozen African countries to pursue bachelor's degrees in agriculture, natural resources and theology. Africa University is a United Methodist Church-related project and is being nurtured and funded by church members from all over the world. It is a consequence of the growth of United Methodism on the African continent and has its foundations in the history and legacy of the church. The University welcomes students regardless of their race, ethnicity, religion, politics, gender, nationality or social background. Five of the seven faculties of the University's master plan are fully operational: Agricultural and Natural Resources, Education, Humanities and Social Sciences, the Institute of Peace, Leadership and Governance, Health Sciences, Management and Administration and Theology.

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I chose Africa University specifically as a representative of Sub-Saharan Africa, the area worst affected in terms of the HIV/AIDS epidemic. The study population will be drawn from more than 20 countries, making it a rich fertile ground for research in Africa. In agreement, Merriam (1991) expressed the view that case study research, and in particular the qualitative case study, is an ideal design for understanding and interpreting observations of educational phenomena. In support, Stake (1995) acknowledged that the case study is the study of the particularity and complexity of a single case, coming to understand its activity within important circumstances. The stigmatization, discrimination psychological, emotional and social effects experienced by the HIV/AIDS affected and infected people in Zimbabwe was a typical case that could be explored and explained through a case study approach. In support, Stake remarked that two principal uses of case study research are to obtain the descriptions and interpretations of others. Yin (2003) expressed the view that while a case study is similar to a history, it adds two sources of evidence not usually included in the historian‟s repertoire, direct observation and systematic interviewing. According to Yin, “A case study is an empirical inquiry that investigates a contemporary phenomenon within its real-life context, especially when the boundaries between the phenomenon and the context are not clearly evident” (p. 21). A case study thus focuses on contextual conditions central to the phenomenon being studied. Furthermore, Yin noted the fact that the inquiry being conducted in the case study relies on the prior development of theories, and data collection must include multiple sources of evidence that can be triangulated. Case studies may involve both qualitative and quantitative research, but do not have to include both. Stake (1995) noted that the qualitative researcher emphasizes episodes of nuance, the sequentiality of happenings in context, and the wholeness of the individual. A case study may be designed with more concern for representation but, again, the representation of a small sample is difficult to defend. The beauty of the case study method, as observed by Stake, is that its use of multiple data collection methods and analysis techniques provides researchers with opportunities to triangulate data in order to strengthen the research findings. The advantages of the case study are its applicability to real life, and accessibility through written reports. Case study results relate directly to the common reader‟s everyday experience and facilitate an understanding of complex real life situations. They can be generalized to theory but not to other populations.

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The Research Design McMillan (1996) stated that qualitative research stresses a phenomenological model in which reality is rooted in the perceptions of its subjects…in naturally occurring situations” (p. 10). In support, Marshall and Rossman (1995) expressed the view that qualitative research is a process of trying to gain a better understanding of human interactions. This case study used detailed semi-structured interviews, observations and documentary sources to collect data on the causes of HIV/AIDS epidemic in Zimbabwe, teacher preparation, policies and the HIV/AIDS education curriculum at Africa University. Stake (1995) acknowledged that the interview is the main road to multiple realities. In support, Yin asserted the view that the use of multiple sources of evidence in case studies allows an investigator to address a broader range of historical, attitudinal, and behavioral issues. However, the most important advantage presented by using multiple sources of evidence is the development of converging lines of inquiry. Thus, any finding or conclusion is likely to be more convincing and accurate if it is based on several different sources of information. Just as with gathering observation data, the interviewer needs to have a strong advance plan. Yin (2003) noted that one principle of a case study is to create a case study database. He went on further to cite the lack of a formal database for most case studies as a weakness, and he encouraged the use of four components of a case study database: notes (from interviews and observations), documents, tabular materials (surveys, frequency counts), and narratives (open- ended answers to a case study‟s questions). The greatest strengths of case studies, as noted by Yin (1994), “is that they use „how‟ or „why‟ questions asked about a contemporary set of events over which the investigator has little or no control” (p.153). Not only do case studies have strengths, but they also have weaknesses such as lack of rigor among some case study researchers and a lack of time limits on the scope of case studies, sometimes leading to lengthy, unreadable documents. Interviews To investigate the perceived causes of HIV/AIDS epidemic, teacher preparation and the role of sex education in Zimbabwe detailed semi-structured interviews were conducted with eight faculty members and eight students. Before any interview was scheduled, I sought the written consent of the interviewees. I was very careful in my interviews, since HIV/AIDS epidemic is a very sensitive topic in a country that has one of the highest infection rates in the

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world. Ethically, I was very conscious not to harm the feelings of the interviewees by directing questions that sought to extract personal sexual related information. I also sought contact information for the faculty from the administration office that directly deals with faculty and advancement programs. In the case of the student interviewees I asked the Registrar and the Dean of the Faculty of Education to provide a list of possible interviewees. Since Africa University is relatively small, the number of the faculty chosen was representative enough of the faculty. The interviews were gender sensitive and targeted both male and female students and faculties in order to gain a balanced input to this case study. I interviewed faculty members who are directly involved in teacher preparation programs and those that teach science related courses at Africa University. The interviews approximately lasted about an hour long and took place either in the faculty offices or in the conference room in the library. I secured the conference meeting room in advance and designed a tentative schedule to meet with the interviewees. The interviews were audio taped with the consent of the interviewees and I personally transcribed the tapes. English is the medium of instruction at Africa University and therefore there was no need to look for a translator. I coded the information according to major themes that emerged from the interviews, and qualitatively analyzed the information obtained from the interviews. Glesne and Peshkin (1991) define a semi-structured interview as a mix between a structured and an open-ended interview. Structured questions form the focus of the interview. However, the tone of the interview is conversational, and the interviewee is encouraged to provide additional information that may or may not be addressed in pre-determined questions. Borg and Gall (1994) noted that a semi-structured interview begins with standard questions, and the researcher follows upon the interviewees‟ initial reactions with more open-ended questions designed to probe more deeply. According to Borg and Gall (1994): The semi-structured interview has the advantage of being reasonably objective while still permitting a more thorough understanding of the respondent‟s opinions and the reasons behind them than would be possible using mailed questionnaires. The semi-structured interview is generally most appropriate for interview studies in education. It provides a desirable combination of objectivity and depth and often permits gathering valuable data that could not be successfully obtained by any other approach (P. 452).

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Yin (2003) concurred that the advantages of interviews are that they are targeted with a direct focus, and they can lead to insightful and causal perceptions. On the other hand, he also cites several possible weaknesses such as bias due to the poor construction of questions, possible response bias, inaccuracies due to the poor recall of the interviewer, and possible reflexivity. In addition, Yin remarked that reflexivity occurs if the interviewee says what he/she thinks the interviewer wants to hear rather than giving candid responses. To check for any inaccuracies I conducted a member check with each interviewee. A sample of the interview protocol is provided in Appendix A. Observation As an alumnus of Africa University carrying out a case study on the causes of HIV/AIDS, teacher preparation and sex education I was a well informed observer. According to Burns and Grove (1999), “in research, observation is a fundamental method of gathering data . . . The aim is to gather first hand information in a naturally occurring situation” (p. 358). The non-participant observer, unsurprisingly, will not take part in the situation being studied, but may well be present in the environment. The best illustration of a nonparticipant observer role is perhaps the case of a researcher sitting at the back of the classroom coding every three seconds the verbal exchanges between the professor and the students by means of structured set of observational categories. I observed a total of eight senior classes that were preparing prospective teachers to go out and serve in some of the worst affected HIV/AIDS communities. By observing eight senior classes I had the opportunity to correlate and code the main recurring themes that were stressed in the classes. I observed the following courses at Africa University: EC1 304 Research Methods, EC1 403 Curriculum Development, ECI 405 Measurement and Evaluation, TEV 200 Ethics and Christian Values, HIT Information Technology, EFN 400 School Organization, EFN 300 , HEN 325 Language and Gender, and EFN 404 Economics of Education. My focus was centered on the emphasis placed by faculties on the prevention of HIV/AIDS epidemic and sexuality that sought to empower student teachers. Of interest to me was how much resource materials students had before they graduated and finally sought employment in the country. I will attend these class activities from the beginning of the lesson to the end, which is approximately one and a half hour to two hours. With the help of the administration I will have the schedules of all senior classes and peer teaching activities before I seek permission to be an observer. Merriam (1991) suggested that field notes based on

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observation need to be in a format that will allow the researcher to find the desired information easily. Formats vary, but a set of notes usually begins with the time, place, and purpose of the observation. A sample of my observation format is included in Appendix B. Documents Data was mined from the following documents at Africa University: curriculum guides, syllabi, course outlines, and handbooks for both undergraduate and graduate studies. A list of documents consulted is included in Appendix C. As usual, I sought permission from the administration to have access to the above documents and carefully studied them. Using the above documents, I qualitatively analyzed how teacher preparation program at Africa University deals with the HIV/AIDS epidemic. Any community engagement efforts carried out by the university will be critically looked at as well as students‟ involvement in HIV/AIDS awareness campaigns. Stake (1995) acknowledged that gathering data by studying documents follows the same line of thinking as observing or interviewing. The potential usefulness of different documents should be estimated in advance and time allocated so that it is judiciously spent (p. 57). Research questions should be carefully developed in advance and a system set up to keep things on track. A number of limitations in using documents can be discerned in any case study research. In addition, Stake noted that documentary data have not been developed for research purposes and therefore the materials may be incomplete from a research perspective. Stake clearly asserted that whether personal accounts or official documents are involved, the source may provide unrepresentative samples. Because documents are not produced for research purposes, the information they offer may come to the researcher in a form he does not fully understand. Furthermore, such data may not fit present definitions of the concepts under scrutiny; they may not correspond with the conceptual model. The strengths of using documents are that documents of all types can help the researcher uncover meaning, develop understanding, and discover insights relevant to the research problem. Moreover, they will not have been written with the researcher‟s views in mind. Merriam (1991) noted that documents are usually produced for reasons other than research and therefore are not subject to the limitations that apply to interviews and observations (p. 87). In addition, Merriam expressed that documents are, in fact, a ready-made source of data easily accessible to the imaginative and resourceful investigator.

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The Organizational Plan of the Dissertation Chapter 1. Overview of the study Chapter 2. Literature Review Chapter 3. Methods and Procedures Chapter 4. Findings of the Study Chapter 5. Conclusions, Discussions, and Recommendations Chapter 2 Literature Review Introduction Extensive literature on sex education the world over has demonstrated varying degrees of successes and failures depending on the social, cultural and historical context among other factors. For purposes of clarity in this chapter I will provide a brief historical context of Zimbabwe; a phenomenological theoretical framework; information about the preparation of teachers in Zimbabwe to teach sex education; and the results of studies of sex education programs in the United States, Thailand and some countries in Sub-Saharan Africa. Drawing from a number of case studies on the selected countries will provide me with some insights and clues in the quest to combat the further spread of the HIV/AIDS epidemic in Zimbabwe. The stigmatization, discrimination and psychological denial associated with people living with HIV/AIDS in Zimbabwe will be explored. Last but not least I will discuss the plight of the widows and the HIV/AIDS orphaned children under the current property grabbing circumstances in Zimbabwe. A Brief Historical Context of Zimbabwe since the Attainment of Independence in 1980 Zimbabwe attained its independence on April 18, 1980 after a century of resistance to British colonialism and a guerilla war which killed an estimated 40,000 civilians and guerillas. Dansereau (2000) highlighted that the promise of significant change was articulated in socialist language, according to which the country would transform the structures inherited from colonialism and during a decade under the 1965 Unilateral Declaration of Independence would improve the living conditions for the majority of the population. In addition, Dansereau observed the fact that it is almost three decades since independence; wages have fallen to below the levels at independence, and approximately 80% of the population now live below the poverty line.

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Block (2007) asserted that demonstrations and strikes at the end of the 1990s reflected the growing dissatisfaction with the government, in place since 1980. Discontented citizens demanded constitutional change, greater political freedom and improved economic conditions. Zimbabwe‟s honeymoon was short lived as state-directed policies now face a world economy that seeks greater liberalization and a reduced role for the state. Block, the renowned Zimbabwean economist, succinctly noted the fact that Zimbabwe has the highest inflation rate in the world at over one million %, underscoring severe economic hardships that cannot be sustained by any modern civilization. The Economic Impact on Sexuality According to Eckner (1994),”The emphasis that is now attached to money and material goods has begun to replace the focus on the extended family and community in sub-Saharan Africa” (p. 17). The transition from an agricultural-based society to an urban, industrialized one has been followed by a surge of rural-urban migration. Eckner furthermore expressed the view that earlier patterns of sexuality-information exchange, ensured by the supervision of village elders, have been eroded (p. 17). The breakdown of the extended family structure has resulted in the inadequate transfer of traditional socio-sexual scripts. In addition, Eckner clearly pointed out that the lack of a formal mechanism to provide critical sexual values and information is further confounded by the fact that strict taboos prohibiting parents from discussing sexuality with their children remain in place. Children, bombarded Westernized media, are in conflict as they struggle to sort out the traditional African values from the emerging Western ones. This situation has caused great social confusion, as African youths are not well informed about the decision- making processes concerning their sexuality. Eckner (1994) observed that increasing urbanization has caused overpopulation and decreased job availability as well as considerably lowering the incomes for many families in sub- Saharan Africa. The lack of financial resources has necessitated young people working as prostitutes, beach-boys or barmaids, or keeping company with “Sugar Daddies” or “Sugar Mammas” as ways to provide food for their families. Prostitution leads to an increased incidence of sexually transmitted infections and HIV/AIDS, especially in economically depressed urban environments, along truck routes, and in bars and clubs. In Zimbabwe, Eckner observed that young girls are sent out to hawk oranges for a few pennies but often return home with large amounts of money. Research findings have shown that older men will buy their goods for a

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higher price in exchange for sexual favors. The economic meltdown in Zimbabwe has caused tremendous inflation comparable to none in the modern world. High poverty levels underscore the desperation and frustration that the ordinary people face on a day-to-day basis. Basic commodities are scarce and if available are usually beyond the reach of the ordinary citizens who struggle to make ends meet. The World Health Organization (WHO) (2007) has pointed out that life expectancy has drastically gone down due to the HIV/AIDS epidemic that is claiming millions of lives. The number of orphans due to the HIV/AIDS epidemic is ever rising as many breadwinners succumb to the deadly HIV/AIDS scourge. Theoretical Framework This research study draws its theoretical insights from the phenomenological approach. According to Wilson (2004),” Phenomenology, per se, is a branch of philosophy, owing its origin to the work of Husserl and later writers such as Heidegger, Sartre and Merleau-Ponty, who took the ideas into existentialism” (p. 15). In addition, Wilson, drawing from Husserl (1970) propounded the idea that the aim of phenomenology is to study human phenomena without considering questions about their causes, their objective reality, or even their appearances. From a historical point of view, Morris (1987) noted that the phenomenological perspective in sociology has been introduced to the United States in recent years with the translation of the collected works of Alfred Schultz, the leading exponent of the principles of phenomenological sociology in Europe. In addition, Morris observed the fact that in America the works of Berger and Luckmann (1996), among others, have helped to popularize the phenomenological approach, although its applications have been limited. Wilson (2004) explicitly noted that the main aim of the phenomenological approach is to study how human phenomena are experienced in consciousness and in cognitive and perceptual acts, as well as how they may be valued or appreciated aesthetically (p. 16). Furthermore, Wilson expressed the idea that phenomenology seeks to understand how persons construct meaning; a key concept is intersubjectivity. In addition, Wilson acknowledged that our experience of the world, upon which our thoughts about the world are based, is intersubjective because we experience the world with and through others. Wilson further noted that whatever meaning we create has its roots in human actions, and the totality of social artifacts and cultural objects are grounded in human activity.

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The HIV/AIDS epidemic in Zimbabwe has to be understood in light of this context, and a possible solution has to be culturally and socially based. The Zimbabwean historical past should be critically examined for possible clues as to why the epidemic has become so severe. Shultz (1964) argued that commonsense knowledge of social structures becomes the foundation upon which each individual‟s Lebenswelt or „life world‟ is built. The phenomenological approach is interested in explaining how social order is possible in any given situation; the life-worlds of the involved actors must be examined to reveal their meaningful structures, and these must be related to the practical ordering of their experiences. Schultz (1964) plausibly expressed the view that people are engaged in an on-going process of making sense of the world, in interaction with their fellows and we, as social scientists, are seeking to make sense of their sense making. The first assumption made by phenomenologists is that phenomena do not have meaning in and of themselves, but are given meaning for someone. From this position is derived the principle that the essential or defining structure of any phenomenon under study includes the elements which make up the phenomenon from the subjective view of an actor and without which the phenomenon either ceases to be what it is or is altered significantly. Best (1985), drawing insights from Husserl, who is generally considered the founder of modern phenomenology, argued that the essential characteristic of human experience is its „internationality.‟ By this he meant that it is always experience in relation to something in the social environment that is given meaning. According to Husserl (1970): The objective of is thus to disclose and describe the intentional structure of meanings of actors in the manifold forms in which they occur throughout society. While social reality, which is taken-for-granted in the life-worlds of the actors, is intersubjectively created, it is important to recognize that it is also the cumulative product of historical social processes that have preceded these individual actors. This means that it is largely „prestructured‟ or „pregiven‟ to the individual during the process of socialization, so that under normal conditions the individual will not consider alternative constructions of reality (P. 123). According to Bittner (1987),”From a phenomenological perspective, however, the supposedly „solid‟ or objective social world of the natural stance is seen to be humanly constructed artifice of intersubjective meanings” (p. 37). Researchers must inevitably make use of the same methods

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of interpretation as does the person in his or her „common-sense world‟. In agreement, Shultz (1964) expressed the idea that the ordinary person, acting in the world, is in a biographically- determined situation, doing what he or she does according to the system of relevancies that enables him or her to select from the environment and from interactions with others those elements that make sense for the purpose at hand. In the phenomenological approach the emphasis is on understanding the person‟s experience of the world and his or her situation. Therefore, narrative accounts and qualitative interviews are regularly employed in research methods. In support, Wilson (2004) argued that phenomenological ideas underlie virtually all those schools of thought that hold that it is necessary to understand the meaning attributed by persons to the activities in which they engage in order to understand their behavior. The phenomenological approach was determined to be the most suitable approach to understand the causes and scope of the HIV/AIDS epidemic in Zimbabwe. The social, cultural, historical and economic context shaping the „life worlds‟ of the people of Zimbabwe has to be analyzed in light of the socialization processes, educational experiences and colonial legacies obtaining on the ground. The intervention strategies that have been applied to deal with the HIV/AIDS epidemic in Zimbabwe, a former British colony, must be understood in light of post-independence discourse. Chilisa (2000) argued that the marginalization of local knowledge systems, established in colonial times, relegated all things indigenous or from the colonized communities to the status of unworthy, uncivilized, barbaric and superstitious ideas. Therefore, the earlier cultural and social contexts of the Zimbabwean people have to be understood before effective intervention strategies can be implemented. According to Chilisa (2000), “Systematic efforts to inscribe Western ways of cultural, economic, political and social systems were applied during the colonial times and maintained in the post-independence era” (p. 45). The educational system did not escape this colonial construction of the colonized subjects and their relegation to otherness. Years after the struggle for independence, the content of what is taught, the methods of teaching, and the approach to research remain Western in non-Western contexts. In addition, Chilisa (2000) acknowledged that this does not only alienate the „othered‟ from their own knowledge systems, it can be a matter of life and death as demonstrated by the HIV/AIDS information and education campaign. Findings from a number of research studies on HIV/AIDS in Zimbabwe have been analyzed within the framework of current prevention

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strategies. More specifically, posters and cartoons used in the campaign against HIV/AIDS illustrate the marginalization of other knowledge systems and the intersection of the „otherness‟ ideology with mainstream First World research methodologies. HIV/AIDS awareness campaigns used in Zimbabwe must be culturally and socially appropriate to convey the message in a vivid way that can change the attitudes and behavior of the most vulnerable groups. Preparation of Teachers to Teach Sex Education in Zimbabwe Zimbabwe, a Southern African country, is facing a serious HIV/AIDS epidemic. The centrality of the school system in Zimbabwe places teachers in a strategic position to pass accurate information on to in-school students about the dangers of HIV/AIDS and other sexually transmitted infections (STI). Chifunyise, Benoy, and Mukiibi (2002) recorded the fact that in 1991, the Zimbabwean Ministry of Higher Education and Technology (MOHET) introduced the AIDS Action Program to train teachers about sexually transmitted infections (STI) and HIV/AIDS combating skills. Chifunyise et al asserted that the program was a nation-wide venture and that all thirty-one tertiary colleges were included. In each college, the HIV/AIDS Education Program was organized by a coordinator, who was one of the two counselors per college trained under the initial HIV/AIDS program in 1991. The AIDS Action Program was started on the predictable assumption that AIDS would soon become the leading cause of death among Zimbabwean adults and the driving force behind rising rates of infant, child and maternal mortality, as well as increased orphanhood. In agreement, O‟Donoghue (2002) noted that people assumed that education and breaking the silence would be a part of the solution to the HIV/AIDS epidemic. The introduction of the AIDS Action Program in 1991 was the culmination of the Zimbabwean Ministry of Health‟s request to the United Nations Children‟s Fund (UNICEF) to become involved in AIDS work. In addition, O‟Donoghue pointed out that following a situation analysis and extensive negotiations with several ministries, it was decided that UNICEF would focus on a combating AIDS program, would concentrate mostly on youth, and would work primarily with the Ministry of Education and Culture (MOEC). UNICEF decided to use this approach because the largest component of the new AIDS Prevention Program was AIDS Education in schools and colleges. An in-school AIDS Education Program was chosen for two reasons. First, in-school youth were still largely uninfected by HIV. Secondly, the educational infrastructure was good and school attendance was high as almost all children attended primary school for at least seven years.

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Chifunyise et al (2002) noted that the AIDS Action Program for Schools is taught from Grade 4 in primary school (9-10 year olds) to Form 6 in secondary school (18-19 year olds), as well as in tertiary colleges. A weekly HIV/AIDS lesson is compulsory in all schools, and in tertiary colleges it is taught as a separate subject. O‟Donoghue identified the following main objectives of the AIDS Action Program: 1. To develop student understanding of the medical and social aspects of AIDS, and to challenge prejudices which stigmatize people with AIDS; 2. To develop values and life skills in pupils that are conducive to positive, responsible and healthy life-skills and will hopefully lead to behaviors that minimize risks of getting sexually transmitted infections and AIDS; 3. To help pupils understand and deal with their anxieties about puberty, sexuality and relationships, as well to recognize child abuse; 4. To increase self-assertiveness and self-confidence in pupils in their relationships with peers and adults; 5. To help teenage boys develop an appreciation of girls and women as equal partners of boys and men. O‟Donoghue (2002) highlighted the fact that the AIDS Action Program sought to effect attitudinal and behavior change among youth in schools. From the onset of the program, the partners decided that a didactic and information-based approach would not be effective. Therefore, in addition to giving factual information on HIV/AIDS, the program aimed to develop positive attitudes and life skills such as problem solving, informed decision making, communication, self-awareness, and avoidance of unnecessary risks. It was believed that the inclusion of life skills in the AIDS Action Program curriculum would equip students with skills that they could use to avoid risky behavior and thus avoid HIV infection. In support of the idea, Chifunyise et al (2002) commented that to complement the life skills approach, participatory teaching and learning methods were used, since students need to participate actively in the learning process if attitudes and behaviors are to change. Such methods included group discussion, brainstorming, playing „devil‟s advocate‟, group work, role-play, projects, poetry, song, proverbs, and story telling. O‟Donoghue (2002) remarked that in both teacher training colleges and schools the Ministry of Education and Culture (MOEC) decided not to make AIDS an examinable subject

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for fear that this would result in didactic rather than participatory teaching, which would defeat the purpose of the exercise. English was chosen as the medium of instruction since this is normal practice in Zimbabwean schools. However, teachers are free to use a local language where necessary to facilitate communication. The main purpose of the program is to encourage students to make informed decisions when it comes to sex and relationships in their life. In-Service Training Chifunyise et al (2002) recorded that planning for the in-service training of teachers began in April 1992. A cascade model of training, the traditional way of disseminating innovations in the Ministry of Education and Culture (MOEC), was chosen for in-service training. The cascade model involved equipping trainers at the national level, who in turn trained other peers at the next lower level, and so on through five stages (national, regional-cluster, regional, district, school) until the classroom teachers were finally trained. O‟Donoghue further expressed the idea that the cascade model was the easiest and most cost effective way to reach the 35,000 teachers involved in AIDS Education Program. It was initially envisaged that the training would cascade to school level by mid 1993. However, due to some challenges and barriers that time projection was underestimated. According to O‟Donoghue (2002),”In 1992, a manual for trainers was produced which focused on basic information on HIV/AIDS, an examination of attitudes towards HIV/AIDS, participatory teaching methods and how to use them in the classroom, and implementing, monitoring and evaluating the AIDS Action Program for Schools” (p. 391). The national, regional, and district training workshops included the same components as the manual. Chifunyise et al (2002) asserted that the cascade training began with a national workshop in October 1992, facilitated by the writers of the training manual and attended by three senior staff members from each of the (MOEC)‟s nine regions. The role of the regional staff was to coordinate the AIDS training program in their regions. As an accompaniment to formal training in AIDS Education Program for students in tertiary colleges, training in peer education for students was meant to provide a sound knowledge base. The idea was that the student peer educators would acquire AIDS Education skills and promote behavior change among students by increasing exposure to peers who endorse change.

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Broad View of Training Importance Dzvimbo (2004) expressed the view that the main goal of preparing teachers to teach sex education is to improve students‟ knowledge, attitudes and behaviors regarding reproductive health and HIV/AIDS. But effective training first has to have an impact on the teachers themselves, helping them examine their own attitudes toward sexuality and behavior regarding combating the spread of the HIV/AIDS epidemic, understand the content they are teaching, learn participatory teaching skills, and gain enough confidence to discuss sensitive and controversial topics. In addition, Dzvimbo noted, that increasingly, countries in sub Saharan Africa are beginning to offer sex education in schools for younger youths who are approximately between the ages of 8 and12. Some teachers will need to know how to relate to students of different ages and use different materials and strategies. In addition, meeting the needs of students requires an ability to relate to young people, build trust in the classroom, and be a good listener. James- Traore, Finger, Ruland and Savariaud (2007) stressed that no subject requires better communication skills with students than teaching about sexuality, reproductive health, and HIV/AIDS. Challenges of Teaching Sexuality in an African Context Teacher training in the context of sexuality often challenges existing norms for educational institutions and the community. James-Traore et al (2007) expressed the idea that as communities take a greater interest in the topic, some may want to include only limited information, for example, eliminating any discussions of condoms from a curriculum. Sexuality education may not be considered as important as reading or mathematics; and, given the usual limitations on resources and time, it may be the first subject to be reduced or eliminated from a school curriculum. According to James-Traore et al (2007),”Reproductive health material is not usually on the examinations because the content is often taught as part of an after-school club or is not part of the national curriculum” (p. 45). Teachers need preparation, skills and support in dealing with all of these issues. O‟Donoghue (2002) observed that while the HIV/AIDS epidemic has resulted in new attention to sexuality education in schools, Africa‟s educational system is struggling to adopt meaningful educational tools. Inadequate funding and poor infrastructure plague education systems throughout sub-Saharan Africa. Teachers overwhelmingly report a shortage of teaching materials, and available materials are often outdated. Dzvimbo (2004) noted that research studies

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in sub-Saharan Africa have shown that in many countries a shortage of teachers has resulted in younger, less experienced teachers who have not had training in teaching sexuality taking charge of big classes. In support, James-Troare et al (2007) acknowledged the fact that support is weakest for teaching sexuality and family planning though even family planning, the least popular subject, is supported by about 40 percent of primary teachers and parents. Research studies on the challenges of implementing sexual education in sub-Saharan Africa by O‟Donoghue (2002) have identified three outstanding obstacles. First, educational policies and local practices have to deal with community sensitivity to the topic of sexuality. Secondly, the attrition of teachers because of the HIV/AIDS epidemic is becoming more pronounced. Third, sexual abuse of students by teachers has become recognized as a major problem. Policies, Practices and Community Norms James-Troare et al (2007) asserted that all youth need information on abstinence and delayed sexual initiation as well as reproductive health and HIV/AIDS. An important prerequisite to school-based programs themselves, and subsequently effective training, are clear policies and guidelines supporting young people‟s access to both information and services. These policies should be widely known by teachers and service providers and should be implemented. According to O‟Donoghue (2002), “In a survey by Educational International of its member teacher unions, 84 percent of those responding, most of them in sub-Saharan Africa noted the fact that they received little or no support from reinforcing policies on the how to combat the HIV/AIDS epidemic and related discrimination” (p. 46). In addition, O‟Donoghue remarked that where supportive policies have been adopted, administrators at the local level may have to cope with input from religious groups and other stakeholders who may object to aspects of a curriculum, particularly discussions about condom use for those already sexually active. Teacher Attrition Due to AIDS In his research study, O‟Donoghue (2002) observed that the HIV/AIDS-related attrition of teachers and managers in African educational systems is alarming. Mortality, morbidity, and absenteeism in high prevalence countries are expected to increase rapidly over the next 10-15 years. The HIV/AIDS epidemic is taking a heavy toll on breadwinners, and teachers and educational leaders are not an exception. Yet, they are expected to take a leading role in the fight against this epidemic.

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In conclusion, O‟Donoghue (2002) highlighted the fact that Zimbabwe‟s AIDS Action Program for schools achieved a lot. AIDS Education was made compulsory in all primary and secondary schools and in tertiary colleges. High quality materials were produced, and the prescribed curriculum was being taught to over 6,000 schools. The AIDS Action Program for schools helped to bring the HIV/AIDS problem in Zimbabwe out into the open for discussion. Like most projects, Zimbabwe‟s AIDS Action Program for schools had its problems. Training weakened as it moved down the cascade. The time needed and the difficulties involved in developing materials were underestimated. Sex Education Programs in the United States Kirby (2006) expressed the view that the United States government is the world leader in responding to the global pandemic of AIDS. The United States government has made the fight against HIV/AIDS a top priority, not only for humanitarian reasons, but because the HIV/AIDS crisis threatens the prosperity, stability, and development of nations around the world. USAID has funded almost $6 billion since the inception of its international HIV/AIDS program in 1986, more than any other public or private organization. Almost all U.S. students receive some form of sex education at least once between grades 7 and 12; many schools begin addressing some topics as early as grades 5 or 6. However, what students learn varies widely, because curriculum decisions are so decentralized. Many states have laws governing what is taught in sex education classes or allowing parents to opt out. Some state laws leave curriculum decisions to individual school districts. Studying some of the sex education programs implemented in the United States, a well- to-do country, provides me with the leverage and experience that I need to develop future sex education programs in Zimbabwe. Inferences and lessons drawn from sex education programs carried out in the United States give me the elevated position from which I can start my own culturally and socially appropriate program. Standing on the shoulders of academic giants enhances the breadth, depth and effectiveness of some sex education programs in their different contexts. The Kinsey Reports The contested and controversial Kinsey Report of the 1950s marked the beginning of a new chapter in the history of American sex education. Research studies on this previously uncharted area were initiated as the teaching and subsequent evaluation of various sex education programs

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were introduced into American schools. According to John and Freedman (1988), “The publication of the Kinsey Report in the 1950s altered the American sexual landscape forever. The scientific context of the report legitimized open discussion of sexual subjects in the media, at universities and in the home” (p. 15). The Kinsey Report encouraged more open discussion of homosexuality, which Kinsey presented as but another form of sexual activity, and also of female sexuality. In addition, John and Freedman noted that the Kinsey Report is composed of two books on human sexual behavior, “Sexual Behavior in Human Male” (1948) and “Sexual Behavior in the Human Female” (1953). According to Crespi and Stanley (1982), “The research astounded the general public and was immediately controversial and sensational. The findings caused shock and outrage, both because they challenged conventional beliefs about sexuality and because they discussed subjects that had previously been taboo” (p. 25). John and Freedman (1988) acknowledged that the Kinsey Report was widely criticized by conservatives as promoting degeneracy. In addition to the moral objections, academics‟ criticism pertained to the sample selection and sample bias. According to Crespi and Stanley (1982), “In 1948, the same year as the original publication, a committee of the American Statistical Association condemned the sampling procedure, saying a random selection of three people would have been better than a group of 300 chosen by Kinsey” (p. 23). Furthermore, Crespi and Stanley noted that criticism principally revolved around the over-representation of some groups in the sample: 25% were, or had been prison inmates, and over 5% were male prostitutes. John and Freedman noted that since at that time most Americans were reluctant to discuss the intimate details of their sex lives even with their spouses or close friends, the Kinsey database was derived from a possibly atypical minority who were willing to tell their secrets to total (if learned) strangers. Selected Case Studies of Effective Sex Education Programs Numerous research studies on the effectiveness of sex education have been conducted in United States high schools and elsewhere for the past five decades. Literature on the effectiveness of sex education programs reveals mixed findings, ranging from significantly effective to extremely ineffective outcomes. Among other factors, the social and cultural contexts of the setting largely influence the outcome. Only a few selected effective sex education programs in the United States and elsewhere will be discussed first to provide an overview of findings relevant to my research project. Ineffective sex education programs will be discussed

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briefly as well to shed some light on some challenges and obstacles encountered in the various sex education programs. Pardue (2005) estimated that more than half of all new HIV infections occur before the age of 25 and most are acquired through unprotected sexual intercourse. According to Smith and McIlhaney (2006), “Many of these new infections occur because young people don‟t have the knowledge or skills to protect themselves” (p. 75). To address this important health issue, the American Psychological Association (APA) (2006) has recommended that comprehensive and empirically supported sex education and HIV prevention programs become widely available to teach youth how to abstain from risky sexual behaviors and to learn how they can protect themselves against HIV and other sexually transmitted infections. According to Pardue (2005): The harmful effects of early sexual activity are well documented in the United States medical history. They include sexually transmitted diseases, HIV/AIDS infection, teen pregnancy, and out-of-wedlock childbearing. As well, teen sexual activity is linked to emotional problems, such as depression, and increased risk of suicide (P. 37). Sex education programs that encourage teens to delay the onset of sexual activity are effective in curbing such problems. Kirby (2005) expressed the view, however, that opponents of abstinence education claim that abstinence programs don‟t work and that there has been “no scientific evidence that abstinence programs are effective” (p. 56). Rotheram (2006) observed that new research proves abstinence education opponents wrong. His research of over 15 years, on a code named program, “Not Me, Not Now,” a community-wide abstinence intervention targeted to 9- to 14-year-olds in Monroe County, New York, which included the city of Rochester showed that comprehensive sexuality education programs for youth that encourage abstinence, promote appropriate condom use, and teach sexual communication skills reduce HIV-risk behavior and also delay the onset of sexual intercourse. Rotheram stated that the “Not Me, Not Now” program devised a mass communications strategy to promote the abstinence message through paid television and radio advertising, billboards, posters distributed in schools, educational materials for parents, an interactive web site, and educational sessions in school and community settings. According to Rotheram (2006):

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The program sought to communicate five themes in a culturally and socially appropriate way: raising awareness of the problem of teen pregnancy, increasing an understanding of the negative consequences of teen pregnancy, developing resistance to peer pressure, promoting parent-child communication, and promoting abstinence among teens (P. 15). Smith and McIlhaney (2006) commented that the “Not Me, Not Now” program was effective in reaching early teen listeners, with some 95 percent of the target audience within the county reporting that they had seen a “Not Me, Not Now” advertisement. In addition, Rotheram (2006) noticed that during the intervention period, the program achieved a statistically significant positive shift in attitudes among pre-teens and early teens in the county. In his research findings Rotheram observed that the sexual activity rate of 15-year-olds across the county dropped by a statistically significant amount from 46.6 percent to 31.6 percent during the intervention period. According to Rotheram (2006): Finally, the pregnancy rate for girls aged 15 through 17 in Monroe County fell by a statistically significant amount, from 63.4 pregnancies per 1,000 girls to 49.5 pregnancies per 1,000. The teen pregnancy rate fell more rapidly in Monroe County than in comparison counties and in upstate New York in general, and the difference in the rate of decrease was statistically significant (P. 17). Rotheram (2006) stated that a case study of “Not Me, Not Now” carried out in Monroe County demonstrated that the sex education program was effective in changing the sexual behavior of the teenagers involved in the study. In addition, Rotheram concluded that sex education should be sensitive to the cultural and social contexts of the participants. In the context of the HIV/AIDS epidemic, teenagers should have accurate information on how to make important decisions as far as interpersonal relationships and sexual life are concerned. Lyon (2006) carried out his research studies in Wilmington, Delaware, and West Point, Mississippi, code-named “Project Taking Charge” A six-week abstinence curriculum was delivered in home economics classes during the school year. It was designed for use in low- income communities with high rates of teen pregnancy. According to Lyon: The curriculum contained these elements: self-development; basic information about sexual biology (anatomy, physiology, and pregnancy); vocational goal setting; family

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communication; and values instruction on the importance of delaying sexual activity until marriage (P. 87). The effect of the program was evaluated in both sites based on a small sample of 91 adolescents. In addition, Lyon acknowledged that the control and experimental groups were created by randomly assigning classrooms to either receive or not receive the program. The students were assessed immediately before and after the program and through a six-month follow-up. Lyon observed that the six-month follow-up to “Project Taking Charge” showed that it had a statistically significant effect in increasing adolescents' knowledge of the problems associated with teen pregnancy, the problems of sexually transmitted diseases, and reproductive biology. Lyon (2006) noted that the research findings of the “Project Taking Charge” program showed that the rate of the onset of sexual activity was reduced by 50 percent relative to the students in the control group. Although Lyon urged caution in the interpretation of these numbers due to the small size of the evaluation sample, it nevertheless suggested that “Project Taking Charge” was effective in its setting. Lyon expressed the opinion that both comprehensive sex education and abstinence only programs delay the onset of sexual activity among youth. In his studies Lyon also concluded that comprehensive sex education is effective in protecting adolescents from pregnancy and sexually transmitted illnesses at first intercourse and during later sexual activity. According to Smith and McIlhaney (2006): Comprehensive sexuality education programs, those that provide information, encourage abstinence, promote condom use for those who are sexually active, encourage fewer sexual partners, educate about the importance of early identification and treatment of sexually transmitted diseases and teach sexual communication skills, are the most effective in keeping sexually active adolescents disease free (P. 91). Lyon (2006) observed also that “Project Taking Charge” had an impact on adolescents‟ sexual behavior as shown by an increased number of adolescents who abstained from sex and also delayed the onset of first sexual intercourse. In support of Lyon‟s findings, Pardue (2005) found that comprehensive sexuality education programs that discuss the appropriate use of condoms do not accelerate sexual experiences as often alleged by the critics of sex education. Furthermore,

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Lyon remarked that these programs decrease the likelihood of unprotected sex and increase condom use among those having sex for the first time. According to the America Psychological Association (APA) (2006): Programs to prevent HIV and sexually transmitted diseases among youth should provide clear definitions of the behaviors targeted for change, address a range of sexual behaviors, be available to all adolescents (including youth of color, gay and lesbian adolescents, adolescents exploring same-sex relationships, drug users, adolescent offenders, school dropouts, runaways, mentally ill, homeless and migrant adolescents), and focus on maximizing a range of positive and lasting health outcomes. In addition, (APA) emphasized that only those programs whose efficacy and effectiveness have been well established through sound scientific methods should be supported for widespread implementation. New programs to prevent HIV and sexually transmitted diseases among youth should be tested against those programs with proven effectiveness (P. 36). Another study of an effective sex education program in the United States, entitled “Take Care of Yourself”, was conducted by Kirby (2006) in Southern California. According to Kirby, The “Take Care of Yourself” intervention program recruited youth when they were 13-to 15-years- old and encouraged them to participate throughout high school” (p. 58). During those school years, the program operated five days a week. Kirby stated that the “Take Care of Yourself” program encouraged the participants to spend an average of sixteen hours per month during the first three years. In addition, Kirby noted that the “Take Care of Yourself” program used a holistic approach, providing multiple services such as: 1. Family life and sex education; 2. An education component that included individual academic assessment, tutoring, help with homework, preparation for standardized exams, and assistance with college entrance; 3. A work-related intervention that included a job club, stipends, individual bank accounts, employment and career awareness; 4. Self-expression through the arts; and 5. Individual sports. Kirby (2006) acknowledged that in addition, the program provided mental health care and comprehensive medical care that included reproductive health and contraception when needed.

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In all these areas, staff tried to create close, caring relationships with the participants. In support, Herring and West (2006) argued that although the program focused on youth, it also provided services for the participants‟ parents and other adults in the community. In addition, Kirby (2006) asserted that the “Take Care of Yourself” study was a rigorous one. It included multiple sites, random assignment, a large sample size, long-term measurement of behavior, and proper statistical analyses. Kirby‟s research study found that after three years and among girls, the program significantly delayed the onset of sexual intercourse, increased the use of condoms as a secondary method with other highly effective methods of contraception used, reduced pregnancy rates and reduced birth rates. Furthermore, Kirby found that among males, the program did not have significant positive behavioral effects, but the study did have one unexpected finding: males in the program were significantly less likely to report using both condoms and other highly effective contraception methods at last sex than girls in the control group. This was found among males who had initiated sexual activity prior to the onset of the program. According to Kirby, “Notably, these findings were reported for all the members of the treatment and control groups, even though some members of the treatment group (especially the boys) did not participate extensively in the program and some members of the control group received a few services from the same organization or other organizations in the community” (p. 58). Furthermore, Kirby (2006) stated that the study of the “Take Care of Yourself” program was the first and only evaluation to date using random assignment, multiple sites and a large sample size that found a positive impact on sexual and contraceptive behavior, pregnancy and birth rates among girls for as long as three years. In fact, the pregnancy rate among girls in the intervention group was less than half the rate among the control group (10% versus 22%). In Kirby‟s assessment, these are strong and very important results. In addition, Kirby noted that it should also be recognized that his research study was a complex program to implement and required significant financial and staff resources. Moreover, some sites did not implement all the components or did not fully engage young people. According to Kirby (2006): Sex and HIV education programs, clinic protocols and service learning are complimentary. The first two groups of the programs focused upon the sexual antecedents of sexual risk-taking (for example, the sexual beliefs, attitudes, norms and

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self-efficacy related to sexual behaviors) in different settings and in different formats (group sessions versus one-on-one), while service learning programs addressed nonsexual antecedents such as connection to adults (P. 59). In addition, Kirby (2006) further noted that sex education programs must include a number of essential components that can help students in different settings and circumstances to make informed decisions relating to sexual matters in their lives. Real abstinence education is essential to reducing out-of-wedlock childbearing, preventing sexually transmitted diseases, and improving emotional and physical well being among the nation's youth. True abstinence education programs help young people to develop an understanding of commitment, fidelity, and intimacy that will serve them well as the foundations of healthy marital life in the future. Abstinence education programs have repeatedly been shown to be effective in reducing sexual activity among their participants. Sex Education Programs in Asia Thailand is considered the world‟s 50th largest country in terms of total surface area with a population of approximately 63 million. It is an independent country that lies in the heart of Southeast Asia. Jenkins and Dusistin (2008) acknowledged that there are very few developing countries in the world where public policy has been effective in preventing the spread of HIV/AIDS on a national scale, but Thailand is an exception. Massive programs to control HIV have reduced visits to commercial sex workers by half, raised condom usage, decreased the prevalence of STIs (Sexually Transmitted Infections) dramatically, and achieved substantial reductions in new HIV infections. Thailand, though, is also a reminder that success can be relative. Its well funded, politically supported and comprehensive prevention programs have saved millions of lives, reducing the number of new HIV infections from 143,000 in 1991 to 19,000 in 2003. Nonetheless, more than one-in-100 adults in this country of 63 million people is infected with HIV, and AIDS has become a leading cause of death. The success story of Thailand, a developing country will serve both as a signpost and a roadmap to me as I chart way forward in dealing with the HIV/AIDS epidemic in Zimbabwe.

The Effectiveness of Sex Education in Thailand In Thailand, Jenkins and Dusistin (2008) conducted a quasi-experimental study among secondary school students to measure sexual behavior, condom use, intention to refuse sex, intention to use condoms, and knowledge regarding sexually transmitted infections/HIV/AIDS

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syndrome and pregnancy. Pasuk and Baker (2002) found that Thailand has undergone major changes in the past several decades, with economic growth and population shifts toward urban centers and away from agriculture along with changes in social norms across a range of behaviors. In addition, Pasuk and Baker noted that premarital sex has become increasingly common among youth, thereby prompting Jenkins and Dusistin to undertake their culturally sensitive quasi-experimental study to establish the effectiveness of comprehensive sex education. According to Pasuk and Baker (2002), “Thai social and cultural norms have traditionally discouraged public discussion of sexuality, particularly for women, and very little factual information and guidance has been provided on a wide scale until recently” (p. 25). Jenkins and Dusistin‟s (2008) quasi-experimental research study used a convenience sample of 552 high school students in Bangkok, aged 13-18 years. The schools were chosen on the basis of being located in the same district, using the same curricula, and having a comparably high enrollment of low to middle income students. Jenkins and Dusistin randomly selected two schools; three classrooms (25-35 students per classroom) from each grade were randomly selected. In a 3-month post-test, 230 (88 percent) from the Culturally Sensitive Comprehensive Sex Education Program (CSCSEP) group and all the students (261) from the control group remained in the study. The experimental group was taught the (CSCSEP) as an intervention strategy to raise the awareness of the participants. According to Jenkins and Dusistin (2008), “The (CSCSEP) was based on cognitive social learning theory (Bandura 1994) and sex education programs with evidence of efficacy” (p. 43). In addition, Jenkins and Dusistin said that the program emphasized Thai values and culture regarding premarital sex, especially the maintenance of virginity until marriage. The (CSCSEP) consisted of six 1-hour modules that were divided equally into two consecutive 3-hour classes that were taught weekly. Jenkins and Dusistin stated that the culturally sensitive comprehensive sex education program was designed to be educative but entertaining and culturally sensitive. The six modules targeted: setting goals and understanding human sexuality, the prevalence of premarital sex behaviors among Thai adolescents and its consequences (Sexually transmitted infections, HIV/AIDS, diminished opportunity for better education, career and life); prevention strategies; ways of abstinence; the sex drive and its management, relationships and risky situations; and Thai values regarding sexual activity and contraception, condom use, problem-solving and supportive resources.

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Jenkins and Dusistin (2008) noted that data were collected using self-administered questionnaires. Students were asked about their sexual behavior (for example, whether they had ever had sex, and for those who had had sex, questions about the first partner, the reasons for sexual debut and recent sexual behavior including condom use and frequency of sex); intention to use condoms, intention to refuse sex, and knowledge about sexually transmitted infections, HIV/AIDS and pregnancy. Jenkins and Dusistin recorded that the outcome measures of the culturally sensitive comprehensive sex education program were significant in the following categories: sexual behavior and condom use, intention to refuse sex, intention to use a condom, sexually transmitted infections and HIV/AIDS knowledge and pregnancy knowledge. Jenkins and Dusistin (2008) found that at 3 and 6 months post intervention, the culturally sensitive comprehensive sex education program had statistically significantly lower proportions of sexually active students during the previous 3 months than the control group. According to Jenkins and Dusistin (2008), “The culturally sensitive comprehensive sex education program appeared to have an impact on intention to use condom the next time when having sexual intercourse at 3-month and 6-month follow ups” (p. 26). In addition, Jenkins and Dusistin observed that both sexually experienced and inexperienced students in the culturally sensitive comprehensive sex education program had statistically significantly greater intentions to use condoms than their counterparts across time. Jenkins and Dusistin noted that the study evaluated the effect of a culturally sensitive, abstinence-oriented sex education program that was designed to be developmentally appropriate for Thai secondary school students. Jenkins and Dusistin (2008) noted that the study made important contributions to sex education research and practice for several reasons. First, there have been few evaluations of comprehensive sex education interventions in Thailand and many of the interventions currently used have not received rigorous evaluation. Celentano (2002) remarked that interventions dealing with sexual behavior in Thailand typically have been HIV prevention interventions and these most often have focused on young adult populations rather than adolescents. Jenkins and Dusistin said that their research findings suggest that effective comprehensive sex education can occur in a Thai school context, with professional facilitation. In conclusion, Jenkins and Dusistin pointed out that the culturally sensitive comprehensive sex education program appeared efficacious in increasing self reported abstinence, increasing intention to refuse sex and intention to use condoms, while also increasing knowledge about sexually transmitted

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infections/HIV/AIDS and pregnancy; however, the culturally sensitive comprehensive sex education program did not lead to consistent condom use among sexually active participants. Sub-Saharan Africa in the Context of HIV/AIDS WHO (2007) noted that sex has focused on stemming the growing HIV/AIDS epidemic that is claiming millions of lives in this part of the impoverished region. Most governments in the region have established AIDS education programs in partnership with the World Health Organization and international Nongovernmental organizations. In addition, WHO asserted that the Global Gag Order has undercut these programs significantly, an initiative put in place by President Reagan, suspended by President Clinton, and re-instated by current President Bush. The incidence of new HIV transmissions in Uganda decreased dramatically when Clinton supported a comprehensive sex education approach (including information about contraception and abortion). The gag order refuses government funding for any efforts that promote condom and contraception use in addition to abstinence and monogamy. According to Ugandan AIDS activists, “The Global Gag Order will undermine community efforts to reduce HIV prevalence and HIV transmission. The plight of Uganda is indicative of AIDS "prevention" efforts across the continent, and the sharp decrease in AIDS transmissions in an era of comprehensive sex education versus current rates of new infections clearly reveals which system is more effective.” Sex education programs drawn from Uganda and other Sub-Saharan African countries provide me with the most recent contemporary intervention strategies that have been tried and tested in social, cultural and historical contexts that resemble the Zimbabwean situation. A Brief Historical Context of Uganda and HIV/AIDS Green, Halperin, Nantulya and Hogle (2006) stated that after 20 years of civil unrest (1966-1986), Uganda‟s improving economic conditions and political stability in the southern and central regions helped to create a conducive environment that allowed many people greater control over their sexual lives. Improvements in health infrastructure, which had virtually collapsed during the country‟s civil wars, had increased access to health information, health care and treatments. Shanti (2006) expressed the view that although gender inequalities were not adequately addressed, advances in women‟s economic and educational status, greater political representation and laws against sexual abuse and rape offered women and girls protection. Green et al observed that peace and tranquility that prevailed in Uganda after a bitter and protracted

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bloody civil war led to an unprecedented high prevalence of the HIV/AIDS epidemic due to the newly found freedom. Shanti (2006) acknowledged that Uganda‟s new head of state President Yoweri Museveni responded to the evidence of a serious emerging disease with a proactive commitment to prevention. Furthermore, Shanti expressed the view that Uganda is often cited as a role model in the fight against HIV/AIDS because of its success in reducing both the prevalence and the incidence of the HIV infection since the late 1980s. An increase in sexual abstinence has been highlighted as a primary cause of the declines; large increases have also been recorded in monogamy and condom use. Mitchel, Nakamanya, Kamali and Whiteworth (2001) asserted that Uganda has experienced a dramatic decline in the prevalence of the HIV/AIDS during the past decade, especially among the younger age cohorts. In support, Shanti stated that Uganda is considered by the UNAIDS (2006) and other nongovernmental organizations that work on the control of the HIV/AIDS to be one of the world‟s earliest and most compelling national success stories in combating the spread of HIV. The intervention sex education programs initiated in this country are worth reviewing and analyzing in this literature review to discern some lessons and insights. Sexuality Research Studies Conducted in Uganda In their research study entitled, “Community-based HIV/AIDS education in rural Uganda: Which channel is most effective program”? Mitchel et al (2001) sought to determine the effectiveness of four channels (drama, video, community educators and leaflets) used in a community-based Information, Education and Communication (IEC) HIV/AIDS intervention in rural Uganda. Mitchel et al conducted their research study in twelve rural parishes (administrative units of around ten villages) in Masaka and Ssembabule districts, situated approximately 150 kilometers southwest of the capital, Kampala. Mitchel et al further stated that subsistence farming is the primary economic activity, and while the Bunganda tribe and the Catholics predominate, both are ethnically and religiously heterogeneous. Their research study was carried out over two years (from 1994 to 1996), used the biological indicators (including HIV incidence) obtained through sero-surveys and behavioral indicators, such as reported condom use and delayed sexual activity. The IEC intervention was guided by the “Behavioral Change for Interventions Model” (King and Wright (2005). Shanti (2006) noted that this model emphasizes the key integration of

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four components, which are viewed as requisite to the adoption of safe sexual behaviors: knowledge acquisition, skills development, attitude development and motivational support. According to King and Wright: The Behavioral Change for Interventions Model was developed specifically to guide the design of interventions and the model emphasized the previous models (such as the Theory of Reasoned Action) and was based on the premise that knowledge alone is inadequate to fight the HIV/AIDS epidemic in Uganda (P. 412). These four key components fed into the content messages and the design of the IEC intervention. The aim of the study was to evaluate the effectiveness of the intervention components as perceived by the rural community in Uganda. Field staff views of the four IEC channels, as well as their perceptions of community response to the channels, were explored through 37 semi-structured interviews. Mitchel et al (2001) stated that a systematic, non probabilistic sampling strategy was used to focus on those most closely involved in the intervention (community educators and parish coordinators) and to be representative with respect to age, gender and parish. In addition, Mitchel et al (2001) acknowledged that the interview schedules were piloted beforehand (number 7) and interviewing stopped when it was felt that saturation had been reached. In addition, Mitchel et al noted that of the 37 interviews, 23 were conducted in the local language (Luganda) and the rest were conducted in English. Results from this research study showed that the participants who had access to all four channels benefited much in terms of adopting safe sexual behaviors, knowledge acquisition, skills development and attitude development in regards to the HIV/AIDS epidemic. The drama and the video channels attracted most of the participants due to the cultural dances and music that provided some entertainment to the rural parishes. Mitchel et al (2001) indicated that through the leaflets channel the community educators drew the attention of a sizable population in all the six parishes that were used as the experimental group. Mitchel et al concluded that no one channel used in isolation scored highly on all the four-process measures after the second year, when a post-test review was carried out. The participants who had access to all four channels-drama, video, leaflets and community-educators showed evidence that they had adopted safe sexual behaviors, had acquired knowledge and skills, and their sex attitudes had considerably changed.

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Mitchel et al (2001) recommended that to combat the spread of the HIV/AIDS epidemic, behavior change, abstinence, condom use, faithfulness, and seeking early medical treatment of the sexually transmitted infections could help. In support, Green et al (2006) argued that successful sex education programs have common elements that can be adapted to various cultural situations. In addition, Green et al noted that elements of the most effective programs give a clear, consistent message such as: “Avoid unprotected sex”, “Abstinence is the best way”, or “If you have sex, always use a condom.” Making the message culturally appropriate to the age and sexual experience of the participants is also essential. Effectiveness of the, “Let‟s Talk About Sex, Baby” Program in Zimbabwe In their mixed methods study, Gwanzura and Kesby (2005) sought to find out how much knowledge children had about HIV/AIDS between the ages of twelve and fourteen. A total of 118 participants took part in the research study that was conducted over a period of twelve months in both urban and rural areas. A pre-test and post-test analysis was carried out to establish the effectiveness of the program. In addition, Gwanzura and Kesby noted that the results showed that 85% of the participants had knowledge about safe sex, how HIV/AIDS is spread and the importance of positive attitude despite the fact that no adults had discussed these topics with them. According to Gwanzura and Kesby, “Since the late 1980s an increasing number of campaigns and interventions have attempted to address the dangerous silence surrounding HIV/AIDS in Zimbabwe and researchers have attempted to explore the barriers to effective communication and sexual decision-making” (p. 200). Furthermore, Gwanzura and Kesby (2006) observed that generational hierarchies and incest taboos have traditionally made plain talking about sex difficult between parents and children, yet research has suggested that children between the ages of five and fourteen represent the “safe window,” or the uninfected age group. In support, Basset and Kaim (2005) remarked that the situation has not been helped by the contemporary socio-sexual construction of childhood and adulthood in Zimbabwe. The traditional mechanisms of sex education have only weakened in recent decades as they have only focused on gendered sexual socialization, not on the promotion of sexual health. In their research study Gwanzura and Kesby (2006) focused on four themes: relationships, life skills, human growth, and development and health. They also measured the effectiveness of the communication skills. In their findings, Gwanzura and Kesby found that the participants knew quite a lot about the four themes without getting that

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information from their parents. Parents and guardians remain reluctant to undertake the difficult and potentially hazardous business of talking to children about sex. Sources of Information about HIV/AIDS Gwanzura and Kesby (2006) stated that it was important not only to find out what the children knew about HIV/AIDS but also where their information came from. The research results revealed that the sources most often cited were broadcast media (78% mentioned the Television and 75% the radio). Basset and Kaim (2005) asserted that these sources are clearly playing an important role in raising general levels of HIV/AIDS awareness among children. Gwanzura and Kesby observed that teachers were cited most often in response to the question „what source have you learned most about HIV/AIDS from (about 34% of children). Furthermore, Gwanzura and Kesby noted that parents, relatives and guardians were selected by over half (66%) of the sample as providing information about HIV/AIDS. According to Gwanzura and Kesby (2005), “Lets Talk About Sex, Baby” education program in Zimbabwe demonstrated that as a relatively „HIV free‟ generation, children (and youths) are biologically the nation‟s best hope of stemming the epidemic in the near future” (p. 215). The research findings indicated that the Zimbabwean children have a much wider awareness of HIV/AIDS than adults give them credit for. The findings further asserted the unsurprising phenomenon given that children are socialized within a context that is increasingly awash with talk about sex and HIV/AIDS. Gwanzura and Kesby further suggested that it is possible, and given an appropriate set of methodologies and techniques, that children are willing to converse with adults about their sexual knowledge and attitudes. In summing up their findings Gwanzura and Kesby observed that primary school teachers in Zimbabwe need more training and support to assist them to overcome their reservations in order to pursue sex education programs in a more interactive, participatory and realistic fashion. Both parents and teachers should continue to talk about sex with children in the most appropriate ways and manners that respect the age level of the children and the cultural context in which children are raised. Selected Ineffective Sex Education Programs In his research study on the effectiveness of some sex education intervention programs in the United States high schools, Dailey (2005) observed that in many ways, sexuality education has not lived up to its potential for reducing human hurt and enhancing human pleasure. According to Dailey (2005):

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As generally conceived and delivered in the United States, it has largely failed to meet its own (admittedly ambitious) goals. Specifically, sexuality education has not had demonstrable success at affecting the behavior of recipients. In a time when sexual dysfunction and dissatisfaction in primary relationships still occur with much frequency, focusing on behavioral change to enhance pleasure continues to be important. In an age of HIV/AIDS and other health-endangering and life-risking consequences, focusing on behavioral change to reduce hurt is particularly crucial (P. 88). Dailey (2005) evaluated thirteen different school-based programs designed to reduce sexual risk-taking that ranged from one-hour didactic presentations to one year-long comprehensive sex education in California. Most of the programs were intended to reduce the degree of pregnancy and HIV transmission among adolescents. Dailey noted that 93% of schools in California offer sex or AIDS education generally in the ninth and tenth grades. In addition, Dailey asserted that early sex education curricula focused on increasing knowledge and emphasized the risk and consequences of pregnancy and HIV. Senior curriculum stressed knowledge but emphasized values, clarification and skills, especially decision-making, communication, contraception against unwanted pregnancy and disease. Some programs espoused abstinence until marriage as the only acceptable behavior. In his longitudinal research study, Dailey concluded that, “evidence showed that these programs neither delayed nor reduced the frequency of intercourse.” (p. 89). Furthermore, Dailey (2005) acknowledged that some educators utilized a limited version of learning by providing students with information about the behavioral implications of their knowledge and values. Unfortunately, that reflected the realm of “knowledge about” rather than internalized reality of learned experience. From his evaluation Dailey expressed the view that knowledge for its own sake is not without value; however, the powerful reality of human sexuality demands attention to its concrete implications for life. According to Dailey, “The linear expectation that knowledge will lead automatically to behavioral change is seldomly demonstrated” (p. 90). In addition, Dailey remarked that there was little question that the attitudes/values issue was a delicate one, almost as threatening to some as the issue of behavioral expression. Attitude/value clarification was part of the educational process; but out of fear of what parents or others outside the educational context would say, educators often neglected it. Translations into Behavior

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Dailey (2005) observed that sexuality education programs appeared to be weakest in their attempts to translate sexual knowledge and attitudes/values into applied behavior. Neither sexuality educators fared well in meeting the challenge of a sex-positive orientation, nor emphasizing the enhancement of sexual pleasure (both physical and emotional). According to Dailey, “Teachers became agents of social control more than genuine educators and students became understandably suspicious, or even resistant, to the learning process” (p. 90). The intervention programs studied by Dailey did not decrease the number of sexual partners, neither did they delay sexual debut, nor increase the effective use of condoms. In support, Kirby (2006) commented that the burden is upon sexuality educators to create a positive context for learning, even when the subject matter has negative or fear-provoking elements. For example, if emphasis is placed upon using condoms as an aspect of pleasurable sexual interaction in addition to their protective potential, then students are more likely to listen and rehearse behaviors that include how to make safer sex more pleasurable. An Abstinence-Only Sex Education Curriculum Young (2006) evaluated abstinence-only education curricula in Arkansas and came up with the conclusion that such programs were ineffective in reducing sexual behavior among teens. The participants in the study were students from fifteen school districts that were divided by grade level into treatment grade levels that taught a “Sex Can Wait” curriculum. Comparison grade levels were taught their regular curriculum (health education with a sex component). The program was offered at three levels: upper elementary (grades 5 or 6), middle school (grade 7 or 8), and high school (grade 9 or above). Young stated that schools were counterbalanced so data was collected at all grade levels from both the treatment group and the comparison group. To be included in the analysis, individuals had to take a matching pre-test and eighteen-month follow- up measure. Young (2006) historically traced the federally funded abstinence education programs that began under President Reagan with the Adolescent Family Life Act of 1986. According to Young, “The definition of abstinence only education emphasized teaching abstinence from all sexual activity except within the context of marriage while substantial amounts of federal dollars are going to support these programs” (p. 414) Denny (2006) stated that, given the funding emphasis that has been placed on abstinence-only sex education, it is important that these programs be evaluated (p. 47).

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In his research study on the impact of the various abstinence only sex education programs on the initiation of sexual intercourse, Young (2006) found that the programs produced no differences between the intervention and comparison groups relative to this variable. Research study results indicated that the upper elementary program produced short-term gains on knowledge, self-efficacy and a more helpful outlook, with long-term gains in knowledge and a reduced likelihood of participation in sexual intercourse in the last month. In addition, Young indicated that in both middle and high school there was no statistically significant short-term and long-term benefit from the “Sex Can Wait” abstinence-only sex curriculum in spite of the fact that several thousands of dollars were poured into the program. Denny (2006) remarked that although the curriculum series did not demonstrate a statistically significant effect on several variables, including sexual behavior, teen pregnancy, and self-esteem among others, in most cases there is room for improvement. In summing up his findings, Young observed that there were a number of influences on adolescent sexual behavior and teen pregnancy, but none of them accounted for a substantial amount of variation in behavior. The Failure of Sexuality Education Programs in Sub-Saharan Africa Bankole, Biddlecom, Guiella, and Zulu (2007) expressed the view that adolescents are a key target group for HIV and pregnancy prevention efforts, yet very little is known about the youngest adolescents, those under the age of fifteen. In their research study on the effectiveness of sex education programs in Burkina Faso, Ghana, and Uganda targeting adolescents, they found that a large majority of the adolescents are attending schools in Sub-Saharan Africa. In support, Shanti (2006) argued that unfortunately most of the sex education programs in these four countries are ineffective, as they do not include the young adolescents who are the „window of hope‟ as they usually represent the uninfected group (p. 65). Bankole et al conducted their research study that stretched from 2004 to 2006 specifically to examine the effectiveness of teaching about sexual behavior, pregnancy information, contraception, sexually transmitted infections including HIV and sources of sexual and reproductive health information. The participants in all four countries were randomly selected and their ages ranged from twelve to seventeen years. From their findings Bankole et al stated that contrary to what might be generally thought very young adolescents in these four Sub-Saharan African countries are not all sexually naïve. Sex education programs in this part of the world should meet the needs of all the vulnerable age groups.

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HIV-Related Stigmatization and Discrimination in Sub-Saharan Africa According to Mann (2007), “The pandemic of HIV has been accompanied the world over by another epidemic of fear, stigmatization and discrimination particularly in Sub-Saharan Africa” (p. 348). This has posed a challenge to those who are concerned about providing not only an effective response to HIV/AIDS but also a humane one, based on a concern for human rights and the principles of social justice. In support, Merson (2005) asserted that this epidemic has severely constrained the abilities of individuals, families, communities and governments to respond effectively, and continues to undermine efforts to prevent HIV transmission at the community and global level. Merson further reiterated that the prevention of HIV remains the key strategy to reducing the epidemic worldwide; however, efforts in many countries are failing as a result of discriminatory public policies, attitudes and behavior. Malcolm (2007) expressed the view that in many societies the existing structural and cultural divisions that limit people‟s rights, opportunities and access to education, income and other resources, may be impeding efforts to prevent and contain the epidemic. In his research studies in the Sub-Saharan African countries, Mann (2007) observed that fear, ignorance, lack of knowledge and denial about HIV/AIDS have led to reactions which have tragic effects on individuals, families and communities. In agreement, Merson (2005) stated that these reactions are primarily derived from the process of stigmatization of people with HIV/AIDS and may result in behavior that scapegoats, stereotypes and discriminates against individuals and groups of people. In addition, Merson asserted that this behavior is manifested directly through the exclusion of individuals and groups of people from social events and valued roles, as well as indirectly through the avoidance and denial of HIV, actions it is more difficult to identify and obviate but which create a more pervasive environment of stigma and discrimination towards those affected. According to Tindall and Tillett (2007), “HIV and AIDS-related stigmatization and discrimination present a major barrier for people wanting access to treatment and care, and to education and information to prevent the transmission of HIV” (p. 73). In support, Gostin (2006) acknowledged that people who are members of already stigmatized groups within communities may find that access to needed services is inhibited by the attitudes and reactions from people

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providing those services. The fear of this response can discourage people from coming forward for information, HIV testing, support, counseling and treatment. Mann (2006) argued that it might also be the case that those who are socially and economically disadvantaged within communities lack resources to access education and treatment and means to follow advice to prevent the transmission of HIV. Furthermore, Gostin noted that denial of HIV and cultural beliefs about causes of ill health, including fatalism, may lead to responses such as the use of local treatments, faith-healing, witchcraft and medications which in some situations may harm or prove fatal to the individual. According to Mane (2004), “Stigmatization and discrimination may be related to many factors, including levels of HIV information, popular ideas and everyday conceptions about people with HIV/AIDS, and prevailing sociocultural attitudes towards specific behaviors, for example, sexual promiscuity, homosexuality and drug use” (p. 340). The challenge confronting the HIV/AIDS patients becomes huge and difficult to manage through stigmatization and discrimination. The Concept of Stigma in the Context of HIV/AIDS According to Goffman (2003), “Stigma has been defined as „an attribute that is significantly discrediting‟, and a stigmatized person is one who possesses „an undesired difference” (p. 77). Goffman maintained that stigma is conceptualized by society on the basis of what constitutes difference or deviance, and it is applied by the society through rules and sanctions to the affected individuals or groups. In addition, Goffman stated that it is in this context that attitudes and perceptions about HIV may have been formed and enacted to alienate and discredit people who are HIV seropositive and/or those seen as more likely to be affected by the disease than others (p. 80). Gostin (2006), however, observed that the societal stigmatization of certain groups of people (for example, homosexuals, sex workers, migrants and other races) existed prior to HIV and the emergence of the disease may have only heightened this stigmatization. Gilmore and Somerville (2005) expressed the view that stigmatization is also seen as a response to a situation of perceived threat when escape or destruction of the threat is not possible and can result in behavior which leads to scapegoating and discrimination (p. 34). According to Mann (2006), “stigmatization can be used as a means of social control through marginalizing, excluding and exercising power over people who exhibit particular traits” (p. 45). McGrath (2004) argued that by attributing blame to an individual or group, society can to an extent

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absolve itself from responsibility and ignore or isolate in one form or another those with the disease or at risk of HIV. For example women are usually blamed; particularly, sex workers have been seen as the source of HIV in many communities. Takahashi (2005) acknowledged that studies on stigma have highlighted the differences which individuals experience and described two kinds of stigma: the „felt‟ or „perceived‟ stigma, and „enacted‟ stigma. Jacoby (2004) noted that „felt‟ stigma is generally considered to be more prevalent and relates to the perceptions that individuals may have about their condition and the responses it may evoke from others (p. 27). In support, Mann expressed the view that enacted stigma, on the other hand, refers to the actual experiences of discrimination (p. 45). Furthermore, Mann observed that in the context of negative responses towards people with HIV, where stigmatization of the disease is heightened, the level of fear and anxiety of a person with HIV remains high. Sources of Stigmatization, Discrimination and Denial in the Context of HIV/AIDS Malcolm (2006) stated that the negative reactions triggered by HIV and AIDS are not unique in history and need therefore to be examined in a historical and contextual framework (p. 44). Currura (2004) noted that the management of previous epidemics and diseases has shown that perceptions of contagion have often led to the isolation and exclusion of the infected with the sanctions of public health legislation (p. 20). In addition, Currura expressed the idea that diseases that are sexually transmitted have not infrequently inspired reactions based on fear of contagion and contamination. According to Mann (2006): Unlike other infectious diseases such as tuberculosis, HIV/AIDS has been accompanied by a threat of death and disfigurement that has added to the fears and fantasies surrounding the epidemic. This has resulted in the characterizations of AIDS as a disfiguring and frightening disease, with little hope of recovery or cure, and which threatens to devastate communities and societies mostly in Sub-Saharan Africa (P. 50). Malcolm (2006) observed that from early on in the epidemic, the language and range of metaphors used to depict AIDS and people with the disease reflected the stigmatization associated with the disease. In addition, Malcolm stated that these metaphors include: AIDS as death; as depicted by images of the Grim Reaper; AIDS as punishment for „immoral behavior‟; AIDS as a crime, often represented in the division of „innocent‟ and „guilty‟ parties; and AIDS as war, in which the virus and sometimes people with HIV are seen as needing to be fought against.

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Mann (2006) acknowledged that another powerful metaphor used to stigmatize those with HIV/AIDS is AIDS is shame, in which people with HIV are seen as a social disgrace and an ignominy to the society. HIV-related Stigmatization, Discrimination and Denial at a Societal Level Gostin (2006) asserted that at an institutional or societal level, HIV-related discrimination is reported to be widespread. This may be because at this level discrimination can become normalized through the existence of rules, policies and procedures. According to Malcolm (2006), “Governments have also contributed to discrimination, directly through covering up and concealing cases of HIV and AIDS resulting in more people becoming infected and being denied necessary treatment and care, and indirectly, through their apathy and failure to act promptly in response to the epidemic” (p. 60). In support, Daniel (2001) commented that ignoring the existence of HIV and those most at risk of HIV infection, or failing to respond to the urgency of growing epidemics, are the forms of denial which have been commonly reported and it is this behavior that may act to further isolate and discredit the needs of those most affected by the epidemic. According to Currura (2004), “It is well understood that societal conditions such as poverty may increase the risks of HIV infection through the need to generate income by involvement in activities such as sex work, lack of access to services and information, and lack of support for behavior change” (p. 21). In agreement, Goldin (2005) remarked that similarly, social unrest and political instability could promote an environment of increased risk to HIV, as communities and services are disrupted and people are forced to migrate or relocate. Examples of war and civil unrest are commonly reported to increase the risk of HIV transmission and the vulnerability of societies caught up in such conflict. In his research findings in Zimbabwe, Currura observed that people infected with HIV were those who had the least access to basic human rights and who had little capacity to access services such as education and health care (p. 21). Furthermore, many of those infected were subjected to laws that stigmatize and discriminate against them, or which deprive them of their liberty to act to protect themselves against infection. The Individual Experience of HIV-related Stigma and Discrimination in Zimbabwe In his research study in Sub-Saharan Africa, Merson (2005) found that the way people perceive HIV as a stigma appeared to be anchored in what they understood to be the commonly

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held beliefs in their society and perceptions of stigma might differ depending on the actual experiences of discrimination or stigma. According to Currura (2004): The fear of an HIV diagnosis, of others finding out about the diagnosis and a lack of trust in the systems responsible for protecting confidential information, are also other factors that discourages people from seeking treatment and care. Those who know their diagnosis often devise ways of hiding this out of fear and shame. This secrecy may help to reduce the social pressures but it may also increase the possibility of further transmission of HIV as people are prevented from learning constructive ways of living with HIV infection (P. 23). Merson (2005) observed that in Zimbabwe, the families of those with HIV might also experience this fear of stigmatization and may attempt to avoid others in their communities, such as neighbors, and try to hide the person who is ill. In support, Goldin (2005) pointed out that the negative depiction of the people with HIV/AIDS, bolstered through metaphors and language used to describe people with the virus has reinforced fear, avoidance and the isolation of people with HIV. In addition, Goldin remarked that these responses may arise both from how people with HIV perceive themselves in the context of their communities and also as a result of their actual experiences of discrimination. Merson observed that in a highly discriminatory environment many infected people are known to withdraw and isolate themselves for their self- protection. According to Currura (2004), “This self-isolation may extend to an exclusion from social and sexual relationships and in extreme circumstances result in a form of premature „death‟ through suicide and euthanasia” (p. 24). Denial Associated with the HIV/AIDS Epidemic in Zimbabwe According to Malcolm (2006): Denial of the risk and vulnerability to HIV is an individual response in many situations and may result from a complex of sociocultural and psychological factors of HIV and AIDS. It may also result in part from the internalization of the societal response and from the ways in which a person‟s identity and self-worth are shaped by the broader social and cultural forces (P. 58). In support, Goldin (2005) noted that denial is often manifest in the process of distancing oneself from the problem and attempting to reduce the threat by placing the problem elsewhere

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and refusing to acknowledge the level of individual or societal risk. In addition, Goldin elaborated that when this kind of response occurs at the individual level it may result in the individual‟s perception of a lack of risk and vulnerability to HIV or refusal to acknowledge the risk of HIV transmission to others, thereby increasing the potential risk of HIV infection within a community (p. 27). Lie and Biswalo (2006) observed that experiences of stigma and discrimination, whether they be actual or perceived, may arise from a range of responses to the HIV epidemic that are occurring within the community. In agreement, Malcolm (2006) said that harassment and scapegoating of people with AIDS has been widely reported since the beginning of the epidemic. It is often motivated out of a need to extend blame and punishment for the perceived threat, or out of fear of difference. According to Friedman (2003): The impact of the HIV and AIDS on women in Zimbabwe and some other Sub-Saharan Africa is particularly acute and that one of the major aspects of this impact is stigmatization and discrimination that women experience as a result of being infected with HIV or being at risk of HIV in a social and cultural environment that generally looks down upon women (P. 104). In addition, Friedman noted that women in many societies are already economically and socially disadvantaged and lack equal access to societal institutions, which include treatment, financial support and education. According to Currura (2004), “In Sub-Saharan Africa women are denied the opportunity to participate equally within the community since they are to a large extent outside the structures of power and decision making, and are subject to laws which exercise control over their bodies and sexual relations” (p. 25). Merson (2005) acknowledged in his research studies that in Zimbabwe and other Sub- Saharan African societies most affected by the HIV epidemic, women provide the majority of care to those who are ill and dying. In support, Goldin (2005) noted that as the epidemic intensifies in many parts of the world this system of care is being undermined and although women are themselves infected and dying, it is commonly the women who are left to manage without support or with little access to resources. For example, a young Zimbabwean mother whose husband died of AIDS related how her husband‟s relatives blamed her for his death and took away all her possessions, including her home. Furthermore, Currura (2004) noted that

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certain practices such as those relating to inheritance in some parts in Sub-Saharan Africa work to deny women access to certain assets as the rights to these are often vested with men and when the men dies the women are left without homes and land. In his research studies Currura observed that in some societies in Africa women are seen as the major transmitters of the sexually transmitted infections STI; hence the disease is commonly known as the „women‟s disease.‟ These identified practices explain the kind of stigmatization and denial that usually characterize the HIV/AIDS infected people in Zimbabwe and some other parts of Africa. Stigmatization, Discrimination in Families and the Community Lie and Biswalo (2006) expressed the view that in many Sub-Saharan African countries, families bear the brunt of the care of people who are ill, even when financially not in a situation to do so. (p. 30) As the result of the HIV epidemic, the family care system in many societies has been undermined to the extent that family members are struggling to cope with the commitment to care for those who are ill. According to Currura (2006), “ The increasing number of orphans and the changing roles of children and grandparents are beginning to present difficulties of coping in those societies most affected by HIV and AIDS. These difficulties are compounded by the stigmatization and neglect orphans may experience from relatives and community members” (p. 25). Furthermore, Currura (2006) noted that these families are part of the communities that may shun them because of their association with a person with HIV. In addition Currura pointed out that in Zimbabwe, it is seen as culturally appropriate for the family to provide the majority of care for its members whatever the illness. However, as many communities in this country are aware of the signs and symptoms of AIDS, some families are beginning to fear the stigmatization that may result if they provide care for a person with AIDS at home. According to Merson (2005): For a person with HIV the fear of rejection, as well as the worry about the burden his/her illness may cause to the family could result in many people denying their illness to the family or avoiding their family when care is needed most. It has been suggested that it is partly their anticipation of stigma and rejection that may preclude people with HIV from informing their families of their HIV diagnosis (P. 67).

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HIV/AIDS and Property Grabbing in Zimbabwe Izumi (2007) acknowledged that AIDS is a disease that creates orphans and widows, and it is anticipated that more land and property disputes will occur in Zimbabwe between wives of polygamous husbands, between widows or orphans and family members of the deceased, between siblings, and between widows and their children, as more die of HIV and AIDS-related illness (p. 13). From his research studies in Zimbabwe Izumi noted that the nature of HIV and AIDS as a disease often puts women whose husbands have died of AIDS-related illness in a vulnerable situation in terms of negotiation of inheritance, due to the stigma attached to the disease. In support, Lie and Biswalo (2006) expressed the view that husbands often accuse their wives of infecting them, although research has shown that women are usually infected by their husbands, many of whom become infected as a result of extramarital relations (p. 32). Furthermore, research studies conducted by Merson (2005) indicated that married women are more vulnerable to infection than unmarried women in Africa, given the lack of control that they often have over sexual contact and the use contraception (p. 69). In addition, Merson pointed out that after the husband‟s death, his family may continue to blame the widow for his illness and death. And even where there is no evidence that a husband died of an AIDS-related illness, his relatives may still accuse the widow of being HIV positive and use that justification to evict her and take her property. According to Izumi (2007), “In addition to the stigma associated with the disease, women who have lost their husbands to AIDS-related diseases are vulnerable for other reasons. Economically, many widows could have exhausted their financial resources by the time their husbands die, in order to pay for hospital fees and funeral costs” (p. 14). Furthermore, Izumi observed that many widows who lose their husbands to AIDS-related diseases are HIV positive themselves; their own health has often deteriorated by the time their husbands die. Currura (2006) remarked that when widows do manage to challenge property grabbing in the courts, relatives might deliberately delay court cases in the hope that the HIV positive widow would die of AIDS-related disease before the judge reaches a decision (p. 27). Lie and Biswalo (2006) asserted that the stigma attached to HIV and AIDS means that other members of a widow‟s social network who in „normal‟ circumstances would have defended and supported her would not do so, for fear of being seen to help a „witch‟ who killed her husband. In short, the challenges encountered by many widows in Zimbabwe were summed by Izumi who stated that stigma,

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poverty, deteriorating health, lack of support, physical and mental harassment and humiliation by the in-laws all together put pressure on widows who are already in a situation of distress, sometimes leading to premature deaths. Conclusion Substantial literature on sex education in different parts of the world provides hope and the much-needed impetus to deal with the high prevalence of the HIV/AIDS epidemic in Zimbabwe. Although some selected sex education programs did not significantly serve their intended purposes, those that were effective can be used as the solid foundation upon which I will design sex education programs. The social, political, cultural and economic context currently prevailing in Zimbabwe is a cause for concern. The hyperinflationary environment characterized with astronomically high prices and a poor macro environment does not support broad-based intervention strategies. Stigmatization, discrimination and psychological denial encountered by the HIV/AIDS patients in Zimbabwe are factors to contend with in dealing with the HIV/AIDS epidemic in Zimbabwe. Despite all the above challenges sex education programs have no substitute in the near and distant future as far as combating the HIV/AIDS epidemic is concerned in Zimbabwe. The centrality of the school system in Zimbabwe places any school based sex education programs on the elevated position to effectively deal with the HIV/AIDS epidemic. Chapter 3 Methods and Procedures Introduction This study used the case study method to take a focused look at how Africa University faculty and students understand and interpret the HIV/AIDS epidemic in Zimbabwe. The case study methodology was determined to be the best qualitative research technique to understand the breadth and depth of the HIV/AIDS epidemic from the perspective of faculty and students at this private international pan-African United Methodist-related institution. The research findings about the faculty and students‟ understanding and interpretation of the HIV/AIDS epidemic would be used to make recommendations to programs, health education initiatives, curriculum planners, and community leaders currently dealing with HIV/AIDS programs.

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Chapter Three has been organized as follows: (1) a description of the setting of the university, (2) an explanation of case study research, (3) the design of the study, (4) a description the interviews, (5) a description of the observations, (6) a discussion of (7) a discussion of document analyzed, the methods of data analysis and validity and reliability. Setting Africa University is located 17 km outside Mutare, Zimbabwe's third largest city. It is a private, pan-African, United Methodist-related institution. This institution of higher learning opened its doors to the public in March 1992 as the first private, international university in Zimbabwe. The pioneer group of 40 students came from a dozen Africa countries to pursue Bachelor's degrees in Agriculture, Natural Resources and Theology. The vision of African University is to improve the quality of life, peace and prosperity for the peoples of Africa through quality higher education that includes teaching, research, and community service and leadership development. Africa University is a United Methodist Church-related project and is being nurtured and funded by church members from all over the world. It is a direct result of the growth of United Methodism on the African continent and has its foundations in the history and legacy of the church. Bhila (2000) noted the fact that Chief Tendai of Manyika Land, recognizing that his people needed to learn new skills, granted land and mining rights during the late 1800s to Cecil Rhodes in exchange for guns and educational opportunities. Bhila further asserted that in 1898, Joseph Crane Hartzell, a Methodist Bishop, stood on Chiremba Mountain above Old Mutare, Zimbabwe, (then called Old Umtali in rural ), and looking down into the valley that is now home to Africa University, envisioning hundreds of African young people with books in their hands, running to school. Hartzell shared his dream with Rhodes and was granted a large tract of land at the base of Chiremba Mountain. This land was part of the original grant Rhodes received from Chief Tendai and had been, for a brief period, the settlers‟ town of Mutare (Umtali) as it was known by then. On that land, the United Methodist Church developed schools, an orphanage and a small hospital to serve the needs of the African people. Bhila (2000) recorded the fact that the proposal for a church-related university first came from Bishops of the United Methodist Church (UMC) in Africa. In 1984, two African Bishops, Emilio J. M. De Carvalho of Angola and Arthur Kulah of Liberia, issued the call to create Africa University. In their analysis, the United Methodist Church leaders argued that increased access to

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higher education was the key to peace, stability and development in Africa. Out of that challenge emerged the Africa University Initiative whose dream materialized in 1992. Regional consultations about the educational and vocational needs were instituted, leading to the planning and site selection of Mutare as the host city, fulfilling the 94-year old dream of Bishop Hartzell of the United Methodist Church. Bhila (2000) noted the fact that the United Methodist plans prompted the establishment of a continent-wide university in Zimbabwe where no private universities existed. President had formed a government commission in 1987 to study the country's higher education needs and to make recommendations on the role of private universities in the nation's overall education scheme. When the proposal calling for the establishment of Africa University in Zimbabwe went before the worldwide church at the United Methodist Church's General Conference in 1988, it fired imaginations. The General Conference approved the founding of an institution to serve all of Africa, funded primarily by the United Methodist Church (UMC) congregations in the USA. In January 1992, President Robert Mugabe granted Africa University's Charter by official proclamation. Farm buildings on the University site were quickly refurbished to serve as teaching facilities. By March 1992, classes had started with 40 students from a dozen African countries studying in three faculties namely Agriculture, Natural Resources and Theology. Bhila (2000) recorded that in 1993, twenty-five new students were enrolled. The process of fine-tuning programs continued with the addition of more faculty members and the University Farm, offering students hands-on experience and practical training. In addition, Bhila noted that on April 6, 1991, thousands of people gathered at Old Mutare, on a site comprising 1545 acres of land donated by the United Methodist Church in Zimbabwe, for the groundbreaking ceremony. Over the past decade, the pace of academic and physical development at Africa University has been phenomenal. Refurbished farm buildings gave way to modern teaching facilities, residence halls and a student services unit with the official opening of the University by President Robert Mugabe in April 1994. Africa University Prospectus (2007) acknowledges that Africa University is a microcosm of the greater African world, with students drawn from the African continent and its diverse cultures. For students keen to benefit fully from this unique community, active participation in student activities is the key. Students can take part in recreation, student clubs, sport, community

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service, voluntary work and many more worthwhile activities. In addition, Africa Prospectus expresses that the main goal of Africa University is to nurture responsible and well-adjusted graduates who will take up leadership roles at a local, national and international level with all the challenges the rapidly developing world poses. The interesting history of Africa University captured my attention and drew me to carry out a comprehensive, qualitative case study of this young and promising institution in Zimbabwe. As an alumnus of this university, I have sentimental emotional attachment to it that academically and professionally changed my life. I owe much to this university that helped me to achieve upward mobility from being a primary school teacher to becoming a prospective holder of an advanced degree. According to Africa University Prospectus (2007),”Currently, the university has an enrollment of 1,300 students from more that 40 countries thereby adding diversity to the university” (p. 56). Different cultures at the university helps students to deal with diversity, hence they are prepared to interact with people from different backgrounds. Education Programs Offered at Africa University The Africa University Prospectus (2007) acknowledges that the Faculty of Education assumes the responsibility to teach all students so that they will attain high standards of academic performance, show concern for improving the human condition know how to reason, and have desire for service. In addition, the Faculty seeks to transmit equitably the social, economic, and cultural experiences of African nations in general and in particular, of those nations from which its students come. This shall be done with full cognizance of the changing needs of Africa and the changing global environment. According to the Africa University Prospectus (2007): The Faculty of Education at Africa University has as its primary goal, the development of value-centered educational leadership through the preparation of competent, moral and effective teachers, teacher educators, curriculum developers, administrators and researchers who will ensure excellence at all educational levels (P. 87). In addition, the Africa University Prospectus (2007) records that the Faculty of Education offers the following academic programs: (1) 4-year Bachelor of Arts with Education (BA Ed); (2) 4-year Bachelor of Science with Education (B.Sc. Ed.); (3) 4-year Bachelor of Science in Agriculture with Education (B.Sc. Agric. Ed);

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(4) 2-year Bachelor of Education (B. Ed.); (5) Educational Leadership Management and Development. To be admitted into the above degree programs candidates must have passes in at least five General Certificate in Education or “Ordinary Level” subjects including and two “Advanced Level” passes in their areas of their choice. As for the 2-year Bachelor of Education (B.Ed) degree program, the applicants must: (1) Normally have a good post-secondary school diploma in education recognized by Africa University; (2) Have participated in a teacher education program for at least three years designed to prepare students to teach at the secondary school level; (3) Have at least 3 years of teaching experience or other relevant professional experience; (4) the equivalent of 1and 2 above with at least 3 years teaching experience or other relevant professional experience. Case Study Research The case study method was chosen as the preferred methodology for this study. Yin (1994) asserted that the case study is a desirable method of qualitative research when the study focuses on an organization, which this study does. According to Yin (1994), “A case study is an empirical inquiry that investigates a contemporary phenomenon within its real-life context, especially when the boundaries between phenomenon and context are not clearly evident” (p. 13). The HIV/AIDS epidemic in Zimbabwe should be understood in its social, political and cultural context. The case study method was determined to be the most appropriate method to find out how students and faculty at Africa University understand and interpret the HIV/AIDS epidemic that is causing a lot of suffering to the population. Merriam (1998), who previously conceptualized a case study as being its end product, concluded that the most defining characteristic of case study research lie in delimiting the object of study, “the case as a thing, a single entity, and a unity around which there are boundaries. I can „fence in‟ what I am going to study. The case then, could be a person such as a student, a teacher, a principal, a program, a group such as a class, a community, a specific policy, and so on” (p. 27). Merriam (1998) observed that three major features characterize a case study. First, a case study is particularistic in that it focuses on a particular situation, event, program, or phenomenon. Second, the case study is descriptive in that its end product is “a rich, „thick‟ description of the

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phenomenon being studied” (p. 29). “Thick description”, which is usually qualitative, means the complete, literal description of the incident or entity being investigated. Third, a case study is heuristic in that it illuminates readers‟ understanding of the phenomenon being studied by providing some new insights or extending their experience about the phenomenon. Students and faculty at Africa University deal with some people who come from affected and infected families. Their understanding and interpretation of the HIV/AIDS epidemic from a cultural, social and historical context will provide some insights that could be used to prepare prospective high school teachers to help their communities. The cultural practices such as wife inheritance and child pledging must be understood in light of the social values that define and bound the people of Zimbabwe. In this study, a comprehensive qualitative case study of one private international university in Zimbabwe was carried out to understand the HIV/AIDS epidemic from the perspective of the faculty and students. Interviews, observations and documentary sources were used as the main sources of data. Yin (1994) expressed the idea that a case study requires the triangulation of data, using at least three data sets. According to Yin (1994): The case study inquiry copes with the technically distinctive situation in which there will be any more variables of interest than data points, and as one result relies on multiple sources of evidence, with data needing to converge in a triangulating fashion, and as another result benefits from the prior development of theoretical propositions to guide data collection and analysis (P. 13). In addition, Yin (1994) further articulated the idea that the use of multiple sources of evidence in case studies allows an investigator to address a broad range of historical, attitudinal, and behavioral issues. However, the most important advantage presented by using multiple sources of evidence is the development of converging lines of inquiry. Thus, any finding or conclusion is likely to be more convincing and accurate if it is based on several different sources of information. The credibility and trustworthiness of the research study can be well established through the triangulation of data from different sources. In the setting of this study, the triangulation of data involves the following data sets: interviews, observations and documentary sources. One principle of case study research as observed by Yin (1994) is to create a case study database. He cites the lack of a formal database

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for most case studies as a weakness, and he encourages the use of four components of a case study database: notes (from interviews and observations), documents, tabular materials (frequency counts, surveys) and narratives (open-ended answers to a case study‟s questions). According to Yin (1994),“The greatest strengths of case studies are their use when a „how‟ or „why‟ question is being asked about a contemporary set of events over which the investigator has little or no control” (p. 9). The advantages of the triangulation of data discussed above persuaded me to use three sources of data. McMillan (2004) expresses the view that the case study approach is a comparatively flexible method of scientific research. Because its project designs seem to emphasize exploration rather than prescription or prediction, researchers are comparatively free to discover and address issues as they arise in their investigations. In addition, McMillan acknowledges that the looser format of case studies allows researchers to begin with broad questions and narrows their focus as their study progresses rather than attempt to predict every possible outcome before the study is conducted. This emphasis can help bridge the gap between abstract research and concrete practice by allowing researchers to compare their firsthand observations with the quantitative results obtained through other methods of research The weaknesses of the case study approach include a lack of time limits on the scope of case studies, sometimes leading to lengthy, unreadable documents if not well planned. According to Yin (1989): The case study has long been stereotyped as the weak sibling among social science methods," and is often criticized as being too subjective and even pseudo-scientific. Likewise, "investigators who do case studies are often regarded as having deviated from their academic disciplines, and their investigations as having insufficient precision (that is, quantification), objectivity and rigor (P. 15). Opponents cite opportunities for subjectivity in the implementation, presentation, and evaluation of case study research. In support, McMillan (2004) observed that the approach relies on personal interpretation of data and inferences. Results may not be generalizable, are difficult to test for validity, and rarely offer a problem-solving prescription. Simply put, relying on one or a few subjects as a basis for cognitive extrapolations runs the risk of inferring too much from what might be circumstance. Yin (1989) remarked that case studies can involve learning more about the subjects being tested than most researchers would care to know, such as information about their educational

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background, emotional background, perceptions of themselves and their surroundings, their likes, dislikes, and so on. In addition, McMillan (2004) stated that personal integrity, sensitivity, and possible prejudices and/or biases of the investigators need to be taken into consideration as well. Personal biases can creep into how the research study is conducted, alternative research methods can be used and the preparation of surveys and questionnaires (p. 74). In addition, Yin (1989) noted that a common complaint in case study research is that investigators change direction during the course of the study, unaware that their original research design was inadequate for the revised investigation. Thus, the researchers leave unknown gaps and biases in the study. Merriam (1998) observed that case studies are too costly in terms of time or funds to produce rich and thick description. The other weaknesses indicated by Merriam are that there is a possibility of oversimplification or exaggeration of the situation in case study reports that can lead to erroneous conclusions about the reality. A case study might be faulty due to its lack of representativeness and over-reliance on the data collection and analysis process by the case study researcher who might not have had enough training to conduct case study research. Challenges of Doing Research at Africa University Block (2007) acknowledged that the search for greener pastures by the Zimbabwean professionals due to the economic meltdown of Zimbabwe characterized with and skyrocketing prices of basic commodities, has driven most of the competent brain power out of the country. In recent years Africa University has been losing a number of dedicated professionals and professors to the neighboring countries with better working conditions. Expatriate professionals and professors who are paid in foreign currency, specifically the U.S. dollar to cushion them against the rising effects of inflation, filled in the vacant posts. Very few Zimbabwean professionals hold a number of key administrative and professional positions at this institution of higher learning as they are paid in the U.S. dollars unlike their Zimbabwean counterparts. This unfortunate scenario made it very difficult for me to gain access to the students for my interviews. I sought permission to carry out my research project at my former university in October of 2007, but never got any response from the Vice Chancellor who has since been fired for alleged incompetence. I only got a favorable response in January of 2008, from the competent and enterprising Interim Vice Chancellor. I was determined to conduct my

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research at my former university, and therefore wrote to the university administration every month. The gatekeepers to vital information (Deans of Education, Health Sciences, The Deputy Vice Chancellor for Academic Affairs and the Registrar) could not let me have access to the students despite the fact the Interim Vice Chancellor had given me written permission to carry out research at their institution. The Dean of the Faculty of Education demanded that I present my proposal to the entire faculty after waiting for one and a half weeks. He further insisted that every communication between him and me had to be formal, which I did not understand as I did not an office there. Upon inquiry as to what he meant, he told me that I had to wait for e-mail communication in spite of the fact that I was living very close to his office and home as well. I strongly suspect that he felt that I was a potential threat to his job to his job as a citizen coming back home where many fellow Zimbabweans are running away all the time. The Dean of the faculty of Health Sciences demanded my detailed Curriculum Vitae, all academic transcripts from the undergraduate level, a laptop, and a letter from Miami University and disregarded the letter of authorization from the Interim Vice Chancellor. Both the Registrar and the Deputy Vice Chancellor for Academic Affairs informed me that they were too busy to help me although they had known for two months before that I was coming. The inconvenience that I suffered from these professionals persuaded my conscience and convinced my reason that I had to report such gross unprofessional practices with the Immigration and Customs officials. I lodged a complaint to the Principal Immigration Officer through the office of the Vice Chancellor and got a favorable response from the university officials listed above. Apparently, petty jealous and insecurity on the part of these professionals contributed to their undesirable conduct. My presence there did not resonate well with some of the professionals who have witnessed several Zimbabwean professors leave for greener pastures either to the other countries of the region or overseas. Although these gatekeepers of information did not want to open up the gates of information, nonetheless I had access to the students and documents through my former sympathetic Zimbabwean professors. For future would-be researchers I wanted to clear the way for them by bringing to the attention of the Immigration and Customs Office the injustice that I suffered as a returning citizen eager to help my country deal with teacher preparation programs and the HIV/AIDS epidemic. Before I left Africa University, I had a meeting with the Interim

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Vice Chancellor to inform him about the frustrations, challenges and inconvenience I had encountered at Africa University. Design of This Study I chose the case study method as my research focuses on an organization. The HIV/AIDS epidemic in Zimbabwe has social, economic, political and educational implications for both teacher training universities and prospective teachers. To fully appreciate the causes of the HIV/AIDS epidemic, I needed to investigate the problem through a variety of data collection techniques. This led me toward a method that would allow the triangulation of the following data sets: interviews, observations and documents. Interview To understand why Zimbabwe, a fairly small country with a population of about 12 million, is heavily affected by the HIV/AIDS epidemic in the Southern African Region, semi- structured interviews were conducted with eight faculty members and eight students of the institution being studied. Patton (1990) clearly explained the purpose of interviews: “We interview people to find out from them things we cannot observe…feelings, thoughts, and intentions…behaviors that took place at some previous point in time…situation that preclude the presence of an observer…how people organized the world and the meanings they attach to what goes on in the world-we ask people questions about those things” (p. 278). In support, Glesne and Peshkin (1991) expressed the idea that a semi-structured interview may be defined as a mix between a structured and an open-ended interview. There are structured questions that form the focus for the interview. The tone of the interview is conversational and the interviewee is encouraged to provide additional information that may or may not be addressed in the questions. A semi-structured interview, as noted by Borg and Gall (1989), begins with structured questions, and the interviewee‟s initial reactions are followed up by more open-ended questions designed to probe more deeply. According to Merriam (1998), “The interviews are semi-structured when they have a protocol with a set of questions and issues to be explored, however, the exact wording and order of these questions is not predetermined but depends on the interaction between the interviewer and the respondent as the interview progresses” (p. 279). The student and faculty interviews I conducted were aimed at probing their understanding and interpretation of the HIV/AIDS epidemic in Zimbabwe. A teacher preparation program that adequately equips its prospective teachers to deal with the social challenges that include

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HIV/AIDS would go a long way toward meeting the immediate and the future needs of the Zimbabwean community. Borg and Gall (1989) concluded by stating that: The semi-structured interview has the advantage of being reasonably objective while still permitting a more thorough understanding of the respondent‟s opinions and the reasons behind them than would be possible using the mailed questionnaires. The semi-structured interview is generally most appropriate for interview studies in education. It provides a desirable combination of objectivity and depth and often permits the gathering of valuable data that could not be successfully obtained by any other approach (P. 452). In her book of wisdom Merriam (1998) suggested that the interviewer needs to be neutral and non-judgmental no matter how much a respondent‟s revelation violates the interviewers own standards, the interviewer should refrain from arguing. The interviewer should be sensitive to the verbal and non-verbal messages being conveyed by the interviewees. Yin (1994) cites the following strengths of interviews: they are targeted with a direct focus and they are insightful with accompanying casual perceptions. He also cites several weaknesses: bias due to the poor construction of questions, possible response bias, inaccuracies due to the poor recall of the interviewer, and possible reflexivity. Reflexivity occurs if the interviewee says what he/ she thinks the interviewer wants to hear rather than giving candid responses. The sample for the interviews was obtained in the following manner. First of all, the Zimbabwean volunteers were sought at a student faculty meeting that I held with all interested students and faculty. Four female senior students and four male senior students willingly opted to participate in the interview from a group of twenty-five interested participants. The confidentiality of all interviewees was ensured as I kept all the interview scripts in my bedroom steel locker. There was positive response from students who wanted to participate in my research project as they were informed that I was an alumnus. A total of twenty-five students initially volunteered to take part in my research project. To have only eight participants I had to choose at least one student from each Faculty represented and three students came from the Faculty of Education. I chose three students from the Faculty of Education to have more in-depth information on how prospective teachers are prepared.

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The faculty interviewees were drawn from the following faculties that prepare prospective high school teachers and administrators: Agriculture, Education, Health Sciences, Management and Administration and Theology at the student faculty meeting. I wanted to have a reasonable purpose sample of the students from all the faculties that train teachers at Africa University. Eight faculty interviewees were chosen at the same student faculty meeting that I held with the participants win the Faculty of Education Board meeting room. Only faculties that teach courses in the teacher preparation program willingly volunteered to participate in my research project. Interview protocols can be found in the Appendix A. Detailed semi-structured interviews were conducted with eight students drawn from five faculties that prepare teachers. The interviews lasted from between 45 minutes to an hour and they were all conducted in the conference room in Jokomo/Yamada library. Eight professors, or lecturers as they are called in Zimbabwe, were interviewed in their respective offices. The university teaching experiences of the lecturers ranged from two years to twenty. Fifty percent of the faculty interviewees were females while the other half consisted of male faculty. I wanted to be gender sensitive by choosing my interviewees from both sexes. The Interim Vice Chancellor referred me to the faculty members that he had talked to before. Two months before I traveled to Zimbabwe I had asked the cooperating Interim Vice Chancellor to help me by choosing volunteer lecturers. Only lecturers that are directly involved in teacher preparation programs were interviewed so that I could get their opinions and interpretation of the HIV/AIDS epidemic. The questions on the interview protocol (see Appendix) formed the focus of the interview, with each interviewee being permitted to view questions just prior to my activating the audiotape. Each interviewee was asked at the end of the structured questions: “How best can teacher preparation in Zimbabwe help to reduce the high prevalence of the HIV/AIDS epidemic?” Additional questions were asked to clarify the responses. From these semi-structured, taped interviews, I double-checked with the interviewees to verify that I had accurately recorded their opinions or responses. Thereafter I did prompt transcription of the interviews into the Microsoft Works computer program database, at which point the Chi‟s (1997) verbal analysis method was used. In addition, he expressed the view that verbal analysis is a method for qualifying the subjective or qualitative coding for the contents of verbal utterances whereby the researcher tabulates, counts and draws relationships between the occurrences of different kinds

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of utterances to reduce the subjectiveness of qualitative coding. Chi‟s method of coding and analyzing the verbal data consists of eight functional steps: (1) Reducing the data; (2) Segmenting it into units; (3) Categorizing; (4) Operationalizing evidence (for coding) in the coded data; (5) Depicting the coded data; (6) Seeking pattern(s) and coherence; (7) Interpreting the pattern(s); (8) Repeating the whole process if necessary. Different colors of markers were used to mark predominant themes and patterns. Frequency counts were also done as to the number of times ideas were stated in different interviews. Both students‟ and faculty interviews were coded in different colors that depicted the emerging themes. Chi‟s (1997) method of coding and analyzing verbal data was determined to be the most appropriate means to analyze interview responses from eight students and eight faculties at Africa University. What was most fascinating to me was the ability to reduce data into segments or units that helped me to further categorize and operationalize evidence from the interviews that I conducted from both students and faculties. I sought coherent patterns from the interview responses that helped me come up with major themes that should be addressed in dealing with teacher preparation in the advent of HIV/AIDS epidemic. The themes that emerged from this verbal analysis helped me to triangulate data from my observations and documentary analysis. Without clear themes it becomes difficult to come up with an analysis that can be validated by other sources of data in order to confirm to disconfirm the research findings. The table below displays some major themes and patterns that emerged from both students and faculty interviews at Africa University.

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Table 3.1: Emerging Themes from Both Students and Faculty Interviews

Major themes that came from student interviews Major themes that came from faculty interviews

The impact of poverty on the population The historical context of Zimbabwe The small house concept The impact of the social and economic meltdown in Sugar daddies and sugar mummies Zimbabwe Lack of HIV/AIDS information in rural areas and The lack of HIV/AIDS information the farming community The impact of polygamous relationships Sex education programs in both primary and The promotion of gender equality secondary schools The growing number of orphans and child headed The natural history of the HIV/AIDS epidemic families Lack of sexual satisfaction Teacher preparation programs and increased The impact of rural to urban migration capacity of leadership from grassroots level The male perception of young girls, condom not Peer education program necessary, “CNN” The impact of stigmatization The cultural tradition of wife inheritance

Observations Another major means of collecting data in this research was classroom observations, which, unlike the detailed semi-structured interviews, allowed me to observe participants in their natural field setting, which is the classroom. As Merriam (1998) explained, not only observations provide a researcher with some knowledge of the context, but also specific instances can serve as reference points for subsequent interviews. The researcher may also observe things, which the observed would not have been willing to talk about in an interview. I observed a total of eight two-hour lessons in a range of classes made up of senior students preparing to be either high school teachers or health educators. All the classes that I observed were large, with from forty students to one hundred. In none of the classes that I observed were there HIV/AIDS materials displayed in the classrooms or lecture halls. However, well-illustrated billboards about HIV/AIDS were erected on all the entrances to the university campus.

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The most fascinating poster in the office of the Director of the Outreach Program read: “The millennium development goal on AIDS is to halt and begin to reverse the spread of the epidemic by 2015. To achieve this, promises and commitments have been made by individuals, communities and nations. Join the World AIDS Campaign to make sure these promises are kept.” The above statement was strategically displayed to catch the attention of all students and visitors who pass through this office. Documentary Sources Merriam (1998) pointed out that unlike interviewing and observing, collecting documents does not intrude upon or affect the research setting and is easier and more convenient than other research methods. However, the reality of conducting research at a university required the collection of some local or personal documents, which still involved some intrusion into the faculty or students‟ normal classroom life. Collecting such documents depended on the consent of the professors and university administration officials, which was not easy for me to obtain due to problems of red tape. McMillan (2004) defines documents as “written records.” They can be virtually anything written or printed, such as yearbooks, school-budgets, dropout rates, committee minutes, memos, letters, newspapers, diaries, tests scores and books. From Africa University I collected curriculum guides and syllabuses from the following faculties: Education, Health Sciences, Management and Administration, and Theology. I also used the course outlines from the above departments and the university prospectus to find out how the teacher preparation program is designed to help prospective teachers deal with the social challenges in their work environments, especially with the advent of the HIV/AIDS epidemic. Data Analysis Initial data analysis took place through analyzing responses on observation notes that I compiled in the eight lessons that I observed. Different colors of markings were used to identify common themes. The themes that emerged from the observations were basically similar to those that came from the analysis of the semi-structured interviews. A table of the major themes that emerged from the interviews is on page 18. Documents collected at Africa University were analyzed in a similar way. Although not much information was contained in the few documents that I collected, themes such as the impact of poverty on the population, the impact of polygamous relationships, the promotion of gender equality and the growing number of orphans

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and child headed families in Zimbabwe emerged. From these three data sources, semi-structured interviews, observations and documents the same themes essentially emerged. Validity and Reliability Maxwell (1996) describes validity in relation to qualitative research as “the correctness or credibility of a description, conclusion, explanation, interpretation, or other sort of account” (p. 87). I sought validity to make sure that I was being trustworthy with the information that both students and faculty shared with me. I made every effort to listen, not for what I expected or wanted to hear, but for what the students and professors were telling me. I was continually alert not to impose my own interpretations of the events or let my own biases affect the analysis of the data. A triangulation of methods was achieved through the use of observations, documentary analysis and in-depth interviews. This triangulation of methods helped me to insure validity and strengthened reliability of data. Validity and reliability were also sought by comparing interpretations of what students and professors told me against what I had found from my observations and documentary analysis. According to McMillan (1996): Reliability in qualitative research is somewhat different from a quantitative definition; rather than looking for consistency of behavior, qualitative researchers focus on the accuracy of their observations. Reliability is the extent to which what is recorded as data is what actually occurred in the setting that was studied (P. 250). In addition, McMillan expressed the view that reliability is enhanced by the use of detailed fieldnotes, accurate comprehension and accuracy of recording, use of tapes, use of participant quotations and literal descriptions, and an active search for discrepant data. LeCompte and Pressler (1993) noted that qualitative research is a personal endeavor; no investigator does research just like another (p. 341). I personally feel convinced that my study is reliable as defined by the above expectations. Conclusion This chapter provided the historical background to the development of this private, pan- African and United Methodist-related institution, methodology and the procedures followed to carry this case study. Detailed semi-structured interviews; observations and documents were used to collect data on the understanding and interpretations of students and faculty on the

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HIV/AIDS epidemic in Zimbabwe. Major themes that emerged from all three different sources are the severe impact of poverty in Zimbabwe, the growing number of orphans and child headed families‟ shows how difficult life has become for the majority of the population. Detailed interviews, observations and documentary sources used in this study showed that HIV/AIDS epidemic has become a national problem and concerted efforts are needed to combat this deadly disease. The number of orphaned children and child headed homes is surprisingly growing indicating that the problem of HIV/AIDS and suffering is still far from being surmounted. The use of multiple sources in this study demonstrates its reliability and trustworthiness. Chapter 4 Discussion of Findings of the Study The setting At Africa University, students, faculty and staff have the beauty and tranquility of a rural setting whilst enjoying a vibrant, international campus community. The campus is in the beautiful and scenic valley of the Nyagambu and Mutare Rivers at Old Mutare. It is nestled in a valley about 17 kilometers outside Mutare, and is surrounded by hills. A mountain prominently visible from the campus adds more scenery to the entire university. From its peak in the year 1898, Bishop Joseph Crane Hartzell looked down and envisioned hundreds of African young people attending school in the valley below. True to the prophetic words of Bishop Hartzell, the campus buildings, red brick structures with tiled roofs, are in harmony with the surroundings. Teaching buildings include the US$1 million Ireson/ Kurewa Center, home to the Faculty of Agriculture and Natural Resources, with its modern, well-equipped laboratories and lecture halls; the multi-purpose building; and the Agricultural Engineering building. The Faculty of Agriculture and Natural Resources farm is located at the university‟s main campus. The soil around this area is red, which is suitable for agricultural purposes. The total area of the university land is 618ha and of this area 75ha is arable. The farm is designed to operate three sections, namely livestock, fisheries and crops. The Agricultural Engineering program provides services to the production units and is concerned with power sources, machinery, and irrigation and farm buildings. The various sections provide a varied practical experience and exposure to the students in the Faculty of Agriculture and Natural Resources whilst at the same time operating on a profitable commercial basis. Practical Agriculture is one

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of the keystones of the curriculum of the Faculty of Agriculture and Natural Resources and hence the main purpose of the farm. The Ireson/Kurewa building has four well-equipped laboratories, namely Animal Science, Crop Science, Soil Science, and Food Science. There are two lecture theatres that can accommodate 40 students and 2 seminar rooms that can accommodate 20 students each. There are two classrooms that can accommodate 50 students each. The multipurpose room is used for conferences or combined classes and can seat up to 100 students. There are also two computer laboratories. One is for staff and the other one is for students. There is also a conference room where staff members hold their meetings. The Agricultural Engineering complex has four laboratories for , metal work, soil and water, and welding. The complex also has teaching classrooms and a state-of the art computer laboratory. The complex also has a language laboratory, which is used primarily for teaching French and Portuguese. The Jokomo/Yamada Library The library supports teaching and research efforts with both traditional and electronic resources. Every effort has been made over the past decade to develop a variety of library resources and world-class study facilities that complement classroom teaching and learning as well as research. Students and their instructors alike are welcome to take every advantage of the collections of carefully selected books and electronic and multimedia resources within the Jokomo / Yamada library and beyond. The library staff assists and instructs readers to help them master the techniques needed to become self-sufficient in accessing the resources available in their particular disciplines. An increasing number of electronic journals and books are now available to the academic community. These publications are likely to proliferate in the future. Access arrangements for these electronic publications often vary as do the types of services offered and users are advised to read any introductory information closely. The library also subscribes to a number of full text e-journals. Halls of Residence Affordable, comfortable and secure accommodations are available to students in twelve residence halls with a carrying capacity of 1005 occupants. Each of the twelve halls of residence offers the following services: shared bathrooms, toilets, a communal laundry area, communal washing lines and a common room. Each block has a sub warden who forms a link between the

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students‟ affairs and the administration. The sub warden represents the views of the resident students. Students are billed for parts and labor associated with all the damages in the halls of residence. If the repair and maintenance staff cannot repair the damages specialist services are sought from the neighboring city of Mutare. The responsible student would be asked to pay the bill without inconveniencing other students. Students from different cultures or countries are encouraged to share rooms in order to promote diversity. Male and female students are housed separately. Students are offered double or triple occupancy rooms in a non-smoking/non-drinking environment. The dining, lounge, laundry and computer facilities are available to all students. At present, Africa University houses about more than 80% of its students on campus. At times indoor games, movies and cultural activities take place in the halls of residence. Private Accommodation Africa University Prospectus (2007) acknowledges that private accommodation has increasingly become important because of the phenomenal growth in enrollment as a result of the new Faculties. The current space in the halls of residence is very limited especially during the first semester when all the students from internships and teaching practice return to campus. The university does not have accommodation quarters on campus for married students; hence the need to seek privately owned accommodation off campus. To alleviate the problem of a lack of accommodation the office of the Assistant Registrar Students‟ Affairs provides help in an advisory role, in securing privately owned accommodation for students. Africa University Prospectus notes that in general, rentals in Mutare are lower than in any parts of the country, which is a considerable advantage for students. Entertainment Africa University Prospectus (2007) describes various forms of entertainment available for the students. Halls of residence are equipped with television sets and videocassette recorders for student use. Apart from these television sets, the Student Union Building also houses various indoor games such as darts and ping pong. From time to time students hire music groups and bands to perform on campus. The university also provides some instruments for students to use. Occasionally students arrange performances to entertain themselves and others in the process. At Africa University students also find entertainment through activities such as beauty and

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modeling contests. Africa University Prospectus asserts that at times students organize barbeque parties to refresh and entertain themselves while on campus. Africa University Prospectus (2007) elaborates that cultural activities such as dances are organized by students and creates an opportunity for all students from the continent to learn and share their traditional heritages and culture. Cultural exchange activities bring students from various nationalities together in choreographing and presenting integrated performances. They nurture cooperation and collegiality among students of different cultural backgrounds and offer entertainment and co-curricular education to students, staff and members of the public. The Cafeteria and Food Services The cafeteria‟s main objective at Africa University campus is to provide a high quality, nutritious and reasonably priced food service program. The structure consists of a kitchen and the main dining hall with an upper level area, which can accommodate 80 persons. The main dining hall has a carrying capacity of 450 occupants. Three meals are served per day: breakfast, lunch and supper. The dining hall is open throughout the year even on all public holidays and during semester breaks to offer service to international students who cannot always travel to their home countries. The university provides food services to students, staff and visitors as well as to workshops, conferences and seminars that are held on the campus. Since one of the objectives is to keep meal prices affordable, the university requires the revenue to break even with the expenditure. However, the hosting of workshops, conferences, and seminars is for income generation since commercial rates are charged. Students on full scholarship are issued meal cards, which they must produce at each meal to get service. The meal card recipients have a set meal composition. The rest of the students and staff purchase meal tickets, which they present in exchange for the different food items on offer. Staff and visitors pay more for their food than students. A seven-day menu cycle is followed and revised to reflect the menu preference of the students. The student representatives provide input from the student body on the quality of food. The “made to order” menu is popular. Students and staff mostly order French fries, grilled cheese sandwiches or casseroles. The food services committee that is comprised of staff representatives from different faculties, departments, and units of the university and student representative council also gives suggestions and recommendations on the quality of the food. Feedback is also received from the whole university community. All university committees often

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have working lunches, and the lunch is served from the same food that the students eat. The food services manager ensures that taste testing of all food is done before food is served to the public. The workshops, conferences and seminars that are served at the cafeteria are also a good source of feedback. The Chapel The strategically positioned Kwang Lim Chapel was built in 1996. The white elevated cross on the apex of the structure clearly demonstrates the dominant faith shared at this institute of higher learning. It is a showpiece reflecting both Korean and African art. The United Methodist Church based in South Korea funded the chapel; hence it was named after the main donating church. It has a sitting capacity of 500 people. The shiny interior altar was designed and built by Zimbabwean experienced sculptors. Although Africa University is a United Methodist related institution, chapel services are ecumenical to cater to the spiritual needs of students from different religious backgrounds. The chapel is also used for wedding ceremonies by the surrounding community and the students. Information Technology Training Center In an interview, the interim Vice Chancellor said, “The Africa University information technology-training center began in February 2002 and on the 19th of February 2003 it celebrated its first anniversary and its official inauguration. Currently the information and communication technology department staff is also staff of the information technology-training center.” The center has the support of the hardware technician and systems administrator who offer invaluable service and support. Within the hierarchy the center also has an administrator, one information technology instructor and a marketing officer. The department has a secretary and accepts students for internships who gain invaluable experience in hardware maintenance, software support, systems development, training and network support. The following faculties have state of the art buildings and classrooms that are equipped with air conditioning and projectors: Health Sciences, Humanities and Social Sciences, Management and Administration, and Theology. Apart from these main faculty buildings the Africa University campus has these departments housed in the administration building that provides crucial support to the day to day running of the university: the registrar's office, academic affairs office, bursar‟s office, outreach office, student affairs office, Africa University

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Press, the main laboratory for the Faculty of Health and Science, the physical planning office, the clinic, and the Institute of Peace Leadership and Governance. HIV/AIDS Billboards on the Campus When approaching Africa University campus, one sees numerous billboards on HIV/AIDS that signal that the HIV/AIDS epidemic in Zimbabwe now knows no boundaries. "Talk about it!” “HIV/AIDS does not discriminate, do you?” “HIV/AIDS kills” are some of the messages that are boldly written on the well-positioned signposts to catch the eyes of everyone who visits the campus. The first billboard message is designed to create interest or to stimulate the youth to talk about the HIV/AIDS epidemic openly. Other explicit messages are pieces of information meant to raise awareness among all the students, faculty, staff and visitors to this beautiful campus. The vulnerability of the youthful students in a hyperinflation environment like the one characterizing Zimbabwe calls for active mass media participation. The billboards are used to raise awareness of the HIV/AIDS epidemic and to contribute towards breaking the barriers of deep seated stigma surrounding the disease and to promote HIV/AIDS-related social responsibility. Perceived Causes of HIV/AIDS Epidemic in Zimbabwe During the analysis of the data obtained from interviews with students and faculty, observations and documentary sources, several possible causes of the HIV/AIDS epidemic emerged. The perceived causes suggested include: poverty; a lack of information/education; an erratic supply of condoms/lack of accessibility to condoms; cultural practices such as wife inheritance, small house or extramarital relations; sugar mammies/sugar daddies; commercial sex workers; and child pledging; rural-urban migration; poor living conditions; denial by the government; and punishment from God. Apart from these perceived causes of HIV/AIDS identified by both students and faculty at Africa University, deeper and more enduring structures in Zimbabwe may have significantly contributed to the spread of the epidemic. The political legitimacy crisis led to the failure of government policies from the national level to the grassroots foundations. The apparent clash of modernity and traditional customs led to the break down of the extended family norms and values thereby contributing to the spread of the HIV/AIDS epidemic in Zimbabwe. In this chapter, I will discuss the findings from the interviews (with emphasis on the interviews), observations and documentary sources and other causes not

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mentioned by both students and faculty. Then, I will relate the identified causes of the HIV/AIDS epidemic to the research questions. The following table illustrates the results of the initial semi-structured interviews that I conducted with eight student volunteers at Africa University. All the items mentioned in the interviews by more than one interviewee have been included in the table below: Table 4.1 Students‟ Perceptions of Causes of HIV/AIDS Epidemic Causes Number Mentioning

Poverty/economic hardships/lack of 7 nutrition Lack of information/education 7 Cultural practices such as wife inheritance 6 Erratic supply of condoms/lack of 5 accessibility to condoms Small house or extra marital relations, 5 sugar mammies/sugar daddies Commercial sex workers/prostitution 4

Child pledging by some religious sects 4

Rural-urban migration/lack of 3 accommodation Denial by the government 3

Theological/punishment from God 3

Research question number 1 asks, “What are the causes of the HIV/AIDS epidemic in Zimbabwe?” Students gave comprehensive and thoughtful responses as to what they perceive to have contributed to the high prevalence of HIV/AIDS in

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Zimbabwe. Poverty, economic hardship, lack of nutrition and cultural practices prominently stood out as the main causes of the HIV/AIDS infection, especially among the rural, mining and resettlement communities. Lack of employment opportunities in these underdeveloped areas has pushed many young women into prostitution in order to survive in a hyperinflation environment. The following interview sheds some light on the HIV/AIDS epidemic in Zimbabwe. Rumano: What are the causes of the HIV/AIDS epidemic in Zimbabwe? Female student interviewee: Poverty is forcing many young girls and desperate women into prostitution in order to survive. Many people lost their jobs since 2000 when the government embarked on the controversial land resettlement program in Zimbabwe. Rumano: How did that contribute to the high prevalence of HIV/AIDS? Female student interviewee: Many of the retrenched people could not afford a decent lifestyle they were used to when the economy was stable, especially young women in a male dominated society were compelled by the circumstances to become sex workers. Rumano: Do you think that these women or girls are aware of the dangers of sexually transmitted infections or HIV/AIDS? Female student interviewee: Desperation and a sense of hopelessness are pushing many of the young unemployed women to conclude that it is better to die of AIDS than to die of hunger in Zimbabwe where food has now become a scarce and expensive commodity. Rumano: Is there any way these young women can protect themselves when having sex? Female student interviewee: The negotiating powers of these young women are seriously compromised as they submit themselves to the mercies of their sexual partners, who have the financial resources. Some of these guys never want to use condoms, let alone go for HIV/AIDS testing before sex. It has now become very common to see many underage girls marrying older men in order to secure a decent life, thereby exposing themselves to the HIV/AIDS infection. The above interview depicts how desperate the economic situation has become even among college students who should be taking a positive role in the fight against the epidemic. Fatalism has now become the greatest enemy to the fight against the HIV/AIDS epidemic, as many young women have lost hope. In their desperation they have concluded that death is eminent and certain either through hunger or through HIV/AIDS. The lack of a nutritious diet

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among the infected persons exposes them to opportunistic diseases that can do more harm to the people living with AIDS. According to a male interviewee what has caused the high prevalence of the HIV/AIDS epidemic in Zimbabwe is cultural practices such as wife inheritance and child pledging. Factors such as cultural norms, values, beliefs and myths have been cited as the main catalysts in the spread of HIV, particularly the common practice of wife inheritance. When an African man dies, in some societies it is the responsibility of his brother to inherit his widow. Unfortunately, this has become a key factor in the spread of the AIDS virus. The main reason given for practicing wife inheritance in some African societies is to have the family of the dead man taken care of and to have his name continued. Usually, a woman is inherited by her dead husband's brother and if he (the dead husband) happens not to have a brother, the closest living male relative such as first cousin, inherits her. The inheritor makes sure that the widow and her children are fed, clothed, sheltered, educated, protected and well kept. A man can only take on a widow if he has a family. His first wife accepts the arrangement because tradition frowns on his having sexual relations with his inherited wife. The interview extracts below alludes to some of the issues raised by the cultural practice and wife inheritance. Rumano: What are the causes of the HIV/AIDS epidemic in Zimbabwe? Male student interviewee: Cultural practices such as wife inheritance and child pledging are some of the leading causes of the HIV/AIDS epidemic, especially in the remote rural areas. Rumano: Why are some people still practicing it in the advent of the HIV/AIDS? Male student interviewee: The culture of wife inheritance has been in existence since time immemorial and it is heavily imbedded in some people who do not have adequate information on the HIV/AIDS. There are myths in some societies that AIDS is an acronym meaning, “American Ideas of Discouraging Sex”, though many of the people now accept that HIV/AIDS is a sexually transmitted disease and is killing millions. Rumano: Is there any cultural friendly method that can be used to teach some of the people that are still practicing wife inheritance? Male student interviewee: Traditional leaders have taken it upon themselves to discourage the practice of wife inheritance and to spread the word that HIV/AIDS is a real disease killing many people.

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In summary of the interview protocol on the perceived causes of the HIV/AIDS prevalence poverty, which ranked so highly includes deprivation, constrained choices, and unfulfilled capabilities, and refers to the interrelated features of well-being that impacts upon the standard of living and the quality of life. It is not necessarily confined to the financial capital, quantified, and minimized in monetary indices. Many people in Zimbabwe are living in such terrible abject poverty. They lack not only money, but also assets and skills. Therefore, people strive to meet their basic needs and indulge into risky behaviors such as commercial sex, to obtain basic survival resources. HIV infection is mostly confined to the poorest, who constitute the majority of those infected in Zimbabwe and sub-Saharan Africa. It is not simply that information, education, and counseling activities are unlikely to reach the poor but that such messages are often irrelevant and inoperable, given the reality of their lives. Even if the poor understand what they are being urged to do, it is rarely the case that they have either the incentive or the resources to adopt the recommended behaviors. The capacity of the individuals and households to cope with HIV/AIDS depends on their initial endowment of assets, both human and financial. The poorest by definition are least able to cope with the effects of HIV/AIDS, so that suffering among the affected populations is increasing. Even the non-poor find their resources diminished by their experience of infection. Many of the poorest are women who often head the poorest households in Zimbabwe and throughout Africa. Inevitably, such women are often engaged in commercial sex transactions, sometimes as commercial sex workers but more often as part of survival strategies for themselves and their dependents. The characteristics of the poor are well known, as are some of the causal factors, like early marriage, which contributes to a “culture of poverty,” with the children of the poor often becoming the poor of the succeeding generations. Poverty is also associated with weak endowments of human and financial resources, such as low levels of education with associated low levels of and few marketable skills, generally poor health status and low labor productivity. However, the consequences of poverty have mostly been associated with migration, sexual trade, polygamy, and teenage marriages as reflected in the extracts from the interview below. The following table illustrates the results of the initial semi-structured interviews that I conducted with, eight volunteer faculty members. All items mentioned in the interviews by more than one interviewee have been included.

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Table 4.2 Faculty Perceptions of Causes of HIV/AIDS Epidemic Causes Number Mentioning

Poverty/shortage of health personnel in 7 search greener pastures Lack of 7 opportunities/underdevelopment/idleness Polygamous relations/small houses 7 Inaccessibility of the antiretroviral drugs 6

Cultural practices/wife inheritance/child 6 pledging Political/economic instability in the rural 5 areas Denial by government for tourism purposes 4

Essentially, both students and faculty identified the same factors as causing the high prevalence of HIV/AIDS in Zimbabwe. However, some faculty members took a casual approach to the interview questions. The sensitivity of the subject might have made it difficult for some faculty members to open up and give detailed responses when they might have had bad relationships. Also, some of the faculty might have either spouses or relatives who have succumbed due to the HIV/AIDS epidemic. The fact that HIV/AIDS is prevalent among the youthful and middle aged could explain a lack of interest among the faculty in giving comprehensive responses. However, there was strong agreement between the students and faculty that poverty has been a leading factor in the spread of the HIV/AIDS epidemic in Zimbabwe. Lack of information on HIV/AIDS among the rural, mining and the newly resettled farmers contributed to the rapid spread of the epidemic. Cultural practices such as wife inheritance and polygamous relationships have also played a major role in the spread of the epidemic.

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The following interview clearly demonstrates the view that poverty in Zimbabwe and a lack of information have significantly contributed to the AIDS scourge. Rumano: What are the causes of the HIV/AIDS epidemic in Zimbabwe? Male faculty interviewee: The economic meltdown has forced many people to live way below the poverty datum line. Some of the young women and girls who loiter in the streets never intended to be sex workers but poverty pushed them to be prostitutes. Rumano: Are these people aware of the dangers of the HIV/AIDS? Male faculty interviewee: Many of them are fully aware of the risks involved in prostitution but they are pressed between two choices: either to die of starvation or of HIV/AIDS. Zimbabwe is currently experiencing the highest inflation that has eroded all the buying power of the currency that has now been rendered useless. Rumano: Is there anything else that these young women can do to earn a living? Male faculty interviewee: There are many income generating projects that can be started such as poultry raising, weaving and gardening among others but all those sources need financial capital. Without capital and infrastructure there is nothing that can be meaningfully done to sustain the livelihoods of many desperate young women and girls. Another factor raised by the faculty that contributes to the spread of the HIV/AIDS epidemic in Zimbabwe is the concept of a small house where either a married man or a married woman engages in an extramarital relationship. This trend indicates those who have strong financial background can afford to entertain an extra affair just for pleasure, but it also spreads the virus that causes AIDS. This idea is developed in the following interview excerpt. Rumano: When did the small house concept start? Male faculty interviewee: The practice is as old as humankind and was practiced by those who had some extra money for their sexual pleasure. Both males and females can have their small houses. Some rich women who are not sexually satisfied can have extra marital relations just like some men. Rumano: How common is the practice now in the age of the HIV/AIDS? Male faculty interviewee: Many female students are picked up over the weekends by their sugar daddies. Sugar daddies are preying on the younger girls, as they perceive them to be free of the virus. However, this practice is contributing in the spread of the disease. The young girls are lured by the financial favors they will get in exchange for sex.

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Rumano: Why do the college girls go out with older men, leaving their college mates? Male faculty interviewee: College boys do not have cars, clothes and cash that are sought by the college girls. Many older men who come to pick up young girls have money to splash on these young girls. In some rare cases rich older women come to the college to pick young handsome boys for entertainment over the weekend. Two male faculty members pointed out that rural-urban migration in search of jobs is to blame for the high prevalence of HIV/AIDS epidemic in Zimbabwe. For a long period some families were separated due to the lack of accommodations in some employment sectors such as the mining industry. Rural-urban migration that occurred in the 1980s left a lot of women in the rural areas while many of the able bodied men joined the fast moving city life. Some of the women left behind in the rural areas engaged in extra marital relationships, as did some of their male counterparts who had joined the city life. Extramarital relationships due to rural-urban migration in Zimbabwe contributed to the further spread of the HIV/AIDS epidemic. Lack of accommodations in cities pushed many married men to cohabit with young women who were looking for cheap accommodations. Another factor that faculty blamed for the high prevalence of the HIV/AIDS epidemic is the non-availability or the inaccessibility of the antiretroviral therapy or (the life prolonging drugs) among the infected people in Zimbabwe. Many experienced health workers and medical doctors have fled the country in search of greener pastures, going either to neighboring countries or overseas. The tense and hostile political situation between the ruling party, the Zimbabwe African National Union (Patriotic Front), ZANU (PF), and the Movement for Democratic Change (MDC) led to an exodus of approximately 3 million Zimbabweans to surrounding countries. Married couples are separated in this case as some political activists or people suspected to be members of the opposition leave their families behind to avoid persecution and illegal detention. One of female interviewees stated that her husband left the country eight years ago and went to Britain but has not been able to come home due to the strict immigration laws. In her words, “My husband has not been able to come back and see our daughter, who is now eight years old and I am not sure if he is now married or has a girl friend in Britain. I am tired of seeing my husband on the pictures only.” The above statement shows how difficult life has become in Zimbabwe, a recipe for the spread of the HIV/AIDS epidemic.

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Some faculty expressed the view that the government did not want to publicly acknowledge the HIV/AIDS epidemic as a national crisis for fear of losing tourists, who significantly contribute revenue to the national coffers. The first reported case of HIV/AIDS in Zimbabwe was in 1985. It was only in 2000 that the government acknowledged that HIV/AIDS was a national crisis. This view is elaborated upon in the following interview: Rumano: Why is the government blamed for the high prevalence of the HIV/AIDS in some quarters? Male faculty interviewee: This irresponsible government chose to have money from the tourists at the expense of human lives. The magnitude and breadth of suffering in Zimbabwe due to the HIV/AIDS epidemic is frightening and disheartening. Rumano: How do you justify your accusation of the government? Male faculty interviewee: The government did not create the forum for free discussion of the HIV/AIDS in the public. The political leadership was not interested in admitting that HIV/AIDS was a national crisis in order to mobilize both financial and human resources needed to combat the disease in its infancy. Rumano: What can you say about the HIV/AIDS orphaned children? Male faculty interviewee: The number of child headed families is on a surge and many students are dropping out of school to provide and care for their siblings. A bleak and dark future awaits the HIV/AIDS orphaned children if there are no long-term interventions or social programs in place to alleviate the psychological trauma experienced by these children. A few students from the Faculty of Theology offered theological explanations as to why Zimbabwe is experiencing a high prevalence of HIV/AIDS. In the words of one male interviewee, “Many people in Zimbabwe have abandoned their God in search of sexual pleasure manifesting itself in the form of small house, sugar daddies and sugar mammies. HIV/AIDS epidemic is a direct punishment from God. Zimbabweans should repent of their sins for salvation. God punishes all those who are promiscuous in the form HIV/AIDS, the incurable epidemic.” The response did not surprise me since Africa University is a United Methodist-related institution of higher learning. However, combating high HIV/AIDS in Zimbabwe calls for decision-making based on accurate, factual information about the HIV/AIDS epidemic. HIV/AIDS testing centers and the provision of antiretroviral drugs should be made accessible to the vulnerable groups.

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The other student from the Faculty of Theology expressed more optimism through religious groups‟ involvement. In her words, “Churches are an integral structural and credible part of communities in Africa. Their involvement in health and education services and focus on social needs affords considerable opportunity to combat HIV/AIDS. Churches play significant roles in care but their overall effectiveness in combating HIV is impeded by a common factor: stigma and discrimination. These issues need to be addressed both within the professional church and society in an open, informed and compassionate manner. Lack of HIV/AIDS policy within the church constrains vision and thus advocacy. Church-related institutions should challenge the existing paradigms on sexuality and gender; bridge the gulf between culture/tradition and religion; target youth; promote and prevent mother to child transmission; advocate on inequalities, social injustices and access to medications; network and share best practices.” The economic situation in Zimbabwe is a cause for serious concern, with over half the population currently in need of food assistance. Along with continued political turbulence and economic decline, people in Zimbabwe will experience continuing food shortages in the coming year due to a combination of dry weather, a lack of affordable food on the market, and a dramatically reduced amount of land under cultivation. The HIV/AIDS epidemic is compounding the premature death of thousands of productive people, particularly women, across Zimbabwe and is wrecking the livelihoods of millions more while sowing the seeds of future famines. Education programs that seek to empower women, youths and all the vulnerable groups should be put in place to inform all those concerned about taking preventive measures to minimize the prevalence of the epidemic. Impact of Government HIV/AIDS Policies on Teacher Preparation Research question number 2 inquires, “To what extent do government policies regarding HIV/AIDS education shape the teacher preparation program at Africa University?” Table 4.3 presents faculty and students responses to this question.

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Table 4.3 Faculty and Student perspectives on Number Mentioning HIV/AIDS Policy and Teacher Preparation Adequate HIV/AIDS resources for 7 preservice teachers and teacher educators The need for comprehensive preservice 7 HIV/AIDS education Current efforts to include HIV/AIDS 6 prevention education in preservice teacher education The policy recognizes the breadth and the 6 magnitude of the epidemic Teachers must be knowledgeable 5 Empower teachers fully 4

Both students and faculty acknowledged that the government has a policy on teacher preparation that encourages the teaching of HIV/AIDS education in Zimbabwe and many of them were not well informed on how the policy affects teacher preparation program at Africa University. HIV/AIDS experts agree that prevention through education is the best way to fight the transmission of human immunodeficiency virus (HIV), which causes AIDS, and that education must begin before young people initiate sexual activity and certainly no later than seventh grade. Because school attendance is a nearly universal experience for Zimbabwean children and youth, schools offer an accessible and appropriate setting for HIV/AIDS education. Unfortunately, the capacity of teachers to provide instruction about AIDS and other related health problems with knowledge and comfort might be limited by a lack of preservice education. From documentary analysis, I concluded that Africa University does not require sexuality education courses for preservice teachers despite the high prevalence of the HIV/AIDS epidemic. There are a number of discernible factors related to HIV/AIDS that make preservice preparation critical in Zimbabwe. Children with HIV disease are living longer and the number of children with HIV/AIDS who are attending school is expected to grow. Teachers need an understanding of the special educational, social, psychological, and medical needs of these

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students as they are found almost in any school community. Since 1990s HIV/AIDS has been the leading cause of death among 25- to 44-year-olds in Zimbabwe. Teachers may expect to confront educational and psychosocial issues among children whose parents have HIV disease and some students who might be suffering from the disease. To prevent the spread of any disease, teachers must be knowledgeable and skilled in using correct infection control guidelines in and around the classroom. In the case of HIV/AIDS epidemic, teachers need to have accurate information. Because of the centrality of school system in Zimbabwe there are high chances that some teachers may be entrusted with information about a student's, parent's, or staff member's HIV status and must understand ethical and legal requirements for respecting confidentiality. In the Zimbabwean schools teachers may be expected to provide HIV/AIDS education and to answer students' questions about HIV disease in a manner that is developmentally and culturally appropriate to the students. Teacher attitudes affect their comfort with and capacity to teach specific subject matter. The preservice setting offers an opportunity for future teachers to explore their own beliefs and biases toward the disease that has become the main cause of death in Zimbabwe. To mitigate the spread of the virus and provide care and support to those already infected or otherwise affected by the epidemic, the Zimbabwean government stipulates that there should be adequate human and financial resources to train preservice teachers. According to the National AIDS Council (2004), “The overarching goals of the national policy and strategic framework are to prevent the spread of the HIV and to reduce the personal, social and economic impacts of the epidemic” (p. 48). In interviews with both students and faculty it emerged that some students feel that the government did not put the maximum effort into dealing decisively with the epidemic in a timely fashion. The following interview excerpt provides more details on the perception of the students toward government response. Rumano: Do you think that the government prudently acted on the HIV/AIDS epidemic? Female student interviewee: When AIDS first emerged in Zimbabwe, the government was slow to acknowledge the problem and did not take appropriate action. Rumano: What action did you expect from the government? Female student interviewee: There was no public discussion on the HIV/AIDS epidemic in the public media. There was not a sense of urgency to warn the population against the disease whose prevalence is now difficult to control. The political leadership in Zimbabwe and President

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Mugabe rarely addressed the subject in his national speeches. When he did, it was not considered newsworthy. Rumano: Why do you the silence on the part of the national leadership contributed to the spread of the epidemic? Female student interviewee: The population misconstrued the silence on the part of the government to mean that there was no impending epidemic since there was nothing said about the disease. I personally think that the government did not want to scare away the potential tourists and investors at the expense of the citizens. In an interview with a female faculty member who had worked for the National AIDS Council (NAC) before joining Africa University, she expressed the view that while the government started levying all the workers in Zimbabwe, the government‟s response to HIV and AIDS has ultimately been compromised by numerous other political and social crises that have dominated political attention and overshadowed the implementation of the national AIDS policy. The NAC has also been constrained by poor organization and a lack of resources. In her words, “The government should not be viewed as an innocent victim of the inevitable epidemic now facing the hopeless population. While political commitment towards fighting AIDS is apparent in Zimbabwe, the decisions made by Mugabe in dealing with other issues have led to a situation where the government is unable to adequately address the crisis.” The National AIDS Council (2004) noted that the National AIDS Co-ordination Program was set up in 1987, and several short term and medium term AIDS plans were carried out over the following years but it was not until 1999 that the country‟s first HIV and AIDS policy was announced. This policy began to be implemented the following year by the newly formed National AIDS Council (NAC), which took over from the NACP. At the same time, the Government introduced an AIDS levy on all taxpayers to fund the work of the NAC. The national policy levies 3 percent from all workers in Zimbabwe to raise money for the HIV/AIDS epidemic that was declared a national crisis in 1999. Generally, the government policy of non- discrimination against the people infected with HIV/AIDS resembles success on the part of the government that has not been performing its duties diligently. A male student interviewee had some kind words for the government. In his words, “Although the government policy has not been well articulated overall, the non-discrimination policy served the intended purpose in a country that is experiencing the highest inflation comparable to none in the modern world.”

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Echoing similar views on the above subject a senior faculty member clearly expressed that, “If there was discrimination of the HIV/AIDS infected people, many of the breadwinners in Zimbabwe could have long lost their means and sources of income. The worst affected sectors are the mining industry, agriculture, long distance haulage transporters and the armed forces that spent considerable long time away from their families.” The teacher preparation program at Africa University draws some of its teaching and learning concepts from the National AIDS policy. Africa University does not exist in a vacuum; therefore, the factors that affect the Zimbabwean population are reflected in the content of what students learn. One male faculty interviewee in the theology department noted that, “We talk a lot about the HIV/AIDS epidemic in our ethics course though many students are reserved when it comes to discussing this subject in some detail. There are strong cultural barriers that restrict many students from talking about this sensitive topic openly.” In an African context it is a taboo to discuss sexual issues openly, let alone an HIV/AIDS epidemic that has been given names such as “slim disease” or “women‟s disease”, clearly showing the difficulty of discussing it openly. One female faculty interviewee from the Faculty of Health Science had these words to say; “HIV/AIDS epidemic should be openly discussed as much as people talk freely about malaria. People should stand up in their capacities as individuals, organizations or communities to learn to acknowledge that HIV/AIDS epidemic is claiming millions of lives. It is high time that Zimbabweans should talk about this devastating epidemic to everyone in an effort to combat this epidemic.” Peer education in Zimbabwe, especially among the youthful groups, rural communities and the newly resettled farmers, might help in combating the HIV/AIDS epidemic. Traditionally, health education information is provided by outside experts to a passive target group to promote behavior change in individuals. In community-led peer education, however, local people are trained to disseminate information through debate and discussion. Assuming that sexuality is socially constructed, rather than being the product of individual decisions, peer education enables people to make collective decisions to change their behavior. A male senior faculty interviewee sounded quite optimistic about peer education. In his own words, “Peer education seeks to empower lay people through placing health related knowledge in their hands. This increases the likelihood that people will feel they have some control over their health. Peer education succeeds to the extent that it promotes two forms

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of social capital bonding and bridging. Bonding social capital refers to trusting and cooperative relationships in homogeneous peer groups, which we believe are necessary for collective debate and , for example, in groups of sex workers.” Bridging social capital refers to collaboration among diverse groups of stakeholders who might not otherwise have had contact and whose collaboration increases the likelihood of the program being successful.” An example of this is an alliance between Africa university students and the surrounding high schools. Africa university students help to peer educate high school students to make informed decisions in their sexual relationships. Table 4.4 Measures that Students and Faculty Think Should be Put in Place

Measures Number Mentioning Introduce sex education to all students 8 Increase the number of peer educators 7 Plan outreach programs effectively 7 Distribute condoms to a vulnerable groups 6 Use mass media communication 6 Empower students to informed decisions 6 Engage the private sector 6 Encourage religious groups to help 6 Talk about the HIV/AIDS epidemic openly 5 Provide both teaching and learning tools 5 Make use of the cultural contexts 5

Both students and faculty were in agreement that AIDS education in Zimbabwe might be a useful way forward to deal with the HIV/AIDS epidemic. We now know much more about how HIV is transmitted than we did in the early days of the epidemic, and we know much more about how we can prevent it being transmitted. One of the key means of HIV prevention is education-teaching people about HIV, what it is, what it does, and how people can protect themselves against it. Over half of the world‟s population is now under 25 years old. This age group is more threatened by AIDS than any other; equally, it is the group that has more power to

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fight the epidemic than any other. The following interview extracts shed some light on how students and faculty at Africa University think AIDS education might help to deal with the HIV/AIDS epidemic in Zimbabwe. Rumano: How can AIDS education help in the fight against HIV/AIDS? Male faculty interviewee: Education can help to fight HIV, and it must focus on young people. Many AIDS educators around the world are disturbed at this growing trend of providing AIDS education from a moralistic perspective, and argue that AIDS education ought to be non- judgmental, making young people aware of how HIV can be transmitted and how they can avoid becoming infected without passing moral judgment on those who engage in infection-related behaviors, whether they do so safely or not. Rumano: How can AIDS education target both students in school and those out of school? Male faculty interviewee: AIDS education can also be targeted at young people in non-school environments through their peers, through the media, and through doctors or their parents. And, in an interview with a female faculty member: Rumano: How can a government that is experiencing serious economic and financial crisis help in this situation? Female faculty interviewee: Foreign governments, charities and nongovernmental organizations that come into the country and deliver AIDS education as part of a larger package of HIV prevention work support AIDS education in Zimbabwe. AIDS education for young people today falls generally into one of two categories: either 'abstinence-only', or 'comprehensive'. These are actually types of sex education, rather than AIDS education specifically. Rumano: What type of AIDS education is taught in the Zimbabwean schools? Female faculty interviewee: AIDS education in many schools comes as a part of a sex education program, if it occurs at all. The type of AIDS education program that is offered usually depends on the attitudes of those who determine the syllabus content. Not all young people are fortunate enough to attend school. In Zimbabwe students‟ pay for schooling, and poor families may be unable to afford to send a child to school, or may be unable to send all their children to school. Sometimes children will be required to work, making them unavailable for school. In other cases, young people live in areas where a local school is not accessible. In some situations, young people may have been

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excluded from school for reasons that might be due to the young person‟s behavior, academic or intellectual abilities, or due to discrimination. Some young people play truant, and will have only very limited attendance. This means there should be ways and mechanisms devised to reach out to school youths. This can include radio and traditional media such as street performances or murals. One advantage of media-based AIDS education is that it can target specific groups amongst the population. If the message is to be targeted at young people, then it will be placed in media that are favored by this audience. Table 4.5 How Faculty and Students Think the Community Can Help

Ways to Help Number of Mentioning Community should have responsibility to 7 combat the HIV/AIDS epidemic Create income-generating projects to 7 empower the people Educate all the community members on the 7 dangers of HIV/AIDS Community leaders to be role models and 6 advocates Start partnership programs to address the 5 needs of the surrounding communities Set up gardening projects to supplement 5 the nutrition of the infected people Provide for the orphans in terms of shelter, 5 school fees and guidance

Despite pharmaceutical advances in the new millennium, AIDS remains a health problem difficult to treat, especially in Africa, leaving preventive interventions as the primary means of promoting risk avoidance. The role of the community leaders, teachers, traditional chiefs and religious leaders can be used to raise much awareness about the dangers of HIV/AIDS in Zimbabwe, where medical care is way beyond the reach of many. Messages of hope and ways of

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combating the HIV/AIDS epidemic can come from every influential community member to achieve the goal of an AIDS free generation. Essentially, both students and faculty shared the same view that concerted effort by the community leaders could be an effective way to deal with the HIV/AIDS epidemic in Zimbabwe. To cushion many of the unemployed people who are experiencing economic challenges and food shortages, income generating projects such as poultry raising, basket weaving and other projects could be started to jump start the economy in the communal areas. Observations The enthusiasm and high expectations that I had when I entered the classrooms of finding wall hangings about HIV/AIDS as well as posters, statements and messages displayed dashed when I could not find any of these artifacts. In all the eight classrooms that I observed, I did not find what I had hoped to find. My expectation was to observe classes that were preparing student teachers to deal with the HIV/AIDS epidemic in their communities upon completion of their four-year study programs. From my role as a mere spectator in all the eight classes I can conclude that Africa University does not have a specific curriculum that prepares student teachers to deal with HIV/AIDS. However, I observed that peer education on HIV/AIDS is well coordinated and functional. The nurse in charge at the university clinic adequately prepares the volunteer students who join the peer educators group. All the classes that I observed were large and ranged in size from 40 students to 100. In all the eight classes that I observed, from the Faculty of Agriculture to Health Sciences there were no visible HIV/AIDS posters. That was in contrast to the outside area that was dotted with HIV/AIDS billboards. Of particular interest to me was the colorful eye catching poster on the office of the Director of the Outreach Program, who is directly dealing with the HIV/AIDS epidemic in a sustained and comprehensive way. The message on the poster read, “The millennium development goal on AIDS is to halt and begin to reverse the spread of the epidemic by 2015. To achieve this, promises and commitments have been made by individuals, communities and nations. Join the World AIDS campaign to make sure these promises are kept.” My criticism of the displayed message is that couples; boyfriends, girlfriends and sex workers should not wait until 2015 to keep the promises. With the breadth and the magnitude of the HIV/AIDS epidemic there is a need to show greater urgency in the messages that serve to

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educate the population on the dangers of this epidemic. All adults that are vulnerable to HIV/AIDS epidemic should take a proactive approach in the fight against the epidemic. When I visited the university clinic I was welcomed by different powerful messages strategically positioned to warn visitors to the clinic about the dangers of the HIV/AIDS epidemic. One huge poster had this message, “Keep your engine clean, and beware of the sexually transmitted infections and the incurable HIV/AIDS.” Metaphorically expressed, the “engines” referred to in the poster are the sexual organs. All the visitors to the clinic will read and try to make sense out of this poster. The other poster hanging on the wall had the following message, “Organize do not agonize by infecting the innocent souls.” Explicit messages like this one serve to remind visitors that some of the HIV/AIDS infected people were the victims of careless and irresponsible people. Another poster in the clinic read, “What is your HIV/AIDS status? Visit the nearest New Start Center today for free testing and counseling.” Students and anyone else at Africa University who visits the clinic will read some of the messages about the HIV/AIDS epidemic. My discussion with the nurse in charge at the clinic led me to one of the most formidable groups of peer educators on campus that is trying to combat HIV/AIDS. The peer educators meet every Monday at 7:00 in the evening in one of the agricultural engineering classrooms. Africa University Peer Educators (AUPE) was formed in 2002 to deal with the issues related to HIV/AIDS and other social challenges facing the students on campus. Africa University Policy (2004) acknowledges that the continent of Africa has been found to have the largest population of people living with HIV/AIDS. Southern Africa has been recognized as a heavily affected area. And in the region, Zimbabwe is among the worst affected countries with regard to the HIV/AIDS pandemic. Africa University, a pan-African institution of higher learning, situated in Zimbabwe, has a student population of over 1200. The students come from 20 African countries, and the university has a strategic opportunity to contribute to reducing the effects of the HIV/AIDS epidemic with relevant and effective awareness, care and prevention of HIV/AIDS programs. Recognizing the severe effects of the HIV/AIDS epidemic and the university‟s own strategic position as a pan-African institution of higher learning, Africa University established a task force on HIV/AIDS. It was from this task force that Africa University peer educators emerged. The task force is composed of twenty-one members who represent all the units at the campus. Every Monday the task force meets to discuss and deliberate on the issues related to the

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HIV/AIDS programs. I observed three meetings to familiarize myself with the issues raised by this committee. The task force formulated the following objectives to fight against the HIV/AIDS epidemic: 1. To generate, receive and share information on HIV/AIDS with relevant stakeholders of Africa University and its surrounding community; 2. To determine how HIV/AIDS is affecting Africa University and its surrounding communities; 3. To describe the current university programs and practices on HIV/AIDS; 4. To develop HIV/AIDS core programs for the university in line with the university‟s vision and policy on HIV/AIDS. The peer educators group was formed as part of the university effort to deal with the HIV/AIDS epidemic affecting several countries in sub-Saharan Africa. The first meeting that I observed the peer educators was an eye opener and helped me appreciate how some students at Africa University are determined to combat the epidemic. The coordinator of the peer educators, a senior female student, outlined the composition of the executive committee as follows: the coordinator, vice coordinator, secretary, public relations secretary, treasurer and three committee members. I liked the leadership skills, maturity and sense of purpose that were shown by the group as they planned campus activities to help their fellow students and high school students in the neighboring communities. As a mere observer, I patiently waited for the deliberations to be concluded by the enthusiastic group of students. The following objectives emerged from the meeting organized, managed and supervised by students: 1. To scale up peer the educators‟ outreach program; 2. To design a systematic but flexible program for the 2008-2009 academic year; 3. To develop campus wide programs; 4. To develop motivational strategies for peer education intervention; 5. To elect the new executive members for the 2008-2009 academic year; 6. To select special committees for the constitutional review and orientation programs. It was fascinating indeed to observe the participants breaking into six groups to brainstorm and discuss the specific objectives. The six groups composed of both female and male students were given an hour to work on specific objectives after which each group presented its report. Each

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group presented its report to the entire group of the peer educators for further discussion and feedback. The participants that worked on the first broad objective came up with the recommendation that transport, home-based care kits and training must be made available to the peer educators. An operational budget that provides the funds for the peer educators comes from the bursar‟s office. It was suggested that home-based visits should be made consistently. Outreach to high schools and to other institutions of higher learning in Zimbabwe such as the National University of Science and Technology (NUST), the (UZ) the ten teachers colleges, Solusi University and beyond Zimbabwe‟s borders in sub-Saharan Africa was discussed. The use of video conferencing was raised as a possibility to expand the peer educators program. The participants resolved that ultimately Africa University peer educators might pioneer the formation of an all universities peer educators association in Zimbabwe. It was suggested by the participants that fundraising activities such as sponsored walks and car washes among other ways of fundraising should be explored. The group agreed to engage the Manica Post, the local newspaper, to run a column to publicize the peer educators‟ activities. A drama group was raised as a possibility to educate both students and the local community. Another group that worked on the development of a campus wide HIV/AIDS program identified the activities, inputs, outputs, responsible people, time frame and the operational budget for the 2008-2009 academic year. Activities such as showing videos on HIV/AIDS, public lectures and live concerts were proposed as effective means to reach out to many high school and college students. The participants agreed that any message conveyed through live shows was likely to be effective with groups vulnerable to the HIV/AIDS epidemic. Inputs such as television sets, overhead projectors, digital cameras and tapes were listed as important assets for the outreach program to use. To all intents and purposes the peer educators hoped that these activities would lead to improved knowledge about HIV/AIDS that might help students and the general public to make informed decisions when dealing with sexual issues. The last group to give feedback talked about the importance of the constitution to the peer educators and the necessity of making the document accessible to the public. It was agreed that the peer educators‟ constitution should address the structure of the committee, duties of the committee, term of office, vote of no confidence, code of conduct, electoral procedure and accountability issues. Other issues raised by the group that worked on the constitution included

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gender sensitivity in the composition of the executive committee, the dispensation of democratic values and keeping the dream alive by expanding the outreach activities to all the most vulnerable groups in Zimbabwe and beyond its geographical boundaries. The peer educators agreed in principle that all the countries that are represented at Africa University should at least have some functional peer educators programs in line with the spirit of pan-Africanism to combat the HIV/AIDS epidemic. The enthusiasm and commitment shown by these peer educators demonstrated to me that, given the opportunity and the resources, this vibrant group might positively contribute to the fight against the HIV/AIDS epidemic. Although the peer educators came up with some ambitious projects and initiatives, their capacity could be minimized by economic hardships in a hyperinflationary environment that has rendered the Zimbabwean currency useless. I wish the national leadership shared the same commitment and desire to deal with the HIV/AIDS epidemic that is causing misery and suffering among hungry and desperate people. From my observations I can conclude that Africa University has some powerful programs to combat the HIV/AIDS epidemic though they are not representative enough of the entire campus. The current coordinator of the peer educators is a female senior student, which shows that the role of women in the fight against the epidemic is being recognized as well their very good and compassionate leadership skills. I had hoped to see the incorporation of some of these activities in the university curriculum, but from my observations of the eight classes I did not see any curricula that addressed HIV/AIDS education, save for the spirited peer educators‟ group. Documentary analysis The analysis of documents at Africa University provided me with a rare opportunity to appreciate the seriousness of the HIV/AIDS epidemic in Zimbabwe. HIV/AIDS is affecting and infecting people from different walks of life, students, staffs, and faculty among others as reflected in the university policy on HIV/AIDS. The documents listed in Table 4.6 were used in the analysis.

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Documents Analyzed Table 4.6 1. Africa University HIV/AIDS Policy (2004) 2. Strategic Plan for both Short term Plans and the Long term Plans (2002) 3. Objectives of the HIV/AIDS Committee Program (2004) 4. End of Year Evaluation and Planning Workshop (2007) 5. Mutare City Council Statistics (2001) 6. Africa University Prospectus (2007) 7. National AIDS Council (2004)

Africa University Policy on HIV/AIDS The opening statement of the university HIV/AIDS policy (2004) acknowledges that the HIV/AIDS epidemic has been a problem in Zimbabwe for almost a quarter of a century since it has been recognized world over as an epidemic in the 1980s. At Africa University in Mutare, Zimbabwe, the HIV/AIDS epidemic has had and continues to have an impact on the operation of the university in a number of ways. First, as a private university, the students‟ parents or guardians pay for tuition and fees. To demonstrate the negative impact of the HIV/AIDS epidemic, the policy document states that there have been some instances in which those responsible for the payment of fees died as a result of the HIV/AIDS epidemic. Following the deaths of such financial supporters, students were forced to withdraw from their studies or live very marginally with little money at their disposal. Another disturbing observation noted in the university policy is that staff regularly takes time off to attend to their relatives suffering from HIV/AIDS-related illnesses or to attend funerals of relatives. At Africa University, the policy document further asserts that some staff members suffering from HIV/AIDS related infections might take time off on sick leave or go to the hospital for treatment, thereby affecting the productivity of the university business. Productivity and efficiency are compromised when human beings cannot concentrate on their core business at the university. University Efforts to Prevent HIV/AIDS In Zimbabwe, where the university is situated, the news on HIV/AIDS is not very encouraging. Drawing from the national policy on HIV/AIDS for the Republic of Zimbabwe, Africa University policy (2004) reported that about one in four people between ages 15 and 49 is

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believed to be infected with HIV and more than 2,000 people die of HIV/AIDS every week. Africa University policy further noted that one of the reasons suggested for a decline in the population growth rate in Zimbabwe in the past decade is the high incidence of HIV/AIDS in the country. Africa University is situated in Mutare and its surrounding environment including Mutasa District where the HIV/AIDS situation does not appear to be any better than what prevails in Zimbabwe as a whole. In fact, Mutare City Council Statistics (2001) observed that in 1998, HIV prevalence among women between the ages of 20 and 24 was estimated at 30 percent in Mutasa, higher than the national figure. Africa University, with a pan-African orientation, admits students from all over Africa. The HIV/AIDS policy (2004) states that at the beginning of the 2002/2003 academic year, the university had a student enrollment of about 1200 from 22 countries, including 20 African countries. The many young people who come from different countries bring to Africa University different norms, values, sexual practices, and levels of knowledge and understanding of HIV/AIDS. This means that the university needs to have a multifaceted approach to the HIV/AIDS epidemic. The university has taken a serious approach to deal with the HIV/AIDS epidemic through peer educators, a task force, mass media campaigns, and outreach projects, among other intervention strategies. A committee of twenty-one members representing all the units at the university has been formed to come up with a strategic plan to combat the HIV/AIDS epidemic. The task force regularly meets to deliberate on issues affecting the welfare of the university and to make recommendations to the university authorities. In response to the high prevalence of the HIV/AIDS epidemic, Africa University policy (2004) has articulated the following responsibilities: 1. The university is committed to programs and policies that protect each individual‟s confidentiality and rights to their personal goals and objectives regardless of their disease status. The university also recognizes the rights of such persons to maintain student or employee status for as long as their medical condition allows and they can perform their tasks. 2. The university is committed to providing HIV/AIDS education in order to better assure the health and welfare of the students, faculty and staff. 3. The university is committed to applying the same status, policy, procedures and resolution to healthy students and to those the affected by HIV/AIDS.

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Non-Discrimination Strategic Plan for both Short term Plans and the Long-term Plans Document (2002) acknowledged that the university adopted the nondiscrimination approach to the infected people in order to create a conducive environment for all students, staff and faculty. To deal with the challenges of stigmatization, discrimination and psychological denial usually encountered by HIV/AIDS victims, the university decided to protect the infected members of the university community. People with HIV/AIDS, their partners, families, and friends shall not suffer from any form of unfair discrimination based on the status of their health. The university policy further makes it clear that staff and students living with HIV/AIDS have the same rights and obligations as other staff and students on campus or in any university residence. In the past people who suffered from the HIV/AIDS epidemic were discriminated against, and that psychologically affected their sense of self-esteem. To deal with the HIV/AIDS epidemic the university policy accorded HIV/AIDS the same respect accorded to other life threatening diseases that affect the Zimbabwean population. Objectives of the HIV/AIDS Committee Program (2004) express the view that to minimize or contain the spread of the HIV/AIDS epidemic, representatives of all sectors of the university are to be involved, where possible, in the development of all preventive interventions and care strategies that specifically address the challenges encountered by various groups on campus. For example, the manager of the cleaning unit might understand and appreciate more the issues that affect this low-income group than does an academic dean whose social and economic status may be much higher. To salvage the dignity of the people living with HIV/AIDS, the principles of confidentiality are supposed to be strictly upheld vis-à-vis the HIV status of any staff or student member. The university aims to achieve best practice standards in all HIV/AIDS interventions without prejudice or causing any harm to the people living with the disease. Africa University Policy (2004) recognizes all the rights of the individual either as a worker or a student. These include /job, privacy, confidentiality between the individual and his/her doctor in matters of health, respect as a human being, and, above all, right to life. In addition, the university policy seeks to enhance the dignity of all the workers, faculty and students. In this respect, the university policy strives to improve the lives of all members of the university community. Africa University does not exist in a vacuum; it operates within an immediate community with which members of the university community interact on a regular

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basis. For this reason, the university policy seeks ways and means of contributing to the improvement in the health status of the surrounding communities through peer educators, outreach programs, and local dramas and community engagement projects designed to deal with cases of discrimination and stigmatization. Accommodation Africa University Policy (2004) stipulates that no student shall be refused accommodation on campus on the basis of his or her HIV/AIDS status. Accommodations are to be assigned to students using the same criteria for assignment of rooms of for everyone. As well, it is an offence for any student to refuse to share accommodations with an HIV/AIDS infected person. The most current medical information available does not indicate any risk to those sharing accommodation with infected individuals. There may be circumstances under in the health of a person with HIV and AIDS may necessitate special housing arrangements, given the student‟s compromised immune system. The university neither requires students to disclose if they are HIV/AIDS positive, nor requires students to undergo a test for HIV infection. In addition, Africa University Policy (2004) provides some ways and means to accommodate the infected workers and keep them from easily losing their jobs. In a situation where HIV/AIDS affects one‟s capabilities to meet one‟s performance contract, reassignment of duties may be considered. Many of the infected people are breadwinners who financially support their families. A lack of nutritious diet among HIV/AIDS infected people exposes them to the opportunistic diseases that can further erode their immunity system and make it harder to fight against the virus. Lighter duties can be assigned to people affected by the HIV/AIDS as a possible way to accommodate them at the institution. The university policy has a non-disclosure principle that states that employees/students with HIV/AIDS are not forced to disclose their status to anyone. Confidentiality plays a very important role when dealing with people that are infected with HIV/AIDS in an environment that experiences discrimination and stigmatization. This is the ethical imperative of keeping and maintaining information and student and employee details about those infected with HIV/AIDS safe at all times. The other positive point of the university policy is that when it comes to hiring, job assignment, performance appraisals, termination, and terms and conditions of employment, there is no discrimination on the basis of the HIV/AIDS status.

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HIV/AIDS Education The importance of sex education in dealing with the HIV/AIDS epidemic cannot be overemphasized at Africa University situated in the fourth largest Zimbabwean city of Mutare that has the highest prevalence of the epidemic in Southern Africa. Many people might be empowered through education to combat the disease by learning how to make wise decisions when dealing with relationships and sexual matters. Africa University Policy (2004) states, “the greater involvement of people living with HIV/AIDS in governance, management and operational structures at Africa University leads to the protection of all infected people” (p. 15). The university policy further seeks to prevent the transmission of HIV through the provision of education and accurate information to all students, staff and faculty. Lack of information on HIV/AIDS among the youthful students can further contribute to the high prevalence of the HIV/AIDS epidemic. Education that empowers all the people living at the university and the surrounding communities must ensure that students and staff who are uninfected remain free from infection. Openness, free discussions and community engagement among other educational intervention strategies helps both the infected and the uninfected to combat the further spread of the HIV/AIDS epidemic. End of Year Evaluation and Planning Workshop (2007) noted that each year in Zimbabwe there are more and more new HIV infections, which shows that people either aren't learning the message about the dangers of HIV, or are unable or unwilling to act on it. Many people are dangerously ignorant about the virus, with surveys in Zimbabwe showing alarmingly low levels of awareness and understanding about HIV amongst many groups. AIDS education can help to overcome such ignorance, and thereby reduce the current high rate of infection. At Africa University AIDS education needs to be an ongoing process, because each generation of young people needs to be informed about how they can protect themselves from HIV as they grow up. Older generations, who have already hopefully received some AIDS education, may need the message reinforced, so that they continue to take precautions against HIV infection and will be able to inform younger people of the dangers. An important and commonly neglected aspect of AIDS education with HIV positive people is enabling and empowering them to improve their quality of life. HIV positive people have varying educational needs, but among them are the need to access medical services and

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medications and the need to be able to find appropriate emotional and practical support and help. AIDS education helps to reduce stigma and discrimination when well articulated. In Zimbabwe there is a great deal of fear and stigmatization of people who are HIV positive. This fear is too often accompanied by ignorance, resentment and ultimately anger. Sometimes the results of prejudice and fear can be extreme, with HIV positive people being neglected to die in isolation. Discrimination against positive people can help the AIDS epidemic to spread, because if people are fearful of being tested for HIV, then they are more likely to pass the infection to someone else without knowing. Admission and Discontinuation Africa University Policy (2004) acknowledges that, given the belief that all individuals, irrespective of personal or family circumstance, , or health status are entitled to education, the university should not discriminate against individuals with HIV/AIDS in its admissions. In addition, HIV/AIDS is not to be a basis for the discontinuation of any student from his/her studies at the university. HIV antibody tests are not required for applicants for admission or candidates for employment at the university. The university does not want to prevent the infected potential students from enrolling for classes. No student is required to have an HIV test prior to admission to Africa University. No students are required to reveal their status prior to admission or during their course of study. HIV status is not supposed to influence the decision to admit a student to a higher degree program, further training or any other activity of the university, unless there are special circumstances that warrant it. Such circumstances must be fully discussed with the student concerned, to whom medical and legal advice must be made available. Unless medically indicated, neither shall HIV/AIDS be a reason to terminate a student‟s registration. Africa University Policy (2004) aims to provide comprehensive HIV/AIDS pre-testing, post-testing and follow up counseling to staff, students and community members. In doing so, the university tries to create a supportive environment where people living with HIV/AIDS (PLWHA) are safe to reveal their status and seek appropriate support and counseling. Through education the university policy seeks to equip students with skills that might help them to live and work in societies that are inflicted with the HIV/AIDS epidemic. In addition, the university plans to contribute towards finding solutions to the HIV/AIDS epidemic. Research work that is related to HIV/AIDS is encouraged from a number of practical and theoretical frameworks. The

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HIV/AIDS committee has the responsibility to plan and facilitate fieldwork that may promote awareness campaigns to deal with the HIV/AIDS epidemic at the university. To consolidate its work on HIV/AIDS outreach programs, the university decided to incorporate the peer educators in its effort to educate and spread the information to the students, employees, faculty and the surrounding communities. Peer Education The university has a vibrant peer education program that functions effectively within the university community, particularly among the student body. The university peer educators organize the outreach programs to the neighboring secondary schools. The Drama Club, Bible Study Group, and Arts and Performance Group among other clubs within the peer educators organize awareness campaigns to help fellow students and secondary school students. Strategic Plan for both Short term Plans and the Long term Plans (2002) acknowledges that the aim of the peer education program is to regularly remind members of the university community about the dangers of HIV/AIDS and how members can avoid the epidemic. The peer education group operates under the HIV/AIDS office and the sister in charge at the university clinic is the patron of this group. The university provides an opportunity for all members of the university community to participate in the HIV/AIDS awareness program by suggesting possible activities that can be undertaken by the peer educators. The format and content of the awareness program is determined by the diversity and the metropolitan nature of Africa University. The university has committed itself to the provision of appropriate educational programs that focuses on students, faculty and staff through staff development appropriate to the targeted group. Africa University raises awareness amongst staff on HIV/AIDS prevention through workshops, seminars, audio-visual aids, study tours and retreats organized by the peer educators. Confidentiality In line with the guidelines outlined above, Africa University policy requires that all information relating to HIV/AIDS be treated as private and confidential. This applies to all personal information on HIV/AIDS that is provided to any staff or office of the University by a student, staff, or any member of the university community and outsiders. A person in the course of counseling, treatment, or research activities may provide such information. Secondly, no person shall be coerced into providing personal information on his/her HIV/AIDS status. Any information to be obtained for the purposes of counseling, treatment, or research must be freely

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given by individual consent. The need for especially strict rules of confidentiality in relation to HIV infection/disease derives from the intense atmosphere of fear, misunderstanding and prejudice that characterizes many people's response to the virus. It is important that Africa University respond to the challenge of HIV infection and disease in a humane and compassionate way. The consequences of a person‟s HIV status becoming known can be, and have been, frequently disastrous for them. Some employees have lost their jobs and their homes and have been rejected and isolated by family, friends, colleagues and society in general. Insensitive or even brutal treatment in both personal and professional relationships is only too common. Because of this there is an urgent need to ensure that both policies and practice are designed to protect the privacy of students, faculty, employees and service users with HIV infection and disease. Although the importance of confidentiality is frequently argued in individual terms, it should not be divorced from the wider public interest. Stopping the spread of infection particularly involves engaging people who are, or who could become, infected in considering and implementing specific behavior changes to protect both themselves and others. A lack of confidentiality only alienates people and means they have less confidence in presenting themselves to statutory and non-statutory agencies. Maintaining confidentiality is therefore an important component in preventing the spread of further infection. Other Possible Causes of the HIV/AIDS Epidemic in Zimbabwe Resistance and Contradiction to the Hegemonic Powers The deep-rooted structural and hegemonic forces such as political oppression perpetuated in Zimbabwe since the colonial period in the twentieth century deprived the population of their potential to make independent choices in crucial matters. Walker (2001) expressed the view that counter-hegemonic resistance mounted by the Zimbabwean population during and after the colonial oppressive and repressive government policies may have contributed to the rapid spread of the HIV/AIDS epidemic in the 1990s. According to Grossberg (1984): Hegemony is the ongoing process by which a particular social bloc (made up of various class fractions) maintains its position of power by mobilizing public support for its social projects in a broad spectrum of social life. Hegemony is a question of leadership…it involves the colonization of popular consciousness or common sense through the

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articulation of specific social practices and positions within ideological codes or chains of connotational significance (P. 412). Research studies conducted in Zimbabwe on HIV/AIDS awareness suggests that over 98 percent of the population is aware of the modes and ways of transmission of the disease but, surprisingly, the rate of infection is ever going up. Several HIV/AIDS awareness campaigns are mounted by the repressive government, that has witnessed the total collapse of the infrastructure and the once thriving economy. Block (2007) suggested that there is clear evidence of oppositional acts of resistance by the restive Zimbabwean population due to numerous forms of political repression and domination by the ruling party, Zimbabwe African National Party (Patriotic Front) ZANU (PF) that has been at the helm of the political domination in Zimbabwe for almost 30 years. The oppressed people in Zimbabwe may use passive resistance by not adopting HIV/AIDS messages to cope with the political and economic challenges which stemmed from the collapse of government policies. In support, Freire (2003) expressed the view that contradictions in the larger society have parallels in individual experience and that educators for liberation must restore the political relation between and the language of everyday life. Furthermore, Freire acknowledged that too often words that are intimately connected to social relations and cultural power recapitulate the asymmetrical relations of power and privilege of the larger society. According to Freire (2003), “All language works to reproduce dominant forms of power relations, but it also carries with it the resources for immanent critique, for dismantling the oppressive power structure of the social order, and also for articulating a more transformative and liberating vision of the future.” (p. 58). The United States Agency for International Development (USAID) (2008) expressed the view that skewed government policies and corruption have worsened the humanitarian conditions in Zimbabwe where thousands of people have died from HIV/AIDS and millions more face hunger (p. 34). In addition, the USAID noted that a decade of economic decline should be equally blamed on misrule by President Robert Mugabe‟s government that left once self-sufficient Zimbabwe saddled with hyperinflation, high unemployment and a collapsed infrastructure. The US government relief agency commented that a shortage of farm inputs and a chaotic and violent farm redistribution program had crippled food production, leaving Zimbabwe, which used to be a regional breadbasket, dependent on food handouts from donors. In addition,

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USAID noted that the failure of the government policies and corruption has exacerbated the humanitarian conditions and HIV/AIDS experienced by of millions of people. According to USAID (2008): Nearly a decade of economic decline, characterized by hyperinflation and high unemployment, the government has failed to maintain the infrastructure necessary for agricultural production, water and sanitation, power generation, and steady fuel supply. To date, food security remains precarious as a result of poor governance, rising global food prices, and low crop production due to insufficient access to seeds and fertilizer, drought, commercial land redistribution policies, and violence targeting farm workers (P. 36). In addition, USAID expressed the view that hyperinflation and government domestic price controls on maize have reduced farmers‟ financial incentives to plant. Once a model African economy, Zimbabwe has suffered acute recession marked by the world‟s highest inflation rate of 231 million percent, last recorded in July 2008, shortages of food, hard cash and every basic survival commodity. The Inequitable Distribution of Land in Zimbabwe According to Walker (2001), “HIV/AIDS and the land tenure systems are extremely complex sensitive issues that considerably contributed to the spread of the disease in Zimbabwe” (p. 37). Zimbabwe's economy is agro-based. At independence, Zimbabwe inherited a racially skewed agricultural land ownership pattern where the white large-scale commercial farmers, consisting of less than 1% of the population, occupied 75% of the agricultural land. A shortage of farm inputs and a chaotic and violent farm redistribution program carried out in 2000 crippled food production, leaving Zimbabwe, which used to be a regional breadbasket, dependent on food handouts from donors. Block (2007) argued that the unplanned and disastrous land reform program in Zimbabwe revolved around the systematic dispossession of the black indigenous people during the period of colonial rule. No one has ever adequately addressed the inequitable distribution of land (p. 77). In addition, Block noted that the agriculture sector contributed about 33 percent of formal employment and accounted for 40 percent of the total exports before the chaotic land reform. The majority of the Zimbabwean population lives in rural areas and derives their livelihood from agriculture and related activities. Agricultural development is therefore a key

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strategy for alleviating poverty and stimulating overall economic progress. In his analysis Block noted that the Zimbabwean people have been subjected for a very long time to oppression and commonly resent any form of oppression through acts of counter government policies. The HIV/AIDS epidemic might have been caused by hopeless people acting in contradiction to the government sponsored awareness campaigns. HIV/AIDS and the Migration of Skilled Health Professionals According to Chikanda, (2004), “The migration of skilled health professionals from Zimbabwe due to poor working conditions to the industrialized countries in the northern hemisphere has reached significant proportions, and there is little evidence that these flows will decrease in the near future” (p. 14). In addition, Chikanda observed that the country‟s health delivery sector is arguably the worst affected by the brain drain phenomenon as health workers are emigrating in search of green pastures mostly in western Europe. The HIV/AIDS epidemic has increased the workload on the health workers and exposed them to additional risks at a time when the number of available health workers has not been increased to enable adequate staffing of both existing and new health facilities. The migration of skilled health workers from Zimbabwe has adversely affected the quality of health care offered in the health institutions. In support, Chisokela (2001) noted that the HIV/AIDS epidemic has added to the strain experienced by health workers and what is worrying is that some professionals alleged that their health institutions were taking inadequate measures to protect them from the risk of contracting the disease. Chikanda (2004) acknowledged that the shortage of health professionals is most critical in rural areas where most health centers are served by unqualified health personnel. Comparatively, Chikanda expressed the view that the situation is better in urban areas where there are alternative sources of medical care. Chisokela blamed the collapse of the once vibrant health sector due to the mismanagement and utter failure of government policies. In addition, he accused the corrupt practices of the government of fueling the HIV/AIDS epidemic and lacking vision and commitment to combat this incurable disease. According to Meldrum (2008), “Zimbabwe‟s once proud health system is deteriorating at an alarming rate. Hospitals are facing dire shortages of doctors and medical supplies. Only political stability coupled with massive external support can reverse the situation” (p. 1059). In addition, Meldrum noted that a further problem is that the health professionals fear for their personal security in Zimbabwe‟s volatile political situation.

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Conclusion The research findings collaborated by three sources namely semi-structured interviews, observation, and documentary analysis provided powerful insights as to what has caused the HIV/AIDS epidemic in Zimbabwe. The causes suggested include: poverty; a lack of information/education; an erratic supply of condoms/lack of accessibility to condoms; cultural practices such as wife inheritance, small house or extramarital relations; sugar mammies/sugar daddies; commercial sex workers; and child pledging; rural-urban migration; poor living conditions; denial by the government; and a theological explanation that it is a punishment from God because of immorality. Many people in Zimbabwe are living below the poverty line. They lack not only money, but also assets and skills. Therefore, people strive to meet their basic needs and indulge into risky behaviors such as commercial sex, to obtain basic survival resources. HIV infection is mostly confined to the poorest, who constitute the majority of those infected in Zimbabwe and sub- Saharan Africa. It is not simply that information, education, and counseling activities are unlikely to reach the poor but that such messages are often irrelevant and inoperable, given the reality of their lives. Even if the poor understand what they are being urged to do, it is rarely the case that they have either the incentive or the resources to adopt the recommended behaviors. The capacity of the individuals and households to cope with HIV/AIDS depends on their initial endowment of assets, both human and financial. The poorest by definition are least able to cope with the effects of HIV/AIDS, so that suffering among the affected populations is increasing. Even the non-poor find their resources diminished by their experience of infection. Apart from poverty the high prevalence of the HIV/AIDS epidemic in Zimbabwe is due to cultural practices such as wife inheritance and child pledging. Factors such as cultural norms, values, beliefs and myths have been cited as the main catalysts in the spread of HIV, particularly the common practice of wife inheritance. When an African man dies, in some societies it is the responsibility of his brother to inherit his widow. Unfortunately, this has become a key factor in the spread of the AIDS virus. The main reason given for practicing wife inheritance in some African societies is to have the family of the dead man taken care of and to have his name continued. Usually, a woman is inherited by her dead husband's brother and if he (the dead husband) happens not to have a brother, the closest living male relative such as first cousin,

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inherits her. The inheritor makes sure that the widow and her children are fed, clothed, sheltered, educated, protected and kept. A man can only take on a widow if he has a family. His first wife accepts the arrangement because tradition frowns on his having sexual relations with his inherited wife. Rural-urban migration that occurred in the 1980s left a lot of women in the rural areas while many of the able bodied men joined the fast moving city life. Some of the women left behind in the rural areas engaged in extra marital relationships, as did some of their male counterparts who had joined the city life. Extramarital relationships due to rural-urban migration in Zimbabwe contributed to the further spread of the HIV/AIDS epidemic. Lack of accommodations in cities pushed many married men to cohabit with young women who were looking for cheap accommodations. Another possible cause of high prevalence of HIV/AIDS in Zimbabwe is fatalism that has now become the greatest enemy to the fight against the HIV/AIDS epidemic, as many young women have lost hope. In their desperation they have concluded that death is eminent and certain either through hunger or through HIV/AIDS. The lack of a nutritious diet among the infected persons exposes them to opportunistic diseases that can do more harm to the people living with AIDS. My research findings further established that another factor blamed for the high prevalence of the HIV/AIDS epidemic is the non-availability or the inaccessibility of the antiretroviral therapy or (the life prolonging drugs) among the infected people in Zimbabwe. Many experienced health workers and medical doctors have fled the country in search of greener pastures, going either to neighboring countries or overseas. The tense and hostile political situation between the ruling party, the Zimbabwe African National Union (Patriotic Front), ZANU (PF), and the Movement for Democratic Change (MDC) led to an exodus of approximately 3 million Zimbabweans to surrounding countries. Married couples are separated in this case as some political activists or people suspected to be members of the opposition leave their families behind to avoid persecution and illegal detention. The enhanced resistance and contradiction by many Zimbabweans in the fight against HIV/AIDS seem to suggest that the suffering population is sending powerful negative signals to the government. Prolonged periods of repressive and oppressive laws enacted in Zimbabwe since the colonial period is resented much as they have impoverished many people. The failed government

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policies and infrastructure due to mismanagement and corruption considerably contributed to the exodus of the Zimbabwean doctors, nurses and other professionals. Inequitable distribution of land and other essential resources in Zimbabwe excluded several people from participating in the economic activities and development of the country. Government initiatives or HIV/AIDS campaigns are viewed with much suspicion by the poor people, who have felt alienated for a long time from their government. Lack of political legitimacy in the country has worsened the situation as there is no accountability on the part of the government. Chapter 5 Summary, Discussion and Recommendations Introductory Statement This chapter summarizes the study and how data was collected and analyzed. It reviews the problem and the purpose of the study and discusses the major findings as they relate to the HIV/AIDS epidemic in Zimbabwe and to the literature review. This dissertation is an investigation of how students and faculty at Africa University, located in Mutare, Zimbabwe, understand and interpret the causes of HIV/AIDS and what they think should be done about it. Recommendations for Africa University, further study and practitioners, community leaders, and governmental and nongovernmental organizations working in Zimbabwe will be drawn from the discussion of the findings. A concluding statement will sum up this study on the HIV/AIDS epidemic and sex education in Zimbabwe. The Problem and the Purpose of the Study The problem of the study was to investigate the causes of HIV/AIDS epidemic in Zimbabwe as perceived by students and faculty at Africa University, a pan African international private institution of higher learning. The main purposes of the study were three-fold; 1) to investigate perceptions of the causes of the high prevalence of the HIV/AIDS epidemic in Zimbabwe, the worst affected country in Southern Africa; 2) to examine the role of teacher preparation programs in dealing with HIV/AIDS in Zimbabwe; and 3) to explore the role of sex education in combating the HIV/AIDS epidemic in Zimbabwe. Summary of the Dissertation This research study was mainly inspired and informed by the need to combat the HIV/AIDS epidemic in Zimbabwe, the leading cause of deaths among young adults and the middle-aged population. Zimbabwe, a Southern African former British colony, is facing a

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serious HIV/AIDS epidemic. In its quarterly report, the World Health Organization (WHO) (2007) noted that since 1990, HIV/AIDS has slashed the average life expectancy in Zimbabwe from 61 to a mere 33 years, the lowest anywhere in the world. It is estimated that there are now over one million children in Zimbabwe who have been orphaned due to HIV/AIDS-related deaths. Expressed in simple statistics, one in every five Zimbabwean children is an orphan as a result of the HIV/AIDS epidemic. In addition, (WHO) noted that with around one in seven adults live with HIV and an estimated 565 adults and children are becoming infected every day, roughly one person every three minutes. Zimbabwe is experiencing one of the harshest AIDS epidemics in the world. In a country with such a tense political and social climate, it has been difficult to respond to the HIV/AIDS epidemic effectively. President Robert Mugabe and his government have been widely criticized by the international community, and Zimbabwe has become increasingly isolated, both politically and economically. According to the Zimbabwean economist, Robertson (2008): The economy is suffering from a rapidly growing rate of inflation that was around 230 million percent in October 2008, making goods twice as expensive as they were in May 2008. This economic decline is fuelling food shortages at a time when poverty is already rife, leading to a desperate situation where HIV and AIDS are in danger of being overlooked in the face of more immediate survival concerns (P. 52). In support, (WHO) (2007) estimated that between 2002 and 2006, the population is estimated to have decreased by four million people. Infant mortality has doubled since 1990. The primary mode of HIV transmission in Zimbabwe is heterosexual contact, and this preventable disease disproportionately affects women. HIV/AIDS education should target the population that is most vulnerable to the epidemic. Education, either formal or informal, is an essential component in the fight against the HIV/AIDS epidemic. The social and cultural context in which children and young people are growing up in Zimbabwe requires openness and the dissemination of correct information about the HIV/AIDS epidemic. One of the key means of HIV prevention is education, teaching people about HIV: what it is, what it does, and how vulnerable people can protect themselves. A teacher preparation program that is specifically structured to address social problems such as the HIV/AIDS epidemic is an example of an approach that could pass vital information that might at least reach the majority of the vulnerable population in Zimbabwe.

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This study sought to answer these research questions: 1. What do the faculty and students at Africa University think has caused this epidemic in Zimbabwe and what should be done to combat it? 2. To what extent do government policies regarding HIV/AIDS education shape the teacher preparation program at Africa University? 3. What measures do faculty and students at Africa University think can be put in place to help control and prevent the spread of the HIV/AIDS epidemic? 4. How do faculty and students at Africa University think the schools in Zimbabwe can help in the dissemination of HIV/AIDS education programs? 5. How do faculty and students at Africa University think the Zimbabwean community can help in the fight against the HIV/AIDS epidemic? Methods and Procedures This study used the case study approach as the heart of its methodology in order to take a focused look at the perceived causes of the HIV/AIDS epidemic in Zimbabwe. The site of this case study was Africa University, a United Methodist-related institution. The case study methodology was determined to be the best qualitative research technique to investigate sex education and other programs in place at the university designed to combat the HIV/AIDS epidemic. The case study design was particularly chosen as a good means of educational investigation because of its ability to explain the causal links in real-life interventions that are too complex for the survey or experimental strategies. In support, Yin (2003) expressed the view that a case study is a desirable method of qualitative research when the study focuses on an organization. The case study design chosen used detailed semi-structured interviews, observations and documentary evidence and employed questioning strategies of a “how” and “why” nature. It did not require control over behavioral events commonly used for studies focusing on present-day events in their real-life context. Africa University opened its doors in March 1992 as the first private, international university in Zimbabwe. The pioneer group of 40 students came from a dozen African countries to pursue bachelor's degrees in Agriculture, Natural Resources and Theology. Africa University is a United Methodist Church-related project and is being nurtured and funded by church members from all over the world. It is an expansion of the growth of United Methodism on the African continent and has its foundations in the history and legacy of the church. The University

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welcomes students regardless of their race, ethnicity, religion, politics, gender, nationality or social background. Five of the seven faculties of the University's master plan are fully operational: Agricultural and Natural Resources; Education, Humanities and Social Sciences; the Institute of Peace, Leadership and Governance; Health Sciences; Management and Administration; and Theology. I chose Africa University specifically as a representative of an institution preparing teachers in Zimbabwe, one of the worst affected countries in Southern Africa in terms of the HIV/AIDS epidemic. In a country with a tense political climate characterized by a hyperinflationary economy, Africa University was chosen because of its neutral stance in the political landscape. Merriam (1991) expressed the view that case study research, and in particular the qualitative case study, is an ideal design for understanding and interpreting observations of educational phenomena. In support, Stake (1995) acknowledged that the case study is the study of the particularity and complexity of a single case, coming to understand its activity within important circumstances. The way students and faculty understood and interpreted causes of the HIV/AIDS epidemic in Zimbabwe strongly suggested that poverty, cultural practices such as polygamous relationships, extramarital affairs, and rural-urban migration, among other causes, are spreading the deadly disease. Stake remarked that two principal uses of case study research are to obtain the descriptions and interpretations of others. Yin (2003) argued that while a case study is similar to a history, it adds two sources of evidence not usually included in the historian‟s repertoire: direct observation and systematic interviewing. In addition, Yin noted that a case study is an empirical inquiry that investigates a contemporary phenomenon within its real-life context, especially when the boundaries between the phenomenon and the context are not clearly evident. My case study thus also explored the contextual conditions central to the causes of high prevalence of HIV/AIDS epidemic in Zimbabwe. My case study used a phenomenological approach to understand why Zimbabwe is one of the worst affected countries by the HIV/AIDS epidemic in Southern Africa. Stake (1995) noted that the qualitative researcher emphasizes episodes of nuance, the sequentiality of happenings in context, and the wholeness of the individual or the organization. One of the major strengths of my case study method was that I used multiple data collection methods and analysis techniques that provided me with the opportunities to triangulate data, thereby enhancing the credibility and trustworthiness of my study.

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The Research Design This study used the case study method to take a focused look at how Africa University faculty and students understand and interpret the HIV/AIDS epidemic in Zimbabwe. Detailed semi-structured interviews, observations and documents were used in the collection of data on teacher preparation, policies and the HIV/AIDS education curriculum at Africa University in Zimbabwe. Stake (1995) plausibly expressed the idea that the interview is the main road to multiple realities. In support, Yin (2003) asserted the view that the use of multiple sources of evidence in case studies allows an investigator to address a broader range of historical, attitudinal, and behavioral issues. I observed a total of eight two-hour lessons in a range of classes made up of senior students preparing to be either high school teachers or health educators. All the classes that I observed were large and ranged from forty students to one hundred. In none of the classes that I observed were there HIV/AIDS materials displayed in the classrooms or lecture halls. However, well-illustrated billboards about HIV/AIDS were erected on all the entrances to the university campus. Yin (2003) noted that one principle of a case study is to create a case study database. He went on further to cite the lack of a formal database for most case studies as a weakness, and he encouraged the use of four components of a case study database: notes (from interviews and observations), documents, tabular materials (surveys, frequency counts), and narratives (open- ended answers to a case study‟s questions). The greatest strengths of case studies, as noted by Yin (1994), “is that they use „how‟ or „why‟ questions asked about a contemporary set of events over which the investigator has little or no control” (p.153). Not only do case studies have strengths, but they also have weaknesses such as lack of rigor among some case study researchers and a lack of time limits on the scope of case studies, sometimes leading to lengthy, unreadable documents. Findings Initial data analysis took place through analyzing responses on observation notes that I compiled in the eight lessons that I observed. Different colors of markings were used to identify common factors. The factors that emerged from the observations were basically similar to those that came from the analysis of the semi-structured interviews. Documents collected at Africa University were analyzed in a similar way. Although not much information was contained in the few documents that I collected, factors such as the impact of poverty on the population, the

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impact of polygamous relationships, the promotion of gender equality and the growing number of orphans and child headed families in Zimbabwe emerged. From these three data sources, semi-structured interviews, observations and documents the same factors essentially emerged. During the analysis of the data obtained from interviews with students and faculty, observations and documentary sources, several perceived causes of the HIV/AIDS epidemic emerged. The perceived causes suggested included: poverty; economic meltdown, a lack of information/education; an erratic supply of condoms/lack of accessibility to condoms; cultural practices such as wife inheritance, small house or extramarital relations; sugar mammies/sugar daddies; commercial sex workers; and arranged marriages; rural-urban migration; poor living conditions; denial by the government; and a theological explanation that it is a divine punishment from God. My findings on how students and faculty make meaning about HIV/AIDS epidemic strongly suggest that students and faculty at Africa University perceive poverty, high rates of unemployment and generally low returns from informal sector economic activities in Zimbabwe to have led to high-risk sexual behavior and the spread of HIV among both women and men. The often-low social and marginal economic status of women was and is still believed to contribute to high-risk sexual behavior and vulnerability to HIV infection. Respondents believed that a not uncommon coping strategy for survival is for poor women and adolescent girls to exchange sex for money or gifts. Indeed, the HIV and AIDS epidemic disproportionately affects women. WHO (2007) noted that in Zimbabwe, women are about 1.35 times more likely to be infected than men. This imbalanced sex ratio may occur in part because women are more biologically prone to infection than men during unprotected sexual intercourse. Similarly, women are more vulnerable to other sexually transmitted infections, the presence of which greatly enhances the risk of HIV transmission. Older men having sexual relations with younger women may also be a significant factor in contributing to higher rates of infection among young women. The documentary evidence largely agreed with the views shared in semi-structured interviews and with the observations. WHO (2007) expressed the view that poverty includes deprivation, constrained choices, and unfulfilled capabilities, and refers to the interrelated features of well being that impact upon the standard of living and the quality of life. However, poverty is not necessarily confined to the financial capital, quantified, and minimized in monetary indices (p. 45). Many people in Zimbabwe are in such poverty that the majority of the

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families cannot afford to bring food to their tables without government or nongovernmental organization assistance due to economic meltdown and hyperinflation. Many of the poorest are women who often head the poorest households in Zimbabwe and throughout Sub-Saharan Africa. Inevitably, such women are often engaged in commercial sex transactions, sometimes as commercial sex workers but more often as part of survival strategies for themselves and their dependents. The characteristics of the poor are well known, as are some of the causal factors, like early marriages, which contribute to a “culture of poverty”, with the children of the poor often becoming the poor of succeeding generations. In Zimbabwe, poverty is also associated with weak endowments of human and financial resources, such as low levels of education with associated low levels of literacy and few marketable skills, generally poor health status and low labor productivity. To combat the HIV/AIDS epidemic in Zimbabwe, HIV education programs that empower vulnerable groups to make informed decisions when dealing with sexual issues should be encouraged from the grassroots level to the national level. Inequality and power imbalances between women/girls and men/boys in the Zimbabwean society heighten the vulnerability of females to infection. In Zimbabwe, women are often taught from early childhood to be obedient and submissive to males. In sexual relations, women are often taught not to refuse sex to their husbands, regardless of whether they have other partners or whether they are willing to use condoms. They are not taught or empowered to negotiate condom use. Because of their low social and economic status, women and girls have more limited access to HIV and AIDS-related information, prevention, treatment, care, support, commodities, and services than men and boys. To cushion vulnerable women and marginalized girls from risky sexual behavior, AIDS education programs that enhance decision making skills in conjunction with income generating projects can economically empower the less fortunate and vulnerable women. However, the hyper inflationary macro environment currently obtaining in the country poses serious challenges to the sustainability of any small business venture. Optimism about success and combating the HIV/AIDS prevalence should be the constant source of inspiration and motivation to initiate programs that can help the most vulnerable groups. My findings on how students and faculty at Africa University make meaning further suggested that the traditionally low use of condoms and incorrect or inconsistent use has been and still is a factor to contend with in the fight against the HIV/AIDS epidemic. Three points are

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important to this discussion. The National AIDS Council (NAC) (2004) expressed the view that when condoms are used consistently and correctly, they are a highly effective means of preventing the transmission of HIV and other sexually transmitted infections (STI‟s). In addition, NAC noted that as the epidemic spread in the 1980s and early 1990s, condoms were not widely used in the country. Low condom use at that critical time was one factor that significantly contributed to the rapid spread of HIV. The distribution and use of condoms subsequently soared during the 1990s, but that was after the epidemic had already taken hold in the country. Even now, condom use has not been sufficient to reverse the HIV and AIDS epidemic. To be effective in preventing disease transmission, condoms need to be correctly used and they need to be used consistently with all partners. Occasional use negates much of the effectiveness of condom use. My findings on how students and faculty perceive the causes of HIV/AIDS epidemic suggested that the settlement patterns and mobility of the Zimbabwean population in the 1980s and early 1990s considerably contributed to the spread of HIV/AIDS. NAC (2004) expressed the view that Zimbabwe is highly urbanized by African standards. The Census Statistics Report (2002) indicated that 32 percent of the population lives in urban areas. About 58 percent of the population resides in rural areas, including on communal lands, small-scale commercial farms, and resettlements. Another 10 percent of the population is clustered in “other” areas that do not comfortably fit into either an urban or rural classification. The “other” areas include, for example, large-scale commercial farms, growth points, and mining areas, and very high levels of HIV infection characterize them. Robertson (2007) observed that transport and roads have been relatively good in Zimbabwe and have fostered high levels of movement back and forth among towns, communal areas, commercial farms and other areas, which in turn has contributed to the rapid spread of HIV throughout the country. NAC (2004) further noted that one of the noteworthy characteristics of the epidemic in Zimbabwe is that the gap between HIV prevalence in urban areas (28 percent) and rural areas (21 percent) is narrower than that found in many other countries. Another factor that both students and faculty blamed for the high prevalence of the HIV/AIDS epidemic is the non-availability or the inaccessibility of the antiretroviral therapy or (life prolonging drugs) among the infected people in Zimbabwe. Many experienced health workers and medical doctors have fled the country in search of greener pastures, going either to neighboring countries or overseas. The tense and hostile political situation between the ruling

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party, the Zimbabwe African National Union (Patriotic Front), ZANU (PF) and the Movement for Democratic Change (MDC) led to an exodus of approximately 3 million Zimbabweans to neighboring countries. Several families have been separated and some have broken down due to immigration constraints and restrictions. Discussion In this section I review and discuss the findings of the data analysis and relate them to the research questions and literature review. Primarily, the purpose of this study was to explore the understanding and interpretation of Africa University students and faculty perception of the causes of the HIV/AIDS epidemic in Zimbabwe and what they think should be done about it. The research question that I decided to explore was one that I found to be very emotionally disturbing and moving. However, with the use of a qualitative research approach, valuable data was attained. I used a phenomenological theoretical framework in my case study of Africa University situated in Mutare, the fourth-largest city in Zimbabwean. According to Solomon (1989): Phenomenology refers to a philosophical movement that has received its most persuasive impetus, formulation and defense from a German philosopher Edmund Husserl. Husserl‟s phenomenology takes, as its modus operandi, Cartesian attention to the primacy of first-person experience and the Kantian search for basic „a priori‟ principles (P. 46). From a phenomenological perspective, it is assumed that the creation of meaning emerges both for the individual and for others through their experience of the world. Thus, the major focus of this research was to explore the understanding and interpretation of students and faculty regarding the perceived causes of the HIV/AIDS epidemic in Zimbabwe and ways to deal with it. Segal (1999) expressed the view that the Lebenswelt (life-world) is the beginning, the foundation upon which phenomenological thought is built. Rather than a construction of consciousness, the life-world is co-created in the dialogue of person and world (p. 39). I chose a phenomenological methodology for my qualitative research because this type of research helped me to understand the cultural, economic or hyperinflationary environment as well as the social and political contexts that significantly contributed to the spread of the HIV/AIDS epidemic in Zimbabwe. Poverty and cultural practices were suggested by both students and faculty at Africa University as the main factors in the spread of HIV/AIDS epidemic. For purposes of clarity my

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discussion will focus on poverty first before looking at cultural practices. Poverty and its associated factors, low education and decreased decision-making power, can indeed increase the risk of HIV infection. Low socio-economic status robs the poor of the knowledge necessary for the prevention of infection with HIV/AIDS, and also increases their susceptibility to infection by making the poor more likely to practice unsafe sex behavior. However, the stereotypes associated with high economic status, such as the view of AIDS as a disease of the poor, increases susceptibility to infection among the non-poor, as they discourage the adoption of safer sexual behaviors. Different levels of poverty (individual, household and community) and their related characteristics such as low education levels, low marketable skills, lack of knowledge or information regarding the risk of infection and the lack of resources to act on this knowledge, lack of capacity to negotiate sex, and high population mobility create a fertile terrain for HIV/AIDS to flourish at different stages of infection. From my case study research I found that the large majority of women lacked control over decisions pertaining to financial resources and were thus encouraged to engage in risky sexual behavior for money. In addition, my study found that women and young girls thrust into poverty are compelled to use sex to survive, trading it for money, food, housing and even educational expenses. In Zimbabwe some young girls are pushed into multiple relationships with older men who have some money, thereby exposing and increasing their chances of becoming infected. Lack of knowledge about condoms was also a factor found amongst poor women that contributes to the spread of HIV/AIDS in Zimbabwe. On the other hand, HIV/AIDS can aggravate poverty by making it hard for the poor to mitigate its impact. The evidence contained in this study has suggested how inseparable poverty and HIV/AIDS are. Poor people often sacrifice their future to ensure a better today. The continued growth of the Zimbabwean HIV/AIDS epidemic is evidence of weaknesses in the current strategies to prevent new infections and also of poor behavioral changes. Therefore, any efforts to reduce HIV infections rates successfully should take poverty into consideration, just as poverty reduction programs aiming at success should take HIV/AIDS into consideration. The key challenge is to find effective and sustainable methods of changing unsafe sexual behaviors. This requires an intense exploration of economic, social, cultural and political factors that influence such behaviors. Sex education programs for both in school and out-of school youth

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should focus on empowering vulnerable groups in Zimbabwe whose hyperinflationary environment has rendered almost everyone poor. My findings also suggest that cultural practices, religious beliefs, and customs also place women and young girls directly in the path of HIV/AIDS. Arranged marriages of young girls, who are sometimes also given to creditors as a form of payment, increases the likelihood of HIV infection through sex with older men. Families now view the paying of the bride price, which used to be modest gifts intended to promote links between families, as a way to use girls to generate income. This practice is unfortunately turning women into commercial commodities, who are expected to live up to traditional expectations regarding child rearing and other duties. This lack of respect for women, and especially the transfer of assets to the husband‟s family on his death, serves to devalue women‟s lives and puts them in danger of abuse and poverty. My research study also suggested that some traditional healers consulted by desperate HIV infected men are advise having sex with virgin girls as a cure for the deadly incurable disease. This practice is leading to rape and an increased infection rate. My phenomenological case study suggested that a lack of respect towards women leads to abuse and sexual assault. Fear of abuse discourages women from getting tested for HIV and getting treatment. Bringing news about their status to their partners or the larger community opens them up to violence. To avoid harassment and violence, some HIV infected women never seek medical treatment when they seriously need it. My research study further found that women in abusive relationships are less empowered to negotiate their sexual activity and advocate for condom use. A political solution in Zimbabwe might bring about economic stability that would usher in the former glory of prosperity and sustainable development. More jobs can be created and that would raise the life expectancy that has been slashed to a mere 33 years due to the HIV/AIDS epidemic. The poor living conditions associated with poverty and unemployment are fueling prostitution, thereby spreading HIV and AIDS. An inadequate food provision has a great impact on the health and welfare of HIV infected people. A nutritious diet can help to boost the immune system of the infected people, and that would reasonably prolong their life expectancy. The plight of the orphaned children can be ameliorated when the HIV infected people have access to a balanced diet and good medication. Meanwhile, AIDS education that is purposefully designed

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to disseminate accurate information about HIV/AIDS and that empowers people economically will help to combat the epidemic. From the way students and faculty make meaning on the HIV/AIDS epidemic, I also found that students and faculty believe that multiple sexual partners or small house practice as it is commonly called in Zimbabwe has been and is still a leading factor in the spread of HIV among the vulnerable young adults in Zimbabwe. Multiple sexual partners, especially those that occur concurrently in a person‟s life, contribute to the spread of HIV, which is primarily spread in Zimbabwe by heterosexual contact. Commercial sex workers who frequently move from town to town due to the good road network have been and are still a major factor in spreading HIV in Zimbabwe. The Zimbabwean highways are infamously known as “the lions‟ den” as prostitutes aggressively entice potential clients by exposing themselves to oncoming traffic, thereby spreading HIV recklessly. As contained in its policy document, Africa University has a well-planned HIV/AIDS Education program and course of action to combat HIV/AIDS and empower its students. The paragraphs below highlight the detailed plan of action but when the program begins to be implemented is subject to speculation and uncertainty while the HIV/AIDS epidemic is taking a heavy on the suffering population. According to Africa University policy (2004): It has been learned that there are universities that are beginning to offer programs on HIV/AIDS in Zimbabwe. At this time, Africa University does not intend to offer a program on HIV/AIDS. However, given the extent of the pandemic, the university shall offer a university-wide required course on HIV/AIDS. The course shall be housed in a Faculty determined by the senate of the university. However, that Faculty working in conjunction with the HIV/AIDS Committee and other units of the university shall determine the content of the course (P. 15). In addition, Africa University policy states that the course shall carry a credit value determined by senate and the teaching and assessment in the course shall follow regulations of the university relating to all other university courses. The content of the course shall include, but shall not be limited to, the following aspects of HIV/AIDS: awareness, prevention, treatment, living with HIV/AIDS, and advocacy. The course should ensure that students are given the opportunity to benefit from intellectual debates about the medical, social, demographic and

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economic issues relating to HIV/AIDS. This will lead to an understanding of the different social groups and attitudes and to a tolerant approach to people living with AIDS. Africa University policy (2004) states that research should be a major aspect of all HIV/AIDS programs and activities because it is through research that the most important strategies to deal with the epidemic can be found. Universities, with their expertise in research, should be recognized as the major source of research activities on HIV/AIDS. Africa University currently has its research committee that promotes research activities at the university. Staff members are encouraged to devote more research time and resources to HIV/AIDS. In addition to the promotion of research on HIV/AIDS through the research committee, the HIV/AIDS Committee shall also source funds for research on HIV/AIDS. The annual budget of the HIV/AIDS Committee shall, therefore, include an item on research. The HIV/AIDS Committee shall thus from time to time sponsor its own research activities by engaging staff from both the university and outside the university. Research activities on HIV/AIDS shall include, but not be limited to those relating to awareness, prevention and treatment, living with HIV/AIDS, counseling, evaluation of HIV/AIDS programs, and the impact of HIV/AIDS on the individual, family, and organization. Africa University‟s Surrounding Communities Africa University sees itself as an integral part of its surrounding communities. Interactions with these communities take many forms, both formal and informal. Formally, the university relates to the Mutasa District Council under whose jurisdiction the university is located. As well, some University workers stay in the surrounding communities. Informally, there are regular interactions between members of the surrounding communities and members of the university community, particularly students, who buy from nearby stores and establish friendships with members of the surrounding communities. It is, therefore, important that the university incorporate the surrounding communities in its HIV/AIDS policy. In relating to the surrounding communities, the following areas should be incorporated to foster good networking with the surrounding community: (1) Local community organizations and institutions that are engaged in the fight against the HIV/AIDS epidemic and exchanging information on programs and activities on HIV/AIDS should be identified. (2) The development of relevant programs and activities directed at ameliorating the impact of the HIV/AIDS on the communities should be

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encouraged. These programs and activities should include research, peer education, awareness, prevention, treatment, and advocacy. In my opinion Africa University is in a state of denial on the breadth and magnitude of the HIV/AIDS epidemic in Zimbabwe. Prospective teachers graduating from this university could significantly contribute in the fight against HIV/AIDS if they were well prepared to serve in the communities that are heavily infected and affected with the deadly incurable disease. Africa University has the potential to effectively disseminate accurate information about HIV/AIDS to its students who are poised to become community leaders who can help in the fight against HIV/AIDS. My other informed opinion is that the theological understanding of HIV/AIDS epidemic might be a limiting factor in the implementation of the proposed HIV/AIDS Education program. In the interviews it was clearly expressed by some interviewees that the HIV/AIDS epidemic is a curse for sinners. Theological explanations from the Old Testament such as the destruction of Sodom and Gomorrah among other legendary and mythological cases of curses were drawn upon to account for much suffering among the “unfaithful population.” Since Africa University has a Faculty of Theology, there could be some underlying beliefs that the proposed HIV/AIDS Education program should not be implemented. Recommendations Recommendations for Africa University Kelly (2000) expressed the view that education changes the socio-cultural climate within which people live and behave. Even in the absence of any concerted effort to bring about change, change modifies certain aspects of the family and community environment. Some practices become unacceptable, others are introduced. Learning institutions can accelerate the process when they themselves, their staff, their environment, their procedures and their policies reflect values and values consonant with profound social change. My findings indicated that Africa University does not teach sex education or HIV/AIDS education per se as a course at all despite the overwhelming HIV/AIDS epidemic engulfing Zimbabwe. My first recommendation for Africa University, a pan African oriented institution, is to introduce a sex education program to equip prospective teachers with skills that can help in dealing with the HIV/AIDS epidemic effectively. Kirby (2007) identified six factors related to HIV/AIDS that make preservice preparation critical:

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1. Children with HIV disease are living longer, and the number of children with HIV/AIDS attending school is expected to grow. Teachers need an understanding of the special educational, social, psychological, and medical needs of these students. 2. Since the 1990s, HIV/AIDS has been the leading cause of death among 25-to 44 year-olds in Zimbabwe. Teachers may expect to confront educational and psychosocial issues among children whose parents have HIV disease. 3. To prevent the spread of any disease, teachers must be knowledgeable and skilled in using correct infection control guidelines in and around the classroom. 4. In some instances the teacher may be entrusted with information about a student‟s, or staff members‟ HIV status and must understand ethical and legal requirements especially for respecting confidentiality. 5. Teachers may be expected to provide HIV/AIDS education and to answer students‟ questions about HIV/AIDS disease in a manner that is developmentally and culturally appropriate. 6. Teacher attitudes affect their comfort with and capacity to teach specific subject matter. The preservice setting offers an opportunity for future teachers to explore their own beliefs and biases toward HIV/AIDS. Africa University can significantly contribute to reducing the HIV/AIDS epidemic in Zimbabwe if it embarks aggressively on sex education to empower prospective teachers. A teacher preparation program at Africa University is recommended to deliver and consistently reinforce a clear message about abstaining from sexual activity and /or using condoms or other forms of contraception. This appears to be one of the most important characteristics distinguishing effective sex education from ineffective programs. To promote behavior change among young adults and vulnerable people, I recommend that a teacher preparation program at Africa University should focus on reducing one or more sexual behaviors that lead to unintended pregnancy or sexually transmitted infections, including HIV/AIDS. To adequately equip prospective teachers I recommend that a teacher preparation program that provides basic and accurate information about the risks of teen sexual activity and about ways to avoid intercourse or to use methods of protection against pregnancy and sexually transmitted infections to be developed. Activities that address social pressures that influence sexual behavior should be effectively addressed in the recommended sex education program.

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A teacher preparation program that recognizes and acknowledges cultural diversity can be easily received by both teachers and the local community. My other recommendation for Africa University is to implement a teacher preparation program that incorporates behavioral goals, teaching methods, and materials that are appropriate to the age, sexual experience, and culture of the students. Sex education programs at Africa University should also be based on theoretical approaches that have been demonstrated to influence other health-related behaviors and identify specific important sexual antecedents to be targeted. Last but not least, I would like to recommend that Africa University teacher preparation program employ teaching methods that are designed to involve participants and have participants personalize information. Recommendations for Further Research My case study research findings were drawn from Africa University, a United Methodist- related institution in Zimbabwe. There is a need to carry out research on all colleges and universities that prepare teachers in Zimbabwe to establish the national position as far as sex education is concerned. The effectiveness of the instructional methodology on sex education is an area that deserves further research. Both primary and secondary schools in Zimbabwe provide another fertile ground for further research to ascertain which topics students cover in sex education courses. I recommend that higher education institutions in Zimbabwe carry out research on how to reduce poverty and improve general nutrition at an affordable price for all citizens. Stigmatization and discrimination have a negative effect on the welfare of the HIV/AIDS patients. Therefore, I recommend that colleges and universities working in partnership with their local communities do research on how to promote sex education programs for both in school and out of school youths to reduce the incidence of sexually transmitted infections, unwanted pregnancies and HIV/AIDS. I further recommend that individual scholars, colleges and universities in Zimbabwe do research on how to implement public education campaigns to destigmatize HIV/AIDS and reduce public hysteria surrounding the disease in Zimbabwe. The hyperinflationary environment currently existing in Zimbabwe has enormously eroded the buying power of the citizens. Poor women and girls bear the economic burden that compels them to venture into risky commercial sex activities. I recommend further research study on how to implement aggressive programs that can empower women and change the skewed power relations between men and women. Literacy levels in Zimbabwe are rapidly deteriorating due to economic challenges that are forcing many

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students out of school, either to fend for their siblings or because money for tuition fees is not available. My other recommendation for further study for individual researchers, colleges and universities is to engage the grassroots level to improve literacy and raise the standard of living of the citizens. Recommendations for Practitioners Teachers and other school practitioners in Zimbabwe are better placed to deal with HIV/AIDS vulnerable groups than other citizens due to the centrality of the school system. All schools in Zimbabwe from on are recommended to offer age and culturally appropriate sex education in a safe environment to combat the HIV/AIDS epidemic. Children in Zimbabwe are a „window of hope‟ for an AIDS free generation. Therefore, I recommend that practitioners assist youths to develop skills in communication, refusal and negotiation. Women and girls are usually exposed to sexual harassment and violence that unfortunately contribute to the spread of the HIV/AIDS epidemic. I recommend that practitioners to assist youths in clarifying their individual, family, and community values in the promotion of human dignity and self-respect. The controversy surrounding the teaching of sex education in Zimbabwe places the practitioners at a crossroads on the way forward. To combat or reduce HIV/AIDS prevalence, I recommend that practitioners accurately teach sex education in a non-judgmental way. Inconsistent or incorrect use of condoms exposes the vulnerable groups to the HIV infection that causes AIDS. Therefore, I recommend that practitioners should have clear goals for preventing HIV, other sexually transmitted infections, and/ or teen pregnancy. Practitioners working in different communities are encouraged to respect community values and respond to community needs in the most culturally appropriate ways. To encourage behavior change among vulnerable groups, practitioners should rely on participatory teaching methods, implemented by trained educators and using all the activities designed to enhance student involvement. Kirby (2007) expressed the view that prevention through education is the best way to fight the transmission of HIV/AIDS, and education must begin before young people initiate sexual activity and certainly no later than seventh grade. However, the capacity of teachers to provide instruction about AIDS and other related health problems with expertise and comfort might be limited due to a lack of preservice education. I recommend that teacher education programs in Zimbabwe be thorough and educate all preservice teachers to be agents of change in

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the fight against the HIV/AIDS epidemic. The strategic position of schools in Zimbabwe offers an accessible and appropriate setting for HIV/AIDS education. Kelly (2000) acknowledged that an education system that does not protect itself against the potential and actual ravages of HIV/AIDS would not be able to serve as a vehicle for reducing the incidence of the disease. The system that is meant to offer protection is itself in need of protection. In addition, Kelly gave an analogy that on every commercial airplane flight, shortly before takeoff the cabin crew demonstrates the safety procedures aboard. Their message always includes information on how to use oxygen masks in the „unlikely event of a sudden drop in cabin pressure.‟ Passengers are then advised to secure their own masks first before helping children or others to secure theirs. Maintaining hope and achieving success in the fight against HIV/AIDS necessitates careful attention to protecting the health and effective functioning of the education system. Evidence from my findings showed that the first and most crucial contribution that an education system can make to reduce the incidence of HIV infection is to take the steps needed to protect itself from the ravages of the disease. Therefore, I recommend that all educators and preservice teachers be adequately prepared to provide meaningful and relevant educational services of acceptable quality to learners in and out of the formal education system, in complex and demanding circumstances. Coombe (2000) asserted that the most visible impact of HIV/AIDS in Zimbabwe is the increase in deaths of young adults. The peak mortality age for women is in the 25-35-age range and for men in the 35-45-age range. Women and men are dying at ages when under other circumstances they would be rearing children. The result is the already noted rapidly increasing number of orphans. Regardless of their social status, these orphaned children constitute a very vulnerable sector of society. This vulnerability is increased for those from a more impoverished background, who may be almost totally lacking in support. Coombe further noted that education systems confronted by such unprecedented human suffering and disrupted social systems should be concerned with three principal challenges to which they must respond through learning programs and curricula: 1. Replenishing the skills being lost through the premature deaths of skilled and qualified adults; 2. Transmitting skills to young people, when the practitioners who should pass on the training are no longer alive; and

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3. Preparing very young people, many of them mere children, for the immediate assumption of adult economic responsibilities, as heads of households or within the framework of households headed by elderly relatives. Recommendations for Community Leaders, Zimbabwean Government and Nongovernmental Organizations Community leadership can provide a support network that can help the orphaned children to have decent lives. Many of the orphaned children cannot go to school, as there is no social welfare system that can help them with either school fees or accommodation. Orphaned children whose future is equally bleak without guidance and support from the community now head several homes. The socially and psychologically affected orphaned children require some guidance and counseling to overcome the traumatic experiences they could have encountered before their parents succumbed to HIV/AIDS. The African extended family concept of caring for one another can be applied to help needy orphaned children. The most immediate effects of HIV/AIDS are experienced at the household and community levels. These levels have already seen an unprecedented manifestation of different coping strategies, including self-sacrificing home-based care for the sick and the matter of fact integration of orphans into already stressed extended families. Government effort is called upon to focus on policy issues that affect the health delivery system, HIV/AIDS education, home-based care and the provision of antiretroviral therapies, among other strategies. My findings revealed that government participation came in rather late and lacked punch to effectively deal with the HIV/AIDS epidemic. My recommendations to the Zimbabwean Government are as follows: 1. High level political commitment to fight HIV/AIDS is urged; 2. Openness about the HIV/AIDS epidemic is central in combating the disease; 3. Government should provide antiretroviral therapies to all HIV/AIDS victims; 4. Introduction of sex education programs in all schools in Zimbabwe needed; 5. Government should work closely with nongovernmental organizations dealing with HIV/AIDS in participatory training activities; 6. The government is urged to adopt the bottom up approach in gender sensitive strategic planning when dealing with HIV/AIDS; 7. Social support for HIV/AIDS orphaned children should be mobilized; and

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8. All sectors of the community should be involved in the dissemination of accurate information about HIV/AIDS. Recommendations for the Future Government of Zimbabwe Effective policies on the public health sector should be formulated and implemented in Zimbabwe to revamp the ailing and dysfunctional essential sector. Lives should not be unnecessarily lost due to negligence and incompetence. I further recommend that the government should look into the salary structures of the health professionals so as to redress this key issue in the retention of qualified personnel. A commission of inquiry should be set up to look into the working conditions and salaries of the health professionals with the intention of bringing back the health professionals back into the country to revive this underperforming sector. I recommend the government of Zimbabwe to consult widely with all the stakeholders when formulating health policies in the advent of HIV/AIDS epidemic. I recommend that there should be rule of law in Zimbabwe, there should be no one above the law. Some health professionals left the country in fear of their lives during the violent campaign unleashed by the youth militia. Health personnel should have adequate protective clothing; medical supplies other incentives that will motivate them. Long term plans should be drawn up to sustain the health care system that is vibrant and responsive to the needs of the population. The private sector should be encouraged to actively participate in the dispensation of quality health care in Zimbabwe. In partnership with senior nurses and junior doctors the private sector can play a crucial role in the health care system by starting their own practices in order to ensure adequate and good health care to everyone. Last but not least I recommend that the government of Zimbabwe should be accountable to its citizens on issues of national interests and health care delivery system. Conclusion This research study sought to establish the interpretation of students and faculty of the high prevalence of the HIV/AIDS epidemic in Zimbabwe and what should be done about it. HIV and AIDS are leading to a massive loss of life in Zimbabwe. The HIV/AIDS epidemic has caused and is continuing to cause severe suffering among those infected with the virus and among those affected by the epidemic. The epidemic also has a pervasive impact on Zimbabwean society and its economy. The World Health Organization (WHO) (2007) noted that since 1990, HIV/AIDS has slashed the average life expectancy in Zimbabwe from 61 to 33 years,

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the lowest anywhere in the world. It is estimated that there are now over one million children in Zimbabwe who have been orphaned due to HIV/AIDS-related deaths. Expressed in simple statistics, one in every five Zimbabwean children is an orphan as a result of the HIV/AIDS epidemic. My research findings came up with the following likely causes of the HIV/AIDS epidemic: poverty; a lack of information/education; an erratic supply of condoms/lack of accessibility to condoms; cultural practices such as wife inheritance, small house or extramarital relations; sugar mammies/sugar daddies; commercial sex workers; and child pledging; rural- urban migration; poor living conditions and denial by the government. The education sector in Zimbabwe is centrally situated to make an effective response to the AIDS epidemic. In other words, the education sector provides numerous entry points and opportunities that can result in a greater return on investment to AIDS programming. In Zimbabwe, many young people at some point interact with the education sector, making it a significant entry point for teaching sex education to combat the HIV and AIDS epidemic. However, for the education sector to effectively play a role in response to HIV and AIDS, educational authorities need to undergo paradigm shifts that do not shy away from addressing the sensitive cultural issues that surround sex and sexuality. In addition, mainstreaming HIV and AIDS work within the education sector requires funding. Education about HIV and AIDS should be ongoing, with new generations being taught about the epidemic and messages reinforced through exposure to mass media communication, peer education, behavior change strategy, cultural teachings, and sex education. Anyone who is vulnerable to HIV and AIDS should be exposed to AIDS education, but more importantly young people who are most at risk yet potentially could offer a window of opportunity for halting the spread of HIV. Education contributes to the empowerment of the individual, as well as to a country‟s economic and social well-being. It helps individuals to make more informed choices about their health, family size, future and the future of their children. The twin pillars of information and knowledge and how to apply these at the personal, family, community and national levels is essential to halting the spread of HIV and ensuring universal access to treatment, care and support. In conclusion, sex education can contribute to reduced stigmatization and discrimination against vulnerable and marginalized communities and people living with HIV. Further, sex education can help people to respond appropriately in the face of challenges presented by social,

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cultural, political, economic and other contextual factors currently existing in Zimbabwe. Education is the only available window of opportunity to salvage the humanitarian crisis that has been created with HIV/AIDS epidemic in the country. Concerted efforts by all the stakeholders can work for the betterment of the situation that is casting a dark cloud insofar as HIV/AIDS epidemic is concerned.

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Appendix A - Interview Protocol for faculty

Demographic Questions:

1. How long have you been at Africa University?

2. Describe your educational background.

4. What courses do you teach?

To be completed by the researcher:

Approximate age: ______

Gender: ______

Interview Questions:

1. Do you have a curriculum in place here that specifically addresses HIV/AIDS?

2. If yes, what issues does this curriculum deal with?

Probing questions: How does your program encourage students to make informed decisions about sex related issues?

In your opinion, how effective is your program in reducing the spread of the HIV/AIDS epidemic?

Does this program include any community project(s) that directly deal with the HIV/AIDS epidemic?

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If so, describe them.

3. To what extent do you think sex education can help people change their attitudes and sexual behavior?

4. What do you think has caused this HIV/AIDS epidemic in Zimbabwe?

Probing questions: To what extent do you think cultural practices such as polygamous relationships are to blame for this epidemic?

What is your understanding of the “small house” concept?

How does this practice contribute to the spread of the HIV/AIDS epidemic?

What do you think can be done to reduce the severity of the epidemic?

5. To what extent do government policies regarding HIV/AIDS education shape your teacher preparation program?

Probing questions: What logistical support do you get from the government?

Do you think the government is providing the necessary resources and awareness on the HIV/AIDS epidemic?

If not, how do think the government could play a more helpful role in dealing with the HIV/AIDS epidemic?

6. What measures do you think both faculty and students could put in place to help control or prevent the spread of the HIV/AIDS epidemic?

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Probing questions: How do you think schools in Zimbabwe could help in the dissemination of HIV/AIDS information?

What programs are already in progress in both primary and secondary schools? How do you help in the fight against the HIV/AIDS epidemic?

What roles could be played by both educational and community leaders in the dissemination of HIV/AIDS information?

What kind of assistance do you think could be given to the HIV/AIDS orphans in your community?

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Appendix B - Interview Protocol for Students Demographic Questions:

1. How long have you been at Africa University?

2. What is your major area of study and minor?

3. What courses have you taken that included reading about or discussion of the HIV/AIDS epidemic in Zimbabwe?

4. When are you graduating?

To be completed by the researcher:

Approximate age: ______

Gender: ______

Interview Questions:

1. Do you have a curriculum in place here that specifically addresses HIV/AIDS?

2. If yes, what issues does this curriculum deal with? Does this program include any community project(s) that directly deal with the HIV/AIDS epidemic?

If so, describe them. 3. To what extent do you think sex education can help people change their attitudes and sexual behavior?

4. What do you think has caused this HIV/AIDS epidemic in Zimbabwe?

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Probing questions: To what extent do you think cultural practices such as polygamous relationships are to blame for this epidemic?

What is your understanding of the “small house” concept?

How does this practice contribute to the spread of the HIV/AIDS epidemic?

What do you think can be done to reduce the severity of the epidemic?

5. To what extent do government policies regarding HIV/AIDS education shape your teacher preparation program?

Probing questions: What logistical support do you get from the government? Do you think the government is providing the necessary resources and awareness on the HIV/AIDS epidemic?

If not, how do you think the government could play a more helpful role in dealing with the HIV/AIDS epidemic?

6. What measures do you think both faculty and students could put in place to help control or prevent the spread of the HIV/AIDS epidemic?

Probing questions: How do you think schools in Zimbabwe could help in the dissemination of HIV/AIDS information?

What programs are already in progress in both primary and secondary schools?

How do you personally help in the fight against the HIV/AIDS epidemic?

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What roles could be played by both educational and community leaders in the dissemination of HIV/AIDS information?

What kind of assistance do you think could be given to the HIV/AIDS orphans in your community?

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Appendix - C Framework for Observation

Date of observation: ______

Name of Course: ______

Number of students: ______

Male: ______Female: ______

Teaching methods used: ______

Attitude(s) toward presence of researcher: ______

1. Are HIV/AIDS materials displayed in the classroom or lecture halls?

What is the quality of the posters or pictures on display?

How well positioned are the posters to draw the attention of the students?

2. In the class, what emphasis is played on the HIV/AIDS epidemic?

What instructional learning aids about HIV/AIDS are made available to the students? How comfortable are the students when discussing the HIV/AIDS epidemic individually or collectively?

How often does the faculty mention member mention HIV/AIDS epidemic or sex education in a lesson?

How effective are the groups when discussing HIV/AIDS epidemic?

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How deep is the level of discussion of the HIV/AIDS education or sex education?

3. Significant statements made by the professor and students:

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Appendix D - Framework for Analyzing Documents

1. Complete bibliographic information:

2. Intended audience:

3. Style and reading level:

4. General purpose:

5. Explicit or implicit causes of epidemic identified:

6. Recommended courses of action:

7. Persons who are identified as playing role in fighting the epidemic:

8. Groups identified as playing role in the fight against the epidemic:

9. Role of government expressed or implied:

10. Is any budget proposed in support of recommendations? If so, describe it 11. What is lacking in the document that could have made it more relevant to the fight against HIV/AIDS?

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Letter of Permission --- On Wed, 2/27/08, Prof. Fanuel Tagwira wrote: From: Prof. Fanuel Tagwira Subject: To: "'Moses Rumano'" , [email protected] Cc: [email protected], "'Registrar'" , "'deanfoe'" Date: Wednesday, February 27, 2008, 10:12 AM

To Whom it may Concern,

This e-mail serves to let you know that Moses Rumano has been granted permission to carry out research at Africa University. The research is entitled “A case study for teacher preparation at Africa University for dealing with HIV/AIDS Epidemic in Mutare, Zimbabwe.

Thank you,

Prof. F. Tagwira

Interim Vice Chancellor Africa University

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