The myth of asexuality? Disability stigma as a barrier to sexual relationships in South Africa Literature review

Reading note 3. Protect or enable? Teachers’ beliefs and practices regarding provision of sexuality education to learners with disability in KwaZulu-Natal, South Africa

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Keywords

Education, Emotional and sexual life

Author’s note

Literature argues that people with disabilities have heightened risk of exposure to sexually transmitted infections, including HIV due to lack of HIV knowledge, access to health services, and increased risk of sexual abuse and poverty. People with disabilities lack access to sexuality education. Teachers should be at the forefront to address this; however there is little understanding of the knowledge, attitudes, practices and needs of teachers of learners with disabilities in regards to sexuality/HIV education in Africa. A pilot study was conducted in ten special schools (eight urban, two rural) representing four types of disabilities in South Africa. Data was collected from 99 teachers using scales investigating beliefs and practice in teaching sexuality education, perceived subjective norms, self-efficacy, and materials/professional preparation. Frequencies, means, standard deviations and Cronbach’s alphas were calculated for all scales. The data shows that overall teachers have positive attitudes towards teaching all elements of comprehensive sexuality education. However, they find it easier to discuss ‘‘soft topics’’ around relationships and personal skills (e.g., hygiene) than to talk about sexual behavior and functions. Teachers expressed confidence in their ability to teach sexuality education but indicated that their professional preparation and materials are not adequate to provide accessible sexuality education to their learners. The study highlights the need to develop appropriate materials and to build teachers’ capacity to deliver sexuality and HIV education to learners with disabilities.

Commentary

In this peer-reviewed article (C4), Chirawu et al. seek to elucidate teachers’ knowledge, attitudes and practices when delivering sexuality and HIV education to learners with disabilities in South Africa by using a mixed methodology. This is a companion article to de Reus et al. (2015) and focuses on the quantitative aspect of the study. Misconceptions about sexuality among persons with disabilities mean that they are especially vulnerable to contracting sexually transmitted infections such as HIV. Prior research has noted that teachers have some concerns over delivering sexuality education to learners with disabilities, however there has been little systematic investigation into teachers’ knowledge, attitudes and practices toward this group. Chirawu et al. help address this gap (C1). The authors recruit teachers (N = 99) from 10 special schools, catering from a variety of impairment types (e.g., cerebral palsy, intellectual), in the province Kwa-Zulu Natal. As Chirawu et al. point out, sexuality research with educators of learners with disabilities is rare. Therefore, this study represents a valuable collaboration with actors in the field (C2). A questionnaire, comprising different attitudinal measures, was given to teachers who participated in the study. Findings revealed that although overall attitudes toward providing sexuality/HIV education to learners with disabilities were positive, teachers were hesitant to discuss some topics (e.g., sexual activity) with them. Additionally, teachers reported moderate confidence in their ability to deliver sexuality/HIV education, but expressed the need for more teaching materials in these areas. These findings highlight the need for service providers to provide adequate sexuality/HIV educational materials to learners with disabilities. The results also suggest that future interventions should target the subjective norms that are held about the sexuality of persons with disabilities. These recommendations provide valuable guidance to the field (C3). Chirawu et al. note that, due to the small sample size, the results of this study are unable to be generalised to all of South Africa. An additional limitation is that, as the study looks at a range of disabilities, impairment specific issues may have been missed.

Reading note 4. Challenges in providing HIV and sexuality education to learners with disabilities in South Africa: the voice of educators.

Access to the reading note and to complete documents in the documentary database of the Resource Center
Key words

Education; Emotional and sexual life

Author’s note

People with disabilities are at increased risk of exposure to HIV, yet they lack access to HIV prevention, treatment care and support including sexuality education. Lack of knowledge, skills and confidence of educators teaching sexuality education to learners with disabilities is related to this increased vulnerability. This study identifies possible challenges educators of learners with disabilities face when teaching sexuality and HIV education. Five focus groups were conducted in three purposely selected types of special schools representing four impairment groups in KwaZulu-Natal, South Africa. Educators recognise that teaching about sexuality is part of the South African Life Orientation curriculum and understand its importance to learners. However, they identified a number of challenges to such work, including barriers in communication and language, cultural values and expectations, learners’ knowledge and behaviour, handling of sexual abuse cases and the teachers’ own life experiences. Educators feel a lack of support from parents, departments of education, fellow educators and members of the community. They report the need for training and adapted HIV and sexuality education tools and resources to accommodate learners with disabilities. This training needs to provide knowledge on disability and HIV, offer guidance on disability appropriate communication strategies, deal with sexual abuse and include educational tools for the classroom.

Commentary

In this peer-reviewed article (C4), de Reus et al. (2015) seek to elucidate teachers’ knowledge, attitudes and practices when delivering sexuality and HIV education to learners with disabilities in South Africa by using a mixed methodology. This is a companion article to Chirawu et al. (2014) and focuses on the qualitative aspect of the study. Misconceptions about sexuality among persons with disabilities mean that they are especially vulnerable to contracting sexually transmitted infections such as HIV. Prior research has noted that teachers have some concerns over delivering sexuality education to learners with disabilities, however there has been little systematic investigation into teachers’ knowledge, attitudes and practices toward this group. De Reus et al. help address this gap (C1). The authors recruit teachers and support workers (N = 47) from 5 special schools, catering from a variety of impairment types (e.g., cerebral palsy, intellectual), in the province Kwa-Zulu Natal. In light of the rarity of sexuality research with educators of learners with disabilities, this approach represents a valuable collaboration with actors in the field (C2). The authors conducted focus groups within each school and the data was then analysed using thematic content analysis. Findings revealed that educators sometimes struggle to implement sexuality with learners who have disabilities and consider many sexual topics (e.g., condom use, masturbation) as culturally taboo. At the same time, there was an overall awareness that learners with disabilities were sexually active, but lacked knowledge about some areas of sexuality and were particularly vulnerable to sexual abuse. Therefore, educators recognised the need to provide sexuality education, though some did not feel confident doing so. The findings highlight both the need for educators to receive adequate training dealing with the sexuality of learners with disabilities and identify some areas which this training could target (e.g., educators’ self-efficacy beliefs). These recommendations provide valuable guidance to the field (C3). De Reus et al. emphasise that, as the present research is relatively small scale, further studies are required to gain a more representative understanding of educators’ needs. Although the authors suggest that the quantitative work of Chirawu et al. addresses this somewhat, it is fair to say that still more representative research could be conducted within this area in the future.