Case Study of WCC’s Work Focused on HIV/AIDS Education in New York City
Background
The Women’s City Club of New York (WCC) is a nonprofit, nonpartisan, multi-issue activist organization that is dedicated to improving the quality of life for all New Yorkers. WCC works to shape public policy to promote responsive government through education, issue analysis, advocacy and civic participation. Now in its second century of service, WCC has focused its efforts to empowering women to become more civically engaged.
Amid the global surge of HIV/AIDS cases in the 1980s, the City and State took up the issue of AIDS education. In 1987, the New York State Regents required that HIV/AIDS education be provided to all students in all schools. The next year, New York City’s Schools Chancellor Richard R. Green went further and required that all public high schools provide six sessions of AIDS education per grade. The New York City Board of Education subsequently developed a suggested curriculum in 1988 entitled “Family Living Including Sex Education - AIDS Supplement.
Despite these mandates, WCC became concerned about the plight of children and families affected by the AIDS epidemic, noting that little attention was centered on these groups and therefore, they had few advocates and few support services to address their needs. WCC members were concerned that students in New York City school were not receiving appropriate education on HIV/AIDS and that elected and appointed officials needed to improve service delivery and ensure schools were properly equipped to respond to the burgeoning healthcare epidemic.
It was projected that by 1991, more than 43,000 people in New York City would have contracted AIDS and 32,000 would have died. In one report, WCC noted that the virus would spread unchecked among IV drug users, and that families who will be the most affected by AIDS over the subsequent five to ten years would have the fewest social supports.
Given the organization’s concerns, a WCC Task Force, which included experienced educators and other professionals, was formed in 1990 and conducted a 17-month study of AIDS education in 60 public, religious, and independent high schools.
Actions
WCC was instrumental in highlighting the problem through the formation of a Task Force, issuing reports, hosting a symposium, and producing a video that was distributed to all New York City public high schools.
Task Force/Study
A WCC Task Force, formed in 1990, was led by health care consultant Rosemary Clemens, PhD. Task Force members were: Beatrice Brennan, Nancy Carr, Joan Dumont, Mary Ellis, Ellie Fralick, Karolyn Gould, Judith Keller, Laura Ludwig, Sr. Elizabeth Mullany, Ethel Paley, Augusta Schenker, Francis Thorpe, Nina Untermyer, Emily Whalen and Alliance Yohalem. Elena F. Deutsch was Coordinator of the project.
The Task Force developed an in-depth questionnaire, and over six months, Task Force members conducted one-on-one interviews with high school teachers and administrators, and then additional interviews at selected independent and religious schools. Additionally, issues were discussed with eight community-based organizations that provided HIV/AIDS services, the City’s Health Department, and the United Federation of Teachers. This study was funded by the Robert Wood Johnson Foundation and was presented to the New York City Board of Education.
Although the 1988 city mandate required six AIDS education sessions per year for grades 9 - 12, the report found that full implementation was carried out at only two of the 25 comprehensive specialized and vocational schools that were visited; additionally, only four of the seven alternative visited schools met the requirement.
The report included 15 recommendations, covering three areas: (1) what schools must do to fully implement City and State recommendations; (2) the imperative of bringing students, parents, community-based organizations into the program to help in policy development and effective implementation; and (3) how optimum use of health care professionals, including the New York City Department of Health and community-based organizations could enhance educational offerings and services;
The report identified a number of weaknesses in the provision of education relating to HIV/AIDS, noting that staff interviewed knew of no formal policies on confidentiality of referral for students who thought they had HIV/AIDS or sought more information about services; local school administrators had limited knowledge about HIV/AIDS; school faculty lacked motivation for the HIV/AIDS curriculum; curriculum integration with HIV/AIDS was spotty except for in science; parental involvement in AIDS curriculum development or evaluation was nonexistent; and schools were limited in their knowledge and use of relevant community-based organizations for HIV/AIDS curriculum enhancement.
Conferences
In 1988, WCC sponsored a Marta Fraenkel, M.D. Symposium titled, “AIDS: Its Impact on Children and Their Families”, bringing together community representatives and city policy officials in a meaningful dialogue about issues surrounding the plight of children and their families affected by the AIDS epidemic.
A written report on the conference noted that, by 1991 in New York City alone, there would be about 1,000 to 1,500 children diagnosed with AIDS, and that for every child that is reported with AIDS, an estimated three have HIV-related disease. “At present there appears to be no integrated systemic approach to dealing with this potentially explosive situation,” the report noted.
The symposium explored the dimensions of need, including in education, housing, and social service provision, as well as the City’s response. At the event, a panel addressed what is being done, including in social services and education, to address the issue; what programs in local communities are affected; and, what can be done so policymakers and care deliverers can contain this “emerging crisis.”
Program participants included moderator Mathilde Karim, Ph.D., founding chair, American Foundation for AIDS Research, and panelists were Stephen C. Joseph, M.D., Commissioner, and Polly Thomas, M.D., NYC Department of Health; Dolores M. Fernandez, Ph.D., Deputy Chancellor for Instruction and Development, NYC Board of Education; Carol Rafael, Executive Deputy Commissioner, Income and Medical Assistance Administration, HRA; Karolyn R. Gould, Exec. Dir., Bronx AIDS Community Service Project; Joan H. Hit Gelman, Ph.D., Dir. Infant and Child Learning Center, State University of New York; and Ruth Rodriguez, Exec. Dir., Hispanic AIDS Forum
Reports
In February 1992, WCC issued a document on the issue titled, “Lessons to be Learned: AIDS Education in New York City High Schools and Community-Based Organizations: 1989-91.”
In the report, WCC undertook the study two years after the New York State Board of Regents mandated an AIDS education program for all high schools, and one year after that the New York City Board of Education followed suit. That report, based on interviews of staff at 59 New York City high schools, including 29 public schools and 30 non-public schools, and eight community-asked organizations, aimed to evaluate how these policies were implemented in city high schools and to recommend ways in which implementation could be improved.
After the public school section of the study was nearly completed, early in 1991, the Board of Education and new Schools Chancellor established HIV/AIDS education as a top priority and adopted a new expanded HIV/AIDS education curriculum, which included condom availability.
The subsequent report noted that there was not a comprehensive policy or program of HIV/AIDS education being implemented by the Board of Education; limited implementation; and, scarce financial resources which constrained implementation. The report further noted that there were few if any close ties with health professionals and community resources, which could have enriched HIV/AIDS educations programs.
WCC recommended that the Board of Education must demonstrate a commitment and leadership in implementing an HIV/AIDS education program by keeping schools informed; providing training and materials; encouraging replication of successful programs; and, providing mechanisms for monitoring and enforcement as well as evaluation. Further, schools should expand their health services and use outside resources, including health professionals, the Department of Health, and Community Based Organizations to enhance their programs and provide referrals.
Finally, WCC recommended that the health education requirement should be increased to two semesters, and the expanded HIV/AIDS curriculum should be integrated with other subjects, so the message is reinforced in a variety of contexts.
However, noting the Board of Education’s new efforts, the report stated, “Nevertheless, the right direction has been set; now it is up to the Chancellor to make sure that the new requirements are met and that the program is constantly improved based on ongoing evaluation.”
The Task Force that was formed also included the NYC AIDS Coalition, Columbia-Presbyterian Medical Center’s HIV/AIDS program, and local service providers from Brooklyn, Manhattan and the Bronx.
Video
In 1995, WCC’s Subcommittee on AIDS produces “Meeting the Challenge: Promoting HIV/AIDS Awareness Among Young People and Adolescents” a 28-minute video used by the Board of Education. The film, edited from a 2-hour program, features public health experts and the young actors of the Star Theater (Mount Sinai’s Adolescent Health Center) and was widely distributed to New York City high schools.
Impact
WCC was instrumental in highlighting the rising number of adolescents in New York City who were affected by HIV/AIDS and fostering public dialogue on the need for improved services in schools and stronger affiliations with community-based organizations to assist adolescents and their families.