CAPE TOWN, South Africa — Kolosa Kokolo bounced around the classroom full of teenagers, speaking rapidly in both English and Xhosa, at one point jumping on a table to emphasize the urgency of her message.
AIDS, the scourge of South Africa and its younger generation, "is here, now," she said.
"There is no cure for it," says Kokolo, a petite woman with a wide smile and a voluminous braided ponytail. "But it's just a matter of reducing the numbers, and to reduce the numbers we need to tackle the cause. And one big factor of the cause is risky behavior."
Kokolo is 20, just a few years older than her audience of 11th grade students at the Manzomthombo Senior Secondary School. The law student is part of a peer education effort that has young people teaching other young people about AIDS and prevention.
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"It works best when they get down to the real reasons why these kids are engaging in these behaviors and trying to warn them about the risks," said Melani-Ann Cook, a project manager for the program. "What we've found is that when our peer educators go (to the schools) ... they really look up to them."
The success of the program and others like it is vitally important to the future of South Africa, which has the largest population of HIV-positive people in the world. The Joint United Nations Program on HIV and AIDS estimates that 5.6 million South Africans were living with HIV in 2009, out of a population of more than 42 million. The U.S., by comparison, has about 1.2 million HIV patients out of a population of 307 million.
Peer education is only one of a wide array of programs under way to combat the problem. Some stress safe sex, use of condoms and care in selecting partners. Others stress abstinence. Some try to curb drug and alcohol use. Still others take aim at changing attitudes, gender roles, after school activities and erasing the stigma that attached to AIDS.
The stakes are high for South Africa, which is often described as Africa's biggest success story and an emerging economic giant. But it is the AIDS epidemic — not political instability, racial division or joblessness — that is frequently cited as the one hurdle South Africa might not be able to overcome.
"We are No. 1 for all the wrong reasons. We are the ones who have to fight the disease more than any other country," South Africa's Health Minister Aaron Motsoaledi told The Times, a South African newspaper.
Candice Stroud, the U.S. Agency for International Development's liaison to the peer educator program, said she doesn't think the full impact of the AIDS epidemic has yet been felt.
"I definitely think in the next 10 to 15 years we will feel the effects, the real effects of AIDS, of deaths," she said. Testing programs are finding students as young as 15 who have the virus. With treatment, Stroud said, a person could live 15 years.
"But they're going to be out of the work force when they're really young." She said. "I think we'll only see the real impact in 15 years."
It seems the efforts are working — a little. In 2007, the United Nations estimated that 5.7 million South Africans were infected with HIV, compared with 5.6 million in 2009, the latest year for which statistics are available.
Kokolo said educating students about risky behavior is important because they too often receive mixed messages from their communities. Many, she said, don't even know how the virus can be contracted.
Athini Ngesi, one of the teenagers in Kokolo's class, said that if a student has the virus he or she is treated differently and no longer feels comfortable in public.
"They won't talk to you, sit next to you, share food with you," Ngesi said.
In her visit to the 11th graders, Kokolo discussed with the students how ingrained expectations of gender behavior can be a little recognized factor that contributes to the spread of HIV. Women, for example, are expected to be passive, and therefore less likely to insist that their partners use a condom. Men, on the other hand, are expected to have many sexual partners, thus increasing their chances of contracting HIV.
"I think a lot of the children that we deal with, they're very — I wouldn't say ignorant, but they're not aware. They're not well educated enough to understand the consequences," she said. "But I think it's a matter of being educated enough about the issue... It's just a matter of reminding them, you just need to emphasize where they are going wrong or where people are going wrong."
But as Kokolo discusses with a group of teenage girls how women are expected to be passive in relationships, making it difficult for them to insist their boyfriend use a condom, the girls pipe in, offering their own ideas. It seems Kokolo is getting through to them.
"I am taking part in the change I want to see in the world. One school at a time, one child at a time," Kokolo said. "Every child we reach is important because we could be saving their life."
(Burnham, a graduate of Penn State University, reported this story from Cape Town for a class in international journalism.)
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