In contexts where large numbers of young people attend school, school-based programs can offer an appropriate setting for HIV-related education. In Tanzania, for example, a school-based program called Ngao (shield), was designed to reduce risks of HIV infection and reduce discriminatory attitudes towards people living with AIDS. The program consisted of factual information, posters, songs, poetry and performances for younger pupils generated by the students. Panel discussions were also held with elders and parents. Six months after the program, pupils who had been exposed to Ngao reported significant increases in AIDS-related knowledge and more positive attitudes to people living with AIDS in comparison to those who had not (Klepp et al, 1994).

Broader political and religious forces may, however, restrict the kind of work which takes place in schools. School-based programs in Tanzania and South Africa, for example, have been prohibited from teaching young people about condoms (Klepp et al, 1994; Matthews et al, 1995). Similarly, legislation and public opinion often means that it is not possible to teach young people about sex and reproduction until they are of secondary school age. This may exclude many young people who do not attend beyond primary school. Moreover, since evidence suggests that young people are becoming sexually active at an earlier age than in the past, sex education may be required prior to secondary schooling. Importantly, in reviewing a number of programs of sex education for young people, Grunseit (1997) has noted that sex education programs have greatest impact if undertaken prior to the onset of sexual activity.

Although school-based programs are useful, it is important to note that in many parts of the developing world some of the most vulnerable young people do not attend school. That said, school-based programs may help reach some out-of-school youth through the messages about safer sex disseminated to their school-attending peers (Blake et al, 1996).