Make Art Stop AIDS Malawi
Using participatory art to foster open and honest sexual and reproductive health education in Malawi and the U.S.
You don’t need a structured focus group to realize youth are uncomfortable talking to their parents about sex, but that’s what my team and I led in Southern Malawi. We evaluated the Make Art/Stop AIDS (MASA) Youth Project which uses participatory arts to teach young people about sexual and reproductive health. The project also uses arts methods to create open dialogue between youth and their peers, parents, and elders. The evaluation found that young people loved using art to discuss tricky and sometimes awkward topics. Involvement in the program built their confidence to discuss these issues, and they felt open to dig deep and get answers to their most daunting questions. Students who were tested before and after participation in MASA also showed improved scores in knowledge, attitudes, and practices related to sexual and reproductive health in post tests.
“I couldn’t talk about sex, it was like a taboo, my parent would think ndalowelera (I am lost) but MASA was like an eye opener to say there is nothing wrong with talking about it and I can now even talk about it with my mother. So I can say the confidence and comfortability wasn’t always there until MASA.”
MASA Youth is implemented by Art & Global Health Center (ArtGlo) with technical support from Dignitas International and funded by Malawi’s National AIDS Commission. ArtGlo is a sister center to UCLA’s Art & Global Health Center. Check out UCLA’s current video series, AMP!, which was created “with the belief that laughter and honesty are the best weapons against the silence that permeates difficult topics like STIs, teen pregnancy, LGBTQ issues, waiting for the right time to have sex, and many other sexual health concerns.”
So how does MASA work? The project recruits university students into “squads,” which are essentially theatre troupes of students. The squads learn how to use art to create unique and interesting sexual and reproductive health content. The students develop their own pieces — including skits, songs, and spoken word — and perform at university events. The squads travel to local high schools and repeat the training process for their younger peers. I was able to attend the high school “festivals” in Malawi, and I was blown away by their bravery and boldness. I would not have been able to stand up in front of my classmates and perform a skit about gonorrhea and condom use in high school, but then again, I didn’t get to attend MASA! A young squad member put me to shame: “Sometimes when discussing with our friends, they laugh at us, but never give up, because you want to help them.”
The idea behind the MASA method is that students will not only share important sexual and reproductive health information with their peers through engaging performances, but they will also learn by doing.
“It was a very good experience. We have been doing different activities entertaining people. At the end of the day people learnt something from the dramas we performed and the songs we sang.” - High school squad member
The students shared their feedback in focus group discussions at the end of the project. While coding the transcripts may have taken many late nights, the energy that kept me going came from the overwhelming positive feedback from the students. Below is some of the feedback from our high school and university squad members:
On feeling open
“I don’t think there was anyone who was not free because the trainers were so open with us so why should we not be comfortable. We could ask the trainers the questions we could not ask our parents because we considered the trainers as our friends/brothers and sisters.”
“It was not age selective. Most ways they don’t tell people below 18 years of age about sexual and reproductive health but at MASA they realized that it’s vital for the youth to know regardless of age some of which we didn’t know.”
On HIV Stigma
“They brought this young lady, it was an important thing to me and my colleagues because, for example my dad and mum died of HIV/AIDS but I could not freely say it. By then it was a very difficult thing for me to say it but after that inspiration speech that she gave us, she took away my burden and I can now freely speak about it that my parents died of HIV/AIDS and I am HIV negative. I can boldly say it has been a very good program; we can freely speak about things.”
On sexual consent
“I feel like I am a real man now. At first I thought I was a dictator to my sexual partner and I could just command her that I want to have sex with her but I have learnt that no, the girl has a voice to be heard too. I have to respect her decisions — decisions have to be made by both of us.”
“When we started learning I called my Mum and explained to her about the issue of consent, when she told my Dad they had some arguments then my Dad called me at night and explained that he learnt something about it.”
“I talked with my sister about the importance of consent, that one should not be forced to be in a relationship or to have sex with someone without her consent. Everyone has a right to accept or not.”
On arts-based teaching and learning
“They say actions speak louder than words. The idea of involving us in the art was effective and made us more open and the things could easily be remembered by people.”
Parallels between American and Malawian needs for sexual and reproductive health education
“In class the teachers are not comfortable discussing sex related topics with students and some teachers just read the book for you instead of teaching, so they leave you on the surface relative to the detailed means of teaching from MASA- high school squad member.”
We surveyed Malawian students and teachers about their experience learning and teaching sexual education in school and found that both groups felt uncomfortable, embarrassed, ill-equipped, and lacked understanding of the topic. Teachers with backgrounds in mathematics, physics, and literature were assigned to teach sexual and reproductive health subjects.
This project taught me a lesson I could bring home: sexual and reproductive health education needs and pitfalls are very similar for Malawian and American youth. Personally, my one semester of public school sexual education definitely fell into the stereotype:
✔️ Taught by the volleyball coach
✔️Constant snickering
✔️Watched a traumatic birthing video
✔️Purely theoretical condom demonstration
✔️You should wait until marriage!!
Then, as awkwardly and abruptly as it started, it was over, with no lasting impact (not unlike some sexual experiences I would have later in life).
Students need an educational environment where they can feel open to discuss stigmatized topics and are encouraged to ask questions. Young people deserve to know factual and detailed information about their sexual and reproductive health so they can make informed and empowered decisions. Abstinence is a choice, but it is not the only choice, and the reality is, many young people will explore other options, without the proper tools and knowledge to keep them safe. Research shows abstinence-only education can actually be harmful for young people. (Read more about the impact on young people of Trump’s budget for abstinence-only education here).
While creating a song about the bodily fluids that transmit HIV and practicing a martial arts sequence to demonstrate condom use may seem silly, I don’t think the students will be soon to forget their experience. (Although we did receive some informal complaints that the students wouldn’t stop singing “Semen! Breast Milk! Blood! Vaginal Fluid! Pre-cum!”…See the UCLA Squad Choir perform the song at TedxUCLA)
“I wish the project goes to as many schools as possible so that we all should have a chance to learn about these things, which I consider vital.” -High school squad member
Our MASA participants in Malawi revealed they were eager to learn information that they felt teachers and elders hid from them because of their age. They also shared how using tools like music, poetry, and theatre helped them shed feelings of shame and embarrassment when talking about sexual health and behavior. Their involvement in the project lead to enlightening conversations with their friends, siblings, and even their parents.
The MASA project found that using art to complement comprehensive sexual and reproductive health education breaks down taboos and encourages active learning and engagement, in a subject that will likely affect students’ lives more than advanced calculus. While ArtGlo Malawi gears up for another year of MASA, I encourage schools to consider these methods as vital strategies for turning the once dreaded subject into an unforgettable learning experience.
So, let’s talk about sex. 🎵
Cassidy Joy is a 2017–2018 Global Health Corps fellow at Dignitas International in Malawi.
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