Amya Gulati & Ethan Freedman
Professor Katrina Balovlenkov
Columbia University School for Social Work, New York
Submitted in partial fulfillment as a Community Change Plan Intervention within the requirements for Columbiaâs School for Social Work program and Prof. Katrina Balovlenkov Advocacy in Social Work Practice course.
Acknowledgements:
In introducing the following work, we would like to begin by acknowledging the traditional, ancestral, and unceded territory on which we learn, work, and resource from at Columbia University School of Social Work is land of the Lenape and Wappinger indigenous peoples. Let us commit ourselves to the struggle against the forces that have dispossessed the Lenape, Wappinger, and other indigenous people of their lands.
We would also like to acknowledge Prof. Katrina Balovlenkov and her class in Advocacy in Social Work Practice (SOCWT7103) for introducing us to pivotal social work principles. Moreover, our peers who we worked closely in discussion and were very influential in developing thoughts around this paper. We appreciate everyone in the class for the ideas they have assisted in generating. With these acknowledgements, we present the following work of our own.
Description of the Problem:
Adolescents and young adults aged 13-29 in New York City are at heightened risk of HIV infection, a public health crisis that disproportionately affects Black and Latino Communities (New York City Department of Health and Mental Hygiene NYC DOHMH, 2024). Despite a 17% decrease in new diagnoses from 2019 to 2023, an estimated 7,200 youth in this age bracket were living with HIV in 2023 (NYC DOHMH, 2024). Among these, 85% of new diagnoses were among men, and 87% among Black and Latino populations, particularly concentrated in the Bronx and Brooklyn (NYC DOHMH, 2024). These data points highlight the urgent need for comprehensive prevention and education measures tailored towards this demographic.
Education attainment is often considered a social vaccine for public health outcomes like HIV, yet education alone has shown mixed results in altering HIV and AIDs transmission rates without integrating culturally relevant health literacy and comprehensive education practices (Pace, 2019). Current New York City public school curricula often fail to provide inclusive, evidence-based HIV education rendering youth agents naive to the consequences and necessary mitigation practices. Abstinence centered messaging contributes to the compounding effects and miseducation or lack thereof, and counteract the best practices of advocating for comprehensive and affirming approaches to health education (Vander Schee & Baez, 2009). Additionally, the erasure and rendered invisibility of LGBTQ+ narratives in existing mitigation materials fosters stigma and deters engagement with safe sex practices. If youth are engaging in their sexuality- regardless of whether they are educated in safe practices or not- informing them about the risks may guide them to engage responsibly. Furthermore, the public school curriculum disregards the transgender community, particularly turning a blind eye to the plight of intersectional identities and HIV: 21.6% of transgender women are living with HIV in the U.S., and 24.9% of transgender people living with HIV are African-American (HRC Foundation).
Recent funding reductions of $5.3 million to LGBTQ+ health services compound the challenges of reaching a population of adolescents and young adults (Gay Men's Health Crisis, 2024; Waller & Goldman, 1993). Without structural and pedagogical reform in public health education for youth and adolescents, particularly regarding HIV/AIDS, adolescents and young adults will continue to face barriers to prevention, testing, and care. Our objective is to implement comprehensive, inclusive, and culturally responsive HIV/AIDS education programming via comprehensive health and sexuality programs in New York Schools with the intention of reducing HIV incidence among adolescents and young adults.
Stakeholder Analysis:
The success of this intervention hinges on the collaborative efforts of multiple stakeholders, including policymakers, the New York City Department of Education (DOE), local health organizations, school staff, students, families, community advocates, and social workers. At the center of this network is Chancellor Melissa Aviles-Ramos, whose position as Chancellor of NYC Public Schools gives her the authority to revise curriculum, allocate funding, and champion inclusive equitable reform (New York City Public Schools, 2025). Aviles-Ramos has a long career in education- including roles as a teacher, assistant principal, and superintendent- which can be used to provide insight on how to navigate and implement curriculum changes while addressing the concerns of those who are directly affected by it.
Activists, sex educators, and advocacy organizations like the New York City Council LGBT Caucus play crucial roles in resisting rollbacks and advocating for reform. Frontline educators and school staff are key to successful implementation, especially when given adequate support and training (Waller & Goldman, 1993). Adolescents and families, particularly from historically marginalized racial and sexual communities are central beneficiaries, and must be active participants in the shaping of these educational methodologies and mediums considering their high incidence rates (DeLeon, 2009; Morrison et al., 2024). Community-based health initiatives, academic researchers, and social workers also act as policy influencers by bringing forward evidence based modalities that address the cultural, racial, and socioeconomic factors affecting youth sexual health decisions (Pace, 2019, Rodriguez-Hart et al., 2022).
Facilitating Actors:
Facilitating actors include school staff committed to inclusive education, public health experts, peer educators, LGBTQ+ student groups, and community based HIV prevention organizations willing to work in line with the New York City public school system. Teachers and volunteers have the capacity to bridge curriculum content with meaningful student engagement, especially when equipped with trauma-informed training and educational tools (Waller & Goldman, 1993). Youth themselves are essential facilitators in some capacity as peer education models, like those documented by Andersen (2019), have shown that young people are more likely to retain information when the content is delivered by peers with which they identify themselves. Moreover, LGBT+ student groups can provide critical insight into lived experiences and help shape affirming educational content. External organizations such as the Latino Commision on AIDS and the Treatment Action Group bring resources, expertise, and community credibility that can strengthen institutional implementation (Rodriguez-Hard et al., 2022). Moreover, public and private partnerships, as well as university led research projects, can support the infrastructure needed to sustain reform (Rodriguez-Hard et al., 2022).
Sanctions:
The proposed objective aligns with the NYC DOEâs commitment to equity and educational access (New York City Public Schools, 2025). Implementing inclusive HIV/AIDs curricula within the domain of comprehensive health education would enhance student health and wellbeing, educational outcomes, and community trustâcore to the chancellorâs mandate (New York City Public Schools, 2025). Chancellor Aviles-Ramosâ leadership history in community engagement and family advocacy supports her role and responsibility as a change agent who can galvanize system-wide reform. They hold symbolic power and for her to endorse a curriculum change can legitimize curriculum reform in the eyes of educators, families, and students. In tandem, the DOEâs mission to provide rigorous, supportive, and inclusive education would be advanced by implementing a curriculum that responds to the realities of HIV transmission among vulnerable youth and young adults.
As an advocate, social workers bring lived knowledge, academic grounding, and access to colations already pushing for the change necessary. Our roles include elevating evidence from research like Pace (2019), which calls for participatory curriculum designs that include marginalized youth, and Morrison et al. (2024) which emphasizes trauma-informed approaches for HIV affected communities. Health education, when done inclusively and contextually, reduces stigma and fosters engagement (Rodriguez-Hart et al., 2022).
Implementation will require partnerships with city health officials, curriculum developers, and school administrators. However, this groundwork is laid by prior comprehensive health education reforms such as those in the late 1980s that demonstrate the feasibility of this feat (Waller & Goldman, 1993). Advocacy in this domain possesses the credibility of aligning with contemporary evidence of historical actions. Drawing from DeLeon (2009), community-based understandings of adolescent decision making show that culturally aligned, trauma-informed, and honest conversations about sexuality foster agency and protection necessary for lowering incidences of HIV/AIDS, STDs, and STIs. The proposed initiative thus meets a clear educational need while falling within the strategic responsibility and moral obligations of the Chancellor Melissa Aviles-Ramosâ office.
Prior Efforts:
The state mandated HIV/AIDS education be taught in all schools in 1987. In 1988, this requirement was further expanded: all public high schools must provide six sessions of AIDS education every year (Womenâs City Club of New York, n.d.). The curriculum was titled âFamily Living Including Sex Education- Aids Supplement.â However, site examinations revealed that many schools were not administering all education sessions- some were not implementing the AIDs curriculum at all. The curriculum itself was controversial, as it teaches students that abstinence is key (Hartocollis, 1995). At the time of its establishment, the material faced backlash from parents and teachers who did not want schools to teacher their children about intercourse, safe sex, and most importantly, homosexual activity. The curriculum went through multiple revisions; for example, âgay and lesbian people are often the target of prejudiceâ was changed to âgay and lesbian people are sometimes the target of prejudice.â Finally, in 2023, the state updated their HIV curriculum to be culturally responsive and reflect recent advances in prevention and treatment (Brachfeld, 2023). Children begin learning about transmission from sixth grade while 12th graders learn about stereotypes and stigma faced by those diagnosed with a sexually transmitted disease. The DOE partnered with HIV experts to create training materials for teachers and educational materials for parents and guardians. As of 2024, the city requires annual HIV lessons from kindergarten to twelfth grade and is subject to change in order to reflect most recent updates and scientific discoveries.
In 2014, NY state announced the launch of Ending the Epidemic, a three-point plan to address the AIDS epidemic; the goal is to achieve a decrease in HIV infections from 3000 to 750 by the end of 2020 (New York State Department of Health, n.d.). The plan includes identifying persons with undiagnosed HIV and linking them to healthcare, maximizing virus suppression for those already receiving health care, and facilitating access to PrEP for high-risk individuals. Cuomoâs administration has set aside $5 million to the plan through Medicaid and the state's AIDS institute (McNeil, 2014). AIDS experts said that this plan would be challenging to accomplish because it depends on the willingness of patients to be tested and treated as well as the money available for such large expenditures. In 2019, NYC announced that 90% of people know their HIV status, 90% are on treatment and 90% are virally suppressed. Mayor Bill de Blasio said that the government would continue pursuing the goals until all New Yorkers receive treatment for their diagnosis as âzero new diagnosesâ are closer than ever. The Health Department will continue with its citywide HIV testing initiative, New York Knows, for another five years, where community-based organizations and health centers conducted the nationâs largest HIV testing initiative. Their mission statement is to provide quality care and treatment for all, regardless of whether they have HIV or not. This agenda was supported by State Senators, the NYC Council LGBT Caucus, the NYC Council Committee on Health, Brooklyn Community Pride Center, the Treatment Action group, the Latino Commission on AIDS, the AIDS Center Queens County, and various other highly esteemed programs and politicians throughout the state.
Despite the curriculum changes and state pledge to address the issue, transgender women of color still face paramount HIV transmission rates, less accessibility to treatment, and lower rates of prevention care. This is due in part to their lack of access to PrEP, their susceptibility to homelessness, incarceration and sexual violence, and the general stigma around seeking preventative healthcare for sexually transmitted dieases. Neither the NYC school curriculum nor the Ending the Epidemic directly address the transgender community and their unique struggle with AIDS.
Force Field Analysis:
A Force Field Analysis reveals the driving and restraining forces that shape the feasibility of implementing inclusive HIV/AIDS education in New York City public schools. Driving forces include:
- Rising rates of HIV among youth, especially Black and Latino populations, which creates public urgency for preventative education (NYC DOHMH, 2024).
- Demonstrated success of peer-led and trauma-informed approaches, which empower students and enhance engagement (Anderson, 2019; Morrison et al., 2024).
- Political mandates and updated curricular frameworks that call for culturally competent education (Pace, 2019).
- Growing coalitions of educators, researchers, and advocates who support social justice centered change (Rodriguez-Hart et al., 2022).
On the other hand, restraining forces include:
- Bureaucratic power and resistance to changing long standing curricula (Waller & Goldman, 1993)
- Community and parental opposition to LGBTQ+ inclusion and comprehensive sexuality and health education (Vander Schee & Baez, 2009)
- Underfunding and staffing shortages in public schools that limit the implementation of already established comprehensive programming (DeLeon, 2009)
- Social stigma and institutional distrust, particularly among youth who are queer, Black, or living in poverty (Rodriguez-Hart et al., 2022; Morrison et al., 2024)
Addressing these restraining forces requires intentional design and implementation strategies that include stakeholder engagement, educator training, and public education campaigns centered around youth and young adults. By amplifying the driving forces and minimizing resistance through inclusive dialogue and evidence-based advocacy practice, the present initiative has a strong foundation for systemic change and mitigation of an ever evolving health crisis and endemic.
PROP:
Minority communities are disproportionately affected by the transmission of HIV. Black and brown men who have sex with other men comprise a large portion of new and current HIV infections, despite the overall stabilization in transmission in recent years. According to a 2023 HIV Surveillance Report, Latino New Yorkers represent 42% of new diagnoses while Black New Yorkers represent 41%. When considering the implementation of current and new policies, an organization and its members must address institutional barriers that prevent certain people from accessing and/or benefiting from the components of the proposition. For example, communities that are predominantly African-American and Latino are less likely to have access to health care clinics and resources. A 2024 report found that Brooklynâs most diverse neighborhoods have fewer health care professionals and less hospital capacity than their wealthy white counterparts (Kaufman, 2024). The existing services are given poor scores in regards to the quality and sufficiency of care provided to residents. Similarly, Bronx had the highest rate of new HIV cases of all five boroughs in 2023 and is also one of the most diverse. Black people constitute 29% of the Bronx population and 47% of new diagnoses while Latinos make up 56% of the Bronx population and 48% of the new diagnoses (New York City Department of Health and Mental Hygiene, 2022).
Resources:
To implement this reform, Chancellor Aviles-Ramos will need access to large infrastructure that includes tangible and intangible resources within multiple domains. Curriculum development and training must be co-conspired with public health experts, educators, and youth, particularly from communities most impacted by HIV. This includes age appropriate lesson plans, inclusive of gender and sexual diversity, trauma informed pedagogical frameworks, and media literacy to critically engage with stigmatized narratives (Andersen, 2019; Waller & Goldman, 1993). Training programs for educators should include workshops on cultural responsiveness, anti-oppressive practice, and present context scientific knowledge regarding HIV prevention, including PrEP and undetectable =Â untransmittable (U=U) (Pace, 2019).
Moreover, implementation depends on financial backing and resources must be allocated for development, dissemination, and evaluation of curriculums. This includes the creation of feedback mechanisms for students and educators, assessment tools for learning outcomes, and evaluations that address race, gender, and sexual orientations. Funding teacher compensation during training, development of materials, and hiring of community partners for supporting roles is also necessary. Sources may include municipal education budgets, medical grants, partnerships with nonprofits, and reallocation of abstinence only program funding (Rodriguez-Hart et al., 2022; NYC DOHMH, 2024).
Sustainable long term change requires collaboration with local health clinics, LGBTQ+ centers, youth organizations, and advocacy groups already working in affected communities. These partnerships can offer credibility, cultural expertise, and access to supportive services that extend beyond the classroom to ensure students have a comprehensive safety net (DeLean, 2009; Morrison et al., 2024). Digital technologies and media platforms are capable of supporting this initiative and includes online modules for teacher training, internet based student resources, and social media campaigns that destigmatize HIV and promote sexual health awareness. Multimedia approaches can increase access for students with limited classroom time and provide confident tools for learning alongside community (Andersen, 2019).
Investing in these resources will not only support the implementation of comprehensive HIV/AIDs education, but will also contribute to a broader transformation of health literacy and equity in NYC public schools.
Receptivity:
Chancellor Aviles-Ramos demonstrates a public commitment to educational equity and community engagement, which suggests she may be receptive to initiatives aimed at closing racial and sexual health disparities through curriculum reform.
Level of intervention:
This intervention will target New York City public schools through Chancellor Aviles-Ramos and organized stakeholder engagement that highlights an alignment between the proposed curriculum and New York State Department of Education equity goals. Strategies will include evidence-based policy briefs, presentations that showcase successful peer-led education models, and public testimonies from youth educators. Collectivity is central to this effort, bringing together public health professionals, LGBTQ+ advocates, educators, and student leaders to demonstrate the broadly based support for inclusive HIV/AIDS education. By illustrating the social, educational, and ethical imperatives of systematic change and providing concrete tools for implementation, the campaign will aim to secure the Chancellorâs support for a system wide policy shift.
Objective of intervention:
This intervention calls on Chancellor Aviles-Ramos to mandate and fund comprehensive, inclusive HIV/AIDS education programs across all NYC public schools. This program must be age appropriate, trauma informed, and culturally relevantâintegrating narratives from LGBT+ youth, students of color, and other marginalized groups. The policy must ensure that education extends beyond biology to address stigma, consent, gender identity, and structural inequality (Pace, 2019; Vander Schee Baez, 2009).
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