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Action for Youth
AIDS Training Manual
T/Cfu
This AIDS training manual 'Action for Youth" has been
funded by:
The Finnish Red Cross
The Netherlands Red Cross
The World Health Organization.
We would like to express our thanks to them and to the
Norwegian Red Cross Society and all the other Red Cross and
Red Crescent Societies who have provided support for the
League of Red Cross and Red Crescent Societies
AIDS Programme.
'>1
/ *//
4/
Community Health Cell
Library and Documentation Unit
BANGALORE
League of Red Cross and Red Crescent Societies
P.O. Box 372
CH-1211 Geneva 19
Telephone: (41 22) 734 55 80; Telegramme: LICROSS-GENEVA;
Telex: 22 555 LRCSCH; Telefax: (41 22) 733 03 95.
World Organization of the Scout Movement
P.O. Box 241
CH-1211 Geneva 4
Telephone: (41 22) 20 42 33; Cable: worldscout;
Telex: 428 139 wsb ch; Telefax: (41 22) 781 20 53.
Dear youth leader,
The League of Red Cross and Red Crescent Societies and the
World Organization of the Scout Movement have produced this
AIDS training manual specifically for youth workers. We hope
it will help you learn about HIV and AIDS and motivate you to
continue to learn and use the ideas presented to carry out AIDS
health promotion with your own youth group.
Young people are full of motivation and enthusiasm for a new
project, particularly if they are included in its preparation and
feel that its outcome will have an effect on their lives. They are
also quick to recognize inequalities in their own lives and areas
of discrimination in their communities. Therefore, we believe
they can be excellent health educators and influence the atti
tudes and behaviour of their peers.
AIDS is a preventable disease. Clear information about how to
avoid infection coupled with an environment which supports
safe behaviour can reduce the likelihood of transmission of the
virus. Young people’s need to try new experiences and to learn
more about other people and the world around them, although
generally to be encouraged, can put them at risk of infection.
They are a group which needs particular attention when plan
ning an AIDS health promotion campaign.
As a youth worker, already involved with young people, you are
in an ideal position to extend your existing health education ac
tivities to include an AIDS health promotion programme. Try
out some of the activities in the manual with your youth group.
You may then decide to develop your programme further and
work within the community. Whatever you decide to do, it is
our hope that the manual will help you understand more about
AIDS and to pass on what you have learnt in a manner suited
to your particular group.
Yours sincerely,
Par Stenback
Jacques Moreillon
Secretary General
League of Red Cross and
Red Crescent Societies
Secretary General
World Organization of
the Scout Movement
3
CONTENTS
Introduction
6
Section 1
Information about AIDS .......
AIDS Questions and Answers
9
19
Section 2
Leader Preparation
33
Section 3
Programme Planning
39
Section 4
Activities for Youth Groups ....
Warm-up Activities
Information Activities
Values/Attitudes Activities
Skills Activities
Techniques
49
55
63
77
87
93
Section 5:
Action in the Community
101
Section 6:
Community Projects
Information Sharing Projects
Care and Support Projects ...
109
113
119
How to conduct focus
group discussions
125
Guidelines for pretesting
health education materials
147
Appendix III
Condoms and safer sex
153
Appendix IV
Guidelines for AIDS and
First Aid
157
Other sexually transmitted
diseases
163
Appendix VI
How to make puppets
167
Appendix VII
Resource list
171
Appendix I
Appendix II
Appendix V
Glossary.
179
5
INTRODUCTION
The material in this manual has been written for youth work
ers who work with young people in their mid-teens and older. If
you wish to use this material in your work with people who are
younger than 15, careful review and adaptation is
recommended.
This pack has been designed to:
•
Provide information about AIDS and how to prevent the
spread of the Human Immunodeficiency Virus (HIV), the
virus that can cause AIDS.
Help you deal with your own worries and concerns related
to HIV infection and AIDS.
I
Suggest a method for planning and evaluating an AIDS
health promotion programme for your youth group.
Present activities you can try with young people to help
them make healthier and safer life choices.
Give ideas for community services projects related to
AIDS health promotion that can be carried out by the
youth in your group.
The development and implementation of AIDS health promo
tion can be the starting point for general health promotion pro
grammes.
You can adapt the ideas, activities and techniques presented in
this pack to other health topics for use in general health pro
motion programmes.
6
i
ACKNOWLEDGEMENTS
This manual was written by Noris Araque de Maldonado, Jane
Springham and Diane Widdus, Consultants of the League of Red
Cross and Red Crescent Societies, Geneva, Switzerland and illus
trated by Liz de la Cour.
The Consultants worked closely with Barbara Wallace, AIDS Co
ordinator in the Health Department of the League, Joanna
MacLean, Head of the Youth Department of the League, and
Abdoulaye Sar, Director of Community Development of the World
Scout Bureau, with administrative assistance from Lisa Michael
and MaryJo Baxter, and technical assistance from the League's
Document Production Department.
We would like to express appreciation to the National Red Cross
and Red Crescent Societies and the National Scout Associations
who completed an AIDS activities questionnaire, sharing materi
als and posters as well as comments and suggestions related to
youth and AIDS health promotion.
The National Red Cross and Red Crescent Societies of the follow
ing countries participated:
Australia
Bolivia
Bulgaria
Canada
Chile
Colombia
Czechoslovakia
Gambia
Switzerland
Iraq
Syria
Republic of Korea Thailand
Lesotho
Uganda
Netherlands
United States of
Norway
America
Pakistan
Yugoslavia
Zambia
The National Scout Associations of the following countries partic
ipated:
Finland
Haiti
Malta
Netherlands
Argentina
Benin
Burkina Faso
Canada
7
I
Tanzania
Thailand
Uganda
United Kingdom
The first draft of 'Action For Life: An AIDS Training Pack
for Youth" was presented at Supercamp '89, a League of Red
Cross and Red Crescent Societies Youth Department sponsored
meeting of youth coordinators and young people from 132 coun
tries, held at Castiglione delle Stiviere, Solferino, Italy, Septem
ber 1-10, 1989.
At Supercamp '89 delegates from the following countries gave
comments through discussion and a written questionnaire:
Bahamas
Israel
Somalia
Belgium
Italy
Sudan
Canada
Jamaica
Philippines
Central Africa Republic Republic of Korea Trinidad
Czechoslovakia
Lebanon
andTobago
Ecuador
Lesotho
Tuvalu
Fiji
Liberia
United States of
France
New Zealand
America
Iraq
Sierra Leone
Zambia
The manual was field tested in Costa Rica, Kenya, Uruguay and
Zambia in February and March 1990.
Special thanks are expressed to the National Scout Organizations
and Red Cross Societies of each of these countries. The Inter
American and Africa Regional Offices of the World Scout Bureau,
and the League of Red Cross and Red Crescent Societies Regional
Office in Costa Rica are commended for their support and facili
tation of the field testing exercise.
The support and suggestions of the staff and youth members of
these organizations were invaluable to the project.
I
Expert advice was received from:
Shirley Ambrose
Christina Baker
Claudia Brann
Bruce Dick
Hilary Dixon
Lennart Fender
Jane Ferguson
Gill Gordon
Janet Hayman
Juan Jose Hurtado
8
Henna Korte
Irene Mparutsa
Myrna Peralta
Eric van Praag
Astrid Richardson
1
Information about
AIDS
This section is designed
to help you:
1.
Review basic facts about
HIV and AIDS.
2.
Understand the global impact
of HIV and AIDS.
Information
about
AIDS
What is AIDS?
AIDS is the name for a combination of illnesses caused by a virus
that can break down the body’s immune system and lead to fatal
infections and some forms of cancer.
A-I-D-S stands for:
A cquired
something you get rather than are born with
I mmune
the system which defends the body from
diseases
D eficiency
becomes weakened by a virus
S yndrome
the body shows a variety of symptoms
..............
What causes AIDS?
HIV is the virus that can eventually cause AIDS. People infected
with HIV may look and feel well for a number of years before any
symptoms of AIDS develop. Today there is no vaccine to protect
people from the virus and no cure once it has been contracted.
H-I-V stands for:
H uman
I mmunodeficiency
V irus
11
AIDS is a new infectious disease which is causing a worldwide
problem. When HIV enters the body, it damages the immune
system that normally protects us from infections. It infects and
eventually kills the part of our immune system that protects us
from infections that we can carry in our bodies which do not
usually affect us and weakens our resistance to other diseases.
HIV can stay in the body for some time without making us ill.
Eventually, because the immune system is weakened, diseases
take hold and the body cannot fight them off.
The length of time between becoming infected with HIV and
getting sick varies. The average time is more than five years.
During this time people look and feel well and may be unaware
that they are infected. The virus is passed on through semen,
blood and vaginal secretions; so, someone who does not know
they are infected may pass on the virus to others. Once a per
son has become infected, he or she remains infected for life.
People who have become infected with HIV have been described
as "seropositive", "HIV positive" or that they have "seroconverted". They may remain well or they may suffer from
swollen lymph glands, weight loss, sweating, diarrhoea and
many other minor infections that may continue for longer than
three months. It is not possible to say they have AIDS at this
point. These symptoms are common in many other diseases.
Eventually the virus destroys the immune system to such an
extent that the infected person may become ill. The person may
suffer from all or some of the symptoms described earlier. In
North America many people with AIDS become ill with a par
ticular form of pneumonia called ’’Pneumocystis Carinii” (POP).
In Africa tuberculosis is frequently seen. All over the world
"Kaposi’s Sarcoma" (KS) is a typical symptom of AIDS. The vi
rus may also attack the nervous system. The person with AIDS
may recover from some of these illnesses. Some can be treated
with antibiotics and radiotherapy. However, AIDS usually
proves fatal within a few years after the first illnesses appear.
People who have AIDS now contracted the infection a number
of years ago. We do not know exactly how many people may be
infected now or how many people become infected every day. As
of mid-1990, the World Health Organization (WHO) has re
ceived reports of over 250,000 cases of AIDS. One or more
cases of AIDS have been reported to WHO from 156 countries.
12
REPORTED AIDS CASES
1 May 1990
i
□ 0 cases or no report
S 1 to 9
10 to 99
ESlOO to 999
^100
■ Over 1000
(GPA/WHO)
However, because of under-recognition, under-reporting, and
delays in reporting, the World Health Organization (WHO) es
timates that close to 700,000 AIDS cases may have occurred.
The World Health Organization further estimates that be
tween six to eight million HIV infections have occurred world
wide. WHO reports that virtually all short-term projections
predict that AIDS cases will at least double or triple in most
areas of the world within the next 5 years.
At present, there is no cure for AIDS and no vaccine to combat
the virus. AIDS is, however, a preventable disease. Public edu
cation which teaches people how to avoid infection will help to
prevent its spread. Development of services for those who have
AIDS and HIV infection, the screening of blood, and a system
of monitoring the spread of the disease will help in dealing
with the situation we have now and in planning for the future.
Since 1987, the League of Red Cross and Red Crescent Socie
ties has been working with its National Societies to inform and
educate about HIV and AIDS. Training materials have been
developed to provide basic information and ideas for action.
Safe blood has been a major issue and workshops have been
held to build skills in donor recruitment. National Societies
have offered support, counselling and care to people with
AIDS, their friends and families. In doing so they have made
every effort to fight discrimination and promote understanding
and compassion.
13
The World Organization of the Scout Movement has been run
ning health promotion workshops for some time. The workshops
are designed to help Scout leaders develop skills in organizing
and implementing community health campaigns. AIDS health
promotion can build on the work that Scouts have already ac
complished in health education for the Scouts themselves and
their communities.
The League of Red Cross and Red Crescent Societies and the
World Organization of the Scout Movement came together to de
velop this manual. The manual is intended to be used by youth
leaders in National Societies and Scout Associations to continue
their AIDS health promotion programmes.
The World Health Organization has been working since 1986 to
provide a practical framework for national efforts and for inter
national programmes. WHO's Global Programme on AIDS is
working with 178 countries. National AIDS programmes have
been established in most countries and work closely with com
munity-based organizations. It is recognized by the Global Pro
gramme on AIDS that this type of collaboration is vital to the
success of any AIDS activities.
Global distribution of HIV infections,
reported and estimated AIDS cases
1 May 1990
AIDS (rep.)
AIDS (est.)
3,500,000
63,842
375,000
2,500,000
153,720
250,000
150,000
644
1,200
500,000
33,896
45,000
30,000
1,976
2,500
over 6,500,000
254,078
over 650,000
Continent
Africa
Americas
Asia
Europe
Oceania
Total
HIV
Excerpt from
World Health Organization
Global AIDS Factfile, May 1990
14
How does AIDS affect people’s lives?
How people deal with the news of a life-threatening illness will
depend on the culture and environment they were brought up
in and their life experiences. How they manage their illness will
depend not only on their own attitudes, but also on the reac
tions of their friends, family, community, co-workers and em
ployers. If people with HIV feel safe and protected and have
support from those around them, it may be easier for them to
come to terms with their illness and to help others with the dis
ease. On the other hand, if people with HIV infection are isolat
ed and live in fear, they may have little reason to take care of
themselves and may possibly get ill sooner.
The following case studies describe the effect AIDS has had on
the lives of a few people from different parts of the world:
Abdu is a married man with two children. He was terrified
when he found out he was HIV positive and wanted to kill
himself. There was a good counsellor at the clinic who
helped him by giving him more information about the dis
ease and helping him to tell his wife. Because of the support
of the counsellor and the care of his wife he is now counsell
ing others in the same situation. He hates the way people
with AIDS are often depicted as hopeless and helpless. He
believes he has learnt a great deal from facing up to his ill
ness and by helping others. Even though he is still fright
ened sometimes and worries about his health he feels he
has developed a purpose in life he didn't have before.
Pablo is twenty. He has just found out his father has AIDS,
and he is frigthened. He doesn't know how his mother will
cope if his father dies and he is worried his sister might
lose her job if people find out at work. He keeps wondering
why this terrible thing should happen in his family when
none of them have ever been bad. He decides to tell the one
person he trusts, his fiancee. She is very angry and fright
ened and leaves him. He goes to visit his father in hospital,
but the ward is locked and the doctors are unhelpful. Even
tually he manages to get into the ward. His father is very ill
and says how frightened he is of dying alone. He has fever
and diarrhoea but there are few nurses willing to work on
the ward, so he is not very often given care. When Pablo's
father eventually dies, he tells his family and friends his fa
ther died abroad. Pablo is very sad. He has no grave to visit
and feels lonely and isolated.
15
Anne found out that she was HIV positive when she took
her baby to the doctor because he was losing weight. The
doctor was worried and took some blood from the baby to
test it for HIV. The test turned out to be positive, and so the
doctor tested Anne too. Anne's test was also positive. Some
time afterwards Anne became ill with AIDS. Her family
and friends responded to the news with disbelief and shock.
Some people disappeared from her life. Sometimes she felt
that she was already dead. She turned to other people with
AIDS and found acceptance and compassion. She met a
very frightened young man named Bill. Even though they
came from very different backgrounds, they found friend
ship and support by meeting together and sharing each
other's problems. Bill was very caring and helped to take
care of the baby. They talked about who would die first and
how each would have a separate task - one would leave, the
other would stay behind. They marvelled at how wonderful
friendship had been, even with bodies so sick. Bill died
first.
Anne was careful not to talk about her condition outside the
group of others with AIDS because she knew that many peo
ple were frightened and misinformed about the disease.
One day, a friend of hers visited and started complaining
how fed up he was with all the fuss about AIDS. He said it
didn't affect his life - he didn't know anybody with the dis
ease. He thought all the news was exaggerated. Of course,
Anne knew why her friend didn't think he knew anybody
with AIDS; no one with AIDS would tell him for fear of his
reaction.
These examples describe only a few of the many ways in which
people are affected by AIDS; you and your group will want to
learn how the people in your area are being affected and are
coping.
16
f
How will this manual help me to join in the
worldwide effort to stop AIDS?
I
This manual contains advice and information to help you plan
an AIDS health promotion campaign with your youth group. It
cannot answer all your questions. We hope it will give you some
information about where to start, give you the confidence to ad
mit when you don’t know the answers to questions and give you
some ideas about how and where to find out more. There are
many questions still without answers. New information is com
ing out all the time, but the basic facts have remained the same.
Preventing people from becoming infected and caring for those
who are ill remain crucial tasks. So there is a great deal you can
do without knowing everything. It is not necessary for you to be
a doctor, nurse or other health care professional to begin your
campaign. What is important is that you prepare yourself well
and have the enthusiasm to see it through to the end.
17
AIDS
Questions
and
Answers
Where does AIDS come from?
This question is often asked. The fact is that AIDS is the result
of an infection by the virus HIV. Although various people have
speculated on the geographic origin of the virus, it is unlikely
that we will ever know where it came from. It is certain, howev
er, that it is not man made. We know that viruses can some
times change from being harmless to harmful. This could have
happened to HIV before the virus spread rapidly. HIV may
have been present for some time in isolated groups before the
AIDS epidemic started. The movement of people from the coun
tryside to the towns and international travel caused people's be
haviour to change, particularly people's sexual behaviour. It is
possible that this is how HIV has spread so rapidly from isolat
ed groups into the general population.
How does HIV weaken the immune system?
Our immune system contains white cells in the blood which rec
ognize foreign substances or germs which enter our bodies, kill
them and remember them. The white cells are able to recognize
the foreign substances or germs if they enter the body again.
When the Human Immunodeficiency Virus attacks our immune
system, it starts to destroy our white cells. Eventually, as more
and more of these white cells are destroyed, the body is unable
to fight off the many germs that live in and around our bodies
all the time. Finally, many people die of infections which are
able to cause illness because the immune system is weakened.
How does a person become infected with HIV?
HIV has been shown to be passed in three ways:
- HIV is passed from one person to another through sexual
contact where there is penetration and semen or vaginal
fluids are exchanged.
It is passed from one person to another through infected
blood or blood products.
- It can also be passed from an HIV positive mother to her
unborn or newborn child during pregnancy or during or
shortly after childbirth.
19
4
Sexual contact
During sexual contact, HIV can enter a person's blood stream
through the vagina, penis or anus.
The exchange of the virus from an HIV positive to an uninfected
person can happen from man to woman, from woman to man, or
from man to man.
The risk of infection is greater
if either partner has another
sexually transmitted disease,
such as syphilis or herpes
where a sore or lesion is
present. This is because se
men or vaginal secretions of
an HIV infected person can
come in contact with open
sores or ulcers on or near the
genitals of the partner and it
is easier for the virus to pass
into the other person's body.
Although there is no cure for
HIV infection, most other sex
ually transmitted diseases
can be treated or controlled.
See Appendix 5: Other Sexual
ly Transmitted Diseases for
further information.
Sexual contact can pass HIV
20
Contact with blood
HIV can be passed on by sharing needles which contain infect
ed blood. Because injecting drug users draw blood up into the
needle and syringe when they inject, sharing needles becomes a
very risky activity and has caused many cases of HIV infection.
Any used needle that has not been properly sterilized can carry
the virus from an infected person to the next user of the needle.
It does not matter what the syringe contains. The risk is from
the blood in the needle and syringe.
Of course, needles and syringes used by health workers also
need to be sterilized.
I
Sharing needles can pass HIV
HIV can be passed on from one person to another through in
fected blood left on instruments used in activities which draw
blood such as circumcision, tattooing, and ear piercing. Tools
used for any procedure that cuts the skin should be sterilized
before each use.
21
In areas where donated blood is not screened for HIV, receiving
a transfusion is also a potential risk for contracting the virus.
However, you cannot get HIV infection from giving blood be
cause the blood-taking equipment is sterile.
Increasingly, blood is be
ing tested for HIV
worldwide. If you are
not sure whether the
blood is tested in your
area, ask at your health
centre, dispensary, or
clinic. People who are at
high risk of HIV infec
tion should not donate
blood, since they may
pass on their infection to
the person receiving the
blood.
A transfusion with unscreened
blood can pass HIV
Pregnancy: An HIV positive mother to her unborn or
newborn child
An HIV positive mother can
pass on the virus to her un
born child either before
birth or during the birth
process. An HIV positive
woman who is considering
pregnancy needs a chance
to talk about the risks of
that pregnancy with a
trained person. See page 30
for information about
breastfeeding.
An HIV positive mother can pass HIV
to her unborn or newborn baby
22
f
I
HIV is not spread by:
Insects
Caring for someone ivith AIDS
I
3J.’
> o'
■o
c
Shaking hands
Toilet seats
Sharing belongings
Touching and hugging
These are the kinds of human contact that do not pass on HIV
from one person to another:
• Using someone else’s clothes or belongings they have
touched.
• Living with or sleeping in the same room as a person with
AIDS.
• Playing with a child who has AIDS.
• Caring for children when the adult is HIV positive.
• Swimming in a swimming pool, river or waterhole with a
person or people with AIDS.
• Travelling on crowded buses with a person or people with
AIDS.
• A person with HIV/AIDS coughing or sneezing on you.
• Caring for someone who has developed AIDS when basic
good hygiene is observed.
However, if the person with AIDS also has active tuberculo
sis (TB), he or she should be prescribed TB medicine so that
the TB will not be infectious.
• Giving first aid when good safety practices are followed.
• Donating blood if you are not HIV positive.
Can kissing pass on HIV?
There is no risk from dry kissing. Deep kissing would only car
ry a risk if there was an exchange of blood from an HIV positive
person to his or her partner. Bleeding might occur because of
damage caused to the skin or mucous membranes around the
mouth. Saliva does not contain HIV in sufficient quantities to
be infectious.
Do mosquitoes spread HIV?
HIV infection is not spread by mosquitoes or any other biting
insects.
Mosquitoes do spread some diseases, such as malaria, but there
is no evidence that they spread HIV. If you have doubts about
this, consider that almost no cases of AIDS occur in children
aged 5 - 15, although this age group receives many mosquito
bites. AIDS cases in children are caused by blood transfusions
or in very young children by infection from an HIV infected
mother during pregnancy or childbirth.
24
I
Who can get HIV/AIDS?
. iw
’0
Anyone, male or female, young or old, from any country, or
any religion can acquire HIV.
HIV and AIDS are not limited to certain groups of people,
sexual preferences, or jobs.
25
What happens after a person is infected with HIV?
1.
When a person first becomes infected with HIV he or she
may have a short illness. Some people suffer from mild
symptoms, such as a general feeling of weakness, loss of ap
petite, swollen glands. Equally, they may have no symptoms
at all and have no indication that they have become infected.
2.
Most people then show no signs of illness for some time.
However, the virus remains in the body and the person can
infect others without knowing it. You cannot tell by looking
at someone whether or not they have been infected with
HIV.
3.
After about three months, it is possible to detect the body's
reaction to the infection by taking a blood test. The test is
called the HIV Antibody Blood Test.
Once a person is infected with HIV, he or she has the virus
for life and can pass it on to others.
4.
!
I
As the disease progresses there may be loss of weight, fevers
and night sweats. Some people complain of persistent tired
ness. These symptoms are very common in many other
diseases.
If people are feeling unwell, they should contact their local
health worker in the usual way.
5.
People infected with the virus may go on to develop AIDS.
The average length of time from infection to AIDS is more
than 5 years, but the time varies from one person to another.
Today there is no cure for AIDS.
6.
A diagnosis of AIDS is made when three features are
present:
• The person will be very ill with one of the diseases a
healthy body would usually be able to fight off. These in
clude certain kinds of pneumonia, tuberculosis and some
cancers.
• The person will be suffering from symptoms, such as
chronic very watery diarrhoea, fever and problems with
the skin, glands and throat. These symptoms will have
been present for more than three months and are often as
sociated with severe weight loss.
• The person will also have a positive test for HIV. In some
countries where testing is expensive or unavailable the di
agnosis is made on the first two features.
Virtually all persons diagnosed with AIDS die within a few years.
With new developments in treatment, however, the average sur
vival time is increasing — at present, in some countries from an
average of 1-2 years to an average of 3-4 years.
26
I
I
How can I protect myself from becoming
infected with HIV?
Sexual contact
You could choose not to have sex.
You could choose to have sex with only one partner who has
agreed to have sex only with you. You will both need to know
all the facts about AIDS and to have discussed any previous re
lationships where you might have put yourselves at risk.
There is no risk of infection if
neither partner is infected no
matter what you do sexually
with each other. In polygamous
(see glossary) societies, you and
your partners can avoid risk if
no partners are infected and you
and your partners have sex only
within the polygamous group.
Avoiding penetration and con
tact with semen or vaginal
fluids also lowers your risk. If
either you or your partner
might be HIV positive, there are
many sexual activities for you to
consider which do not involve
penetration. To learn more
about safer sex talk to a health
worker at your local health
clinic or clinic which provides
services specifically related to
sexually transmitted diseases or
family planning.
If you choose to have sex with several partners, you increase
the risk of becoming infected with each partner you have. How
ever, it is not just a question of how many partners you have.
Any one act of unprotected intercourse (sex without a condom)
with a person who is infected with HIV could result in you be
coming infected.
27
It may be that your partner is also taking risks with other peo
ple. If you are not sure about you or your partner's HIV condi
tion, then you can reduce the risk to yourself and your partner
by using a condom, a close fitting cover, which fits over the pe
nis during sexual intercourse. You must use it from the begin
ning to the end of the penetration.
A condom prevents contact with high risk body fluids — blood,
semen, and vaginal secretions. For this reason it is also useful
as a protection against many sexually transmitted diseases and
pregrancy. Condoms make sex safer, but they do not make sex
100% safe. However, if it is used correctly, it is good protection.
See Appendix HI: Condoms and Safer Sex for more information.
For good protection, a new, good quality condom must be used
every time. Never re-use a condom. Condoms may be used with
spermicide cream or a water based lubricant. Never use oil
based lubricants with condoms as it makes them ineffective. Af
ter you have finished having sex, remove the condom carefully
and dispose of it in a tissue without spilling the semen.
Talking openly
with your part
ner about all
these things is
important and
possibly diffi
cult, but it may
help you to
create a health
ier sexual rela
tionship.
28
t
Blood
If you live and work in a country where blood is not always
tested for HIV or in a situation where you are not sure about
the sterilization of needles and other instruments that draw
blood, then you can do the following things:
• You can lower your risk of needing a blood transfusion by
avoiding situations which could lead to major accidents. If
you are travelling in a car, use a seat belt, if available, and
keep to a reasonable speed. Drinking alcohol and driving
greatly increases your chances of having an accident. So,
don't drink and drive. Avoid driving in the dark if road condi
tions in your area make this dangerous.
• If you need medication and an injection is recommended, ask
whether the medication can be taken in another form, such
as pills. You can make sure that any needle that is used for
any kind of injection is either a new needle or a needle that
has been properly sterilized. Be sure that any knife, razor, or
other instruments used in a process that draws blood has
been thoroughly cleaned. Instruments may be cleaned by
leaving them in a weak solution of one part ordinary house
hold bleach to ten parts water (1:10) for 30 minutes or boil
ing them in water for 20 minutes.
Be aware that in some countries bleach is not very strong
and you will need to use more bleach per parts water.
In dealing with people who are bleeding you should practice
good hygiene. HIV has never been found to be passed on
through giving or receiving first aid. See Appendix 4: Guide
lines for AIDS and First Aid, for more information.
Always follow first aid
guidelines
29
Mother to child
The risk of an HIV infected mother passing the virus on to her
unborn child is about 20%-45%. The risk is probably greater if
she is ill with AIDS than if she has no symptoms yet.
The risk of passing HIV through breast milk is very small.
Breast milk has many substances in it that protect an infant's
health, and the benefits of breast-feeding for both mother and
child are well recognized throughout the world today. Bottle
feeding may be an alternative, but in some countries it is not
safe to bottle feed because of difficulties in sterilizing the feed
ing bottles or lack of clean water supplies. On balance, the
slight risk of an infant becoming infected is thought to be out
weighed by the benefits of breast-feeding.
t
How can I find out if I have become infected
with HIV?
When germs enter the body a reaction takes place and chemical
substances called antibodies are produced in the blood. Usually
antibodies act to stop the infection.
When HIV enters the body, antibodies are formed. Even though
these antibodies are not effective in killing the virus, they do in
dicate that the virus is present. We cannot tell if antibodies
have been formed for two to six months after the moment of in
fection. The way that we find the antibodies is by taking a sam
ple of blood. When a person is found to have antibodies in their
blood we call the blood HIV positive.
The test is not a test for AIDS. We do not know how long it will
take an individual with HIV to progress to AIDS. What we do
know is that those people who are found to have antibodies in
their blood are infectious to others through their blood and
through semen in men and vaginal fluid in women.
30
What should I think about before taking the HIV
test?
Before deciding to have an HIV antibody blood test, it is impor
tant to consider what effect the result of the test will have on
your behaviour and your life. For example, if your test is posi
tive, how will you manage, knowing you have an infection for
which there is no known cure? Will it help you reduce the possi
bility of passing on the infection to others? Who will you tell
about the infection? Your family, friends, sexual partner, em
ployer? How will they react? Confidentiality must be assured if
you are to take an HIV test.
Whatever you decide, you should make sure you have discussed
what the test means for you with the health staff who are pro
viding the test. This has been called "pre-test counselling".
They will help you to think about the advantages and disadvan
tages of taking the test in your culture and environment.
If your test is positive, think about to whom you will tell the re
sult. You should only tell people you can trust to avoid unneces
sary rejection and prejudice. Make sure that at the centre
where you take the test confidentiality is guaranteed.
Finding out that you are HIV positive can be distressful and to
some may come as a shock. Try to find someone you can trust
and who you feel able to talk to easily. You may know of some
one who is also HIV positive with whom you can discuss your
fears. Whoever you choose, he or she should be sympathetic and
willing to listen. Don’t sit and go over all your worries and fears
by yourself. Try to talk with someone about them as often as
you feel you need to.
Remember that HIV cannot be passed on by casual contact. It
is perfectly safe to cuddle and care for your children and part
ner, to share cooking and household utensils and lead a normal
life. It is only in sexual relationships and contact with your
blood that you need to change your behaviour. Practice "safer
sex" by not letting your partner come into contact with your se
men if you are a man or vaginal fluids if you are a woman. Do
not donate blood.
If you decide not to take the test or your test has a negative re
sult, you should still make sure you always practice safer sex.
Everyone who intends to have sexual intercourse must think
about their level of risk and act responsibly with partners. Saf
er sex needs to become the way to show you care.
31
How can we help someone with HIV/ADDS?
First, try to picture yourself as HIV infected. How would you
like to be treated? Having HIV or AIDS can make you feel very
isolated and lonely. People who are not afraid and still care for
you are a great help.
People with HFV/AIDS and their families should not have to
fear discrimination from individuals or from their community.
Having HIV/AIDS should not exclude you from the same provi
sion of services and care as any other person well or ill.
You can help someone with HIV/AIDS by behaving the same
way you would with anyone, infected or not. Talking to or hug
ging someone does not pass on the virus from one person to an
other.
There are also community projects that you and the youth
group can carry out to help educate people about HIV/AIDS
and to offer care and support for people with AIDS, their
friends, and families. Section 5 and Section 6 in this manual
describe community projects that youth around the world have
provided.
I
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/
SHl!
t
I
32
I
Leader
Preparation
This section is designed
to help you:
1.
Identify your own worries
and concerns about HIV/AIDS.
2.
Think about the leadership
skills needed to work with
young people and AIDS
health promotion.
Leader
Preparation
AIDS is a new area of work for many youth leaders. Before you
start planning your AIDS health promotion campaign, take
some time to prepare yourself first.
You can begin by thinking about how much you already know
about AIDS. Is there anything you will find difficult to talk
about with your youth group? In talking about AIDS we inevit
ably have to talk about illness, sex, and death and dying. You
will find this less difficult if you have thought of some questions
and answers to these questions beforehand.
The materials in this pack are provided to help you sort out the
facts from the fiction. They give current knowledge about AIDS
and will help you to pass on clear up-to-date information.
However, we deal with information on two levels. We can un
derstand the facts about AIDS, but often because AIDS forces
us to talk about sensitive subjects, our feelings may get in the
way of the facts.
szTr
I
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J
35
What are your worries about AIDS?
infection
dying
prejudice
conflict
promiscuity
drugs
sex
illness
anger
fear
dependence
guilt
isolation
risk
pain
despair
homosexuality
shame
bereavement
discrimination
loss of employment
uncertainty
prostitution
embarrassment
There are many words used in connection with HIV and AIDS
which people find frightening.
It is understandable that we feel uncomfortable and would rather
avoid talking about our fears.
(
Nevertheless, we need to be aware that our feelings, values and
attitudes are shaped by our past experiences, where we grew up,
our family, school, peers and religious organizations.
We bring these feelings, values and attitudes with us in our com
munication. They affect the information we give, the way we give
it and the choices we make in life.
Using the activities in this pack will lead to discussion of sensitive
issues. To help you think about how to deal with this, some per
sonal preparation is needed.
I
What are your feelings, values and attitudes which
could affect your work?
Thinking about your own feelings, values and attitudes related to
HIV/AIDS and how they can affect your work with AIDS health
promotion is not always easy. To help with the process, try asking
yourself some questions.
36
Look through the manual. Which subjects are you com
fortable discussing and which are ones you would prefer to
avoid?
If some topics seem difficult, why might that be? Do you
need more knowledge about the subject? Or, would your
feelings about the subject make talking about it difficult?
A topic you would rather not discuss might be the very one
that your group needs help with.
Are there some subjects related to HIV and how the virus
is passed that you realize you have strong opinions about?
Everyone may not share your opinions about what type of
behaviour is appropriate. Leading the AIDS activities will
involve dealing with attitudes and values that may be dif
ferent from your own. If your group gets the message that
they can only say things you agree with, the programme
will soon lose their attention.
Have you already thought about what having HIV/AIDS
means to the person infected and also to their family and
friends? What are your feelings towards someone with the
virus?
Maybe you know the facts about how HIV is passed and
not passed, but you are still afraid of getting AIDS from
casual contact.
This could affect how you present the facts or how you
react if you find that a member of the group has HIV.
These questions are just a few examples you may want to con
sider as you prepare to work with your youth group.
37
What can you do to develop your skills?
It may be helpful to meet with other youth workers, health
professionals, or teachers to discuss ideas and thoughts
you have about working with AIDS health promotion.
Trying out an activity together, such as the Case Study in
the values/attitudes activities section, can help you to ex
plore your thoughts and feelings. Likewise, an information
exercise can help clarify the facts.
You can also work with your fellow leaders or other trust
ed peers to discuss and practice answering the sensitive
questions that will arise in the youth group. The Listening
Game and Working with a Community are good activities
to try.
You may find that allowing time to think on your own
helps you to understand why you find a certain issue diffi
cult.
I
If possible try to attend workshops on HIV/AIDS which
may be held in your district. Keep your eyes open for any
training opportunities that might help you in your work,
such as group leadership or communication skills training.
[’I
1
T
’’'///ar
V"vS
t
■
Youth leaders prepare for working with their groups
38
I
Programme
Planning
This section is designed
to help you:
1.
Work effectively with the
agencies in your community
that are providing programmes
and services related to HIV
and AIDS.
2.
Choose the best methods of
working with your group.
3.
Consider involving parents
in the programme.
Programme
Planning
First of all, what do we mean by the word programme? Pro
gramme in this text is used to mean all the AIDS activities and
projects you carry out with your own youth group and/or with
the community, i.e. your total AIDS health promotion pro
gramme. Programme planning is the process of deciding and
developing what you want to do and how you want to do it.
Section 4: Activities for the Youth Group and Section 5: Action
in the Community, provide ideas for planning these two major
areas. Before the youth group works within the community, it
is important they learn about AIDS themselves and have time
to develop their ideas for community projects.
This section will describe some questions to ask and things to
consider before you begin planning your overall programmme.
What AIDS activities are already going on in
your area?
Make sure you are aware of all the AIDS activities going on in
your area. There may be AIDS clubs formed by other groups.
Some schools have AIDS prevention clubs, non-governmental
organizations are providing education on AIDS and your Na
tional AIDS Programme may be working with young people in
your area. It may be possible for you to work together with
these other groups and, if you can, you should; you and they
have much to gain from each other. Many areas have periodic
AIDS training courses run by the government or by non
governmental organizations. Try to get a place in one of these
courses to increase your own knowledge and confidence.
I
From whom can you get support and advice?
Think about who you have in your National Society, your Na
tional Scout Association, National AIDS Programme or local
community to give you advice and to help you if you need an
swers to questions that arise in the course of your work. This
may be a doctor, nurse, primary health care worker, teacher or
religious leader who has been trained in AIDS information,
education or counselling.
41
Discuss with them how your activities could be developed to in
volve the community. Enlist their help in seeing your pro
gramme through to the end. Be sure that all the activities you
undertake have been approved by your National Society and/or
National Scout Association and the National AIDS Programme.
If you know of people with HIV or AIDS, take time to listen to
their views. When possible involve them in your programme.
Understanding their needs increases your awareness of how
AIDS affects people's lives and makes AIDS more real.
How can you get clear, correct information?
• Think about where you can find reliable information about
AIDS — a doctor, nurse, a local health worker, government
campaigns, the newspaper, posters, etc.
• Start collecting information about AIDS.
• Compare all the information you collect and write a list of
the questions that arise, particularly where two items say
different things.
• Take the list of questions to people you feel already have
some information about HIV/AIDS and compare information
with them.
• There is information in this pack to help you answer some of
your questions.
• When you hear new information, be sure to check if it is the
truth before you pass it on to your youth groups. Since the
media is always eager to publish news about AIDS, some
AIDS information may be premature or incorrect.
42
I
What do you want to happen?
Knowledge alone will not prevent the spread of HIV infection in
your area. There has to be a change in the attitudes and values
people hold in order for them to understand how they need to
change their behaviour. Think about what you would like to see
happen in your community, both in terms of the activities of
your group and changes in behaviour. You will need to find out
what people really think and feel about AIDS and how much
information they already have. In order to do this, carry out
"focus group discussions". This will help you to plan your AIDS
activities based on a better understanding of what people really
want. Full details of how to run focus group discussions are giv
en in Appendix I.
What are the best ways to share information
with a group?
• Why are you presenting the information? Think about what
you want to achieve with your particular group. How will
they be using this information? Don’t go into more detail
than is necessary.
• What do you want the group to do with the information?
Young people need to understand how the information will
affect themselves and the future of their community.
I
• What is the best way to present the information? A lecture, a
play, slides or a film, a question and answer session? There
are many ways to present information, some of which are de
scribed in this manual. However, most of the activities in the
manual use group work and "learning by doing", rather than
a more passive "lecture-style" approach. Experience through
out the world shows that young people and adults learn best
when they are actively involved in the learning — when they
can process information through questions and discussion,
solve problems and practice skills.
43
Why choose group work?
Often our own experience of learning comes from how we were
taught at school. We may have been given information, as
though we were empty vessels that needed filling, and then giv
en an exam on it to see if we could remember it. If we failed, it
was thought we had not been listening to the teacher well
enough. In other words, it was our "fault”, and we felt we were
not good enough students. So, motivation to learn was low and
confusion about many of the facts remained because we had no
opportunity to ask questions.
I
<z> o
■
•l
A lecture can be boring...
44
Young people come to a group with a great deal of information
and life experience. You will find that your group is more moti
vated to learn, learns faster and thinks of new ideas if you in
volve them in the learning process. Don't just give them infor
mation. Help them use that information to make choices that
are right for them. A person will find it easier to make those
choices if she or he has the opportunity to talk about his/her
own feelings and ask questions.
Working together in a group enables young people to share
ideas and learn from each other's experiences. They can begin
to take responsibility for their own actions, support each other
and produce materials in their local language that have a real
impact on themselves and their peer group. They decide what
they most need to know and they make plans together to go and
find the information they need. Learning from each other, they
will soon develop skills and confidence to try out what they
have learned with their community.
1*11*
Working together and involving the group members
45
What are the best ways to work with your
group?
The first step is to develop a trusting relationship with the
members of your group. This means ensuring that they feel
they can talk openly and express themselves freely without be
ing worried about criticism. They will need to know that infor
mation will not be discussed outside the sessions. The group
needs to get to know each other and to feel that you as group
leader are accepting of them. Some of the ’’warm-up” exercises
in this manual will help you to begin to work together.
The group needs to feel committed to the task. Ensure that
each member wants to be part of the group working on AIDS.
They should not be made to feel uncomfortable if they choose
not to join in.
I
Three rules for developing a trusting relationship with your
group:
Confidentiality - ensuring that what is discussed in the group
remains with the group.
Respect - ensuring that people feel they can express them
selves freely without fear that their opinions will be ridiculed.
Mutual support - ensuring each member of the group can rely
on their co-group members to listen and care for them.
Involving parents
Parents may want to know and understand the information
their children will be given and the kind of activities in which
they will be taking part.
The following information will help you to consider the benefits
of including parents in decisions about the activities you are
about to undertake. You may decide that involving parents is
not appropriate within your setting or culture. However, even
if you have not worked with parents before, you may want to
think about it in relation to starting AIDS health promotion
with the youth group.
Information about AIDS and HIV infection touches upon areas
that some parents will have difficulty discussing with their
children. The natural enthusiasm of young people involved in a
new project will spill over into the home and they will want to
tell their parents about what they are doing and ask their
46
parents’ opinion. Cultural, religious and moral beliefs may
make it difficult for children to ask and for parents to answer
these questions. Parents may feel they don't want their children
discussing subjects such as sex and sexuality and death and dy
ing. Involving the parents right from the start can help them to
understand your entire programme and their children's involve
ment in it.
If you decide to involve parents directly, you could plan a
meeting using the following suggestions:
1.
Invite all the parents of your youth members to a meeting.
Tell them you want to discuss how best to go about pro
tecting the young people against infection with HIV.
2.
Provide basic information about AIDS and HIV and how it
is affecting the world, your country and young people in
your community. Explain how it is spread and not spread
and how important it is to get young people to think about
the kinds of behaviour that might put them at risk.
3.
Make sure that you give the parents an opportunity to ask
questions, express their fears and to think of ways to pro
vide clear, up-to-date information to their young people.
Divide them into small groups and give them topic areas to
discuss, for example:
a)
What are our worries and concerns?
b)
How can we as parents best work together with the
youth leaders to ensure the young people get clear,
up-to-date information?
c)
How can we as parents work together with the youth
leaders to deal with the worries and fears that the
young people may bring us about AIDS and HIV in
fection?
d)
What can we as parents do to ensure the smooth run
ning of the young people's AIDS health promotion
programme?
e)
How can we help the young people to provide care
and support for people infected with HIV or those
aready ill with AIDS in our community (if this is rele
vant in your area)?
Having completed their discussions in small groups, have
each group share their ideas with the larger group. Help
the large group to begin a plan of action based on what
they have discussed.
47
4.
Throughout your programme parents should be kept in
formed about content and progress. It may be useful to
have a regular meeting with parents to further discuss
how they feel about the AIDS activities and their chil
dren's participation. Their involvement will ensure that
they can provide understanding at home. It will also en
sure that the young people will be able to carry out their
AIDS activities with the support of a caring environment.
5.
Some of the parents may have special skills related to
AIDS health promotion and you may choose to ask them to
be more directly involved.
Involving other relatives
Not all young people will have parents with whom to discuss
the information they have learnt about HIV/AIDS. If you decide
to involve parents in your programme, remember to include
those in a parenting role, such as other relatives or foster
parents.
Young people may also decide not to discuss the subject with
their parents or surrogate parents, but may choose to talk to
other trusted adults. Religious leaders, social workers, teach
ers, local healers, primary health care workers or local birth at
tendants may all, from time to time, offer advice or a listening
ear to young people. They are often involved in community deci
sions and share in the support and care of young people. When
planning your AIDS health promotion programme, their
thoughts and involvement should be considered and can be in
valuable. This is one way to ’’involve the community”.
Involving other caring agencies
In some communities specific organizations have direct respon
sibility for the welfare of young people. Schools and colleges
take care of the personal and social, as well as academic aspects
of their students' educations. Group homes for children without
parents are provided in some societies and their leaders may
want to become involved in your work. They provide an excel
lent resource for understanding the values and attitudes of chil
dren with special needs and you may choose to begin your pro
gramme within one of these organizations.
48
I
Activities for
Youth Groups
This section is designed
to help you:
1.
Increase your knowledge of
active learning methods as
tools in AIDS health
promotion.
2.
Select and adapt AIDS health
promotion activities for your
youth group which increase
knowledge, explore values and
attitudes and build skills.
Activities
for Youth
Groups
Involve the youth group from the start
It is important that the youth group members feel involved in
their own programme and are part of the planning and deci
sion-making.
Try not to make assumptions about what group members think
and feel. They may or may not be sexually active. It could be
some time before they feel they can talk openly.
To plan AIDS health promotion activities you need to find out
what they already know about HIV and AIDS and what their
needs and interests are in relation to AIDS activities for them
selves and the community.
(
How do I find out?
Carrying out "Focus Group Discussions” with the group can be a
good way to start.
Focus groups provide a structured way of carrying out group
discussions. See Appendix I which gives guidelines for this
procedure.
51
MION
7?™
)
If your youth group is too large to conduct a single focus group
with all of them, try running a focus group with a smaller num
ber. The young people in this focus group can then run similar
groups for the rest of the youth members. Each group feeds
back their answers to the entire group. Write down on a large
piece of paper all the areas where the group has any difficulty
and all the questions raised in the discussions.
Look at your large piece of paper and divide what you have
written into two sections:
• What information do we already have as a group?
• What else do we most need to learn?
Now you will wonder
How are we going to find out more information and increase our
understanding about AIDS and HIV?
It may be helpful to think of AIDS health promotion for your
youth groups as having three important areas:
• Providing young people with information.
• Encouraging them to explore their values and attitudes.
• Helping them to learn new skills, so that they can make
responsible decisions to protect themselves from becoming
infected with HIV.
The activities described in this section have been designed for
young people of about 15 years old or older. However, they have
been used successfully with younger teens. Think about how
suitable these materials are for your culture, the age of your
youth members and their abilities and adapt the activities as
needed.
The activities use "learning by doing" methods. Young people
learn more quickly and stay more involved when they can ac
tively process information, solve problems or practice skills.
Using creative energies and different senses encourages partici
pation. Young people do not all receive or express information,
thought, or ideas in the same way. Trying different ways of do
ing things can be fun and keep the group going.
52
t
I
Before you choose an activity, think...
• What does the group need?
• What are my goals for using this activity?
For example: If your group members are confused about how
people become infected with HIV, your goal would be to make
sure that the group clearly understands how HIV is spread.
Then after you have chosen an activity and tried it, take time to
evaluate.
• How well did the activity go?
• Did it accomplish the goal or goals you set?
For example: Using the same example as above — ask: Does
your group now understand how HIV is spread?
Some examples of ways to evaluate how the activity went and
if you met your goal or goals are included in the activity
descriptions.
Evaluating each activity as you go along can help you to know
what is working best with your group and to decide what you
need to do next.
The activities that you choose should build on each other to
make up your youth AIDS health promotion programme.
The first section will describe warm-up activities that can be
used to help the group get to know each other, or to build and
maintain trusting relationships. This will be followed by sec
tions which present activities related to information, values and
attitudes, or skills. The last section describes some specific tech
niques used in many of these activities which you can also use
to develop your own ideas.
Adapting the materials to fit your culture and the age and ex
perience of your group is essential. If the youth members don't
see the activitiy as relevant to their lives, they cannot learn
what you are trying to teach.
li
53
Warm-up
Activities
In order for the AIDS activities to be enjoyable and for them to
help your group understand more about HIV/ AIDSt you need to
spend some time getting to know each other better. You may have
been working with your group on other issues for some time.
However, being free to discuss difficult and sensitive subjects to
gether means you have to feel happy and trusting in each other's
company.
These warm-up activities help you to get to know your group bet
ter. They can be used over a whole day or used to introduce one
of the other activities. In the same way as you need to warm-up
your muscles before you start an exercise programme you need to
warm-up your group in order to start an AIDS related activity.
I
The name
game
Purpose
Setting the scene and beginning to start a group working
together.
Number of people
Your whole group.
Time taken
Between 15 minutes to half an hour depending on the size of a
group.
Method
1.
Have the group sit in a circle. Start with yourself as group
leader and write your name on a large piece of paper. You
could also say what your name means or any story asso
ciated with it, e.g. "My name is John and I was named after
my father".
2.
The next person writes his/her name on the piece of paper.
He/she also adds a story associated with his/her name.
3.
Each person in turn writes his/her name and tells his/her
name's story. The paper is then attached to the wall for the
duration of the session.
55
Variation'. You can also ask group members to tell their names
and related stories without writing them. Each person has to
try to remember all the names that went before him or her.
This provides a way to do the activity without having to write
anything and may be helpful if some of your group members do
not write well.
My story
Another way of getting the
group used to each other and
to know you is to find out a
little bit about each member
of the group. This activity is
particularly useful if group
members know each other
but not you.
my Name
IS
Ask the group to sit in a cir
cle. Then get them to say
their name and something
about themselves. This may
be a personal characteristic;
for example nMy name is
John and I have big ears", or
something about their lives
such as "My name is John
and when I was very small I
used to keep bread under my
pillow to stop me getting
hungry at night!".
I
It is a good idea to start with yourself to give the group the
idea of how the game works. It is also a good opportunity to
stress the need for confidentiality amongst the group
members.
56
Type of activity: Making collages*, group discussions.
My
favorite
things
to do
* A collage is a design created by gluing various materials to a piece ofpaper.
Purpose
The purpose of this activity is to help the group members get to
know each other. It also supports the self-esteem of each partici
pant by placing value on what they think and feel. It may show
how group members are alike or different. The activity has the
potential to encourage respect for others and their choices.
Leader note:
When leading the group discussion, it is very important to sup
port and encourage the participants as they describe their col
lages. You can act as a "role model” in accepting and not judging
the likes and dislikes of each participant.
x__________________________________________ __ _____________________
Materials needed
Paper, pencils, markers, old newspapers and magazines, twigs,
flowers, leaves, any left-over handcraft materials - bits of string,
bottle tops, etc. - glue, tape and scissors. Be creative. Many dif
ferent types of materials can be used - it’s whatever you have.
What to do
1. Place all your materials in the middle of a table or on the
floor and ask participants to sit around in a circle. Give
each person a piece of paper.
Ask the group to create designs on their pieces of paper
2.
which tell their favorite things to do. Explain that they can
use any of the materials they wish to make the designs.
3.
4.
z
Give the group time to think, cut out and paste materials
to make their collages.
After everyone has finished, give each person a chance to
show the group his or her collage and to explain what it
means.
Leader note:
Encourage the group members to ask each other questions and
try to keep the mood relaxed and easy going. This activity can be
used as a "warm-up" exercise before you try a more intense activ
ity or just by itself to help everyone get to know each other.
x____________________________________ ________________________ ——y
57
Evaluation
This activity involves using materials as well as talking. How
did the group like this method? Did using materials help them
share more about themselves? Did the activity help create posi
tive attitudes toward each other? Were there any problems?
Thinking about this can help decide what the group needs. Ask
the group — how did they Eke this activity?
58
What do I
know?
What do I
need?
Purpose
A useful exercise to help you and your group assess the infor
mation you already know and to discuss what else you need to
find out.
’X
Leader note:
You can use this exercise to help you work out the specific needs
of your group. It can also be used for planning work in the com
munity after your group has worked together with some of the
activities.
Method
Each member of the group thinks about what skills and knowl
edge they have about HIV/AIDS. They could write this down or
remember it.
They also think of the areas in which they have little knowl
edge or in which they would like to develop new skills.
The group then moves into pairs and discusses with their part
ner the thoughts they have had. They should take turns telling
each other rather than developing a conversation. When listen
ing, it is important that the listener shows that he/she is inter
ested in what the other person is saying and helps the speaker
to think realistically about the information he/she knows and
the sort of things he/she might be able to do as part of the
group's AIDS health promotion programme.
The group leader then brings the group back together and dis
cusses the areas that have been talked about. It is important
that no one is ridiculed for his/her ideas and that each area is
talked about seriously.
59
{
Human Knots
60
Human
knots
Purpose
To develop trust.
To have fun.
To do something physically active.
Group size
Divide into small groups of about 7 to 9 people, but make sure
that the number of people in the group is uneven. This activity
requires a lot of physical contact. Think about whether it is ap
propriate in your culture to have a mixed group or whether you
should have separate groups of boys and girls.
What you need
The activity can be fun to do inside or outisde. Make sure you
have a place with plenty of room.
How you do it
1.
2.
3.
Ask everyone to stand in a circle facing towards the
middle.
Now ask everyone to extend their arms forward and then
grasp the hands of others within the circle. Ask that all
are careful not to grasp the hand of someone just next to
them and not to hold both hands of anyone else.
The goal is for the group to get the "knot" untied with ev
eryone standing together in one circle holding hands.
Leader note:
I
Sometimes groups end by a spontaneous expression of happi
ness I satisfaction that the group was able to get the "knot" un
tied. This expression can be laughing, clapping hands or mak
ing noises.
Sometimes a group has a hard time getting the knot undone.
This is not a failure. It can give a good chance to talk about how
it feels to try something hard that does not always work.
The "trying" is the important thing. The group can learn some
thing about how they are working together by talking about why
getting the knot untied is hard.
y
61
Information
Activities
There are many ways to help young people clarify the facts about
HIV and AIDS and better understand the many related issues.
This section presents some activities you can try. The activities
are useful both to share new information and to observe what
group members have already learnt.
Additionally, you may want to share information by using slides
or videos about HIV/AIDS. A set of slides is available from the
League of Red Cross and Red Crescent Societies in Switzerland.
The resource list in the appendix section of the manual includes
an order form for the slides. Preparing your own flip chart is an
other way to share information.
What
do we
know?
Purpose
This exercise allows participants to share information among
themselves and then to clarify what they do not know.
Leader note:
The suggestions for the statement cards may or may not be suit
able in your culture or with your group. It is important that the
statements be relevant to the group's information needs and the
youth members' lives. Select those statements that are appropri
ate for your group, or you may prefer to create your own.
y
Materials needed
Paper for the statement cards, colourful markers of some type.
Number of participants
If you are working with more than 12-15 people, it is best to di
vide the participants into smaller groups with a set of cards for
each group.
63
What to do
Before you start the activity, you will need to prepare a set of state
ment cards. You will need at least one card for each person. Ideas
for the statements should come from your findings in the focus
group discussions. Then the activity will exactly meet the need for
clarification and information expressed by your group.
Photographs or illustrations drawn by the participants can be used
instead of written statements.
Suggestions for statement cards
Kissing on cheeks
Having an injection from a
local pharmacist or clinic
Oral sex
Having sex within marriage
Having a blood transfusion
Using someone else's
toothbrush
Swimming in a pond
Caring for someone with AIDS
Being bitten by a mosquito that
has bitten someone with HIV
Having many sexual partners
Having your ears pierced
Sleeping in the same room as
someone who has AIDS
Being tattooed
Anal sex
Hugging someone who has HIV
Being bitten by bed bugs
Using a public latrine
Having sex with a drug user
Witchcraft
Group circumcision
Deep kissing
Plus - you will need to prepare four more cards: High risk, Low
risk, No risk, Don't know.
Next, ask the group to imagine or draw a Line of Risk on the floor.
Label one end of the line with the High risk card and the other end
with the No risk card. Place the Low risk card somewhere in the
middle. Decide with the group a place for the Don't know card.
Have the group sit in a circle and give out the statement cards to
each person. Explain that in all cases which involve contact with
others, the other person might have HIV.
Invite everyone to take a turn to read out what is on their card and
then to place it where they think it belongs on the Risk line that
you have drawn. Ask them to tell the group why they have put it
there. Remind them that they can place the cards in the Don't
know space.
64
Anyone can challenge them with more information and sugges
tions about where the card ought to go. The person placing the
card can change his/her mind and move the card or leave it
where it is. Then, the next person takes a turn, and so on until
all the cards are laid out. This part of the exercise takes about
twenty to thirty minutes.
Identify cards about which there is no disagreement. Put these
to one side. Then discuss the cards about which there are ques
tions or disagreements. Try to reach a consensus in the group.
Provide the necessary factual information to help the group
make decisions about each risk activity.
Leader note:
It may be helpful at the end of the exercise to list the activities
under each risk heading. Discuss with the group if there are any
issues or questions they would like to explore further. This may
help you decide what other activities the group needs.
Suggested answers to AIDS game
High risk
Anal sex - Anal sex is a very efficient way to transmit HIV
since the lining of the anus tears and can bleed, providing a
way for semen to get quickly into the blood.
Having many sexual partners - Having sex with many part
ners increases the risk of becoming infected with HIV. Howev
er, it is not just a question of how many partners you have. Any
one act of unprotected intercourse (sex without a condom) with
a person who is infected with HIV could result in you becoming
infected. (This is a good opportunity to go over the information
on safer sex.)
Having sex with a drug user - If a person uses drugs by in
jection and does not use a clean needle every time but borrows
other people’s, then he/she is at high risk of getting infected
65
with HIV. Having sex with someone who behaves in this way is
also very risky. Using drugs or alcohol in any form affects your
judgement, so you are more likely to engage in unsafe sex and
put yourself at risk of infection when under their influence.
Group circumcision - Many societies circumcise young people
in groups. When instruments are not sterilized between each
use, they could pass on HIV.
Low risk
Having your ears pierced - If sterile procedures and disposa
ble needles are used there is no risk. However, if everyone in a
group is having his/her ears pierced and is using the same
needle, then, group members are subject to a small degree of
risk. Being tattooed is a practice which also requires that ster
ile instruments be used every time.
I
Using someone else’s toothbrush - A practice which should
be avoided because of the general risk of minor infections being
passed from mouth to mouth. No known cases of AIDS have
been passed in this way but it is possible to catch hepatitis B
which is also a very serious disease.
Deep kissing - Deep kissing could carry a risk only if there
were an exchange of blood from an HIV positive person to his/
her partner. Bleeding might occur because of damage caused to
the skin or mucous membrane around the mouth. Saliva does
not contain HIV in sufficient quantities to be infectious.
I
No risk
Having sex within marriage (with an uninfected partner) This can carry no risk providing you and your partner have not
had sex with anyone else before or after you were married. In
some societies where polygamy is practiced, it is important that
all partners within the marriage remain mutually faithful.
Using a public latrine - The virus is not passed on by urine or
faeces. HIV has been found in these body fluids but not in suffi
cient concentration to spread HIV.
66
Swimming in a pond - HIV is very fragile outside the body.
Water dilutes the virus so it wouldn't be concentrated enough
to infect you even if it could find a way into the body.
Kissing on cheeks - Again there is no way for the virus to get
into your body.
Caring for someone with AIDS - This is a low risk activity if
you follow good hygiene practices. Make sure any cuts on your
hands are covered, wrap up any dressings soaked with blood
and either bury or burn them. Wash soiled linen with hot wa
ter and soap, and dry them in the sun. The person you are car
ing for deserves all the care and attention that anyone might
expect to receive.
Being bitten by a mosquito that has bitten someone with
HIV - If HIV were transmitted by mosquitoes or head lice, we’d
expect to see some infection in children which could not be ex
plained in any other way. Infection in children is only seen
when they have been infected in their mother's womb or
through blood products or sex. HIV is not adapted to spread
through insects.
Sleeping in the same room as someone who has AIDS No risk, unless the person is suffering from open TB, in which
case there would be a risk of being infected with TB and not
AIDS. People with AIDS can often feel isolated and lonely, so it
may be important for them to feel someone is happy to share a
room with them.
Hugging someone with HIV - No risk. It is important to
show that you care. There is no route of infection for the virus
in hugging.
I
Witchcraft - AIDS is caused by a virus, not by ill-wishing or
other such activities.
Don’t know
Having a blood transfusion - In some countries donated
blood is not screened for HIV. In these cases, the blood you re
ceive in a blood transfusion may contain HIV, so the activity
could be high risk (it is useful at this point to stress that it is
safe to give blood and that people should continue to do so if
they know they are at low risk of having HIV). In areas where
67
blood is screened for HIV, having a blood transfusion carries a
minimal risk and is therefore low risk (you should decide on
where this card goes depending on your local situation).
Oral sex - This is a difficult area; we are not sure yet if oral
sex carries any great risk, especially if the man doesn't ejacu
late in his partner's mouth. But good studies are hard to find,
as few people just practice oral sex. Oral sex should never be
practiced if either partner has bleeding gums or mouth ulcers,
because other infections like herpes can oe passed on.
Having an injection from a local clinic or pharmacist This carries no risk if the injection is carried out with a clean
needle every time. It is very important to check this before you
accept the injection. Small amounts of blood tend to remain in
used needles, and if the blood contains HIV, you could be infect
ed in this way.
68
The
immune
system
play
Purpose
To teach how the immune system works in a healthy person
and how HIV damages the immune system.
Cast
Mary
Mary's immune system - a group of people
HIV
An infected boil
A story teller.
Materials
You can have some fun making costumes for each member of
the play or you can stick labels on to each person with the name
of the character they represent.
Method
(The stage directions are in brackets.)
The story teller stands at the side of the room and reads out the
story.
Story teller. This is the story of how a healthy immune system
works and how HIV damages the system.
(Mary comes forward and stands in the middle of the room.)
Story teller. Mary is protected from infection by her immune
system.
(Small group of people, holding hands in a circle, surround Mary.)
When she gets an infection her immune system fights the infec
tion and Mary becomes well again.
(An infected boil comes forward, Mary looks in pain. The boil tries to
break through the immune system circle, but they do not let him and he
goes away.)
Story teller. Mary has had sex with her boyfriend. He did not
use a condom and she felt too shy to ask him if he would. Now
Mary has become infected with HIV because her boyfriend car
ries the virus and they have had unprotected sex.
(HIV comes forward and starts to fight with Mary's immune system. HIV
manages to get inside the immune system circle. HIV hits one of the
members of the group who falls down and dies.)
69
Because HIV has managed to get inside the immune system and
kill a part of it, the immune system is weak and cannot fight
HIV. Because the immune system is damaged, it becomes unable
to fight off other infections.
(The rest of the immune system members fall on the floor.)
Story teller. Mary starts to get sick and develops AIDS. She
falls down and dies.
The immune system normally protects us from disease. When
HIV gets into the body, it damages the immune system. The im
mune system eventually becomes weak and cannot fight off in
fection. The body can no longer cope with infections. It is the in
fections which kill a person who is infected with HIV.
The end.
Leader note:
The play can be followed by discussion. Use the question and
answer section of this manual to help you. If you do not know
the answer, be prepared to go and find out the answer from a
health worker and tell the group next time.
The group may want to use this play in schools or community
events to show others how the virus works. Before putting on the
play for a community group, spend some time discussing how to
answer questions from the audience. "Working with a commw
nity activity" could be used to help the group prepare.
70
Quiz on
AIDS
and HIV
A quiz can be a good way of checking people's knowledge about
AIDS and HIV. It should not be treated like an exam that peo
ple pass or fail, but as a basis for discussion. The participants
can answer the questionnaire individually or in small groups.
Questions that people have some difficulty with can be left to be
discussed later.
The questionnaire can be based on the questions from the focus
group discussions or from the statement cards in the previous
activitiy. For example:
1. You can catch HIV
from using a public latrine: true
false.
2. You can catch HIV from having
true
sex without a condom:
false.
Another method of writing a questionnaire is to use a multiple
choice format, giving a selection of possible answers from which
the participant has to choose the right one, for example:
1. If you are HIV antibody positive:
a) You have got AIDS.
b) You will be dead in five years.
You are infectious to other people.
c)
(Answer c) is correct because people may be well and HIV anti
body positive for many years before they go on to develop AIDS.
We still don't know how long it takes to progress to AIDS or why
the time varies with different people.)
2. HIV has been shown to be transmitted through:
a) Blood
g) Breast milk
h) Skin
b) Saliva
Semen
c)
i) Vomit
d) Sweat
j) Faeces
k) Urine
Vaginal fluid
e)
Hair
l) Tears.
f)
(Answer - the key words here are "shown" and "transmitted".
The only body fluids from which HIV has been shown to be
transmitted are semen, blood and vaginal fluids. HIV is present
in many other body fluids but not in a sufficient concentration to
infect anyone.)
71
Other topic areas that can be covered in a questionnaire of this
type are:
Symptoms
Transmission in pregnancy
Who would you tell if you were HIV positive?
Where did AIDS come from?
What is risk behaviour?
(
I
72
The blood
donor
activity
Purpose
1.
To give young people an opportunity to think about blood
donation.
2.
To talk about the kind of worries and anxieties people may
have in relation to blood donation.
3.
To think about and plan activities in relation to blood do
nation.
What to do
1.
Choose one or more of the following scenarios to discuss
with your group.
2.
Brainstorm, thinking about the misinformation the scena
rio contains. Write the ideas on a flip chart.
3.
Organize the contents of the flip chart, identifying areas
where information needs to be corrected.
4.
Work out with your group a plan of action which might
help to clear up these areas of misinformation.
For example:
a) The group may choose to run an information session in the
blood donation centre.
b)
They may decide to go as a group to donate blood to show
the community that it is safe to do so.
z
Leader note:
I
The following scenarios are suggestions only. Ifyou choose to in
clude questions about blood donations in your focus group dis
cussions, you may decide to use some of the local information
gathered to develop your own scenarios.
The scenarios could be written as role plays with each member
of your group having the opportunity to take a part. The role
plays could then be followed by discussion about why the situa
tion occurred and what young people can do to correct misinfor
mation.
Scenario 1
A child is run down by a motor car and needs blood. A group
of young people are asked to donate, but they are afraid that
if they give blood they will get AIDS.
73
y
Scenario 2
A regular donor is very pleased when his test for HIV is neg
ative, although he has had sexual intercourse with many
girlfriends. He feels he must be immune to AIDS and decides
to continue to give blood regularly and to continue to have
sexual intercourse with his girlfriends.
Scenario 3
A young woman is about to give blood. She has had a number
of sexual partners, but does not feel she is at risk because
she is not a prostitute.
Scenario 4
A group of young men are about to give blood despite the fact
they had sex with bar girls the week before. They think that
if their blood is infected it will be detected by the laboratory.
I
Scenario 5
A young man is coming to give blood. He disregards the pre
donation questionnaire because he recently became very re
ligious, so feels he could not possibly have AIDS. Besides, he
has never felt healthier in his life.
t
I
74
AIDS
’’memory
game”
Purpose
To provide a relaxed way for the group to increase their aware
ness of a specific aspect of AIDS information.
Type of activity
This activity uses pictures to encourage group participation.
Group discussion and use of a flip chart are also part of this
activity. *
Leader note:
This game I technique can be used in relation to many themes
you wish to share related to the basic facts about AIDS. This
sample will use the theme "How AIDS is not spread”. You may
choose to adapt this game / technique to other themes that are
relevant to the needs ofyour group.
Preparation
Before you begin the activity you will need to prepare two sets
of pictures on small cards related to the theme you have cho
sen. Try to find pictures from magazines or newspapers. Cut
and paste the pictures onto small cards. You can draw pictures
on the cards if you cannot find appropriate pictures from other
sources. For example, for the theme "How AIDS is not spread",
you might find pictures of people hugging, shaking hands,
swimming, eating or being bitten by mosquitoes. You need to
find or draw two pictures of each activity. See example drawn
below.
75
Procedure
1.
Place the cards you have prepared face down on a table.
For a group of twelve people you will need at least 15 sets
of pictures. Remember each set has two cards with the
same picture, or as closely alike as possible. Place the
cards in equal rows.
2.
Explain to the participants that the purpose of the game
will be to match as many cards as they can.
3.
Taking turns, each participant will turn two cards face up.
If the cards are the same or have the same message, the
person will take the cards from their place and keep them.
If they are different, the person will turn the cards back
over in their original places.
4.
As the participants take turns, they try to remember
where they have seen matching cards.
5.
When all the cards are picked up, participants can count
to see who has the most matched pairs of cards.
6.
Now you can ask each player to describe the pictures they
have collected and how their pictures relate to the theme.
For example, if the theme is "How AIDS is not spread", the
group can discuss each picture and decide if the actions or
situations in the picture could result in getting AIDS. The
group could make a list on a flip chart, big piece of paper
or chalkboard of ways you do not get AIDS. This discus
sion can also give a chance to answer questions and clarify
information.
t
Group size
10 to 12 people.
Time
45 - 60 minutes.
* Note\ For additional tips on how to select pictures for this type
of activity, see Pictures and Photographs, in the Techniques
section.
76
Values/Attitudes Activities
No sex
now
Purpose
To help young people consider that choosing not to be sexually
active at the present time is a viable alternative.
Type of Activity
Brainstorm, whole group discussion.
Materials needed
Board, pen/chalk.
What to do
/
i.
Write the heading "No sex now" on the board and draw
two columns, headed "Advantages", "Disadvantages".
2.
Ask the participants to brainstorm the advantages and
disadvantages of deciding not to have a sexual relation
ship.
3.
Conclude with whole group discussion which highlights
the main points raised in the brainstorm.
Leader note:
No sex now
Sample:
Disadvantages
Advantages
• No worries about
Transmitted Diseases
(STDs), Pregnancy.
• Perhaps no boy /girlfriend
• Not making a decision
because ofpressure.
• Perhaps no boy /girlfriend
• Sticking to ones own
beliefs / morality.
Evaluation
At the end of the activity, ask what they learned. Consider if
their responses match what you hoped they would learn. Did
the group members actively participate? Was this a good way of
working with your group?
77
Choices
and
sexual
expression
Purpose
To think about why and when people choose to have sexual
intercourse.
To recognize the importance of pressure from other people and/
or groups on values and actions related to sexual behaviour.
Materials needed
Paper, pencils, blackboard.
What to do
1.
Open the session by describing the following situation:
''Yahiya and Leila have started meeting regularly. Their
friends discuss whether or not they are having sex".
f
Leader note:
Ask the group to choose local names for the characters (not
the names of anyone in the group).
2.
Write the following questions on large sheets of paper:
a) Is it alright for Leila and Yahiya to have sex?
b) When is it alright for Leila and Yahiya to have sex?
c) Will their parents think it is alright?
d) Will you, as their friend, think it is alright?
e) Will their religion think it is alright?
f) Will their school think it is alright?
3.
Divide into small groups of 4 to 6, or in pairs and talk
about each question.
4.
Ask the group members in each small group to consider
what they think would influence their decision to have a
sexual relationship.
5.
Ask the groups to discuss the differences between their
own opinion and the opinion of others.
6.
In the whole group, discuss "what responsibilities regard
ing sexual behaviour do you have towards yourself,
parents, religion, boy/girl friend, community?".
78
z
Leader note:
Be aware of any participant that seems upset or withdrawn dur
ing the activity. They may need a chance to talk on a one-to-one
basis.
This activity can collect a lot of information about your group
which may be useful in deciding what your group needs are.
y
Evaluation
One way to evaluate this activity would be to use a short ques
tionnaire at the end of the session. Include in the questionnaire
several short questions such as: Did you find this discussion
useful? Did you find it hard to take part? Were you embarassed
or anxious during the discussion? Did you learn anything new?
What else would you like to know about AIDS? Participants do
not need to put their names on it. Collect the questionnaires
and share the answers with the group. Discuss with the group
what they want to do next.
79
Jigsaw
puzzle
game
z
——----- —---------------------------------------------------------------- Leader note:
The examples of puzzles suggested here are only to give you
some idea of hotv the activity works. It may be that the group
decided on a different set of factors related to why a person may
become infected with HIV. The reasons will change from culture
to culture, and the idea of the activity is not to match the rea
sons stated here, but to think about the pressures on people
which might force them to put themselves at risk.
Purpose
To encourage participants to think about the multiple reasons
which lead a person to become infected with HIV and how
other factors may cause a progression to AIDS. This idea may
be used to explain multiple causes of disease, generally, and
can be followed by discussion of how we can prevent this.
Time: About two hours.
Materials
Paper, card or material for the jigsaw, scissors, pens or pencils.
Number of participants
A large group divided into groups of three or four or one group
of three or four.
Method
1.
Get the group to brainstorm* all the reasons why a person
in a particular situation might become infected with HIV.
For example, what factors might lead a young person to
have unprotected sex and become infected with HIV.
2.
Lay a large piece of paper, material or card on the floor
and begin to design how all the contributing factors fit
into one another. Draw the shapes on the paper and then
cut them out.
3.
The group can then discuss how other problems may re
late to one another. You can ask:
• What can we do about these problems to avoid them all
fitting together?
• Will solving one part of the jigsaw solve the whole prob
lem?
• Where should we begin to start solving the problems?
4.
Encourage the students to make other puzzles relating to
subjects like:
• What are all the factors we need to consider when car
ing for people with AIDS in the community?
80
I
• What factors lead people at high risk because of their life
style (such as "sex workers") to continue to put themselves
at risk?
* See brainstorming in the Techniques section.
An example of a puzzle:
Factors which may lead to HIV infection
in a young person
Lack
Peer pressure
Unprotected
sexual
to have sexual
Boredom
Attraction to risk
encounters
experiences
self-confidence
Recurrent
Inability to
sexually
communicate
transmitted
No access to
counselling
with partners
diseases
Loneliness
Fear of
Condoms
unavailable
Need for love
Loss of
control
and
No access to
affection
information
Denial
Lack of
Experiments
future
\ with drugs and
prospects
alcohol
to
I
communicate,
with adults
81
An example of another puzzle you may try:
Factors which may lead to HIV infection
in a "sex worker"
Too many
Poverty
at home
Lack of
| girls in
Untreated sexually
transmitted diseases
/the family
formal education
Many
Low
wages
Inability to
Fear of lack
partners
(
negotiate
condom use
support a
child
Move
No access
Lack of
to
to health care
Lack of
No access
to information
Lack
of
stable
partner
self-esteem
skills
No access to
counselling
Pregnancy
Fear of male
Isolation
violence
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Case study...
The story
of A, B, C,
and D
Purpose
To examine the participants' attitudes and values about certain
types of behaviour. If the group has strong opinions about cer
tain kinds of behaviour, this activity will help to identify and
discuss them. There are no right or wrong answers, and they
may end up having to agree to differ on the behaviour of the
characters in the story.
Time
1 hour.
Resources
Paper and pens or pencils.
Number of participants
Small groups of four.
Method
1.
Read the case study to your group slowly and carefully. A
sample case study follows on the next page. Outline the
main points several times. You could also make copies and
give people these to read themselves. In place of A, B, C
and D, use local names taking care not to use the
name of anyone in the group.
2.
Each group member decides if the characters have acted in
a responsible or irresponsible manner.
3.
In the small groups, they then compare their opinions and
discuss the reasons for making their choices.
4.
The group must reach agreement. It is better if they all
agree, but if after much discussion this is not possible,
they can vote.
5.
Each group then reports back to the larger group and dis
cusses the difficulties they have had in reaching consensus
and the reasons for their choices.
Leader note:
Get the group to look at the kind of value judgements they have
made and the reasons for making these judgements.
See the case study example that follows on the next page.
y
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Case study
A has just discovered that her boyfriend B is carrying HIV
and, as they have been having a sexual relationship, A is
worried that she is infected too. After a row, A leaves B and
refuses to see him again.
The following day at work A is told by C, her boss, that she is
more likely to get a promotion if she has sex with him. A likes
C and is flattered by his attention. They begin to have a sexu
al relationship.
C's wife, D, has been wanting to have a baby for some time.
She has just discovered she is pregnant.
Think about this case and the characters. The group can also
discuss how the people in this story could behave more
responsibly.
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Leader note:
Leading an activity in which there are no right and wrong an
swers can be hard. Try to let the young people do most of the
talking. The process of having the group members talk, listen
and think about the issues is the goal.
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Activity
on non
discrimina
tion
Purpose
To help young people better understand what the term
"discrimination" means.
To increase awareness of discrimination against people who are
HIV positive or who have AIDS.
To identify ways to prevent discrimination against people with
HIV/AIDS.
Leader note:
It may be useful to review how you would define discrimination
before you lead the exercise. Also, you may want to think about
ways you have seen discrimination take place in your village or
area.
Suggested description: Basically, discrimination consists of
treating another person as a symbol of something rather than as
a person: as a symbol of an ethnic group, a sex, a physical condi
tion, a body of believers, a life style. It stereotypes, it excludes, it
shuns, it moralizes, it harasses a person not on the basis of who
that person is as a unique human being, but on the basis of
what that person is perceived to represent.
What to do
1.
Ask the group to break up into small groups — 3 to 4 in
each group. Then pose the question "What do you think
discrimination means?". Give the groups about 10 minutes
to discuss their ideas.
2.
Ask each group to share a short summary of their ideas
with the whole group. Your task as leader will be to listen
to each group and write on a piece of newsprint or paper
the main points expressed. You could also simply repeat
the main points. The goal is to help the group members
come to agreement on what discrimination means.
3.
The next step is to identify ways that discrimination oc
curs against people with HIV/AIDS. In small groups, list
ways in which this type of discrimination takes place.
Then, in the large group, prioritize which of the types of
discrimination listed are the most harmful. The goal is to
increase awareness of how and when discrimination takes
place.
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4.
Now the task is to help young people think of ways to pre
vent discrimination. Ask each person to think of some
thing they can do as an individual and one thing their
youth group can do. These ideas can then be shared in
small groups for discussion or in the large group.
Leader note:
The technique of discussion is suggested as one way to work on
issues of discrimination. Look through the Techniques section
for other ideas. You could present a story of someone with AIDS
and ask the group if there are examples of discrimination in the
story. The group may want to role play ways people are treated
and positive ways they might respond to prevent discrimination.
______ __________________________________________________________________ >
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Skills
Activities
This section describes some activities to develop the skills we
need to prevent ourselves becoming infected with HIV and activi
ties to help develop the skills needed to work with others.
Saying
"No"
Purpose
• To identify the pressure on young men and women to have
sexual intercourse.
• To find ways of dealing with the pressures.
• To identify situations in which young people might be at risk.
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Leader note:
This activity is best for groups who have already learnt some
basic information about HIV and STDs. You may need to think
about the difficult or sensitive questions that could arise during
the activity and prepare answers beforehand.
Try some of the values and attitudes activities with the group be
fore you try this activity. Remember that the decision to have a
sexual relationship or not to have a sexual relationship will ulti
mately be made by young people themselves. This activity helps
young people to explore the choices they have and to develop the
skills needed to say no if they so choose.
What you need
Paper, pen or pencils.
What to do
Start in small groups of 3 or 4. Single sex groups or male/female
groups can be used for this activity. You will need to decide
which is best for your group within the local culture. It has
worked well in some places to start with single sex groups and
then to bring the groups together to share ideas.
Start by having each group think about the kind of messages
they have heard that might encourage people to have sex.
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For example:
"There is something wrong with you if you don't."
"This is my first time too."
"We'll keep it a secret."
"It is your fault, you lead me on."
"I just won't believe you love me, if you don't."
Each group reads out the result of their discussions to the
whole group.
Have the group divide into pairs — not necessarily male and fe
male. Ask each pair to practice effective negative responses
to these lines. Ask them to choose the ones they feel they could
use. This exercise helps prepare the participants to face poten
tially risky situations.
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"Role Play"
The group can discuss which of the responses they feel they
could use and plan a short "role play*" in which they create a
situation where the lines and responses are incorporated. Take
15 minutes to plan the role play.
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Take turns playing different roles. Show the "role plays" to the
rest of the group. Follow with discussion on the situations and
characters portrayed.
Do they feel more able to cope in these risky situations?
Would the response work?
Did the person saying no seem like he/she really meant it?
Would it be hard to say no in that situation?
Leader note:
You may have time for one or more role plays depending on the
length of the discussion. The important thing is to get the youth
talking and thinking about what is appropriate sexual behavi
our.
This activity ivill probably take at least one hour and a half. It
is possible to split the total activity into two parts, stopping after
the group has been divided into pairs to practice saying no. If
you stop then, be sure to have each pair share with the whole
group a couple of the negative responses that they practiced and
think would work. The group could use most of the questions as
mentioned above to evaluate these suggested negative responses.
You could then try role plays in another session.
Evaluation
This activitiy is a good one to observe how well the participants
can share their own thoughts, feelings or decisions directly
with others. Does it seem that they need more practice and dis
cussion in this area? Ask the group how they felt saying no. Do
they want to work in this area more?
* See "Role Play" in the Techniques section
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The
listening
game
Purpose
To learn how to listen to people. *
Preparation
Explain to the group the difference between listening and con
versation. Have them choose topic areas, for example "What I
like best about my school", or "If I could choose anywhere in the
world where would I go and why?".
What to do
1.
Divide the group into pairs. Each person takes a turn to
talk about a chosen topic area. The "listener" must not in
terrupt, but must show that he/she is listening by looking
at the person who is talking or nodding when appropriate.
Each person has about five minutes. The group leader
keeps the time.
2.
After each person has had a turn to talk and a turn listen
ing, everyone returns to the larger group.
3.
Each member of the group tells how much he/she remem
bers of the topic his/her partner talked about.
4.
Discuss with each member of the group what it felt like to
have the opportunity to talk without being interrupted and
to listen without interrupting. What made the "talkers"
feel they were being listened to? What did the "listeners"
feel about how much more they learned by listening only.
5.
Practice listening and talking. Change the topics and ex
tend the talking time. Gradually introduce more sensitive
topics. For example "How does AIDS make you feel?", or
"What frightens you most about AIDS?". Always follow the
practice with time to discuss how much is remembered and
what it felt like to listen and be listened to.
—
Leader note:
Gradually the group will begin to feel more confident with this
technique and begin to think how they can use it in community
work, as well as in working with each other.
The next activitiy, ''Working with a community", uses this tech
nique and gives an opportunity for using the information you
have learnt about HIV/AIDS.
* See "Listening" in the Techniques section.
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Working
with a
community
Purpose
To give people an opportunity to practice answering questions
in the community about HIV/AIDS, using good listening skills
and their knowledge.
Materials needed
A selection of local costumes and clothes.
What to do
1. Set the scene — Ask the group to imagine that they are or
ganizing a discussion in the market place. Different people
have arrived to take part and they have many questions.
2.
The group dresses up in the costumes and each person
takes on a character that might be part of the market
place discussion. For example, an old man, a worried
mother, a young over-confident person.
3.
Each member of the group thinks about the kind of ques
tions that his/her character is likely to ask in this situa
tion.
4.
One member of the group takes on the role of the leader of
the discussion in the market. As questions are asked, the
person in the role of leader makes sure he or she "listens"
to what is being said and tries to answer, using the knowl
edge gained from information sessions.
Leader note:
The purpose of the session is not to test knowledge, but to
enable young people to experience using their HIV!AIDS
knowledge and listening skills to answer real questions.
-Z
5.
Rotate the roles so that everybody gets a chance to both
ask and answer questions.
6.
Lead a discussion on what has been learnt. Some ques
tions to consider:
Were answers easy to understand?
Which questions were hard to answer and why?
Did the people asking the questions feel they were listened
to?
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Did the people find it hard/easy to answer questions?
Are there any areas about which people feel they need
more information to be able to answer questions
effectively?
Leader note:
If the group knows each other and works together well, it may be
possible for them to give constructive comments to each other.
You could also ask everyone to point out areas in which they
themselves need more practice.
\_________________________________________________________________
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Techniques
Techniques are methods of working with a group. This section
will describe in more detail the techniques that have been used
in the activities previously described.
These techniques can be used in many ways, so be creative.
Consider how you and the youth group can adapt the ideas
presented for use in your own culture and situation.
Discussion
Discussion enables people to think about and then express
their opinions based on their own experience. Listening to oth
ers may broaden or change their opinions and eventually help
them to clarify their ideas, attitudes, values and behaviour. In
some cases, debating issues helps individuals to face conflict
and reach consensus.
Discussion may take place between two individuals or in
small groups. A group of six to eight people is the ideal num
ber to ensure that everyone gets a chance to speak and feels
able to contribute.
It is often useful to elect one member of each small group to
feed back the main points of the discussion to the whole group
and to reach some agreement on a course of action.
Brainstorming
Brainstorming is a good way of involving the whole group and
allowing them to think freely about a certain subject. Provide
the group with the question, for example "How can we help
people with AIDS?". Everyone has a chance to call out his/her
ideas. The leader of the group writes down all the ideas with
out comments. Now you can look at the list and clarify com
mon opinions, identify priorities and set common goals. There
may be areas you need to discuss further before deciding on
your action plan.
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Be sure that you write down everyone's ideas, although you
may need clarification if you don't understand the point being
made. If someone has plucked up courage to make a sugges
tion, it is important that the suggestion is added to the list,
otherwise that person may not speak again and feel rejected by
the group and by the group leader. Everyone's opinions are val
uable and can be used in discussion later on.
Role play
Role playing involves presenting small spontaneous plays
which describe possible real life situations. Ideas for role plays
might come from your focus groups, from young people in your
group, or from similar situations which are familiar to you. Be
careful, however, not to portray a real-life situation which can
be identified as that of someone from the group or local
community.
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In role playing we take on someone else's character. This is
less intimidating than having to express our own ideas and
emotions. A situation or problem is given to the group and they
take on the roles of the people involved. The action evolves as
the play goes along. For example, the group might be given the
following situation to act out:
Asamoah has been meeting Boatema for some time. They
have a close, caring relationship and discuss most things.
Asamoah and Boatema have been thinking they might
have a sexual relationship sometime in the future. Asa
moah is worried by all he reads about AIDS: he decides to
talk to his friend Samuel about the whole business to see if
he has any ideas which might help.
Group members volunteer to take on the parts of Asamoah and
Samuel. They act out the discussion. Other members of the
group watch carefully and after the play they all discuss their
reactions to it.
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It is important for the group leader to identify some of the ideas
expressed, the feelings shown and some of the behaviour which
might have lead to difficulties. The sort of questions asked after
a role play are: "How do you feel?", "Were you happy with the
way things turned out?", "What could be done to solve the
problem?".
We can learn about our own behaviour through role play; how
our behaviour can contribute to the problems we experience.
Another use for role play is to practice situations before you
meet them in real life. For example, you may want to practice
going to a pharmacist and asking for a packet of condoms or
talking to your partner about how to use a condom. This
preparation will help provide the skills young people may need
in order to protect themselves from becoming infected with
HIV.
It is important at the end of the role play to "derole", that is to
stop pretending to be somebody else and return to reality. Give
the players a chance to express their feelings about the charac
ters and situations they acted-out. All the players should re
move any special symbols they used to play their characters. It
may be necessary to have everyone change seats and say their
real names. Do not underestimate the need for this.
Listening
Wheti we talk to each other, we often don't concentrate on what
the other person is saying. We may be busy thinking about
what we are going to say next, or sometimes, we get excited
about the subject of the conversation and have a hard time lis
tening.
Learning to listen well can help us in many areas of our AIDS
health promotion programmes. If we make a decision to let the
other person speak, not to interrupt and to concentrate on what
he/she are saying, we can learn all sorts of things about how
they think and feel. They have the opportunity to think about
what they are saying and finish a thought without fear of being
interrupted.
4
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It is important to show the other person you are listening and
interested in what he/she is saying. Looking at him/her while
he/she is speaking, smiling when it is appropriate to do so, and
occasionally helping him/her along by summarizing for him/her
what you think he/she has said will all help to show you are
listening.
Try out this activity and practice it in pairs, within your group,
with your group leader or with your friends. At first, you may
find it is quite difficult to listen without interrupting or losing
attention. However, when you start to work in the community,
pretesting your materials or carrying out Focus Group discus
sions, you will soon see how important it is to listen to what
people are saying.
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Pictures and photographs
Pictures and photographs can be used in several ways to work
with your youth group or as part of community projects. They
are useful to draw people's attention to a topic, to start discus
sions and stimulate group participation, to help people to re
member what you are presenting and to illustrate a point you
want to make.
You can use pictures/photographs as part of a game such as the
"Memory Game", to illustrate topics such as "How AIDS is
spread and not spread", and to convey messages on posters and
displays for example. Pictures and photographs can be used to
present a specific situation or problem, the causes of it, and/or
suggest possible actions for solutions.
You can find pictures and photographs in magazines and news
papers, or the youth group can draw their own pictures as part
of a group activity.
When selecting pictures or photographs to use as part of a pres
entation, activity or project, the pictures and photographs
should:
• Show local situations and people who look and dress like
local people.
• Focus on one main idea to avoid confusion.
• Be large enough for your group to see easily.
• Be clear enough to be easily understood.
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It will be important to pretest any pictures you plan to use for
educational purposes and for information sharing projects such
as posters and display boards. See Appendix II "Guidelines for
pretesting health educational materials".
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Videos
Videos, if they are available, are a useful way of promoting dis
cussion. They should not be used as a teaching session in them
selves. Leaving a group of young people in front of a video and
then allowing no time for discussion does not allow them to
work out how they feel about what they have learnt. Choice of
video for the session is very important. Teaching videos (those
which give facts and information rather than telling a story)
can be taken in small sections; stop the video every few minutes
to check whether the group has understood. Discuss the infor
mation as you go along. A storytelling video has more impact
when people can see the story straight through and then dis
cuss it afterwards. Be sure you have seen the video before you
show it to your group. Prepare some topics for discussion and
think about which questions you are likely to be asked.
Flip charts
A flip chart can be either a series of pictures which tell a story
or a series of blank pieces of paper for writing ideas and infor
mation presented by a group.
If you are going to use
a flip chart, it is bet
ter to join the series
of pieces of paper at
the top. You can use
glue, string, pins or
clothes pegs. This will
prevent them from be
coming damaged or
lost. While you are us
ing your flip chart,
you can rest it over a
chair or a table.
Al OS
WIL
Pens, pencils, felt markers, paints, charcoal or coloured chalk
can all be used to write on your flip chart. Fabric can be used in
stead of paper to make your flipchart more durable.
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Case studies
Case studies describe a situation or problem that the group has
to solve. They can be designed to give people information, help
them to consider their attitudes and values or discuss the skills
they might need to deal with the problem. For example:
They can be very simple stories which ask the group to think
of strategies they might use to solve a situation:
Fernando died of AIDS recently. Now no one will go near his
wife and children and some people are suggesting they
should be made to leave the village. What should be done to
help Fernando's family and the village1
?
Or, they can be much longer and have more characters who
face difficult problems or situations. Remember that your
group may have difficulty in reading. You may have to read the
case study to them very slowly. Don't make it so complicated
that they forget who did what, when and how. It is a good idea
to go over the main points to make sure everyone has under
stood.
Proverbs
Proverbs (local sayings) have been used for generations to de
scribe sensible ways of living. They are culturally specific and
can be adapted easily in a way that local people can under
stand. They help people to associate new information with old
knowledge.
You may already know or have found out from your focus
group discussions many of the local proverbs. Think about how
they can be used in your health programme. They can be used
with talks, demonstrations, stories, dramas or put on posters
or flip charts. Their meaning may not be immediately clear to
you, so it is important to find their meaning by asking many lo
cal people.
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Fables and story telling
Story telling is a traditional method of providing information
and discussion topics. It can be made to fit a particular culture,
and as it only takes one person to tell the story, it is also cost
effective. The same situations that were developed for your role
plays, dramas and puppet show can be used for developing a
story.
Use of traditional people and figures from your culture's story
telling tradition can add to the effectiveness of the story. In
Zambia, they use a rabbit called Kalulu, who is famous for wis
dom in their folklore, to give information about AIDS.
Fables are stories that have been told to explain how people
can put themselves in danger by acting in a certain way. The
fables often involve animals as the characters, and therefore,
allow people to learn from the messages contained within them
and yet not feel they are being personally blamed. The stories
can be developed to contain health messages about AIDS and
can be followed by discussion of the lessons learnt. An existing
fable can be told in its entirety, and then the first question can
be:
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"This is a very old story and yet it has messages for us even
today. What do you think it can say to us about AIDS and the
effect it will have on our community?".
Having got people to think about what the fable means in
terms of AIDS, have them think about what they can do to
change things for the better.
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Action in the
Community
This section is designed
to help you:
1.
Select a "community" of
people with whom to work.
2.
Select and organize
community projects related
to AIDS health promotion.
oocum^tat«oh
)
Action in
the
Community
Before carrying out an AIDS health promotion project in your
local community, you and the youth group members need to un
derstand the information about AIDS and to have thought
about your attitudes and beliefs in the context of this informa
tion. Review of Section 3 is also recommended.
Work through the activities in Section 4 to prepare yourselves,
before planning community projects. Doing this will also help
the group to work as a team. You can now start to think how
you can adapt what you have learnt to help people outside your
youth group, people in the community.
"Community” can mean different things to different people.
Some people think of a community as a certain geographical
area, such as a village, a city, a neighbourhood, or a rural area.
However, community can also be thought of as a group of peo
ple who share common interests, values, background, experi
ences or activities such as school, work, religion and recreation.
Identifying the various communities that exist in your local
area can be useful as you plan your projects.
The next section of the manual, Section 6: Community Projects,
gives examples of different types of community projects related
to the prevention of the spread of HIV and to the care and sup
port of persons with AIDS. Before deciding which project you
would like to initiate in your area, consider the points dis
cussed in this section.
Choosing a community to work with
First, you and the youth group can identify the different com
munities that exist in your local area. What do you know about
the people already? What are their needs in relation to infor
mation about AIDS? Are there any communities which are at
special risk? You will have to do some local research to be able
to discuss this fully. If you can work with programmes that al
ready exist in your area, it will ensure that the work you wish
to do is appropriate and needed.
After discussion, you can decide which community, for example
your own families, school groups, people in the local markets,
mothers' groups, out-of-school youth, etc., is the one you want
to work with.
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Knowing your community
Before starting an AIDS health programme project with the
group you have chosen, you will need to know more about their
specific needs.
For example, a youth group in Zambia, having spent time
working on AIDS themselves, decided to start a project and
chose the local school. Some questions they had about the
school group were: What do the students already know about
AIDS? Is their information correct? What are their fears and
concerns about AIDS? What methods would be the most effec
tive in helping them to reduce their chances of contracting
HIV?
You could conduct focus group discussions. This will help you to
clarify the needs of the group. Remember, before you carry out
a focus group or any other activities in the school, be sure to get
the permission from the appropriate school authorities. Involv
ing the staff at the school and the parents of the school children
from the start will ensure the smooth running of your project.
Selecting your project
The project you select should be one that will respond to the
needs you have identified.
For example, by having focus groups the group in Zambia
discovered that young people knew very little basic informa
tion about AIDS and were afraid of catching it themselves.
After discussion, they decided to have an AIDS prevention
campaign for the whole school.
The project you select should be appropriate to the abilities of
the people in the youth group and should consider the human
and material resources you have available.
Examples of resources:
• Youth members' time’, number of hours, time during the day/
evening.
• Youth members' abilities', talking, teaching, caring, writing,
drawing, organizing, singing, acting, ect.
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• Meeting place', public building, health centre, central place in
village with shade or cover.
• Transport’, truck, car, scooter, bicycle, horse, donkey.
• Funds’, money from local, regional or national AIDS health
promotion programmes or from your own organization.
• Light for working at night’, electricity, paraffin, lamps,
candles, torches,
• Materials for making posters, puppets, leaflets.
Don't forget to calculate how long your materials will last and
where you can get further supplies.
One youth group identified their resources: 1) a big room at
the schools that they could use; 2) a school drama group that
could put on a play about AIDS; 3) several teachers who
could support them; 4) a group in the school who could make
posters; 5) free time for the students to work; and 6) a local
Primary Health Care Worker who would like to help.
You may have other resources to take advantage of, but the
most important thing you need to start your project is enthu
siastic and well informed young people.
Choose activities and projects that the youth group feel they
will be able to carry out. If you attempt anything too difficult at
first, the youth members will soon lose confidence and the mo
mentum of your programme will be lost.
Think about the activities you would like to do. People like to
do different things and finding a project that includes some of
these things will help keep you motivated.
Look through Section 4: Activities for Youth Groups and Section
6: Community Projects. Which activities or projects do you
think will work best based on the interests, size, age, needs and
concerns of the community you have chosen?
The group in Zambia talked about all these things and decid
ed to put on a play for the school. The play was followed by
small group discussions with different age groups.
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Planning the best time
Choosing the right time for starting your programme or start
ing a community event is very important if you want it to be a
success. It is no good organizing a play in the market place, if it
is not market day and everyone is staying at home. Equally, if
you plan your programme of events to coincide with harvest
when everyone is in the fields working or you decide to plan an
event in the school, and it turns out to be the school holidays,
no one will be around to listen to what you have to say.
Think about who you are trying to reach. Where do these peo
ple meet and at what time of the day? Are there community
events taking place where you know many people will be meet
ing? Talk to the organizers of these events and ask them if you
can take part by putting on a play or puppet show. Getting per
mission from the organizers is very important as you will need
their support to ensure you have an audience. Places such as
train or bus stations or outside the health centre where groups
of people often have to wait can be good places to put on short
plays or songs followed by discussion.
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Another way of ensuring you have an audience is to join in a
national event and organize local response. Every year Decem
ber 1st is World AIDS Day. On that day, the World Health Or
ganization's Global Programme on AIDS supports national and
international events to encourage people to spread the word
about how AIDS is affecting the world. To find out more about
this event and how you might get involved you can contact
GPA. The address is in the Resource section of this manual.
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Carrying out your project
In order to carry out your project, you need to make sure you
have permission from relevant authorities to work with the
community you have chosen. The people you have identified as
being in a position to help you will be there to turn to if there
are problems. It is important to keep them informed of your
progress.
106
How do I maintain the programme’s
momentum?
Young people can get easily bored if they are doing the same
activity over and over again. The enthusiasm generated at the
beginning of the programme may be lost, particularly, if they
can't see major changes being made or cease to feel included.
Equally, the task may seem too big or take too long to com
plete.
Try to include the youth group in all discussions about changes
to the programme and ask their advice. Make sure tasks are
achievable in a reasonable amount of time. Ensure that the
project is within the capabilities of the young members. Give
praise where praise is due — people get disheartened when
they feel their work is not being noticed. Make sure the youth
members don't get overtired. They need to pace their work and
get plenty of rest. Remember this is a health promotion pro
gramme, and so it is just as important for the young people to
stay healthy as it is for the community they have chosen to
work with to become healthier.
How will we know if we have helped our
community to know more about AIDS?
At regular intervals you will need to know whether you are
meeting the needs of your chosen community. To do this you
can repeat the focus group discussions you began with, or you
could try out the quiz from the Activities section. In doing this
you will not only find out whether people have understood the
information you have tried to put across, but you will also iden
tify what they want to know next.
Bring your group together again to discuss the findings from
their focus group discussions. It may be necessary to make
changes to your programme. What went well and why? What
were the problems you met? What would be fun and interesting
to try next? Make sure there is plenty of time to organize new
activities; don’t hurry your plans. Preparation time saves time
later on.
107
Community
Projects
I
This section is designed
to present:
1.
Examples of projects
that present clear and
up-to-date information.
2.
Examples of projects that
provide care and support
for people with AIDS, their
friends and families.
Community
Projects
What you do in your community will be unique. It will be de
signed by you and your group to specifically meet the needs of
the people you have chosen to work with. The following sec
tions describe various community projects that fall into two
main categories:
• Those that provide clear and up-to-date information.
• Those that provide care and support for people with AIDS,
their friends and families.
The newly trained young people can also become involved in
community activities which are related to AIDS, such as blood
donation programmes.
Blood donation falls into both of the categories identified. First
ly, your youth group can be involved in making sure the com
munity has clear information about where and how to give
blood. There is no risk of contracting HIV from giving blood.
Posters and radio spots can be prepared by the youth group to
pass this message on.
Secondly, giving blood is a caring activity. Blood is always
needed by hospitals and youth groups can organize blood don
ors or help at blood donation sessions. They will know from
their information sessions how important it is for people who
have the lowest risk of having been infected with HIV to give
blood.
Youth group members can use their knowledge to discuss with
their peer group who is at low risk of having HIV infection.
Discussion groups can be organized in schools or with other or
ganizations to help individuals make the choice about becom
ing a blood donor. Dates and times of blood donation sessions
can then be advertised.
Remember, all the activities described in the Youth Group
Activity section of the pack can also be adapted as appropriate
to your community work. Confidentiality, respect and mutual
support are equally as important when working with the com
munity as they are in your own group.
X
111
•‘•A
vuk
. t>r / o)
TV
v
UcVk
■W r'
Using puppets in the market to share AIDS
information
112
Information
Sharing
Projects
There are many ways to share information about HIVIAIDS.
This section presents some that have been used successfully in
different parts of the world. It is important to carefully consider
the messages that you want to convey to the community. The
AIDS resource people you have identified in your area can be
good sources of information in choosing clear, simple messages.
Don't forget to pre-test messages and use local languages when
ever possible.
Drama and puppetry
I
You can develop your role play situations into full plays which
you can then act for local community groups, for example, in
schools, youth clubs and factories. At the end of the play, the
messages of the play will probably be more effective if discus
sion with the audience takes place to find out what they felt
about the situation described in the play, whether they felt it
had any relevance to their lives and if they could suggest alter
native ways of dealing with the problem.
It should be noted that it is not always necessary to use scripts.
In cases where people find it difficult to read or remember the
written word, improvisation can be equally if not more success
ful. Planning for an improvised play involves the same produc
tion of props, music, costumes and setting, but the players take
on the characters and develop them as the play progresses.
This can be a powerful method of getting the message across to
the audience, and it is often a fulfilling experience for the
actors.
Puppets can do things that actors may find difficult to express
for cultural reasons. The audience gets just as involved with
the characters that the puppets represent, and can also ask the
puppets questions after the puppet show.
Using puppets in describing AIDS messages is particularly use
ful as many of the issues can be either embarrassing or difficult
to discuss openly. Puppets can present stereotypes without
causing offense and introduce humor into a sensitive subject.
See Appendix VI: "How to make puppets".
113
Posters
Posters (large sheets of paper with words and pictures or sym
bols that convey a message) can be used in many ways as part
of AIDS health promotion in the community. The youth group
can create their own posters or you may find some available
from the National AIDS Programme, or local health agencies.
Before you use posters — ready-made or ones you make your
selves — pretest them to make sure they are appropriate for
your local community and that people understand the message.
Appendix II: ''Guidelines for pretesting health education materi
als" describes how to do this.
Posters can be used:
1.
To present a specific AIDS health promotion message,
such as "How to prevent AIDS"\ to the community in gen
eral by placing the posters in locations where people are
likely to go, such as markets, churches, communal meet
ings places, health clinics.
Note: You may need permission to put up posters in some
locations. Be sure to ask first, before posting anything.
2.
To announce important programmes or events that you
are presenting, for example, to invite people to a puppet
show to be held in the local market.
3.
As part of a special school AIDS campaign. School classes
could be asked to create posters with AIDS health mes
sages after they have participated in some basic AIDS
education. You could hold a poster contest for the most
original or colourful, or you could include all the pictures
in a school or community display to increase awareness
about AIDS and HIV.
4.
For group discussion or presentations. Use of posters in
this way is very similar to using pictures or photographs.
Creating a poster is an alternative to pictures and photo
graphs. See Pictures and Photographs in the Techniques
section.
114
I
Making posters
Materials can include large sheets of paper, pens, pencils,
crayons, markers, paints and paint brushes, old magazine
pictures, glue, candle wax, vegetable dyes and fabrics.
There are many ways to design your posters. You could cut out
pictures from old magazines and paste them on the paper, draw
or paint the pictures you need, or copy or trace designs/
pictures.
When you make a poster:
• Make sure all the words you use are in the local language.
• Use as few words as possible.
• Use symbols that everyone can understand — those who can
not read as well those who can.
• Select just one important message about AIDS for each pos
ter. Too many ideas on one poster could be confusing.
Music, dance and poetry
Expressing health messages or emotions through music, dance
or poetry can have a powerful effect on your audience. It is
easier to remember a line that rhymes, especially if it is put to
music or expressed in a dance. You don't have to be a great poet
or an excellent musician. Use tunes that are known locally and
put your own words to them. Use dances that everyone knows
and write words to go with the dance. The whole group can get
involved in writing words to go with the dance. The whole
group can get involved in writing the words or preparing the
rhythm or dance. Start with one person saying "AIDS makes
me feel like..." and get each of the members of the group to
think of words to describe how they feel (for example "AIDS
makes me feel determined to fight it"). You can join all these
sentences together and fit them to a rhythm. Alternatively you
can express how AIDS makes you feel in body movements and
join those movements together to make a dance.
115
Some groups have developed a theme song about how they are
going to stop AIDS in their community. They sing the song eve
ry time they meet to renew their commitment to the work they
are inolved in. Use local words and make the song a community
song. You might want to run a competition in schools to choose
the community song. None of the poems or songs have to be
perfect. The important thing is to enjoy yourselves in the prep
aration and to pass on clear messages about AIDS prevention.
I
Radio spots
Local radio stations are often very willing to get involved in
health education programmes. Designing an exciting message
that can be put out regularly by the local radio can be fun and
a useful learning experience. It is very important that the
messages are written in the local language and that they fill in
gaps in people's knowledge.
116
The results of the focus group discussions will provide your
group with the expressions necessary for the radio spots and
also the subjects people most need to learn about. A popular
tune to introduce the radio spot will catch people's attention
and the message should be short and to the point.
Put the radio spots on at a time when people are most likely to
be listening.
Advice on the length of the radio spot and the choice of music
can be gained by working with the radio announcers. An exam
ple of the kind of message that is useful is:
(Music)
I
"Young people like us don't have to be worried about AIDS, if
we learn how to keep safe. Find out all you need to know from
your local health centre. They provide confidential advice and
information and the staff is waiting to meet you on Fridays.
No appointments necessary."
AIDS is with us and here to stay
Don't just think it will go away
Make sure you listen to your radio station
It will give you your AIDS information!
(More music to follow.)
I
)
i
>
7
m~o
117
Radio plays, serials and stories can also be effective. Some of
the role plays and dramas created by the youth group may
make very effective radio plays. They take hold of people's
imagination and listeners get involved in the characters' lives.
The AIDS messages the characters convey can, therefore, be
very powerful in changing people's attitudes. Music attached to
AIDS messages will start people singing the information you
want to get across. Be sure to pretest all your AIDS messages.
See Appendix II for pretesting guidelines.
J*'
118
I
Care
and
Support
Projects
Starting with ourselves
To carry out care of any kind you need to take care of your own
health. Keeping healthy means being aware of what kinds of
food provide the vitamins and proteins we need, getting plenty
of rest, and exercising. Think about how you are taking care of
yourself and what is possible to change in the context of life in
your culture and your available resources.
Taking care of each other
J
Next, think about the other members of the youth group, your
family and friends. What could you do to help them stay well
and healthy? Ensuring that those around you feel healthy and
cared for is a first step in learning to care for those who are ill.
Being a resource for people who want
information
Having learned more about how HIV/AIDS affects peoples' lives
you will be able to offer help to friends or family members who
need information or care.
People with AIDS
are sometimes lone
ly and feel isolated
and rejected by
their community,
They may appreci ate a visit from
someone who will
keep them company
and assist them
with small tasks.
119
What can your youth group do?
There are many ways in which your youth group can assist peo
ple with AIDS and their families. What you decide to do will de
pend on the needs of the people you wish to assist, the interests
of your youth group, and the resources available in your com
munity. Remember, it is important to work with other people
and community agencies, such as health workers, churches,
women's groups, traditional healers and local leaders as you
plan your projects.
Examples of projects include:
Educating the community in which the person lives —
When someone in the community is known to have AIDS, other
community members may be afraid to visit the family, since
they may not understand the ways in which HIV is spread.
They may discriminate against and blame the person and the
family for the illness. They may not realize that AIDS can af
fect anyone and that in the future they could face the same
problem in their own family. Educating the community can en
courage them to support people with AIDS and their families.
The presence of a person with AIDS in the community may also
lead others to change their own risky behaviour, since they can
see the results of HIV infection in someone they know. This is a
good opportunity for the youth group to carry out preventive
education.
Even if the youth group is not involved directly with people
with AIDS, they can include caring messages towards people
with AIDS in their community projects. For example, a commu
nity play could show how people offer help and assistance to a
neighbour with AIDS. A poster competition could feature
themes such as "How I would show a person with AIDS I care
about him or her”. Messages of care and compassion for people
with AIDS are an important part of all AIDS education.
Income-generating projects — When the person who is ill
was the wage earner, other family members may be left with
few other sources of income. Youth groups can assist communi
ties to set up projects which generate income, so that the fami
lies of people with AIDS have a means to earn money. Such
projects can also be run by the youth to help orphans with
school fees and other basic needs.
120
F
L
If you want to offer help directly to people with AIDS and their
families, it is important to work with your local health unit
when possible. Working with a recognized community agency
will help insure that the help you want to offer is needed and
that it will be coordinated with other services being offered.
The local health workers can help you identify and plan which
care projects are most appropriate for the youth group mem
bers to carry out in the local area. They can also help to orga
nize the training and support needed for youth workers work
ing with persons with AIDS.
Read through the ideas suggested in this section, discuss them
with the youth group and think how you might adapt the ideas
to make them appropriate in your culture.
Examples of direct care include:
Physical care — People with AIDS are often weak and unable
to help themselves. You may be able to help the health care
worker and the family to make the person more comfortable, or
you may be able to look after a person with AIDS for a short
time so the family can have a rest.
Emotional support — People with AIDS may be frightened,
sad or depressed. They may be afraid of dying or worried about
what will happen to their family after they are gone. Some of
these things may be difficult for them to talk about with those
who are closest to them, and it may help them to have regular
visits from someone who will listen and with whom they can
share their feelings.
Material support — In some communities it is difficult to
care for people with AIDS because basic items such as soap,
plastic and cotton sheets, clothing and food supplements are
lacking. Lack of basic items may also be a problem for the fami
ly, particularly the children, if the wage-earner is ill. Your
youth group may be able to collect and distribute needed items
such as clothing, food and bedding.
Helping with domestic chores — When an adult member of
the family is ill, it may be difficult for families to carry out all
their usual domestic chores. Youth members can help with
looking after children, shopping, growing or harvesting food,
running errands, or cooking a meal.
121
Educating the family — The families of people with AIDS
may not know a great deal about AIDS and may be fearful that
they will get HIV if they care for their sick relative or friend.
By befriending a person with AIDS and talking with the family
about the ways in which HIV is and is not spread, you may be
able to reassure them.
Support for families after the death of someone with
AIDS — The need for support does not stop with the death of
someone from AIDS. Youth group members should continue to
befriend and support those who the person with AIDS leaves
behind.
A note for youth leaders:
r
In providing a service for people with AIDS, their family and
friends, youth group members will become involved in the pro
gression of the illness. They should be given an opportunity to
discuss their worries and fears with someone they trust. Many
young people will find working with people with AIDS easier if
they work in small youth teams, rather than individually. They
can then share their feelings with other members of the team.
Most communities have traditional ways they deal with illness,
death and dying. Support for the youth group member, if the
person with AIDS dies, should be provided in an appropriate
way.
A local person who has been trained in counselling may be
available to assist the youth group both in caring for people
with AIDS and in making sure that the youth members do not
become depressed or overwhelmed by the problems associated
with AIDS.
122
APPENDICES
123
Appendix I
How to
conduct
focus group
discussions
Focus groups are group discussions in which a leader asks
questions for the group to discuss, and an observer writes
down the main things the group says. Focus groups are useful
in several ways. They allow the group to define the issue — in
this case, AIDS — in their own terms: how they understand it,
and what it means in their own lives. Focus groups also en
courage the group to come up with proposed actions and solu
tions to the problem which make sense to them and to their
community. Focus groups reveal misunderstandings and
myths about AIDS which need to be corrected. Finally, focus
groups reveal the words and phrases people commonly use in
talking about AIDS and about sexuality.
To organize a focus group
I
1.
Identify people to invite to the group.
2.
Each focus group should have 6-12 participants, plus the
group leader and an observer who writes down the main
points made by the group. Focus groups work best when
participants are of the same sex and are of similar ages,
educational levels, background, etc. It may only be possi
ble for you to organize a mixed group; if this is the case,
recognize that some people may not feel so comfortable
about expressing their opinions freely. Avoid inviting
anyone who is an ’’expert”, such as the local doctor or
midwife, or who has a very different status from the rest
of the group, as this may also intimidate people in the
group.
3.
The focus group should be held in a place which is com
fortable and free of distractions and interruptions. Partic
ipants and the group leader should sit in a circle.
4.
As the participants arrive, chat with them to put them at
ease. When they have all arrived, ask them to sit in a cir
cle. Introduce yourself and the observer, and ask the par
ticipants to introduce themselves (try to remember or
write down their names so you can use their names
during the discussion; use name tags if you prefer).
125
5.
Explain to the group that the purpose of the meeting is to
get their ideas about what they know and feel about AIDS.
Let them know that the meeting is not an educational lec
ture in which you are the "expert" and they are the learn
ers, but that you are there to gather opinions and ideas
from the participants and to learn from them.
Let the group know that you will not be giving facts or ex
pressing your opinion during the discussion, but that you
will be happy to answer questions at the end of the
meeting.
Stress with the people present that their ideas and
opinions are very important in developing health
education, and everyone should express their opinions
freely. The only "rules" are that only one person speaks at
a time, that all participants address the subject being dis
cussed and that no one is obliged to speak.
6.
Start by asking each person in turn to answer a general
question not related to the topic, so that everyone gets
used to speaking. For example, "how long have you been a
member of this youth group?". Then go on to the questions
suggested below. During the session, be sure you stay neu
tral and do not express your personal opinions or knowl
edge as this can influence the group. Encourage all partici
pants — don't allow a few to monopolize the group. If you
are encouraging, friendly and relaxed, this will make the
group more comfortable and the discussion will be better.
Be flexible in letting the group talk, but move them on to
the next question before the discussion loses energy or be
comes repetitive. The whole focus group should last no
longer than 1-2 hours.
7.
The observer should write down the number of people
present, the location, the sex and approximate ages of the
participants, and how long the group discussion takes. Do
not include the names of the participants. He or she should
also note down the "atmosphere" of the group — lively or
bored, anxious or relaxed, etc. For each question, he or she
should write down the main opinions expressed; the words
and phrases used for key ideas having to do with AIDS,
sexuality, etc; and the areas of particular sensitivity or
strong feeling. A form is included in the appendix which
can be used to record the focus group information.
Be sure the observer writes down the terms and ex
pressions people actually use.
126
I
8.
To end the meeting ask the participants one-by-one if they
have any final comments. Explore these comments if they
seem interesting or relevant. Also ask the group if they
have any questions for you; at this point you can freely
share with them your own knowledge and experience.
Thank the group and repeat that their ideas were valua
ble and will be used in designing health education materi
als.
Suggested questions for focus groups
These questions are suggested because they are "open ques
tions" — they can't be answered with yes or no, but require
group discussion. If you adapt or change any of the questions,
be sure you keep them "open".
1.
This disease AIDS — what do you know about it?
2.
What do you think causes AIDS?
3.
How do you know if someone has the virus which causes
AIDS?
4.
How do people get infected?
5.
Who is at risk of getting AIDS?
6.
Who is not at risk?
7.
In your opinion, how might AIDS affect people in our com
munity, now and in the future?
8.
How important do you think AIDS is compared to other
problems people face?
9.
What can people do to keep themselves from getting in
fected? How easy or difficult is it to do these things?
10. How would people in this area feel if someone in the fami
ly or community had AIDS?
11. What or who do you think could be good sources of infor
mation about AIDS which people would really listen to?
Why?
12. What can young people do to help prevent AIDS in the
community?
127
13.
What can young people do to help people and the families
of people who are already infected or have AIDS?
14.
What sorts of information/training/materials/other sup
port do you need to help prevent AIDS and to support peo
ple with AIDS and their families?
For some focus group discussions you may want to learn infor
mation on a specific topic. For example, it may be that the fre
quency with which people have been giving blood in your area
has decreased. You may feel it has something to do with the
fear of infection with HIV and some misinformation. It will be
useful to find out what information people have in order to or
ganize a health promotion campaign which directly answers
people's questions. The following are some suggested questions
to help you find out what people already know and where their
fears lie.
Blood donation questions
1.
Why do some people choose to give blood?
2.
What are some reasons people might have for not wanting
to give blood?
3.
What sort of people do you think would be willing to give
blood and ought to be encouraged?
4.
Are there any people who you think should be discouraged
from donating blood? Why?
5.
What effect do you think AIDS has had on blood donation?
6.
What do you think are the ways people can get the virus
which causes AIDS?
7.
Who do you think is at high risk of having the AIDS virus
in his/her blood?
8.
Who is not at risk?
9.
In your opinion, what are some ways donors could be edu
cated and reassured about AIDS?
10.
What do you think are some ways to encourage more blood
donations?
11.
How would you feel if you knew your blood was going to be
tested for the AIDS virus?
128
12. If your blood was tested, how would you feel about being
informed of the result?
13. What or who do you think could be good sources of infor
mation about AIDS in the community, which people would
really listen to?
14. If you visited a donating centre, what sort of information
and advice would you like to have about AIDS, and how
should this information be made available?
15. Do you have any other questions about blood donation?
Focus groups can also be used at later stages of your AIDS pro
gramme as an education or evaluation tool.
For example, you could begin with a brief flip chart teaching
session, video, puppet show, role play, etc. Then follow with a
focus group to see whether the participants understood and to
enable them to discuss causes and possible solutions to the is
sues and problems raised. Be sure that you ask questions which
are truly open-ended and do not have the answers built in. Be
prepared to have the group come up with ideas and solutions
which are completely different from those you had expected.
Focus group discussions can also be used by youth workers to
evaluate the success of activities. Be sure the person leading
the group is open to criticism and disagreement and that the
group is able to be open and frank with its group leader.
129
Focus group results form
Describe the characteristics of your group:
Average age:
Average educational level:
Male/female:
I
How easy or difficult was it to carry out the focus group
discussions? Please explain.
Below listed are the questions suggested for the focus
groups. Please write down the main messages coming
from the groups in response to each of the questions. If
you did not ask some of the questions or did not get any
response, please write this down as well. It is important
to use the respondents’ own words and not your own im
pressions of what was said.
Focus group question Number 1 - ’'This disease AIDS - what do
you know about it?"
Group response:
131
Question Number 2 - "What do you think causes AIDS?
Group response:
Question Number 3 - "How can you tell if someone has the virus
which causes AIDS?"
Group response:
Question Number 4 - "How do people get infected?"
Group response:
133
Question Number 5 - ,rWho is at risk ofgetting AIDS?"
Group response:
Question Number 6 - "Who is not at risk?"
Group response:
Question Number 7 - "In your opinion, how might AIDS affect
our people, now and in the future?"
Group response:
135
Question Number 8 - "How important do you think AIDS is
compared to other problems people facer
Group response:
Question Number 9 - "What can people do to keep themselves
from getting infected? How easy or difficult is it to do these
things?"
Group response:
Question Number 10 - "How would people in this area feel if
someone in the family or community had AIDS?"
Group response:
137
Question Number 11 - "What or who do you think could be good
sources of information about AIDS which people would really
listen to? Why?"
Group response:
Question Number 12 - "What can young people do to help pre
vent AIDS in their community?"
Group response:
I
Question Number 13 - "What can young people do to help people
and the families of people who are already infected or have
AIDS?"
Group response:
139
Question Number 14 - "What sorts of information I training I
materials I other support do you need to help prevent AIDS and
to support people with AIDS and their families'?"
Group response:
* 3jc * * *
The following questions can be answered after you have conduct
ed the focus group discussion.
Of all the messages coming across from the groups which
came across most strongly or did you feel were most
important to the people you spoke with?
I
141
What did you learn about the need for AIDS
information?
What did you learn about attitudes towards sexual
behaviour which puts people at risk?
What did you learn about feelings towards people with
AIDS and their families?
I
143
What do the people you spoke with need from you
or the youth group in order to become active in AIDS
prevention and/or care?
145
Appendix II
Guidelines
for
pretesting
health
education
materials
What is pretesting?
Pretesting means field testing communication materials be
fore they are produced or printed. By interviewing the audi
ence the materials are meant to be used with, we are able to
find out:
1.
If the materials are understood. That is, if the message
or idea is conveyed in the way it was intended.
2.
If the audience likes the materials presented.
3.
If the material offends or embarrasses the audience.
It will also introduce the idea that you are planning a health
promotion campaign and that you want to involve the target
audience from the start.
e
Therefore, pretesting is a cost effective way to prevent large
expensive disasters occurring. For example, if 10,000 copies of
a teaching poster were sent out countrywide and you found
out later on that the target audience did not understand or
accept the poster, you would have made an expensive mis
take.
Pretesting will save:
a) money
b) time
c) resources.
Pretesting may be done several times. The idea is to test
while it is still possible to change the materials after assess
ing the audience reaction.
For example: a flip chart testing means taking the flip chart
to the target audience when the materials are still in a rough
state, i.e. pencil drawings.
Materials for pretesting
1.
2.
3.
4.
5.
6.
7.
8.
Posters
Flip charts
Flash cards
Pamphlets
Handbooks
Radio programmes
Video programmes or films
Roles and dramas.
147
Preparing your materials for pretesting
People interpret pictures in different ways depending on a
number of factors, for example:
• Their religious beliefs.
• Their environment and life experience.
• Their education and employment.
We cannot assume that people understand or can interpret pic
tures. They may spend so much time trying to understand the
picture that they miss the message it is trying to convey.
They may not have an understanding of what is "up” and what
is "down”, and so may not know which way up to hold your
materials.
Colour can also be confusing and should be used with care.
For example, people’s responses to colours which seem strange
to them may be:
• "Why does the man have a green face?”
• "Buffaloes in our area are not yellow!”
Size, too, can cause misunderstandings. A larger than life size
mosquito on a poster may lead people to think that they have
no need to worry about the mosquitos in their area as they
have never seen one as large as in your picture.
Use simple language and, if possible, use local terms for
diseases.
Try to be aware of the social, cultural and religious beliefs in
your area. If the materials cause offense, the target audience
may refuse to help you.
How to pretest your health promotion materials
First of all, consider who you hope will use the materials you
are designing.
Identify people in your community or approach people in their
homes or in the market place and ask them if they will answer
some questions about your materials.
Be sure to explain why you want the answers and what the
materials will be used for in the future.
148
e
What do you want to find out?
Are these materials intended to inform people, give them a skill
or motivate them? Be clear about what you are trying to find
out. Ask many questions about the materials in order to build
up a picture of people’s understanding of the messsage you are
trying to convey.
When do you pretest materials?
As soon as possible! Once you have some basic ideas down on
paper start to pretest. None of your materials may be under
stood. You have to be prepared to change them many times.
When you have put a lot of work into preparing the materials,
you may feel angry or upset that people don’t understand. If
you recognize this might be a problem, involve the community
right from the beginning of the early sketches, then you will
feel happier about changes which need to be made. It will save
you a great deal of time and money because the greatest cost is
in the final production stage, and you want to be sure by then
that the materials will be a success.
How are you going to record the answers?
It may be simpler to have a questionnaire which just requires
you to fill in ’’yes'’ or "no” answers, but the information gath
ered will not be complete enough for you to make a judgement
about what changes need to be made. You may know that
someone did not like the picture, but you may not remember
why. An example questionnaire is attached which requires
more detail from the respondent.
How long will pretesting take?
This depends on how much material you are pretesting and
how many people you are testing them upon. Experience shows
it takes approximately 10-20 minutes to test a single picture.
Remember to add on time for finding the respondents. It takes
time to find out whether the respondent is really interested in
helping or whether they just want to find out what you are
doing.
149
Conducting the interview
Where?
Choose a social setting where you will not be disturbed by too
many people. Respondents may become inhibited if you choose
too public a place.
Introduction
Be sure to introduce yourself and explain what you are doing
and why. Always treat people with respect.
Let people touch the material
Another reason for beginning pretesting your materials when
they are still in a rough state is that people will want to touch
the pictures and this may spoil them. It is important that the
respondents feel able to touch the materials. It will help you to
build up a rapport with them.
i
Encourage people to talk
Take time over the interview. Encourage people to ask ques
tions. Remember you don't want "yes" and "no" answers to your
questions; you want reasons why the respondent does or does
not like or understand the picture.
Take a few materials only
Only take a couple of pictures at a time. This will allow plenty
of time for answers and avoid both you and the respondent feel
ing pressured by time constraints.
Always make the respondent feel he/she has been helpful. Re
peat what the pictures will be used for. Remember you may
want his/her help again, and you also want to keep a good repu
tation in the community so others will be willing to help.
Recording
Pretesters, where possible, should work in pairs — one to con
duct the survey and one to write down the answers properly. Be
sure to write down the expressions people actually use and not
your own interpretation; they may be useful as slogans on the
pictures.
150
4
Post-testing
Once the materials have been produced and used for some time,
you may want to conduct more interviews to see whether people
actually liked the pictures, understood them, have changed
their behaviour because of them, and what else they would like
to have information about.
Suggested questions for a pretesting interview
These questions are "open” questions — they can't be answered
by "yes" or "no" and require an explanation.
Remember to introduce yourself and explain the reason for ask
ing these questions.
• What do you see in the picture?
• What else do you see? (It may be necessary to discuss each
part of the picture in detail.)
• What does the picture mean to you?
• What, if anything, do you find confusing?
• Is the picture:
... easy to understand?
... hard to understand?
• What is worth remembering in the picture?
• What, if anything, do you like about the picture?
• Is there anything in the picture that you particularly dislike
or that bothers you? If yes, what?
• In your opinion, is there anything in the picture that is hard
to believe? If yes, what?
L/<S>rr LIBRARY
ov
oecOMertTATto* J -11
151
• In your opinion, what type of person is this picture talking
to?
It is talking to:
... someone like me?
... someone else, not me?
It is talking to:
... all people?
... all people but especially people in my
community?
• Which of these words or phrases best describes
the picture?
... interesting
... not interesting
... informative
... not informative.
• Did you learn anything new about AIDS from the picture. If
yes, what?
• Have you any other question you would like to ask?
/
152
Appendix III
Condoms
and
safer sex
Even before AIDS, condoms were used to prevent sexually
transmitted diseases and unplanned pregnancies. With the
growing awareness that AIDS is a potential threat to all of us,
condoms have had a lot of attention as one strategy to avoid
infection with HIV, the virus which can cause AIDS. For peo
ple who are already HIV positive condoms are one way to re
duce the likelihood of passing the virus on to others.
This information sheet aims to give you clear information
about condoms and about their role in safer sex. Needless to
say, this information is equally important for both men and
women.
How safe are condoms
Condoms make sex safer. They do not make sex absolutely
safe. Condoms do sometimes fail — sometimes because of
manufacturing defects, sometimes because the people using
the condoms are not as careful or consistent as they should be.
There are still risks involved in sex even if you use a condom.
However, condoms greatly reduce your risk of contracting sex
ually transmitted diseases, including HIV infection. Condoms
are not 100% foolproof, but they are much better than using
no protection at all.
Where to get condoms
I
Condoms should be of good quality latex, and each batch
should have been routinely tested by a national consumer or
ganization to see that the condoms meet quality standards
and are not defective. In many places, tested condoms carry a
quality control mark, such as the British kitemark. The World
Health Organization is trying to ensure that all condoms are
tested, but in many places good-quality condoms are not easily
available. If you are living and working in a place where you
are not sure of the condom quality, your local family planning
association may be able to advise you.
Use of a lubricant with nonoxynol 9 in it will increase the ef
fectiveness of the condom (look on the packet to see if the con
dom contains spermicide with nonoxynol 9), both in protecting
against infection and in providing lubrication so that the con
dom does not tear. Never use oil-based lubricants or greases,
such as Vaseline, as these will damage the condom.
153
Condoms should be packed in a non-transparent package, and
not exposed to sunlight, fluorescent light, excess heat, damp
ness or crushing during storage. Good-quality condoms stored
properly will probably last a year from the date of manufacture
in tropical countries, and longer in temperate climates. If you
have not used a condom before, find a new, good-quality con
dom and unwrap it, so that you will be able to tell the differ
ence between a good-quality condom and one which has obvi
ously deteriorated due to heat, humidity or poor storage.
Using and disposing of condoms safely
When you take the condom out of the package, make sure you
don't damage the rubber with your fingernails, with jewelry or
with the foil of the wrapper. Put the condom on after the penis
has become erect, but before the penis has come into contact
with the partner's genitals.
Roll the condom all the way to the base of the erect penis. Pinch
the tip as you roll it on, so that you leave a centimeter of empty
space at the top of the condom.
After intercourse, withdraw the penis immediately, holding on
to the rim of the condom to prevent spilling.
Tie a knot in the condom, wrap it in tissue and dispose of it
carefully. Wash your hands. Never re-use a condom.
If you want to avoid pregnancy, it is more effective to use a
backup method of birth control such as the diaphragm (cap) or
pill. However, remember that only the condom protects against
sexually-transmitted diseases.
Anal sex and traumatic sexual practices (see glossary) are par
ticularly risky, because the condom is more likely to break. An
extra-strong condom and use of water-based lubricant, such as
KY jelly, reduce the risk of infection.
If the condom breaks in use, get medical advice as soon as
possible.
154
f
Other sexually transmitted diseases
With all the anxiety about AIDS it is important not to forget
that condoms protect you against a number of other sexually
transmitted diseases as well, such as chancroid and syphilis.
Many of these are still much more common than HIV infection.
They can cause sterility, damaged unborn children, and lead to
other complications if untreated. If you have a genital ulcer, a
discharge, soreness, a burning sensation while urinating, or
other genital problems, see a health worker immediately for
diagnosis and treatment. The presence of genital sores makes it
easier for HIV to enter your body. Unlike AIDS, many other
sexually transmitted diseases can be treated and cured.
Other choices for safer sex
Remember that it is impossible to tell by looking at a person
whether or not she has HIV or another sexually transmitted
disease, since most sexually transmitted diseases have long
periods when they are dormant in a person's body and produce
no symptoms. Unless you are absolutely sure of your partner or
partners, use a condom or another means to ensure safer sex,
such as sex without penetration. The risks of oral sex are still
undetermined, but the risk is probably minimal if there is no
ejaculation during oral sex.
155
How to use a condom
CHECK THE
XP/ier AATS OR MANUFACTURE DATE
t Hold the top of the condom
” Press out the air from the tip
and roll the- condom on.
Use both hands.
f
Leave
space- at the Up
of the condom for
semen.
9 Roll the condom
riqht to -fne
/
X base of X
i
After ejaculation,
when you start losing
erection, hold the condorn
dt the base and slide- if
carefully off.
I
T/,
Make- a knot viz
and dispose- of the condom
in a pif-latrine.
R'LVER
USE
A
COA/DOM
TWtCF
II
Appendix IV
Guidelines
for AIDS
and
First Aid
These guidelines on AIDS were developed for Red Cross/Red
Crescent First Aid training (for use where such guidelines do
not already exist) and have been checked for accuracy by
WHO’s Global Programme on AIDS. The guidelines will be
regularly updated, as necessary, to ensure that they reflect the
latest scientific information on AIDS.
It is important to stress that the guidelines do not represent
any new advice, but reinforce already existing guidance on hy
giene in First Aid.
To date, no cases of infection with HIV (the virus which causes
AIDS) have been reported from any part of the world as a re
sult of giving First Aid. However, good hygiene is extremely
important in First Aid, because many infections can be passed
on by unhygienic handling of body fluids.
There is no need to consider any special precautions when giv
ing First Aid to people who are not bleeding, don't have open
wounds and are breathing by themselves.
It is also important to note that concern about good hygiene
and protection from infections must apply in both directions.
In other words, the first aider should not only consider his or
her own personal risk, but the risk which unhygienic practices
pose to the person needing care. There could be cases when it
is the first aider who is HIV positive, rather than the person
needing care. The advice given during First Aid training
should be the same in either case.
I
157
Messages about AIDS and HIV
Ways in which HIV is transmitted
First aiders should be clear about the ways in which HIV is
transmitted, so that they can educate themselves and inform ;
others. HIV has only been shown to be transmitted in three
ways:
• Through unprotected sexual intercourse (man-woman, i
woman-man, man-man).
• Through infected blood and blood products (such as receiving blood or blood products contaminated with HIV; use of ;
contaminated needles and syringes; use of contaminated ;
equipment which draws blood).
f
• From an infected mother to her child before or during birth.
x.
..................................... ,
,
Ways in which HIV is not transmitted
First aiders also need to be clear about the ways in which the
HIV virus has not been shown to be transmitted. A suggested
list is given here, but the list should be changed to reflect local
concerns and worries.
• Insects
• Coughing or sneezing
• Giving blood
• Human touch (hugging,
shaking hands, etc.)
• Saliva
• Sweat
• Food and water
• Air
• Toilets
• Clothes and bedding
• Tears
158
I
Areas of concern to first aiders
The AIDS pandemic has caused concern for first aiders in two
areas:
1. When giving mouth-to-mouth resuscitation.
2.
When dealing with someone who is bleeding.
Mouth-to-mouth resuscitation
Mouth-to-mouth resuscitation has not been shown to transmit
the HIV virus. From the theoretical point of view, the only
significant risk could arise from situations where the patient is
bleeding from the mouth and the caregiver has open mouth
sores. In practice, however, HIV has not been shown to be
transmitted in the few cases where caregivers have resuscitat
ed people with HIV who are also bleeding from the mouth.
Special equipment for mouth-to-mouth resuscitation is not
recommended, except for professional first aiders, such as
ambulance people, who would have such items available as
part of their regular equipment. Use of rigid airways by un
trained or inexperienced people can cause bleeding and actual
ly increase risk. In addition, most people who have undertaken
basic First Aid training would be unlikely to carry rigid air
ways, mouth covers, or similar equipment at all times, on the
remote chance that they may need to resuscitate someone. Ex
cessive concentration on the theoretical risks of HIV transmis
sion by mouth-to-mouth resuscitation may cause needless panic
and lead to denial of care, both of which need to be prevented.
I
Dealing with someone who is bleeding
Blood should always be treated with respect. A number of in
fections, such as Hepatitis B, may be passed on if blood is not
handled carefully. AIDS does not require new procedures but
merely highlights the need for existing good hygiene proce
dures to be practiced at all times.
159
Safe handling of blood in a First Aid situation does not require
’’space suits” or excessively high levels of protection. What is
required is basic good hygiene, a few precautions and good
common sense.
First aiders should realize that the HIV virus is fragile. Once
outside the body, it does not usually survive for long, and is
easily and quickly killed by heat, or external use of household
chemicals such as bleach (sodium hypochlorite) or alcohol. Un
broken skin provides a good barrier to prevent the HIV virus
from entering the body. On the other hand, there is some
chance of the HIV virus entering the body through broken skin
or through mucous membranes, although studies of a large
number of health care workers indicate that this chance is ex
tremely remote.
Specific recommendations
1.
Cover your cuts — As a matter of routine hygiene, cover
your exposed cuts and grazes with a waterproof dressing.
For people with chronic skin conditions on their hands
which cause open sores, it is best to avoid direct contact
with any patients who are bleeding or have open wounds
unless clean gloves are available (be sure to wash your
hands before and after using gloves).
2.
Avoid direct contact — If possible, people who are
bleeding should stop the bleeding themselves. The first
aiders should show the person how to apply pressure to
the wound, using a clean cloth, for 5-10 minutes. Howev
er, if the bleeding person is a child or bleeding severely, or
is confused or unconscious for other reasons, she may not
be able to help herself. The first aider should stop the
bleeding in this case. Use a thick cloth or other barrier to
avoid coming in direct contact with the blood if possible.
160
I
I
3.
Mop up pools of blood carefully — If blood spills oc
cur, mop up the blood and dispose of the cloths safely (i.e.
in plastic bags or by burning or burying them). Avoid di
rect contact with the blood. Treat the stain with disinfec
tant or a bleach-water solution (i.e. in many countries 1
part bleach to 10 parts water; however, the strength of
bleach varies from country to country).
4.
Wash clothes, linens and instruments with soap and
the hottest water available (above 70 degrees centrigrade)
if they are stained with blood. There is no need to dispose
of clothes or instruments as long as they are well washed.
You should wash materials stained with other body fluids
in the same way for general hygiene, although significant
concentrations of HIV are only found in blood, semen and
vaginal secretions.
5.
Clean yourself and the patient — After First Aid care,
wash thoroughly with soap and water. If blood splashes in
the eyes or mouth, rinse immediately with lots of water.
Wash your hands.
6.
Be careful of cuts — Avoid cuts when giving care. If you
do get a cut, encourage the wound to bleed freely for a
little while, then wash with soap (except around the eyes)
and warm water. Apply antiseptic or alcohol and a dres
sing if possible.
7.
Don’t try to guess who might be infected. People infect
ed with HIV may look and feel well. Treat everyone with
the same high standards of care, practice and respect.
Consistently high standards will also protect you and the
people in your care against a number of other diseases.
161
A final note
Many people are excessively worried about remote or theoreti
cal risks of contracting AIDS, such as the risk from giving First
Aid. At the same time, they may not be considering the real
risks they may be running because of sexual or other behaviour
which may place them at risk. First aiders should be encour
aged to focus on their real risks and consider behaviour change
if necessary.
First Aid training should stress that the first Red Cross Princi
ple is that of humanity — to prevent and alleviate human suf
fering wherever it may be found. Red Cross and Red Crescent
members sometimes put themselves at real risk in situations of
disaster and catastrophe (as they do, of course, in the activities
of ordinary life, such as travelling in a car). To deny First Aid
care to someone in need, given the remote, theoretical risk of
HIV transmission from such care, is inconsistent with Red
Cross Principles. The Scout Law and Promise also requires a
Scout to show respect and to do his best to help other people.
Many Red Cross and Red Crescent Societies train large num
bers of first aiders every year. These trained people can in turn
become important in educating their communities about AIDS.
Such face-to-face, personal communication from trusted and
knowledgeable people is crucial in slowing the AIDS pandemic.
First Aid training should not be considered complete without a
group discussion of how first aiders can educate themselves
and inform others about AIDS.
162
i
Appendix V
Other
sexually
transmitted
diseases
Why do we need to know about sexually
transmitted diseases?
As a youth leader, you will be using this pack to learn more
about AIDS. Many of the youth group members will want to
discuss subjects relating to AIDS as well. AIDS is only one of
the sexually transmitted diseases (STDs) and knowledge about
some others will help you to answer their questions. If the
youth members are already sexually active, it will help them to
protect themselves from infection. If they are not sexually ac
tive, the information will provide a good basis for their under
standing of AIDS.
What is a sexually transmitted disease?
STDs are those diseases which are transferred via the mucous
membranes and secretions of the sexual organs, throat and rec
tum. Most STDs are easy to treat. If they are detected and
treated early, they do not cause serious problems. If they are
not detected and treated early, the infection may spread and
cause complications such as sterility. They are relatively easy
to contract, and so it is important to know what they are, what
they look like and what you need to do to get them treated.
The following describes all the basic information you need to
know about STDs. The information is followed by questions to
think about before preparing to discuss the subject. The most
important thing to remember is that if you intend to have
sexual intercourse, condoms are the best way of protecting
yourself against STDs. Make sure you have a condom with you
and that you know how to use it if you intend to have sex. Ap
pendix III of this pack will help you.
How do I know if I have a sexually transmitted
disease?
STDs often have very few symptoms. You may be infected for
some time and not know it. The danger is that you can spread
the disease to others without realizing it. The following de
scribes some common STDs and how they are treated:
163
Chlamydia:
A bacteria. Often there are no symptoms. The infection
may lie dormant for some time and then start to cause
problems. The symptoms include a discharge or burning
sensation when urinating.
Treatment: A swab is taken by a health worker and it is
analyzed in the laboratory to make sure the right anti
biotic is given for the infection. It is very important that
both partners are treated and that they avoid sexual in
tercourse until they have finished the treatment.
Risks: If Chlamydia is not treated the infection may
spread causing inflammation in the womb and sterility.
It is a very common infection.
Gonorrhoea:
Symptoms occur 3-5 days after infection. In men, it
causes a yellow/green discharge and pain on urination.
Women may also have a discharge but both women and
men may have no symptoms at all.
Treatment: Antibiotics. Both partners must take the
treatment and not have sexual intercourse until the
treatment is finished.
Risks: If the infection is not detected and treated, then
it will spread and may cause sterility. There are some
strains of Gonorrhoea that are resistant to certain anti
biotics, so it is important to have swabs taken by a
health worker and analyzed at a laboratory in order to
make sure the infection has been properly treated.
Herpes:
Caused by a virus. Herpes lives in the nerve root end
ings and once infected a person is infected for life. The
first attack after infection is often the most painful.
Small blisters occur around the site of infection — the
mouth or the genitals — about 2-20 days after infection.
The blisters may be accompanied by a high fever, gener
al aches and pains and swollen glands. The blisters
burst after about 2-4 days and eventually heal. Attacks
occur about 3-4 times a year for many years but gradu
ally decrease in intensity.
164
Treatment: There is no cure for herpes. The symptoms
can be reduced by bathing the blisters in warm salty
water and by taking painkillers. It is important to avoid
sexual intercourse until the blisters have completely
disappeared. To avoid spreading the infection, the suf
ferers should make sure they keep their own towel and
avoid contact with their eyes without first washing
their hands.
Risks: Women who are pregnant should have swabs
taken by a health worker and analyzed in the laborato
ry before delivery. To avoid contamination of the baby
during its passage down the birth canal, a ceasarian
section may be necessary. Herpes can infect the brain.
Condyloma:
A virus that causes warts which appear on or around
the sexual organs. These flesh coloured bumps can be
very difficult to identify, especially if they appear in the
birth canal of a woman. They usually appear 3-9
months after infection. This long incubation period
means it is difficult to find out where they came from
and they can be passed on to others.
Treatment'. The warts are painted with a solution called
podophyllin. The solution must be washed off after 4
hours to avoid irritation. No sexual intercourse should
take place until the warts have completely disappeared.
Both partners need to be checked to see if they have
any warts.
Risks: Women who have come in contact with the Con
dyloma virus should have their wombs checked regular
ly for the first stage of cancer. The Condyloma virus is
very common.
Trichomoniasis:
Women complain of a smelly discharge, itching and
soreness. Men usually have no symptoms at all. Symp
toms start 2-3 days after infection.
Treatment: Swabs should be taken by a health worker
and sent for analysis in the laboratory. Both partners
need to be treated. No sexual intercourse should take
place until the treatment has finished.
165
Syphilis:
The first sign of infection is a small painless ulcer
(chancre) at the sight of infection — usually the sexual
organs or the mouth — which appears 9-90 days after
infection. This disappears in a few days and may not be
detected. The infection lies dormant in the body for
some time. Later a red rash may appear all over the
body. This also can pass undetected.
Treatment: Antibiotics by injection for 10 days. Both
partners need to be treated and they must not have sex
ual intercourse until the treatment is finished. A blood
test may be taken to detect whether infection has taken
place if the small ulcer is not detectable.
Risks: If syphilis is left untreated it can cause major
problems in later life. Heart disease is not uncommon
and in the terminal stages dementia is caused by infec
tion in the brain. Women may pass on syphilis to their
unborn child and this can cause congenital abnormali
ties. Treatment can take place at any time once syphilis
has been detected, but it is more successful in curing
the disease and the treatment is shorter, if detected
early.
Some questions to think about before discussion
1.
Where can you get condoms to protect yourself from
sexually transmitted diseases?
2.
If you thought you might have become infected who would
you talk to?
3.
If you thought you might have become infected how would
you tell your partner?
4.
What are the skills you can practice in your group to feel
more confident about telling a partner or talking to a
friend?
5.
How could you organize the information in this document
to be made available to people who may be putting
themselves at risk of a sexually transmitted disease?
6.
What else do you think you need to help you understand
more about sexually transmitted disease?
166
I
Appendix VI
How to
make
puppets
These pages from Puppets for Better Health, by Gill
Gordon, illustrated by Sue Gordon are reprinted with kind
permission from Macmillan Education Ltd., London and
Basingstoke.
Puppets for Better Health
MAKING CLOTH PUPPETS
We need:
Skin-coloured cloth
Cloth for costume
Coloured cloth for features
Cotton
Wool for hair
Buttons and decorations
Cotton, kapok or cloth for stuffing
Method 1
(1) Cut two circles of cloth and sew
together, leaving a gap for the neck.
(2) Turn inside out and stuff. Sew or
glue on features, ears and hair, using
cloth, wool, string or buttons.
(3) Givethefaceexpression and
personality, as described on p. 38.
Head
Body
(4) Cut out neck. Sew into a cone.
Make thebody and hands as described
on pp. 39-40.
(5) Sew head and body to neck on the
lines.
(6) If the head is stuffed with cloth, the
puppet can be gently washed.
Method 2
(1) Draw profile onto folded cloth and
cut out.
(2) Cut a strip of cloth to go from the
throat, over the face, to the back of the
head.
167
(3) Sew strip onto the two sides of the
profile. Turn inside out and fill with
small pieces of cloth.
Making puppets
Cloth babies
Make small children from cloth and
stuff them. We made a thin baby with
light-coloured skin and hairmadefrom
maize tassels. Our fat baby had darker
skin and real black hair.
Prop the babies up onthe stage while
their mothers are acting. We used a
hook or screw.
(
MAKING A ROD PUPPET
Rod puppets are bigger than glove puppets, so that large
audiences can see them. Simple rod puppets cannot perform so
many different actions as glove puppets. We can build them up
from a variety of locally available materials — for example,
wood, cardboard, string and dried stalks.
We need: one papier m£ch6 or plaster head as shown for glove
puppets, but with a straight neck.
<U> <•>
Cnn)
J
Or wrap banana fibres into a ball, and
tie onto a stick. Glue on a layer of
paper.
A banana fibre puppet
168
Puppets for Better Health
Try shells, Fanta bottle tops, nuts or stones for the eyes
Length of dowel or stick
Cardboard box
Tape or glue
String
Screw-hooks and eyes if available
Wire (e.g. coathanger, bicycle or umbrella spokes)
Cloth for costume
(1)
1
(2)
Fil1
box with pap0r‘
*
Wrap tape or strip of paper glued onto
rod. This supports the shoulders and
allows them to turn freely.
i
I
Make a hole inthecentre
of the box and put onto
the dowel.
(3) Join armsto shoulder
with string
-jk/
Screw hook and
eye, orstring.
fl
Make armsfrom dowel; rope alone, or
filled out with cardboard taped onto
the rope; or use cardboard tubes. Try
local pods—for example, from the
flamboyant tree.
Make handle from papier mftchd, wood
or tape.
Sew wire onto hand.
Make hand from cloth,
papier m3ch6 or wood.
169
(4) Fix the head onto the rod and
clothe the puppet as with glove
puppets; or glue pieces of cloth onto
the shoulders and build a costume
around the puppet. Hold the central
rod in one hand and the hand wires in
the other. Practise turning the head
and working the hands.
Making puppets
EASY PUPPETS
Plant puppets
Plant puppets are easy for children to make. Carve faces on
yams, potatoes, cassava, pumpkin, carrots, etc.
Stick puppets
Children can easily make stick puppets. Older children can
teach younger ones how to make faces with different expres
sions. In Ajoya, Mexico, children put on a very successful
puppet show about the story on p. 16. This is how they made the
puppets.
If the puppet needs two expressions, put two cardboard
drawings back to back. During the show, turn the puppet to
show the face you want.
Happy
Angry
t
Gluethese backto backon a stick.
Paper bag puppets
Paper bag puppets are easy to make if paper bags are available.
See p. 25.
Open andcloseyourhand
to make it eat or speak
I
To make a bigger puppet, attach a
cardboard face to the bag
• Taken from Helping Health Workers Learn, by David Werner and Bill Bower,
Hesperian Foundation, 1982.
170
Appendix VII
Resource
list
The following list covers examples of information on HIV/AIDS
which you can order. Most organizations carry their own re
source lists which they will send you on request. You can then
choose which materials would be most appropriate in your cul
ture and community. Some of the materials are available free
of charge and where possible this is indicated.
Videos
nA World United Against AIDS", 30 minutes. Highlights
individual, community and national efforts against AIDS.
Available as VHS in English. Price: Swiss Francs 55 or
US$44 per copy including postage by surface mail and
handling. Specify PAL, SECAM or NTSC,
Order from: Distribution and sales, WHO, 1211 Geneva 27,
Switzerland.
"Survivors", 15 minutes. Includes a VHS video, a guide for
street workers and a pocket size comic book for children. De
scribes the reality of AIDS for street children in any city in
the world. Provided in language of your choice.
Order from: Survivors Distribution, Street Kids Interna
tional, 221 Front Street East, Toronto, Canada MSA 1E8.
I
" Caring About Aids — The Common Ground", 37 min
utes. VHS, PAL, SECAM or NTSC. Award winning film
about the response of four different communities to AIDS
epidemic. Made in partnership with the World Council of
Churches, the International Planned Parenthood Federa
tion and the American Red Cross. Available in English,
French and Spanish.
Order from: Health Department, League of Red Cross and
Red Crescent Societies, 17 Chemin des Crets, PetitSaconnex, Geneva, Switzerland.
171
” Strategies for Hope” consists of a series of video pro
grammes, 15-20 minutes in length, designed for education
and training. "Strategies for Hope” also provides a series of
booklets, 25-40 pages in length, which cover AIDS care and
prevention, the AIDS support organization in Africa called
TASO, and AIDS management. The videos and booklets are
designed to help health and community organizations plan
and organize care and education programmes. Available
from Teaching Aids at Low Cost (TALC).
Order from’. TALC, P.O. Box 49, St Albans, Hertfordshire
AL1 4AX, United Kingdom. National AIDS control pro
grammes and AIDS organizations working in African coun
tries south of the Sahara can order the videos and booklets
free of charge. Available in English and French.
I
n Young Canadians Talk about AIDS”, 8 minutes, VHS/
PAL, produced by the Canadian Red Cross. The young peo
ple talk in both English and French about their thoughts and
feelings relating to AIDS. The video also includes pictures
painted by the young people showing how prejudice affects
the lives of people with HIV/AIDS. The video will be useful to
encourage discussion amongst youth groups' members.
Order from’. Cancross Communications, The Canadian Red
Cross, Ottawa, Canada. Price Can. $ 30, plus shipping.
Slide sets
Three sets of 24 colour slides are available from Teaching
Aids at Low Cost (TALC). Suitable for a range of health
workers/health educators in Africa. Each set includes teach
ing notes and subjects for discussion. The first in the series,
Virology and Transmission, should be used before the
other two sets, Clinical Manifestations and Prevention
and Counselling. Each set costs $2.75 for self-mount sets
with instructions. Sea mail to developing countries or $0.60
extra for airmail.
Order from’. TALC, P.O. Box 49, St Albans, Hertfordshire,
AL1 4AX, United Kingdom.
172
" Working Towards Understanding" — The League of
Red Cross and Red Crescent has developed a pack to be used
for AIDS training within the workplace. This pack contains
training and discussion materials such as a self question
naire, a slide presentation (60 images) with script, case stud
ies and an exercise on non-discrimination. Available in Eng
lish and French. See order form following this section.
Newsletter and leaflets
'AIDS Health Promotion Exchange"— Newsletter giving
examples of AIDS health promotional activities from around
the world. Published by the Global Programme on AIDS of
the World Health Organization, with editorial and technical
collaboration of the Royal Tropical Institute in the Nether
lands. Free of charge to organizations directly involved in
AIDS health promotion who are unable to pay for subscrip
tion. Annual subscription for those who can pay: Swiss
Francs 20 (or US $16). Available in English and French.
" Broadcasters1 Questions and Answers on AIDS"— A
manual aimed at people working in the media but useful for
everyone. Gives general information about HIV/AIDS and
covers most of the questions you are likely to be asked. Very
clear presentation. Available in English and French.
" World AIDS Day Action Kit" — Information on how to
plan your World AIDS Day activities which occurs on 1st De
cember every year. Includes action check list, camera ready
copy for World AIDS Day symbol and information on all you
might need to think about when creating or planning your
activities. In English and French. Available from June to 15
November annually.
All the above can be ordered from'. WHO/GPA, 1211 Geneva
27, Switzerland.
173
"AIDS Action" — Monthly newsletter produced by Appro
priate Health Resources and Technologies Action Group,
Ltd.(AHRTAG). Concerned with AIDS prevention and
control, offers useful articles on current issues and a review
of new materials from across the world. Produced and
distributed free of charge to developing countries.
Order from: AHRTAG, 1 London Bridge St., London SEI
9SG, United Kingdom.
" Red Cross And Red Crescent Information and Materi
als on AIDS"— Resource list of posters, leaflets and book
lets from RCRC Societies around the world with addresses.
Order from: Health Department, League of Red Cross and
Red Crescent Societies, 17 Chemin des Crets, PetitSaconnex, Geneva, Switzerland.
I
"AIDS Watchn— Quarterly magazine jointly produced by
the International Planned Parenthood Federation (IPPF),
the League of Red Cross and Red Crescent Societies. Availa
ble in English and French.
Order from'. IPPF Distribution Unit, P.O. Box 759, London
NW1 4LQ, United Kingdom — free of charge.
"World AIDS" is published every two months by the Panos
Institute in association with the Bureau of Hygiene and
Tropical Diseases in London. "World AIDS" is made possible
by funding provided by the Ford Foundation. The Panos
AIDS unit is funded by the Norwegian Red Cross.
Order from: Subscription rates: £12 or US $25 per year (six
issues). Remittance to United Kindgom should be made in
sterling (payable to Panos Books), 8 Alfred Place, London
WC1E 7EB, United Kindgom.
174
f
Books on AIDS
” Preventing a Crisis”— Produced by Gill Gordon and
Tony Klouda. A training manual on AIDS and family plan
ning directed towards developing countries. Excellent ideas
for working with groups and in the community. Very com
prehensive and useful.
Order from: IPPF Distribution Unit, P.O. Box 759, London
NW1 4LQ, United Kindgom. Please enquire about payment.
” Talking AIDS, A Guide for Community Workers” —
Produced by Gill Gordon and Tony Klouda, AIDS Prevention
Unit, International Planned Parenthood Federation. This
guide is designed for anyone who is involved in counselling
and education about sexual health and AIDS in the commu
nity. The book aims to promote understanding of AIDS and
awareness of the means of preventing its spread, and to sup
port people infected with HIV.
Order from’. IPPF Distribution Unit, P.O. Box 759, London,
NWl 4LQ, United Kingdom. Please enquire about payment.
Books on general health education
” Helping Health Workers Learn”— by David Werner.
General training book for primary health care workers in
developing countries. Contains many ideas for making train
ing materials to make learning exciting. Available in Eng
lish, French, Spanish and Arabic.
Order from: Hesperian Foundation, P.O. Box 1692, Palo
Alto, CA 94302, U.S.A.
” Puppets for Health”— by Gill Gordon. Excellent and
easy to understand. Describes many ways of making puppets
and using them as part of a health promotion programme.
Encourages community involvement and group participa
tion.
Order from'. Macmillan Education, Ltd., Houndsmills,
Basingstoke, Hants., United Kindgom (check on how to
order, money, etc.).
175
"Education for Health"— A manual on health education
in primary health care. Very detailed book on planning and
carrying out general health promotion programmes. Includes
methodology for working with knowledge, attitudes and be
haviour, using local resources and local people.
Order from: Office of Publications, WHO, 1211 Geneva 27,
Switzerland.
176
GLOSSARY
I
AIDS
Acquired immune deficiency syndrome — A combination of dis
eases caused by a virus which affects the immune system. The
immune system becomes unable to fight off infections.
Anonymous
Without giving a name. In the context of this manual a test for
HIV would be taken but no name written on the specimen so
that the result could not be traced back to the owner.
Antibiotics
Drugs given to fight certain types of infections.
Anus
The back passage through which faeces are passed.
Condom
A rubber sheath which fits over the penis when a man is sexu
ally excited and the penis is hard. It can be used to protect
against pregnancy and sexually transmitted diseases.
Health promotion
I
Includes health education, health policy formation, community
development, diagnosing the causes of ill health both
economically and socially and the promotion of healthy
lifestyles.
HIV
Human immunodeficiency virus — the virus which can cause
AIDS.
181
HIV antibody test
A blood test which detects whether the body has reacted to the
presence of HIV. The body will have tried to protect itself
against the virus by producing antibodies. The reaction takes
an average of three months after infection to show in the blood.
If the test is positive, the infected person will have been able to
pass on the virus from the moment of infection. This is not a
test for AIDS. You cannot tell from this test when or how the
person tested will proceed to AIDS.
Immune system
Protects the body from infection by recognizing diseases, kil
ling them and then remembering what they look like so that
they will be able to fight them off again.
f
Karposi’s sarcoma
A rare form of skin cancer.
Lymph glands
Organs of the body which play an important part in protecting
the body against disease. They can be found, for example, un
der the arms and in the groin. When an infection tries to enter
the body, the nearest lymph glands may become swollen be
cause of the activity of the white cells in fighting the infection.
Penetration
Used in the context of this manual to describe the act of putting
the penis into the vagina or anus whilst having sex.
Penis
The part of a man's body with which he passes urine and has
sex.
182
I
Pneumocystis carinii pneumonia (PCP)
A type of organism which causes pneumonia — inflammation of
the lung. Normally the body can fight off this organism . How
ever, when HIV enters the body, it infects the part of the im
mune system which would normally protect us from becoming
ill with this organism.
Polygamy
Having more than one wife or husband at the same time.
Radiotherapy
Treatment which is given for some cancers.
Semen
The fertilizing fluid that passes through the penis during ejacu
lation.
Seropositive
Can also be called HIV positive or that a person has seroconverted. About three months after being infected with HIV the
body develops antibodies to the infection. These can be detected
in the blood which is tested in a laboratory.
Sexually transmitted diseases (STD)
Diseases which can be passed from one person to another by
sexual contact.
Sex worker
A person, male or female, who offers sex in return for money.
Traumatic sexual practices
Sexual practices which involve some damage, major or minor,
to the body of either partner involved in having sex. This will
include tiny cuts in the mouth or vagina or on the penis caused
by prolonged rubbing.
183
Tuberculosis
A disease which often affects the lungs and bone. It is still very
common in some parts of the world. It is treatable.
Vaccine
An injection which prevents people from becoming sick from
certain diseases even if they come into contact with them.
Vagina
Part of the birth canal of a women which leads to the womb.
Vaginal secretions
The lubricating fluid of the vagina which increases when a
women becomes sexually excited.
184
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