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J
1
AIDS PREVENTION
*1
THROUGH
HEALTH PROMOTION
Mobilizing
Local
Organizations
p IS '325 ------ —
—1—
“
r>t»X
Draft: Q-isinhution for Review PurpsS£sJ3-nL”
f
World Heaitti Organization
Global Programme on AIDS
DraftDate: Jxjae 1988
*
___AinQ DRFVFMTION
t
Introduction
Huw could I do it better?
Would the case
organization?
studies be appropriate to the needs of the
and still get discussion groups to talk
the
story
How could I change
m ight face?
about the problems they
-- --) be written " with your
Fart n of ACTION NOTES continues to
iSdes 10-15 examples of AIDS health Promotion
dssibtance. Part II
n.a..
programmes within
training materials,
contribute.
recommended changes to.
Please address your
Ms Jennifer Mason
WHO/GPA/HPK
^211 Geneva 27
Switzerland
Tati v ducLion
THBO^GH HEALTH PROMOTION
MTS
ACTION NOTES:
MOBILIZING LOCAL ORGANIZATIONS
ACTION NOTES are designed to assist district and local level health
to collaborate with
educators mouillze a variety of local organizations
ACTION NOTES
AIDS Prevention and Control
- ATns HEALTH PROMOTION:
of the health
ACTION NOTES apply the health promotion process at
AC MON
pp / .
_ _
the potential t0 play
educating their membership <-- -“* b"ad,t
about AIDS.
to influence positively the
AIDS Health Promotion is a process
control the spread of HIV
Vo'naviour of individuals and groups to
' • «e-i know about AIDS,
infection, using our most effective strategies, what
education, society and culture,
and what we can learn about information, (
and education component of an
AIDS Health Promotion is the information <
AIDS prevention and control programme.
The Health Promotion process provides
a rational and svstematic way
to:
Plan
Implement
monitor and evaluate
combat AICS. ACTION NOTES applies
information and education programmes to
this process, within local organizations.
-•
------- i of organizations
part i of ACTION NOTES identifies five types
Prevention
ands Control
Plans. They
mentioned frequently in National AIDS F
can be adapted
for
of
s
P-id. a
target audiences:
Military services
Youth organizations
Women’s groups
The workplace
Religious organizations
a
Pr„;"at. Jiviti... AS
taU this ». th.
r..d t>,«. t.8ln » thank,
t sppsosth an
- —
itstlsn to assist in planning
organization
their education and training?
a
» i i H\1
Table
R f
Contents
__ aids
mnilGH
AIDS PREVENTION THROUGH HEALTH PROMOTION
ACTION NOTES:
MOBILIZING LOCAL ORGANIZATIONS
SECTION
1
Health Promotion modules suggested for:
ARMED FORCES
YOUTH WORKERS
WOMEN’S GROUPS
IN THE WORKPLACE
RELIGIOUS ORGANIZATIONS
SECTION
2
<■
-
p.:'
- --
-
Examples of Health Promotion activities to prevent the spread of
Hl* infection from around the world
- - "SV -■
References
''
If
_______
/
/
ffCTiOH
NSTES:
Armed
Forces
7 OX 1.
ACTION NOTES
FOR
MOBILIZING LOCAL ORGANIZATIONS
AIDS INFORMATION AND EDUCATION PLAN
i
Initial meeting
with steering
committee
< Identify group to
provide information and
education based
activities
Reassessment
Local Health
educator
Budget and imple
mentation schedule
Meet with target audience
to discuss needs and
existing behaviour
Setting objectives
and developing strategies
J
Identification and
Development of
support systems
gathering materials
and designing training
oousta
nmeasGS?
-2general understanding of safer sex practices?
c)
What is the
d)
What are the problems associated with using condoms?
e)
How are past sexual histories
f)
What needs to happen to ensure avoidance of risk taking oenaviour*!
discussed with present partners?
Setting objectives
audience and selected a
Having gathered information from the target the activities programme, a
1
facilitators
to
group of people who will act as
be— considered.
plan of action can L
---Infomnation Campaign
Training Process
Production/gathering of
materials
Training of activity
facilitators
Pilot Dissemination of
materials to representative
samples
Division of staff into
small groups
I
Evaluation
Dissemination of materials
to all staff
Small group activity
sessions
I
Evaluation
I
Feedback and Evaluation
Programme Development
Materials may be drawn from existing material produced by theRational
AIDS Committee or AIDS Health Promotion campaign or ad^t^“d Paining.
iZrmv with the help of artists, actors and people with media training
Where baseline discussions have highlighted a particular area o
Examples of training for the activity facilitators are
presented
in Box 3.
A suggested plan for implementation over a
suggested in Box 5.
12 month period is
ACTION NOTES
AIMED FORCES
for all the armed forces
with the objectives
and Control plan. (See Annex 1^.
draw from the National
The district level civil and military forces may
local AIDS health
AIES health promotion programme and would request a
“ join their onltidlreipLihar? pl.mins t.»>. This planning team
and development of
AIDS prevention for all their staff.
Formation of a_ steering committee
u
4.4^01 nr district level, the NAC health promotion
.”d
aetWitl...
Thl. ««rlnS ec-itte. ».|U
ensure that:
a)
All AIDS prevention activities are coordinated.
b)
The momentum of the activities is maintained.
activities to maintain accuracy of the
c) There is supervision of the
messages received.
authorized and implemented, for example,
d)
Follow-on activities are
from different ranks receives training
a group consisting of volunteers
that they should take on the group
by the health educator in order
activity 'work
-- within the organization.
• j and evaluation procedures are authorized in order to
e) Monitoring
modify or add
--- to the overall strategy.
training appropriate to the
f) Senior managers in the service receive
needs of the organization.
---- j all the areasi that need to
In order that the steering committee covers
provide the meeting with
u._.. the enclosed
be discussed the health educator may 1
planning checklist. (See Box 4).
Base line information
i rank will ascertain the
Group discussions held with people of the same
behaviours
and practices and
i...
present state of knowledge about AIDS, present L—
areas of need.
Some suggested discussion topics:
level of knowledge about AIDS and STDs?
a) What is the current
attitude towards those who are HIV antibody
b) What is the current
positive?
Suggested Training Schedule
Training on HIV and AIDS is ideally part of an existing program^
hPallh related issues, particularly when discussing sexually transmit
diseases or personal relationships. However, where these courses do n
e^st Tt is important that the activity facilitators and health educa.
feel comfortable about introducing these subjects when emoarking on th»
AIDS health promotion and education programme.
1
£
continuous but flexible to the chang^
The programme is designed to be
task is training for senior
needs of the organization.. The primary the need for both the information
managers in order that they understand
Both the managers and the
campaign and the small group discussions,
goals and receive
activity facilitators need regular updating to reassess
new information.
■Mr
Information should not be delivered in isolation. Immediate follow up
with smlll group discussions on how individuals can make cnanges in their
Vvt « orolect themselves and their partner from HIV infection will
1
o that oeoole are not left anxious and wondering what they themselves
^^to do PThe following outline is a suggested ideal for introducing the
health promotion plan. It will be necessary to adapt the plan to fit with
«Sing schedules of new recruit intakes and inservice training.
Month
1
Managers and trainers
initial training with
regular update
X
2
4
5
6
■7
8
9
10
11 12
X
X
X
X
X
X
Education and
information campaign
Inservice training for
all staff
3
X
X
X
X
X
Schedule for Planning
ClLettn, -afrUU .nd =o„d«etU, .-11
th. ...d. of th. .coups to b. r-ctad 1. . J.J- £«
h—lth oromotion and education process. It may take o moncna
th. participants is essential to th. success of the progrann..
”
j
■
npfvENTION
■!__________________________________________________________________________________________ _________________________
J—
Development of support systems
/
Even An small groups it may be difficult or frightening to discuss
individual problems. It is necessary to provide avenues for face to face
counselling establishing clear sources and availability and
i ' an opportunity
to help those seeking further advice. This needs to available to all ranks
and it may be advisable to provide a referral system to hospital services
should treatment be necessary, A confidential telephone advice line will
enable chose who wish to remain anonymous get the help they need.
Budget and Implementation Schedule
Planning MBS education and health promotion must both meet the needs
of the target audience and also be realistic in its costing, It is
imperative that the strategy be maintained and become part of the existing
health promotion services, Financial support will be needed in the
following areas:
Materials production, e.g., leaflets posters
Printing - mimeograph machine
Cost of special events, e.g., projector for slide shows, Hire of
premises, refreshments
Telephone
Office supplies
Part time staff
Transport/petrol
Per diem/speakers fees
The steering ommittee and activity facilitators will be providing
their services as part 01 their existing workload.
The cost both short term and long term will also depend on the
implementation of the plan and this will be calculated on the basis of the
initial education campaign and long terra, small group activity.
Monitoring and evaluation
C
The success of the health promotion and education programme depends on
the following.
1) That the steering committee recognizes that the process of
gathering information about knowledge, attitudes and behaviour may take
several months and that this must be allowed for in the planned
programme.
2) That the steering committee maintains involvement and assists in
providing the authority and institutional support for the programme.
3) That the group discussions are carried out at regular intervals
with a cross section of the participants to assess the levels of
understanding of the messages delivered and any changes in behaviour or
attitudes. Changes may need to be made in the programme as a result of
these group discussions.
Reassessment
Information about AIDS and HTV infection changes rapidly. It is
difficult to maintain the momentum of a programme that may be seen as
repetitious to the organizers. It is essential that regular reassessment
of the entire programme is maintained and goals are redefined if necessary.
Step 3
Translating this awareness into behaviour change by adoption of
practices through understanding and personal choice.
The emphasis of the training is to concentrate most time on st^
Each
- steps 1 and 2 alone will not lead to behaviour change.
understand
how
knowledge
about
AIDS
and
HIV
infecti
individual has to
lead to change in their own behaviour and how they can go about
must
doing this.
%
This outline is meant only as a guide to possible approaches in
-~2 and2 HIV infection.
' " —' —.
The health
facilitating discussion on AIDS
presented
here
and
change
the situations and
promoter can use the ideas
culture,
restrictions
and environments.
case studies to suit their own
--- r out the activities in
£2 suggested that the facilitators- carry
Wives
of
enlisted
men should also have
small, single sex groups.
VI.—
At
all
times
confidentiality should
access to discussion and support,
clear
that
subjects
discussed in the
be maintained.
It should be made
further
discussed
outside
the
seminars.
small groups should not be 1----
training for activity FACILITATORS/TRAINERS (target audience 1)
Notes
Ideal group size is no more
Training should follow steps 1, 2 and 3.
than 20 with most of the work being done in groups of 2 or 3.
be given extra tine to discuss, and work out
(The managerial group will
relating to employment and occupational health).
strategies for issues
6 hours
2 hours
Time for facilitator training
Time for extra training
i.e. employment and occupational health
SUBJECT
Step 1
Information about AIDS and
HIV infection covering
the virus transmission,
course of illness,
infectivity.
METHOD
Slides or video followed
by discussion
'AIDS WISE’ (See
attached)
TIME
1.30
r err-**-
Example of training for trainers
Target Audience (1) • The team who will function as trainers
Target Audience (2) “ Enlisted men
PERSONAL'
BEHAVIOUR
what does
\
this mean for me?
STEP 3
CONCEPTS AND IHPLICATIONS
what are the issues
important to the target
audience?
STEP 2
FACTS AND INFORMATION
STEP 1
Step 1
Increasing in awareness and knowledge about AIDS and HIV infection.
Step 2
Recognizing the importance of:
Safe sex
o Abstinence from sex
o Staying with one partner who is faithful and uninfected
o Use of condoms from start to finish
o Limiting the number of sexual partners
o Avoiding sex with sex workers - or people who have had
many sexual partners
o Avoiding penetrative sex - vaginal or anal
- Safer drug using practices ie always use sterile needles
- Safe invasive procedures scarification
clitoridectomy
M/F circumcision
- Avoidance of discrimination against people who have antibodies to HTV
in their blood or people with AIDS.
SUBJECT
Step 3
Managers’
Extra
Example:
METHOD
6. How do I cope with
’group pressure’ in order
to avoid 'high risk
behaviour1 e.g.,
amateur tatoos?
7. What have I
gained from this
a) training?
b) what else might I
need?
c) who can I turn to
for help?
Evaluation form to
be filled in
conf identially.
Discussion of employ
ment and personnel
issues and planning
a strategy.
The following are
some of the issues
that may need to be
addressed:
a) How do we ELir.aged
HIV antibody positive
staff?
b) What support
system is in place
to help staff deal
with these new stresses?
c) Is blood screened
for HIV antibodies in
all situations?
d) Is there to be
special training for
First Aid staff?
e) What provision can
be made for counselling
partners of personnel?
Presentation of methods
used in orther organiz
ations1 approaches
- presentation of
- Government/Armed
Forces policy on
documentation
at work.
Discussion of identified
AIDS-related issues in
the light of the previous
training.
Case study for step 2 'Frank?
Frank has been stationed away from home for four months. He is
twenty-fw0 and has a wife who is six months pregnant. He feels lonely
and fed up. Recently he went to the nearby city on leave. He got very
drunk and towards the end of the evening his mates persuaded him to go
along with them to- a-------brothel,- Ha had sex with a prostitute without
using a condom, f
be is very frightened he thinks ha ’may have
AIDS’. Next month he will be going home to his wife.
--- --- * What should he
do?
\
SUBJECT
Step 2
Step 3
TIME
METHOD
1.30
1. What are the general
implications for us with
regard to the political/
social economic impact
of AIDS/
Presentation of direct
and indirect costs of
caring for people with
AIDS.
Discussion on
impact of AIDS and HIV
infection on society.
Recognizing degree of
risk in certain
behaviour and possible
ways of changing that
behaviour.
2. Reasons for stereo
typing and prejudice.
Exercise: who gets the
cure? (attached)
3. Identification of
particular problems
relating to the armed
forces, e.g.
How will some staff
deal with:
a) enforced abstinence
on long trips away
from home?
b) what provision is
made for dealing
with marital
conflict?
Case study:
(attached)
1. What kind of
situations might
soldiers find
themselves in where
they might put
themselves at risk
of infection.
Case study: ’Xnn and Jeff’
(attached).
Discussion in small
groups followed by
general feedback
3hrs
2. Discussion on
attitudes and fears
relating to AIDS and
HIV infection.
Using discussion
exercises (see attached)
in small groups to work
out ways of dealing with
difficult situations
3hrs
3. Hom do I talk about
using a condom?
3-6. Discussion
exercises (condom
distribution could be
considered here).
4. How can confiden
tiality be maintained?
5. What provision is
made for voluntary
testing of all
personnel?
’Trank’
Discussion in small
groups followed by
general feedback
I
n c
G
U
i.
z
n
S0T£S:
--•p to explore the assumptions which
This exercise enables a group
innocent’ and ’guilty’ in relation to HIV
of inn
surround the concepts of
infection.
y.ZTHOD:
divide into pairs or threes.
Explain to the groupo that they are to
each small group:
Then allocate one of
cf the folowing roles to
HIV infected babies
HIV infected black Africans
HIV infected homosexual men
HIV infected injecting drug users
HIV infected haemophiliacs
HIV infected female partners of bisexual
men
Ask them to imagine
discovered, but that
They have 15 minutes to compile a case as
individuals.
of infected
i--why they SXLJiU pSs^th^msrto^h^'st tfSCSpa“Si=ioa^s.
be chosen
When all the groups
*ach group has 5 minutes to present their case.
while remaining in
Sve done so. ask them to discuss the arguments
their allocated roles for 10-20 minutes.
• ■
a close, it is important that
cechn.quB CQ make sure that
When the discussion is brought to
-a
de-role
(this
means
using
a
participants
role and returned to being themselves - it is
has
left
the
teverybody H—, really
involved), Ask them to
people
may get
i_-*■.
as
some
[
very important
the group and
i---- ask each person
: then go taround
-----looking "forward to that
get up and change chairs:
name and something they are This is a way of bringing
to say theirwhat
they had for breakfast.
evening or
rhem back in touch with reality.
PROCESSING:
pay particular
In the discussion of the exercise in the large group
attention to the following:
participants?
What feelings did it produce among
»< tuu b. tor '...V — "« “• S”"”
they represented?
nocenu”, ’’guilty’1 and ’’deserving
What do the concepts ’’innocent
attitudes towards particular
reflect about society’s i-------groups?
11
EXAMPLES
For small discussion groups, in step 3.2.
All the new trainees are getting tattooed by one of the soldiers
at the base. You are worried about HIV. How can you :
a.
b.
avoid the tattoo?
suggest its risky to share needles?
2.
One of your friends says he is being pressurized by an older
colleague to have sex. He is frightened - what can he do?
3.
A girl you meet will not have sex with you because ’she knows what
soldiers are like’. What does she mean? How does it make you
feel?
’What are the positive decisions soldiers can make about their sex
lives to prevent them putting themselves at risk?
5.
A lot of your friends boast about the numbers of sexual partners
they have had:
Do you believe them?
Why do they have to boast?
Do you think this influences others’ behavious?
6.
What responsibility does a man have towards a person he has sex
-■*.
with? Is this different for:
■ - JX. -.—
a girlfriend?
a casual partner?
a'wifa?
■
I
‘
7
- .’r—. -r; " ■ - "
'7
:r-*:
*- V
.. ,T • •*’
’
•-
’e-*^
L*
•’
l<r*
*-rr«
4»
’7r
•
’?
Example : Case study for step 3 'Ann and Jeff1
Ann has been married to Jeff for two years. Recently they have not
been getting on very well
While Jeff was away on manoeuvers. Ann
heard from a friend that her ex-boyfriend injects drugs
She is
frightened and worried she may ’have AIDS’. She knows she must
discuss this with Jeff before they next have sex but she does not know
now.
% y
IT
If Ann was your wife what do you think she should do or say.
Note to activity facilitators
Using this case study with target group 2 facilitators should try to
explore extreme superficial responses such as 'I’d beat her'.
DISCUSSION EXERCISES FOR STEP 3 (see sheet at end of section)
Target audience
After senior management training is completed. The health promoter
will assist in preparing the activity sessions for
ailother
--------personnel. The content of the course remains the same using part or
all of the material as appropriate. Case studies or discussion topics
may need to be altered depending on the group or the cultural
background of the staff.
Conclusion
U
Is
In order for group work to be considered successful the momentum needs
to be maintained. Participants have to feel the activity is relevant
to their lives and that changes in practice both occupationally
and personally are made and recognized as having taken place.
Positive feedback from faciliatators to participants is as important
as evaluation by the participants is for the facilitators. Individual
questionnaires should be completed after each seminar and suggestions
for changes in the programme taken seriously and reflected in future
activities.
Plans for regular updating should be a major part of the
administration of the programme. It may halp to use an outside
evaluator to look at how the process is prog
i
i
F
BOX 2
AIDS HEALTH PROMOTION
RELATIONSHIP TO NATIONAL AIDS PROGRAMME
National AIDS Committee
advises on all aspects of
AIDS Programme
development and
implementation
I
National AIDS Plan
Strong links with
decision and policy
making levels of “4
government
Objectives:
• prevent transmission
• reduce individual and
social impact of HIV
infection
►
'^"l
All major sectors and
organizations represented
►(including education.
media. NGOs. etc.)
NATIONAL AIDS PROGRAMME
Education sector
Media
>• Community organizatio
<
4
►
Health institutes
>
Civil and Military
Defense
>
National
AIDS
Health
Promotion
Programme
^.Special target audiences
(IV drug users, prostituti
gays, etc.)
4
4
► Unions/Employers
4
► Other NGOs
4
.>» Religious Groups
;\r.*
i
-tmaLarn viT—
jWWfX-
Youth
Workers
.<,-' Z C?l£ - SOCHAfiA X&Z
\!(
Koi m.,: b <ja 1 a
\ :<z^8»3r»az.kyrc x\. ■ '<■'/ /r •
A
' o ’j
y
-------------••"■r av-* ..'^•
V
w ■
BOX I
action notes
FOR
MOBILIZING LOCAL ORGANIZATIONS
aids information and education plan
Initial meeting
with steering
conmittee
< Identify group to
provide information and
education based
activities
Reassessment
Monitoring
progress
'
Local Health
educator
/Budget and imple- \
mentation schedule,)
Meet with target audience
to discuss needs and
existing behaviour
Setting objectives
and developing strategies
1
Identification and
Development of
support systems
gathering materials
and designing training
A
M:T?
'W
J
Setting objectives
With the results from the survey
survey the 1 —
committee
can set
the objectives for
Workers and
for th*
th8thAIDS
campaign
. It
staees
■t is
Xf P
Particuia;f.'^_
articu^rly important
J edu“tion and steering
all rstages ln planning to ensure that ! that
“
! to ensure that
delivery are developed.
hat aPPr°priate
—a messages and channels
?-™s p„pl.
Information Campaign
Production/gathering oof
materials
nationally and locally from
young
people
Pilot dissemination
of materials
to representative samples
I
Evaluation
Training Process
Training of youth workers
Youth workers begin
activities with young
people
I
Dissemination of r-materials/medi a
posters, leaflets
--- > etc
Production of fl
Plays, comic
strips, Puppets,
.
---- - T-Shirt
logos and badges
Young peopleLork with
1 peers
the community and ,
assist
organization. in
developing outreach
activities
Feedback and evaluation
Evaluation
Programme Development
1 ch® National AIDS
promotion <-or «m«Cralttee AIDS health
of the outcome of
use locally cr
or may
thttwlvM.
a«iVitias with Ithe youth workers
1 be developed as part
— J oy the young people
discussing AIDS
the need for
further emphasise
discussion f
by ■' d
messages which have r
themselves. Small plays”
•■ha young people
part
Part of the AIDS education acUv?M PUPPet Sh°WS “«* posters produced
become ]Part
-- of the district
Within th*CMpaign O,Th21Z?ti0n Can then as
information
shows can be taken
meeting placas s^Jh Pli?S and puPPet
the market place
■»«
«o.d
a.
.
ta.j,
f-„ ® P CM such a» bus stations or
discussion.
— community education and
tb-..!™.,
X'"1”
---- -.to M"“ X”rU“
action notes
YOUTH OHGXNIEAITONS
school AIDS prevention activities areoaSg^P^“ntay
Out of within the education system r^e
specially trained
programmediscuss personal behaviour in a youth^clu
as part £ the
able to dthan with their teachers in
h
workers uithin youth
youth workers health promotion plan, train g
national AIDS
organizations is essential.
Zog!ation of
oLJLSt££S
i.n^ Conmittee
a
POSSible
A steering committee
They will ensure that:
a)
All AIDS prevention
activities are coordinated.
of the activities is maintained.
The
momentum
b)
of the
to maintain accuracy
is ssp—l—
c)
received.
messages
out activities
training in order to carry
d) Youth workers receive
within the organization.
authorised in order to
■ , and evaluation proceedures are
e) Monitoring
addYo the overall strategy.
modify °r *-training appropriate to the
«
t-hp service receive
Senior managers m the
needs of the organization.
-- » of in-school
A coordinated programme
would be the 1—
values based activities
-“ - for the Xrmed forces to
health promotion
cheCkli3t
‘steering committee. (Box 4)
See theall areas are covered by the --make sure
Base line information
.„.S
t of young people will
AIDS, present behaviour an
practices and areas of need.
Some suggested
discussion topics:
AIDS and STDs?
of knowledge about
current
level
a) What is the
HTV antibody
attitude towards those who are
b) What is the current
pos itive?
practices?
What is the general understanding of safer sex
c)
the problems associated with using condoms?
d) What are
sexual histories di'scuss.d with present partners!
e)
f)
How are past
What
avoidance
needs to happ«n to ensure
of risk taking behaviour!
w
Some of the funding may be raised by production of T-Shirts sticker^
part of
of the
AILS prevent^
badges which can be sold locally at a profit as part
the AILS
prevent^
awareness campaign.
is.
Monitoring and evaluation
• - committee monitors the progress of the campaign and
The steering
of:
all
the
reviews i-- -- evaluation materials. This may be in the form of.
a)
Survey results pre and post training.
Evaluation forms filled in by the young people after activity
b)
sessions are completed.
Focussed discussion groups following a pre-set questionnaire before
c)
and after training and activity sessions.
Reassessment
rampaign is adapted in the light of
progress and if necessary re-set goals.
District media campaign
TV, radio, leaflets, posters
Activity sessions
with young groups
____
'V
production of materials
by young people themselves
Peer group activities
and organisation
community
participation
activities
Development of support systems
It is preferable that the AIDS education and prevention work within the
youth organizations be part of an on-going programme of personal skills
traiing, including decision making and sexuality education. However, where
this is not possible the youth worker should consider broadening discussion
to include these areas. The ability to make life choices is fundamental to
the ability to avoid infection with HIV.
Many of the youth workers and their target audience may find discussion
difficult at first particularly when discussing individual personal
behaviour. It is important therefore to prepare a'support system before
training begins to ensure individuals have an opportunity to evaluate their
own behaviour and life decisions in a comfortable, confidential environment
with someone they trust. A telephone helpline may help those who do not
wish to be identified.
If sessions with young people are carefully planned before
hand a great deal of anxiety will be averted. Youth workers need to make
decisions in the following areas:
a) Where will young people go for extra help after the sessions if
necessary?
b)
What will the group size for the sessions be?
c)
What will the age range be?
d) What is the previous knowledge about AIDS and HIV infection of this
group (refer to survey).
e) hat is the ’comfort level1 of participants in dealing with personal
information.
Budget and Implementation Schedule
financial support will be needed in the following areas:
Materials production, e.g., leaflets posters
Printing - mimeograph machine
Cost of special events, e.g., projector for slide shows, Hire of
premises, refreshments
Telephone
Office supplies
Part time staff
Transport/petrol
Per diem/speeders fees
I
I
\
Box 2
Listening Skills
Providing some simple
< *
listening skill*- will c i
educator offer a more
-p
PO
„lv.
in1
help.
n
come for
Advice and information
1 is often not enough for clients t
make clear decisions with
regards to taking a blood test forto be able to
HIV or deciding to make a <
antibodies to
change in a particular type of behaviour.
However, training to become a
counsellor is a Tlong and involved process
and for the primary health
care worker it may be of benefit
extra skills immediatPlv
---- to offer some
Listening
In the course of conversation t
«e often do not 'receive' all the
nformatxon that is being given
say m response. Equally when we are
d fftcu t^r^ idea fUrther b—se we are
finding the subject emotionally
ifficuit or because we are interrupted.
and e^
hear^ha^they
With0Ut int«rupti
assess their lifCtytes
that they hav° an e- on helps us to
opportunity ”to
to change behaviour”
UstXr^T^0"3 and wil^8ness and
capacity
without discrimination oJ ensure "at^h t0 i* ^^etfc, to 'hear'
-ir fears
opportunity to
Activity
1.
In pairs, taking it in turns, tell
your partner a shortened version of
your life history - 5 minutes.
2.
expressions and bodyPlZnguIge?Ura8einentS through thei* facial
3.
Change roles and make
sure the person who is talking is
interrupted.
not
4.
Now tell y
---?uF Partners life story
to the main group, f
sitting and listening
Discuss how
J only, made you feel,
--- - How much did
and what were the
-J yyou remember
reasons you could not remember the whole
--- 1 history?
Sometimes the cl
client gets stuck <---on in what they have-i to say.
M
fee\ thay r9ed t0 be -oved
An ’open
“ ended
Pndsd ^Mtion might help.
For example?
id
'How did that make
you feel?"
A
■
EXAMPLE
Training for Youth Workers
METHOD
STEP
SUBJECT
Step 1
Information about AIDS and
Hrf infection covering
the virus transmission,
course of illness,
infectivity.
Slides or video followed
by discussion
’AIDS WISE' (See
attached)
Step 2
Identify AIDS related
desired practices for
young people
e.g. Safer sex (use of
condoms, avoid casual
partners, avoid sex
with prostitutes etc)
Discuss these
practices in
relation to the
issues involved for
the young people
you work with,
(pairs or threes)
Are there any others?
(Whole group)
What are some of the
other factors that may
block these desired
safer practices e.g.
peer pressure
adolescent risk
taking behaviour
Whole group brainstorm
Step 3
1) Avoiding high risk
activities
2) Looking at sex
role stereotyping
1) Discussion
3) ’No Sex’
3) See attached
worksheet 1
4) How to say no I’ll wait?
4) See attached
worksheet 2
TIME
1.30
1.30
2) Word game ’Ideal Man
Ideal woman’
3.00
5) How do I say ’I want
condom? ’
to use a condom?
5) Presentation
Cartoon game see
attached worksheet 3
6) What have I learned?
What else do I need to
know?
Where can I find
this information?
6) Evaluation
Focus group discussion
Questionnaire
4s;
-2An open ended question is one that needs an explanation rather than a
’yes' or ’no' answer.
If your client seems to be going over the same ground many times,
summarizing where they have got to might help them to move on to their next
thought.
For example -
’So as I understand it you felt frightened by all the
information you received about AIDS, but you did not know
where to go for help. Now you have come to see,us and you
feel you would like to find out more about the 'test', fs
that correct?
Practising ’listening’ and ’moving on’ with your friends and colleagues
can dramatically help your approach with clients and help them to come to
terms with their present difficulties.
4*
I
1 ■■■" U ,11,1 II
*
"N 0
S E X”
PURPOSE
f
To have considered that choosing not to be sexually active at the present
time is a viable alternative.
METHOD
Draw two hftadings on blackboard:
DISADVANTAGES
ADVANTAGES
OF 'NO SEX NOW1
n the advantages and disadvantages of
Ask the whole group to brainstorm
sexual relationships until they are (? 18? married).
deciding not to have i----- —
I.■■IIUA JSHL
"AIDS
W I s
■
PURPOSE
Recognizing the difficulty of translating formal information into a useable
form for young people, f*
"
Finding
ways to understandj risk taking behaviour.
-IKETHOD
■ ''Mel
Prepare cards with the following words:
Mosquito bites
Using a latrine
Hugging someone with HIV
Having your ears pierced
Deep kissing
Swimming in a water hole
Having sex with a drug user
Scarification
Anal sex
Caring for someone with AIDS
Vaginal sex with a condom
il:
• +
High risk.
•f ww
Anal
with a condom
Oral Sex
. J •.
Sex with your husband
Receiving a blood transfusion
'
Helping someone with a________
nosebleed
. Sharing a drinking glass
...
Injecting drugs for the first tima
..f
I
1
.
‘
• Low risk
No risk
Don’t know
.
Put risk cards on the floor in a line
-
*• •• • -
w. ’
• Hand out statement cards to group. ‘' Each person reads what is on their card
and places it on the continuum of risk stating why they think this activity .carries the risk they have chosen. Others in the group may challenge the «
decision and the person may change their mind or leave the card where it is.
At the end of the game discussion takas place concerning the cards over which"1*^
there was dispute and the cards placed in the ’Don’t know’ area. The trainer
provides factual Information or helps the group to put the risk into
perspective by describing a ’worst possible scenario’ and th. group decides"^'how realistic the risk is in everyday life.
*? "
•*'
__
I I) E A V
MEN,
I D P, A !.
W 0 M F N”
FJBPOSE
.
To look at the role of.and the reasons for sex role stereotyping and its
effects on sexual behaviours.
To understand how stereotypical sexual behaviours can have an inhibitory
effect on the adoption of safer sexual practices.
1
i
This exercise can ba used in either small mixed or single sex groups.
the headings ’Ideal man’ ’Ideal woman’ write all the adjectives used to
describe men and women.
Under
1
1.
Can the male adjectives be used to describe the female or visa versa?
2.
Why do we use different adjectives for different people?
3.
What effect does this have on either sex?
4.
How is this relevant when discussing ’safer sex1 behaviours?
&
pi
I
HOW
D 0
T
SAY
A
"T
WAN T
T 0
USE
CONDO M"
PURPOSE
r
To consider Che difficulties of discussing Che use of condoms with a sexual
partner.
Method
Maria has decided to ask Juan if he will use a condom.
What do you think might be said if:
a)
Juan feels uncomfortable about using condoms.
b)
Juan feels happy about using condoms.
Fill in the balloons to show a possible script for (a) and (b).
balloons if necessary.
*
Add more
i7
r
"N 0
1% L
W A I TH
'T
PURPOSE
To encourage trainees to consider ways of not being sexually active at
present.
r<
METHOD
not
eax* campaign which is trying to promote the message that £ot
Imagine a media
sexual relationship is the exciting thing tc have happen these
being in a
days. The campaign should highlight the benefits of this choice.
Divide the class into small groups and get them to plan a media campaign
etc.
using various channels - TV, radio, posters, etc.
.
.
■ ^r.\:
^«^“h=h01“
a'--:-
r”. ’
:•
jFM*
. ......... ....
. ■7 '^’
:e
.
;,A;. *•-r-/. v.v." ■
•.■
. :T*1
.
-‘ 7
*■ - :
u. .
. i
71
■nil ■■■■■i t iiiF
' :.-.V, --jr
OPTIONAL EXTRA
CASE STUDY
MARTHA
The trainer leads a d i scuss ion and o r
brainstorm about the issues raised in this
study.
Her parents have arranged
for her to marry a man whose previous
Martha is frightened.
wife died of AIDS.
Martha is 17 .•
What
qh• H o ?
I
Ii
II
■
'O
JUAN
MARIA
i
r
'll'
JUAN
MARIA
I
A
30X I
ACTION NOTES
FOR
MOBILIZING LOCAL ORGANIZATIONS
AIDS INFORMATION AND EDUCATION PLAN
Initial meeting
with steering
committee
< Identify group to
provide information and
education based
activities
Reassessment
\
\V'
Monitoring
progress
Local Health
educator
S'iudget and imple- \
( mentation schedule )
Meet with target audience
to discuss needs and
existing behaviour
Setting objectives
>
and developing strategies
J
Identification and
Development of
support systems
gathering materials
and designing training
tl
*
BCTiSN
NOTES:
Womens
Groups
r-1'
¥
1
■ t.
Formation of a Steering Committee
Each organization should organize a steering committee, the membership ofv
which should include the leadership of key organizations and those who already V
v
have some responsibility for the education, care and support of women locally, V
e.g. doctors, nurses, teachers, religious leaders. This group will be
responsible for the programme and ensure that:
\
(a)
All AIDS prevention activities are co-ordinated.
(b)
The momentum of the activities is maintained.
(c) There is supervision of the activities to maintain accuracy of themessages received.
(d) That the group leaders receive training in order to use the training
materials appropriately.
(e) That monitoring and evaluation proceedures are authorised in order to
modify or add to the overall strategy.
(f) That the programme planning and implementation directly meets ths
needs of women as reflected in the information received in the early
discussion groups.
(g) Senior managers in the service receive training appropriate to the
needs of the organization.
(See the health promotion planning checklist for the Armed Forces to make
sure all areas are covered by the steering committee.)
Base line Information
The group leaders will meet with small groups of women in order to
understand their present knowledge attitudes and practices relating to AIDS and
;
HIV infection.
It will be important to concentrate on specific practices of
women and their children which may put them at risk of contracting HIV
infection or of developing AIDS. e.g.
a)
What is the current level of knowledge about AIDS and STDs?
b) What is the current attitude towards those who are HIV antibody
positive?
c)
What is the general understanding of safer sex practices?
d)
What are the problems associated with using condoms?
e)
How are past sexual histories discussed with present partners?
f)
What needs to happen to ensure avoidance of risk taking behaviour?
These arei VERY sensitive questions and thus need to be handled with care,
will have to know the women well and the women must feel able
The group 'leader
--
■
ACTION NOTES
WOMENS GROUPS
(
AIDS and HIV infection will affect the lives of i--women and
both in terms of the possibility of them becoming infected
and their children
-—
d ofprovide
thea having
to take care of relatives or friends with AIDS. Womens
Womens groups
an
----*
excellent point of contact for AIDS education. T.._z
P P
0 an
They include womens income
generating cooperatives, social clubs, church affiliated
------ associations, social
action groups and literacy projects.
engaging womens groups in AIDS prevention and control. The training materials
in this section may be adapted to be used as small plays, puppet shows and
radio messages to help , develop discussion. More importantly however, a careful
study of existing knowledge about AIDS and HIV infection and
and the
the present
Practices and problems relating to avoiding infection myst be carried out.
With this information changes in the suggested exercises presented here can be
made. The training programme is created towards women who have a leadership
role in women s groups. To be able to discuss the specific difficulties women
face W!th regards to AIDS and HIV infection it is essential that training is
provided for the group leaders in order that they should have an opportunity to
recognize their own knowledge, attitudes and feelings.
7
Women in politically strong positions can be directly involved in planning
the AIDS programme and it is their commitment to supervising the content and
delivery which needs to be assured from the outset.
-4-
Development of outreach activities
I
Dissemination of materials
media involvement, posters
leaflets, etc
I
i
Evaluation
r
Feedback and evaluation
Activities begin
Evaluation
Programme development
Materials can be
and adapted for use
the women themselves are involved in
activities with women —
groups,
- will be readily understood and general discussion and
production, the messages t-ll
JIL. in their p»a»etion. Th. .dht.tx.n -t.r..!.
further learning can t'1’
posters or radio messages. Pre-testing of all
may be in the form of leafletse interviews with the target audience to discover
the materials understand
is essential
the i.message presented and whether they like the form in
whether they
which it is presented.
Development of Support Systems
will often already have developed1 informal support systems amongst
Women
each other in their work and discuss problems as
themselves, They will help <difficult to discuss individual problems
they arise. However, it is more --or their partners. In the
relating to personal behaviour either
t eir ownsuggested
<
activities
here, it may be that
course of implementing some of the
--. .
-- J detail and in confidence. The
individual problems need to be discusse
in the support system for further individual
group leaders act as 'first line orefer
1
to discuss difficulties outside of this
discussion. However, women may p needs to be developed to allow for thi’organization and a referral system
□ and doctors, and it may be possible
The referral system should include nurses
Programme in setting up a
to assist the local AIDS Prevention and*i Control
C
local health centre.
counselling clinic at the
I- —
Budget and Implementation
Financial support will be
needed in the following areas:
Materials production, e.g.» leaflets posters
-Printing
- mimeograph
nde 5sno
hows, Hire of
Cost of special
events,machine
e.g., projector ffor slide
-
premises, refreshments
Telephone
Office supplies
Part time staff
Transport/petrol
Per diem/speaders fees
Costs should be covered by the funding for the
*•
National AIDS health
-3-
to speak in confidence. It may be preferrable to talk to women individually or
allow them to come and talk to the group leader in a safe place. It may be
possible to find out the incidence of ’sex for money’ in a particular area or
how frequent is the sharing of hypodemic needles when using"injectable"drugs^
However, the group leaders themselves must feel at ease when talking about
these practices. In formulating the areas for discussion with the district
health promotion team the group leaders must have an opportunity to discuss
their own feelings on these subjects.
In addition to the knowledge about the present risks for women of
contracting HIV infection it would be useful to ascertain those practices which
would cause women already infected with the virus to go on to develop AIDS more
quickly. Remaining generally healthy is crucial in avoiding multiple
infections and often women are least able to do this because of:a)
their workload,
b)
multiple pregnancies/anaemia,
c)
1they
’
often take their meal when the rest of the family has eaten so
they are least likely to eat fresh food.
Women are often the victims of other peoples refusal to make changes in
their behaviour. It is therefore also important for women to look at ways they
can work together to bring about a change in attitude of those around then.
Setting Objectives
Mith the results from initial group discussions, the steering committee car
set the objectives for the AIDS education and prevention campaign. The women1 r
group leaders should be involved in all stages of planning to ensure that
appropriate messages and channels of delivery are developed.
The training for womens group leaders needs to take place first so that
training sessions can start at the same time as the education rampaign, If
information is given about AIDS without there being immediate follow up
up at an
individual level anxiety may increase due to people not knowing how to deal
with specific problems relating to their personal behaviour.
Information Campaign
i
1
Training Process
I
Production/gathering of
materialsnationally and
locally
|
Identification of specific needs
of womens group leaders
Pilot dissemination of materials
to representative groups of
women
Development of materials for
discussion to meet identified needs
Evaluation
Training
-6-
METHOD
C.ONTEKT
TIKE
Step 1
Information about AIDS and
HIV infection, and virus
transmission
Presentation, video slides,
charts, discussion
Step 2
Identify the major issues
relating to women and AIDS
in the light of information
from step 1. e•g•
Brainstorm
- Taking care of relatives
with AIDS
- Preventing children from
becoming infected
- Staying with one faith
ful partner
- Using condoms for
penetrative sex
- Avoiding multiple
partners.
- Making sure children do
not receice multiple
injections
- Safe sex working
- Safe practices in
circumcision
Break into pairs or three’s.
Take one of the issues and
discuss it in relation to
how it will affect your life.
How can women work towards
changing their position
with regards to these
issues.?
Role play - see attached
o Mary and Ron
o Asamoah and Boatema
What can I as an individual
do to protect myself from
HIV infection and AIDS?
Having worked out a plan of
action for each of the
characters in the role play,
decide how you would deal
with the same situation.
What would you want your
children to know about
AIDS?
o What behaviours would
you wish them to adopt/
not to adopt.
o What other practices e.g.
multiple injections may
|
affect your children's
liklihood of becoming
infected.
I o Can you change these or
I have you any influence
I
on them.
Discuss the answers to these
questions and then prepare
small dramas taking on the
role of mother and child.
How do we talk to young
people about these issues.
Step 3
Plan for Action
'What do I hava, what do I
need' (Sea attached)
-5promotion campaign however the budget should be realistic in order to prevent
the programme having to close due to lack of funds.
Monitoring, Evaluation and Reassessment
4
1
The steering committee is responsible for monitoring the progress of programme
and reviewing all the evaluation materials.
This may be in the form of:a) Reviewing the content of the group discussions before and after the
group leaders have conducted activity sessions.
b) Evaluation forms filled in after the training of the womens group
leaders.
c)
Reviewing the comments of the pretested materials.
In order that the campaign meets the needs of the community reassessment of
the materials produced and the reception of the messages needs to be undertaken
at regular intervals throughout the programme. Changes should be made where
necessary and the women groups leaders should be invited for training updates
every 6 months.
Suggested Programme Schedule
2
1
Formation of steering
committee
4
5
6
7
8
X
X
X
X
X
X
X
X
X
9
10
11
il
12
X
Womens group leaders
prepare group discussion
X
Group discussion and
evaluation
Education campaign
prepared and pre
tested
X
Training for womens
group leaders
X
I X , XX I X
Education campaign
Activity sessions
with women
Evaluation
3
X
I
I
X
X
X
The programme may then be repeated after reassessment of goals and possible
change in content after review of the evaluation results.
Annex 2
What do I have?
What do I need?
Notes
This exercise is particularly useful if the group is feeling negative that they know nothing, that they lack skills or that they cannot change
anything.
Method
1)
Work alone.
2)
2) Think about what knowledge, skills and abilities you already have that
will help you to talk about AIDS and HIV infection - particularly to raise
with your peers some of the issues you have discussed today.
3) What do you need to be able to do some of the things you have discussed
today?
4) After 5 or 10 minutes choose a partner and talk through your thoughts.
The partner should encourage you to clarify your thoughts, Do not develop a
conversation. Work out a simple plan of action for you to take away with you.
If possible, begin to arrange some of the support you feel you might need,
before you leave the training session.
i
ZWhe-sochahaS-A
t^{ Koramangaia
VV^Bangalore -
p is Ci>-5
N8&
y-H
f
-1-
Role Play:
Mary and Ron
Mary has been married to Ron for three years. She is pregnant and also has
to work full time to pay the bills. Ron is having sex with other women and
Mary has just found out. She would not manage on her own now the baby is on
the way when she will have to stop working for a while.
Ron knows he is HIV positive but has not told Mary yet. He is frightened
he has already infected her and the baby. Today he was given the sack from
work so he will be dependent on Mary until he can find another job. Ron feels
he 1loves his wife and that the casual relationships he has on the side do not
matter. He has started using condoms with his casual partners but does not
know how to bring up this subject with Mary.
Take on the roles of Ron and Mary, Mary has just told Ron that she knows
he is having other partners. Work out a plan of action:
a)
for them both as partners;
b)
for them each as individuals.
OR
Role Play:
Asamoah and Boatema
Asamoah has been married for a year, He is a truck driver who is away from
home for several weeks at a time, In the past he has had casual sex with women
he meets at the truck stops.
I'
Now
he knows about AIDS and is worried he may be
infected. His wife JB.pa.tema wants a child,, they
cney do
ao not uee condoms so very soon
she may become pregnant, Asamoah is worried he may have already infected his
wife. He is not sure what to say to her.
Boatema wants a child. The other women in her village are already
wondering why she is not pregnant. Boatema says it is because her husband goes
away so much for his work. Her friend’s husband who was also a truck driver
has just died and people say it was because of ’slim’. Boatema is very happy
Asamoah is such a ’good’ husband. She has seen how people now treat her friend
when they go to the market and she would not like people to be as frightened of
her.
Take the roles of Asamoah and Boatpma. Asamoah has plucked up courage to
speak to Boatema. What happens? What will they do?
Always come out of role
Once you have finished this exercise it is important that you cease to be
the characters you have chosen. It is quite easy to feel upset by the emotions
raised. Tell your partner your real name, where you live and if you had one
wish what you would wish for. Talk for about two or three minutes.
?0X 1
ACTION NOTES
FOR
MOBILIZING LOCAL ORGANIZATIONS
AIDS INFORMATION AND EDUCATION PLAN
Initial meeting
with steering
committee
' Identify group to
provide information and
education based
activities
Reassessment
Monitoring
progress
Local Health
educator
Budget and imple
mentation schedule
Setting objectives
and developing strategies
4
-
Meet with target audience
to discuss needs and
existing behaviour
J
Identification and
Development of
support systems
i
gathering materials
and designing training
■
J?£77£¥
THE
IDORKPLHCE
!
4*
4
a)
What is the current level of knowledge about AIDS and STDs?
b) What is the current attitude
positive?
towards those who are HIV antibody;
c)
sex practices?
What is the general understanding of safer
d)
What are the problems associated with using condoms?
e)
How are past sexual histories discussed with present partners?
avoidance of risk taking
f) What needs to happen to ensure
behaviour?
How employees would react to?“
a
b.
c.
Working with colleagues who carry antibodies to HIV.
Themselves becoming infected.
Caring for 1) colleagues
□r friends who become ill
ii)' family members
with AIDS.
3 if they need more individual help over specific
4. Where will they goAIDS and HIV infection.
problems relating to i.
The group leaders after receiving training which will enable them to carry
K.y,_ irtivitiea designed to meet the needs of the staff will begin by
XX
"tin, the lnltl.1 ‘"^""tlon 8«he.,lnjS session. It is
Confidentiality must be
important that employees
'e’i lo b, seen as tmsteorthy
emphasised and maintai w.
spend time together before group
and approachable,
. t their own feelings about some of the issues
^Tlirte^lin/eyn’in ^™\h^"L^4~t“»lln,
-’etX to autos,., .hst
h.
difficult subjects for them.
Setting objectives
One. th. results of th. initial group discussions have been assessed, plans
be made. This may be in the
for a specifically directed education canpaign can
be produced to give general messages
frvrm of leaflets, posters and cartoons can '
□ who have HIV infection is
about HIV infection and that working with co
23 of condoms and ways HIV
safe. Information about methods of safer sex,
infection is transmitted can also be presented. It
- may be possible to make
j to use then by explaining the
condoms available at work and encourage employees
they always do.
method and using local personalities to suggest that
L.
distributed to all staff so
A plan of action over a period of tim* can be
information and a chance to
they understand how and when they will receive
discuss individual problems.
XCTION NOTES
7115. WORKPLACE.
The workplace is defined here as commercial, service.industrial
The “°rkPl
based occupational settings, excluding
health care, military, school and like settings
depends almost, entirely on
education understanding
in the workplace
---- . of —
maintaining
The success of
or AIDS
aivo euut-o
the importance
-"t2 a
from management to It is the management7 who will in the first
^ll^iMtXd^nrheSTtaff.
and healthy staff.
of transmission and also how
need to become i..---i relating to AIDS and HIM
be enlisted as an important
ES^of ‘ inXreVndTm
Programmes.
i Committee will have as part of its
The National MBS Health Promotion
----- i to
organize outreach programmes
I employers.
. .
National MBS plan an objective to r
of
AIDS
information
need assistance to plan a Pr°8ra^e
discuss the particular
II?staff and also give
3 of their personal behaviour
colleagues who may be HTV
— antibody
- - positive or u
with information, individual support andl a
To ensure all staff are provided
AIDS and HIV infection a team should be
chance to discuss issues in relation to
maintain its momentum.
trained to act as group leaders to help the programme
Formxation of a Steering Committee
,
f
the programme should be developed and
t».
ior th.
maintained by a :
associations.
organisation l
committee will be to:
responsibilities of the steering (----receive training including the ’management extra’
1. Ensure all managers
suggested here.
*
e
•X.A.^^ee*
2.
To ensure the group leaders receive training.
3.
To ensure all AIDS prevention
4.
That the momentum of the activities
(
5. There is supervision of the
messages received.
activities are co-ordinated.
in maintained.
activities to maintain accuracy of the
6. Monitoring and evaluation proceedures are
or add to the overall strategy.
authorized in order to modify
Base line information
of the employees small group
In order that the programme meets the needs
The content of these discussions
discussions, samples need to be carried out.
should cover the following areas.
-athe adaptations
ented here or
studies
pres
:t 13
A ►
spots.
been identified . The case
basis for the radio
i
materials
need
to
needs have
studies may be used as a local language and the t—into
general
case
being put
of those <
■ 3 the need to use
recognize
audience before
1important. to
“sinhl sample of the target
be tested on a
use.
sustems
,
fallowed by discussiona of attitudes
Develop >ment_ 2L-^2£££k-^_'
.
t AIDS and HIV even wnen
stm leave some in.
-;a;X“’•••« “"°m- r”
.
peopl.. to. this
and beliefs.
feeling anxious about
feeiinB
related issues
structure f
flden„f dealing with people
wayof or ae»i«‘s outside
._.a_ th® organisation
«
----- b®?."3 propriace,ro«ay
Ration prograwe
anisation may be an
P
q pbone a counsell
ar 4i£
t0 phone a
4i£ficulty
ficulty or
or
an otgi
duscuss t^ir particu^^ £a(..litiM My
remain
^selling .-th ref erral
detailing alternatives
but using Pace to face counselling^
agencies
o available for sta: e.g
request,
in some casesorganization should leaders, other counselling
necessary
nearest hLpitai. r.lig-3 support system
nearest health centre
agencies.
a—
'“i^sr^th.
■_ Where
r ha realistic
realistic in its costing. health
activities1 must b® in an organisation.
exist within an <
financial
.
support will
'The funding of these
services already c overall strategy. -health Promoti°"
of the
hould become part
promotion stareas:
following
needed in ^e
leaflets posters
projector for slide shows. Hire of
d““0"; iL
•
- p”
mimeograph
—8
-'
,
projector
Printing
of'* special events, e.g.. PIUJ
Cost
freshments
premia®5» re£
Telephone
Office supplies
Part time staff
Transport/petro
Per diem/speeders fees
term small group
• i and long
not going to be
education campaign
ff condoms are
both
short
term
calculated.
’The coat
• n of distribution may ba
need to be_ nationalisation
will
also
i
activities ’■
! then soma
of those most in need.
continually available
the
basis
considered e • g • on t-ind Reassessment.
■ 3 the progress of
Honitorin] Evaluation.
for monitoring
Evaluation may be in
—ions ible
tearing committee will be
results,
The 3t a and reviewing all the evaluation and post training and repeating
of the workplace at
leaders pre
the campaign
sample
with
a
representative
n
of
forms
termssmall
c.
group discussions u—the t—
regular intervals*
Budget
4-
-3-
Suggested plan of action
YEAR 2
YEAR 1
8
2
MONTH
9
2
10
Steering committe
meets
Identification
group leaders
Management + group
leader training
X
Group leaders meet
to plan group
discussion
Group discussions
to identify needs
Evaluation and
education campaign
planning
X
Collection of
materials and
development of
locally appropr
iate messages
10
YEAR 2 (cont)
3
4
Pretesting
materials and
evaluation
X
X
Dissemination of
education materials
X
Group activities
with all staff
X
Evaluation and
Reassessment
X
12
X
X
in a shorter period of
It may be necessary to carry out this programme Individual support for
all the units need to be included.
time* However,
1-——
at the earliest
employers and employees should be built in to the programme
opportunity.
Materials development,
from the National AIDS health promotion campaign
Materials may be gathered Group
leaders may wish to develop specific
and adapted for■ use locally.
the
initial
discussion groups Ihav«
-- been completed and
educational materials once
J
*
-5-
/
CONTENT
METHOD
Step 1
AIDS information. Facts
about transmission, the
virus, and epidemiology.
Safety at work and first
aid proceedures.
Presentation, Video, slide
show, charts, discussion
Step 2
- Implications of this
information for
behaviour
- AIDS and its effect on
the organisation
Discuss
Case Study (1)
See attached
Step 3
- Reasons for stereo
typing leading to
discrimination
- To test or not to test
for antibodies to HIV
- Does peer pressure change
personal behaviour?
- To look at our own values
and how they affect
behaviour
- Optional extra
Use of Condoms
Exercise see attached
’Who gets the cure’
from Armed Forces Module
Small Group discussion
See attached
Case study discussion
See attached (2)
’Jenny’s story’
- How useful was this
session
- What more do I need
- Where do I go if I
want more help.
Managers
Extra
Discussion of employ
ment and personnel
issues and planning
a strategy.
The following are
some of the issues
that may need to be
addressed:
A
(Optional) Presentation
It may be useful to provide
a family planning
practitioner to make a
presentation on the
method of using condoms
safely followed by a
discussion of some of
the advantages and
disadvantages of using
them.
TIME
t
;•
Evaluation
Questionnaire and
discussion in small
trainer led groups.
i
Presentation of methods
used in other organis
ations’ approaches
- presentaiton of
- organisation's
policy on
documentation
at work.
CASE STUDY
Purpose
To highlight issues relating to AIDS and discrimination in the workplace.
Jones and Co is a large manufacturing company, The manager of the company
has called an executive meeting to deal with a current crisis, This is the
situation.
The chef in the company canteen is opnely homosexual and at work he
frequently discusses his relationships. The manager’s secretary overheard him
telling a friend on the phone that he is HIV antibody positive. She spoke to a
number of others about her concern over this, and the staff association has now
approached management threatening strike action unless the chef is dismissed".
Present at the executive meeting are:
the company mananger, male, married, 2 children, bisexual, HIV antibody
positive;
the administrator, female, whose boyfriend has many partners but refuses
to use condoms;
the managers personal assistant, female, having a casual affair with the
manager, unaware of his bisexuality or antibody status;
the company accountant,.female, whose husband is a haemophiliac with
AIDS;
the staff association president, male, disapproves of homosexuality;
the chef, homosexual, HIV antibody positive, knows about manager’s
bisexuality and antibody status.
Discussion
o
o
o
o
What might happen at this meeting?
What issues do you think will be raised?
What would you consider the best possible outcome of the meeting?
What would you consider the worst possible outcome?
(Role-playing this meeting is an option which can be considered; however,
remember the need for thorough debriefing and discussion.)
A
-6-
CONTENT
Managers
Extra
a) How do we manage
HIV antibody positive
staff?
b) What support
system is in place
to help staff deal
with these new
stresses?
c) Is blood screened
for HIV antibodies in
all situations?
d) Is there to be
special training for
First Aid staff?
e) What provisioni can
be made for counselling
partners or personnel?
METHOD
TIHE
Discussion of identified
AIDS-related issues in
the light of the previous
training.
•an should reflect both the changing Informationi about AIDS with
,d to be reset in the light of
reacitons from the workforce.
■>
CASE STUDY (2)
Does Peer Pressure change behaviour?
Jake has been attending the AIDS Seminars with his colleagues that have been
put on by the occupational health department at work. There are condom machines
in the toilets near his office. Many of his friends say they are using condoms
now and Jake recognizes how important it is and admires his friends for having
been able to change their behaviour. However, Jake is a very shy man, he does
not make friends easily. Occasionally he meets someone he would like to have a
sexual relationship with but he is too embarrassed to discuss using condoms with
them and so has unprotected intercourse. He is very worried about AIDS. He is
afraid to talk to his friends about his problem because they seem to have had no
problems with changing their behaviour.
Discuss how Jake might overcome his present difficulties.
What could Jakes peer group do to make it easier for him to talk about his
problems?
What could the group then do to help others who were finding it difficult to
change their behaviour?
4^
v
TO TEST OR NOT TO TEST
Purpose
To examine the reasons for and against taking a test for HIV antibodies.
Mary has been married and having unprotective penetrative sex with her
husband John for three years, Yesterday she heard that a boyfriend she had had
four years ago has just died of AIDS. Mary had not known he was an intravenous
She is just about to start a :
drug misuser.
new job and will have to have al medical where they will ask her her
- Mary and John are just about to buy
antibody status -• confidentially
-- 21their first house and the
—’ will not give them insurance if she is HIV and
insurance company
have
been talking about having a baby.
Mary and John
Should Mary have a test?
Should John have a test?
Reasons For
What would you do?
Reasons Against
i
optional hxtra
£2^ S E STUDY
The
T9
C 0 N C L C S IQ v ;
C ra ine r
1 e adg a discussion
and o r
brainstorm
about che - s a u e 3
raised i n
this s cudy.
A v o m a n you know
t o nave had
manv partners
has been brought
i n : o che
health worker
vi C h whom you V H r k
closely blcedi
ng
Profusely after a
fight .
Hov does Chia
make you feel?
What do you do?
Wha c
advice can
you give her?
88
>•
¥
jennts story
Purpose
of AIDS
own values about a range
To assist participants to clarify their
related issues.
• ; bisexual and HIV
I sexual intercourse for the
Jenny leaves her
Jenny has not yet had an antibody test.
discovered that her
boyfriend after a row.
of the managers. Phillip, has indicated
i if she has sex with him.
finds Phillip attractive. Phillip
Jenny is both interest in the promotion and
and Jenny comence a sexual relationship.
• • to
• j talk Phillip into
...
.Nancv who has unsuccessfully tried
\ without his knowledge or
h
Phlchildren decides' to deliberately become pregnant u
proves positive.
agreement. Two months later her pregnancy test
1 being the characters behaviour
Rank the characters in the story from 1-^.
least support.
4 being the characters behaviour you
you most support to <
j
1 , Ask them to
-- 1 of no more than
six.
- into
Divide the large g^
0UP sma 11 groups(no more than 2 minutes)
r------- and then to reach
rank the characters (
first individually
group consensus on the ranking.
MB
Voting is not a
method of reaching consensus.
Report back from small groups
to large group
Note for group. leader
-I will not reach consensus,
It is likely that some, perhapsi all of the groups
of discussion and clarifying of
it is the process c.
It is important to stress that
f.
r than the final group
t of the activity rather
before the activity as it might lead
values which is the purpose
’ " However, do not explain this 1---decisions.
decision making process.
members to loose interest in the
group i--
AWZX"
Religious
Organizations
y
)
ACTIC:; NOTES:
RELIGIOUS ORGANIZATIONS
Religious leaders within the communitv are already involved in the
pastoral care and education of their members, Therefore they are in a
prime position to organize activities which wiill be both educational,
as
part of an outreach programme to the local copulation and
t
-- L to provide
individual care and support for people with HIV infection or those
w i th
AID5
This will be organized as aa local
local response to the National AIDS
education and prevention campaign.
In addition to frequently having close
personal contact with their
congregation, religious leaders also have influence to support behaviour
change and understand the social and cultural
context in which health
promotion messages must be developed in order to have the greatest
effect. They provide a confidential environment for
people in need of
individual counselling and support and will often be
more acceptable to
families who need help than public agencies.
Religious organizations provide a channel through which information,
education and counselling services can be developed and disseminated to
the wider population. This r
----- provides an ideal opportunity for
process
different denominations to work together in
i
order to protect their
communities from the spread of HIV
infection,
- --------However, it may be that
individual denominations e.g.-, Hindu, Muslum, Catholic,
can work more
effectively with their own rgroups so that health
;
promotion messages can be
developed within the context of the specific teachings» of each sect or
religion.
Formation of a steering committee
Religious leaders should bring together representatives of
groups
within their^organization and with the help of the district health ‘
promotion
officer of the National AIDS
,
—Committee
-------- 1 can form a steering
committee to ensure that:
a)
All AIDS prevention activities are co-ordinated.
b)
The momentum of activities is maintained.
c)
There is supervision of the activities to maintain accuracy of
the messages received.
d)
A group of volunteers from the religious c_
organisations are
trained in order to provide information and
..J undertake activities
with particular target groups to assist in identifying areas of
need for behaviour change and support to ensure it is maintained.
e)
Monitoring and evaluation procedures are authorized in order to
modify or add to the overall strategy.
In order that the steering committee covers all areas that need to be
discussed the Health Promotion checklist from
-this manual can be used.
Base line information
Group discussions with ra --7
--- -- - •
- of- the target
representative
sample
groups
within the community will ascertain the
p
---_..j present state of knowledge about
AIDS, present behaviour and practices and areas of needi
A
]
Some suggested discussion topics:
a;
'.'That is the current level of knowledge about AIDS and STDs?
b)
What is the current attitude towards those who are HIV antibody
positive?
)
What is the general understanding of safer sex practices?
J)
What are the problems associated with using condoms?
e)
How are past sexual histories discussed with present partners?
f)
What needs to happen to ensure avoidance of risk taking
behaviour?
The group discussions will also give the volunteers an opportunitv to
get- ^3
to know their clients and identify people with specific needs who may
be helped by the supportive environment of hostels, day care centres or
youth groups.
Setting objectives
With the results from the initial group discussions, the steering
committee can then set objectives for the AIDS education and prevention
campaign. The volunteers who organize and conduct the group discussions
should be involved in all subsequent stages of planning. Training for the
volunteers should take place before the information campaign begins in
order for them to be carrying out the follow-up activities with specific
groups at the same time as information is generally available to the
public.
Development of Support Systems
Training for Steering Committee
Information campaign
I
Production/gathering of
materials nationally and
adapting them or developing
new local materials
Training process
Identification of volunteers
with religious organisations
Identification of their
specific training needs
Pilot dissemination of
materials to representative
sample of audience
I
Evaluation
Dissemination of materials
media involvement
I
Feedback & Evaluation
Development of materials
to meat those needs
Training
I
Development of outreach
activities by volunteers
I
Evaluation
Activities begin
Evaluation
Monitoring and evaluation
The steering committee _
IS responsible for monitoring the progress of
the campaign and reviewing the evaluation
----- 1 material.
This may be in the form of:
a)
Evaluation results pre- and post- training
b)
Discussion groups following a
pre-set questionaire before and
after activity sessions.
Reassessment
The campaign should reflect both cthe
’..^ changing information about AIDS
with regular updates for voluntary religious
. ~ of the
5 representatives.
Goals may
need to be reassessed both in the light
pprogress
and
evaluation
of
the campaign and the degree of involvement of the
-.a religious organisations
in meeting the needs of the community.
Programme Develodment
Materials for the campaign can be gathered from the National AIDS
Health Promotion Campaign and adapted for use locally or may be developed
as part of the training for the volunteers. The educational materials may
be in the form of leaflets, posters, raJio spots, dramas, puppet shows
cartoons or slide shows.
It is possible in some congregations for
'’liturgical” materials or materials used in prayer services such as songs
and decorative motifs, to be adapted to include concerns such as AIDS and
the opportunities for self-lessons and love which may accompany it.
Pre-testing of all materials is essential and interviews with the target
audience to discover whether they understand the message presented and
whether they like the form in which it is presented.
Development of support systems
Volunteers can also carry out pastoral work as representatives of
their organizations. They will, therefore, often be involved in the
direct care of people with AIDS and HIV infection and provide support for
their family and friends. Having the opportunity to discuss experiences
and concerns helps carers come to terras with their own feelings about AIDS
related issues, death and dying, high risk sexual practices, drug misuse
and the emotional effect on a family losing a relative. Equally others
may wish to find out more information, discuss a particular problem or
have time to come to terms with a positive diagnosis for this reason a
system of counselling and referral needs to have been developed and in
place before the campaign begins.
Budget
Within most religious organizations there is an opportunity for fundraising activities to take place. This will help in providing small
amounts of money for specific local ventures relating to the campaign.
Provision of premises for community based activities and volunteer
staff to help with those activities may well be given free of charge and
so will help to keep down the overall costings.
Otherwise financial support is needed in the following areas:
Materials production e.g., leaflets & posters
Printing miemeograph machine
Cost of special events e.g., projector for slide shows and
refreshments
Telephone
Office Supplies
Transport/petrol
Per diem/speakers ’
4^
fees
/
STEP
CONTENT
Step 1
Information about AIDS
and HIV infection
covering the virus,
transmission, course
Step 2
In the light of this
information:
1 ’What are the implications
for behaviour change
on the community?
2 What effect will AIDS
have on our community
in 10 years.
3 How can religious
organizations be involved
in protecting the comm
unity from HIV infection
'METHOD
Slides or video
followed by discussion
(Try ’AIDS WISE’ see
youth worker training)
Brainstorm as a group
A village in an outlying
district has been found
to have a seropositivity
rate of 3Z amongst the
young farming men. What
effect will this have on
the village over the next
10 years? What can be done
about it?
Divide into pairs or threes
to discuss this. Report back
to the wnole group. Produce
a plan of action a) in the
short term, b) in the long
term.
4 Which are the groups we
need to work with first?
5 What are the main channels
of communication the
religious organizations use
which could be used for
the information and
education campaign?
Step 3
It is important to look
at :
our own attitudes and
feelings on AIDS related
issues.
'Who gets the Cure’
(see Armed Forces)
- How can we help those who
come to us to discuss
problems?
Listening skills
(see Youth Organizations)
-How can we help people
with AIDS, their family
and friends talk about
death and dying?
(see attached comment)
- What have we learned?
What else do we need to
to carry out our work?
Where can we go for
further help and advice?
1
Group discussion
Discussion
TTNE
OPTIONAL EXTRA
THOMAS
CASE STUDY
The trainer leads a discussion and o r
issues
brainstorm about the
raised
in
this
s t udv .
Thoma s died o f
will
AIDS
recentlv.
go near his wife
some people are
chi Idren and
and
suggesting
the village .
made
leave
done
to help Thomas'
Now no-one
they should be
What
should be
family and
the village?
Talking about death and dying
Each community has its own way of dealing with death, wnich is a part
of a specific cultural response co loss and bereavement. Hie religious
organizations may already have training programmes for their lay preachers
to help with the approach to these issues.
It is of primary importance that volunteers understand how they feel
as individuals about death. Therefore, it is essential that training for
volunteers includes access to already existing programmes or that r.ealth
educators develop culture - specific activities to allow discussion of loss
and death issues. Another factor to be considered is helping volunteers
recognize culturally appropriate responses to death as opposed to tr.ose
which could require specialist medical intervention.
L
Section
Two
i
B
F
AIDS mVENTION TllHOUCn HEALTH PROMOTION
ACTION NOTES:
MOBILIZING LOCAL ORGANIZATIONS
SECTION 2
Examples of Health Promotion activities to prevent the spread of HTV
Infection, from around the world.
This section continues to be written
with your assistance.
Section 2 inlcudes 10-15 descriptions of AIDS health promotion programmes
within a variety of local organizations along with examples of their
training materials. These examples will be continually up-dated. Please
contribute.
It is hoped that descriptions of activities will be submitted by AIDS
health promotion programmes all over the world. Those who regularly
travel to these programmes could act as a valuable resource in helping to
collect samples. Many groups who may be working hard to produce AIDS
health promotion materials rarely get the opportunity to share their ideas
with other programmes. This is one way they may do so.
The descriptions should include the same basic information:
1.
A brief description of the organization and its AIDS programme
including:
Type of organization, its purpose and membership
Initial planning meetings
Organization of discussion groups
Information gathering and assessment activities
Development of messages amd materials
The training activities themselves
Counselling and support services
Community outreach organized by the organization
Monitoring and evaluation
Cost
2.
A description of the education and training materials developed by the
programme.
e
A
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