Lesson 3 Safe Sex ATTITUDE AND VALUES TOWARDS HIV, STI and Safe Sex (statements) Objective - Explore and become aware of own attitudes and values related to hiv, STI and Safe Sex - Explore impact of own attitude and the impact on own work 15-30 minutes Statements Signs with agree, disagree and don t know. Preparation Select some of the statements you feel are relevant to the group. Create new statements as well. Arrange the training room so that there is adequate open space for participants to assemble near the Agree and Disagree signs. Explain Explain that this exercise will help us understand viewpoints that are different from our own, and to consider how these attitudes and beliefs about HIV and AIDS might affect the way we treat people who are HIV positive. State that there are no right or wrong answers and that we are all entitled to our own opinions. Ask participants to gather in the centre of the open area. Direct their attention to the signs. Explain that you will be reading a series of value statements. Read statements aloud After you read a statement aloud, the participants will decide whether they agree or disagree with the statement, or if they are unsure of their response. Those who agree will move and stand by the Agree sign. Those who disagree will move and stand by the Disagree sign and if you are not sure, to the Don t know sign. If they hear something that causes them to change their opinion during the course of the activity, they may move from one area of the room to another. The facilitator remains neutral by not offering interpretations for the statement that would influence participants responses. However, he or she can share factual information to clarify matters, as needed. Read a statement and then get feedback as to why participants chose that point of view. In order to explore a range of issues, you may need to limit discussion of each statement to comments from one or two participants representing each position. If everyone moves to one side of the room (e.g. everyone agrees with the statement), you can ask the group how a person with the opposite opinion might defend their position. Alternatively, facilitators can step into that spot and speak out on the opinion, clarifying to the group that they are just stating the rationale for that position in a direct and straightforward manner. Discussion Ask the participants to return to their seats for a group discussion. Facilitate a discussion to explore differences of opinions and values more deeply, based on the following questions. 1
- How did you feel during this exercise? What was it like for you? - Were there any opinions or values expressed that surprised you? - Which statements were the most controversial and why? - How can you explain the differences between individuals in this group? - How did you feel when other people expressed values and beliefs that were different from yours? - Why is exploring these issues important? - How might attitudes and beliefs affect the way you behave toward or treat colleagues or clients? - How do our fears about HIV and biases towards HIV-positive people or those thought to be infected or at risk influence our values, opinions and actions? - How can we keep our own values from influencing our work in a negative way? - How might you address some of these difficult issues in your workplace? Sample value statements - People with HIV should stop having sex. - Putting sex workers in prison will stop HIV. - All hospital patients should be tested for HIV. - PLHA should be discouraged from getting pregnant. - PLHA should be encouraged to be sterilised. - HIV/AIDS is punishment for humankind s sins. - Condoms should be made available for free at schools. - Sex education encourages young people to be sexually active. - If the law was more strict and properly applied with regards to sex workers, there would be a reduction in the spread of HIV/AIDS. - It should be made easier to dismiss PLHA who are not working properly; they are a drain on the business and economy. Voorbeeld stellingen Nederlands - Mensen met hiv zouden moeten stoppen met seks - De verspreiding van hiv is te stoppen door prostitutie strafbaar te stellen - Alle ziekenhuis patienten moeten getest worden op hiv - Mensen met hiv moeten ontmoedigd worden om kinderen te krijgen - Hiv en aids is een straf - Condooms moeten gratis beschikbaar zijn op alle scholen - Seksuele voorlichting moedigt jongeren aan om op jonge leeftijd seks te hebben - Als je kanker krijgt, hebben mensen met je te doen. Als je hiv hebt, vinden mensen dat je eigen schuld - Mensen met hiv hadden toch beter moeten weten. - Mensen die geen hiv hebben, zijn nog steeds bang voor hiv - Hiv en aids is geen probleem meer; de behandeling wordt steeds beter. - Hiv besmetting is een straf voor morele tekortkomingen of gebrek aan zelf-controle - Als je gaat solliciteren moet je vertellen dat je hiv hebt. - Met hiv kun je niet voorzichtig genoeg zijn. - Je moet anderen waarschuwen wanneer je weet dat iemand hiv positief is. Op deze manier kan iedereen zichzelf beschermen. 2
ONE STEP FORWARD; Knowledge on Hiv, STI and Safe Sex (quiz) Objective - to identify what they know and don t know about HIV and AIDS. - understand basic facts and information about hiv as a basis for dealing with misinformation, believes and myths 10 30 minutes Improvised microphone Questions Ask participants to stand with their backs against one wall of the training room. Improvise a microphone (e.g. a banana, a wooden stick). Then say, All those who know the three routes of HIV transmission take one step forward. Interview a few of those who step forward to find out their answers. Continue this process, adding new statements each time. After a while, stop and get participants to discuss how much they know or don t know. Add more questions if necessary. Keeping the determinants of hiv stigma in mind; questions should increase knowledge on transmission (how the virus is (not) transmitted), the seriousness of hiv (hiv is a chronic disease), personal responsibility ( anyone can get infected) Sample questions for this exercise: - What are the three routes of HIV transmission? - What is the difference between HIV and AIDS? - Name two bodily fluids that can contain HIV. - What does the window period mean in HIV testing? - Why can t you get HIV from shaking hands with a person who has hiv? - What are three advantages of taking hiv medication? - How can you stay healthy after becoming HIV positive? Voorbeeldvragen Nederlands - Wat zijn de 3 transmissie routes van hiv? - Noem 2 lichaamvloeistoffen die het virus kunnen bevatten - Hoe lang kan het virus buiten het lichaam overleven - Wat betekend windowfase bij de hiv test - Waarom kun je geen hiv krijgen van handen schudden met een hiv positief persoon - Waarom kun je geen hiv krijgen als je tijdens de seks een condoom gebruikt - Kunnen insecten hiv doorgeven - Wat is het verschil tussen hiv en aids - Hoe weet je of iemand hiv of aids heeft - Is hiv een virus, bacterie of een schimmel - Noem 3 voordelen van het gebruik van hiv medicatie - Hoe kun je gezond leven leiden als je hiv positief bent - Waarom noemen we hiv tegenwoordig een chronische ziekte - Wat is de gemiddelde levensverwachting van iemand die op zijn 20 ste besmet raakt met het hiv virus en medicatie inneemt - Wanneer is het wereld aids dag? - Wie kan er allemaal hiv krijgen - Hoeveel mensen wereldwijd zijn besmet met het hiv virus (33 miljoen) - Hoeveel mensen in Nederland zijn besmet met het hiv virus(10.000-14.000) 3
- Wie loopt het meeste risico op hiv besmetting in een hetroseksuele relatie? Man of vrouw? - Hoe groot is de kans dat een hiv positieve moeder haar kind besmet als zij geen borstvoeding geeft en hiv medicatie neemt? <2% 4
CONDOMS; (dis)advantages Objectives - describe the advantages and disadvantages of condom use CARD STORMING condom use 15-30 minutes Cards Markers Tape Preparation Ask participants to think about advantages and disadvantages of condoms. Ask them to record each point they can think of on a card and tape on the wall. Cluster common points. Or when this is too confronting for the group members divide participants into pairs and ask: What do you think people see as advantages and disadvantages of condoms. Ask pairs to write single points on cards and tape them on the wall. Then ask participants to prioritise: What do you think is most important / of most influence on decision to use / not to use a condom? Processing and reflection Ask the group to discuss the following questions; How could you use this information in your prevention message? Role-play Ask each pair to select one of the high priority (dis)advantages and make a role-play to show how this is affecting the decision to use a condom Some possible (dis)advantages participant might describe: Sex feels better without condom; condoms smell bad, condoms are expensive, they can break, it is not cool to use a condom, my girl is taking the pill ect Using a condom protects you from std, pregnancy and hiv. It keeps your sheets clean. It is a sign of respect ect. 5