Public Movement "Faith, Hope, Love"

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Название	Public Movement "Faith, Hope, Love"
страница	3/8
Дата публикации	20.08.2013
Размер	419.09 Kb.
Тип	Программа

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Warm-up

Verbal evaluation of the level of knowledge about methods of transmission of HIV/AIDS
Presentation of the rules for the training

The trainer should present the rules. This exercise is instrumental to ensure the training is efficient. The rules are obligatory: participating in the discussion, respecting others’ opinions, turning off one’s mobile phone, and other rules which will create a comfortable situation for all involved, trainer and participant alike.
Part 1 – HIV/AIDS and STIs (1 hour, 15 minutes)

Section 1. What is HIV/AIDS?

Informational message: Statistical data on HIV/AIDS and STIs

It is important to remember that HIV/AIDS prevention and the treatment of related illnesses are not purely biological and medical issues, but also community and social concerns. The problem of HIV infection and AIDS touch everyone, without dependence on someone’s race, sex, age, nationality, and other distinctions between people.
The trainers should place an already prepared list of statistics related to HIV/AIDS and the sexual health of young adults on the flip chart and go over the statistics with the group.

Flipchart #1

The AIDS epidemic has been going on for over 20 years
Since 1995 there has been a rapid increase in the number of HIV/AIDS infections in Ukraine
In 2005, the number of officially registered cases of HIV infection was more than 26,000
The majority of people living with HIV/AIDS are young people between 20 and 29 years of age
In Ukraine, more than half of HIV-infected individuals have died from AIDS
Males often do know they are infected and often act as carriers of STIs as well as HIV.
Symptoms of STIS tend to more quickly show up in girls as a result of the biology of the reproductive system.
In Ukraine, around 50% of girls aged 19-20 have never seen a gynecologist and around 50% of boys haven’t seen an urologist is also 50%

The trainer should clarify how the audience understands this overview of HIV/AIDS. Next, a chart detailing the meaning of HIV and AIDS should be placed on the flipchart.
Flipchart #2

Human - The HIV virus can only attack the immune system present in humans and cannot adjust to life in other organisms.

Immunodeficiency – The organism’s immune system is attacked with the goal of preventing it from protecting the body from disease. A person without a functioning immune system is unprotected against infections, viruses, and bacteria, which means a person will fall ill or seriously ill from illness against which their immune system had previously protected them.

Virus – creates illness, transferred from an infected person to another person through means specific to the type of virus

Acquired – When a person acquires something in life—in this case—immunodeficiency.

Immune – See above

Deficiency – See above

Syndrome – The complex of symptoms that characterize an illness
Together, the group and the trainer should identify the difference between HIV and AIDS.
Informational Message: The progression of HIV-infection
HIV-infection develops over a long period of time. From the moment of transmission to death a person may live from 2 or 3 years to 10 to 15 years.

The illness develops over three distinctive periods.

Transmission and the infection—the beginning of the virus’s lifecycle in a new host
Period without symptoms or with mild symptoms
AIDS

During the first stage, nothing unusual can be observed in the organism. Around 30-40% of those who become infected have symptoms similar to those of a severe respiratory infection (temperature, weakness, headache, sore throat, diarrhea). After 10-15 days the symptoms go away with treatment.
The second period is characterized by feeling healthy. This can last from two to 12 years. AIDS is the last stage of the infection. It usually lasts from a few months to 2-3 years.
Role-playing game: Elephants and lions (15 minutes).
Instructions:
Invite one person to volunteer. He/she must stand before everyone. This person is a vulnerable baby elephant.
Invite six more volunteers. They are adult elephants which care about the fate of the baby elephant. The adult elephants should stand in a circle around the baby elephant and join hands so that the baby elephant is guarded from every angle. Their job is to protect the baby elephant. If the volunteers have understood, they will move together so as to protect the baby elephant from any attack. The trainer can try to hit the baby elephant to show the importance of protecting him. The adult elephants should stand very close to the baby elephant.
Invite four-five more volunteers. They are lions. Their goal is to kill the baby elephant. They can kick with their legs or hit with their hands, but not hard.
The game begins, the lions should try to touch the baby elephant. The game will continue while the elephant remains untouched.
Now it is important to ensure that participants understand the game. The volunteers should stay in their places.
Discussion Questions:

What does the baby elephant represent? - The human body

What do the adult elephants represent? - Immune System

What do the lions represent? - Infections (not HIV!)
The lions are now given names—tuberculosis, cholera, diarrhea, pneumonia, hepatitis, etc.
Question: Do infections always lead to death?

Answer — No, when a person is healthy or is taking medication they don’t lead to death. Every day, microbes attack our bodies, but the immune system (trainer points to the adult elephants) fights against them and protects the body. The trainer should point to the baby elephant and explain that the hits inflicted upon the baby elephant are infections trying to enter the organism. A person (elephant) can become week, but usually does not die while the immune system (adult elephants).
The trainer should tell the group that he/she is a hunter and wants to kill the elephants so as to sell their ivory. The trainer touches a few of the adult elephants, “killing” a few of them. Those “elephants” whom the trainer touched must sit down.
Question: Who is the hunter, what does the hunter represent?

Answer: HIV. HIV infects a person, killing his/her immune system. The baby elephant is unprotected without his immune system (adult elephants).

Now, the lions are permitted to attack the elephants (only touching—no hitting). The lions easily kill the baby elephant.

The trainer should explain that HIV kills or suppresses the immune system. The lack of an immune system response is an invitation to illnesses—tuberculosis, cholera, diarrhea, pneumonia, hepatitis, etc., to enter and kill a person.

Volunteers should sit down and the group should continue to discuss the situation.

Questions:

Does HIV kill a person? - No, diseases kill a person

What is HIV? - A virus that weakens the immune system

What is AIDS? - AIDS begins when the immune system is destroyed so that it allows microbes, viruses, bacteria, etc. to enter the body, cause illness, and often cause death.

Section 2. Methods of transmission.

The trainer should clarify what the participants know about methods of HIV transmission.
Informational message: Bodily fluids through which HIV may be transmitted.

Blood

Sperm and pre-ejaculation fluid
Vaginal discharge
Mother's milk

The virus can be located in different fluids (urine, saliva, sweat), but the concentration is very low. The concentration of virus in the exchanged fluid determines whether a person is infected.

For example, the necessary amount of infected blood is a drop of blood on the head of a needle. In order to be infected through saliva, a person would have to receive four liters. There is a high concentration of the virus located in the lymph glands, but that fluid is not transferable to another person, so there is not any danger of infection from the lymph system

Group discussion: Routes of transmission.

Through blood.

The trainer should clarify, with the participants, what they know about routes of transmission through blood and should add information is necessary. The trainer should also work with the participants to clarify levels of risk from different activities/situations.
Examples:

Medical use of surgical equipment and needles, which are not sterile. Use of unsterilized needles for injecting drugs, tattooing, piercing ears, unsterilized razors used for shaving, toothbrushes, manicure sets which are not sterile, blood transfusion.
Avoidance of contact with the blood of others, using sterile equipment, needles, and manicure scissors, using only one’s razor for shaving, putting on latex gloves before helping someone with an open wound.

Sexual contact (horizontal transmission) – Through unprotected sexual contact with a person infected by HIV.

The trainer should clarify the different types of sexual behavior and the risks specific to each type.

Vaginal – contact with sperm and vaginal discharge
Oral – contact with sperm and vaginal discharge
Anal – The anal opening is not intended for sex and micro-tears can appear which enables the sperm to have direct contact with blood.

A simple and accessible methods of protecting oneself and one’s partner is to practice safe sex. Safe sex—this is sex which eliminates the possibility of the penetration of one’s blood, sperm, or vaginal discharge into another person. This can be sex without penetration, “petting,” etc. When having penetrative sex, a condom or latex dental dam must be used.

From mother to child (vertical transmission).

The trainer should lead the group in a discussion of how babies are infected and add information if necessary.Тренер уточняет у аудитории, каким образом возможно инфицирование ребенка и дополняет в случае необходимости.

HIV is transferred during birth or breast-feeding. If the placenta is not punctured during pregnancy, HIV is not transferred. However, this does not apply to other sexually transmitted infections, such as syphilis, gonorrhea, or herpes, which can be transferred through the placenta.
The infection of a baby can be avoided if ARV-therapy is undertaken during pregnancy, the mother gives birth through caesarean section, and the baby is not breastfed. If all of these rules are followed, the chance of infecting a child is reduced to 7%

Section 3. Testing for HIV and treatment.

By law in Ukraine, HIV-testing in voluntary, anonymous, and confidential. If you do not want to get tested, no one can make you give blood for testing.
Informational message: How to determine if a person is HIV-infected

The is impossible to feel if you are HIV-infected. The only way to know if a person is infected is to do a blood test, i.e., be tested for HIV. When a person is infected, antibodies are formed to fight the infection. The test determines exposure to HIV through testing for antibodies to HIV in the blood. In the majority of cases, the test only shows exposure to HIV after approximately three (occasionally six) months after a person is infected. This period from infection until the identification of antibodies in a person blood is called the “window period.” During this period, a person can already transmit HIV to others. If a person undergoes testing for HIV during this period, they might receive a negative result, as though they are not infected. In order to obtain a more accurate result, the test should be repeated in a few weeks.
What can be learned from a test result?

False – this means that evidence of infection was not discovered.

Indefinite –this means that it is necessary to repeat the test.

Positive – this means that HIV antibodies were discovered.

It is very important to remember that the diagnosis of status demands further confirmation of the result and repeated blood tests for HIV.
How often should a person undergo testing for HIV?

It is recommended that a person undergo testing once every six months, and if a risky situation has occurred, it is better to undergo a blood test ASAP so as to receive post-contact prophylaxis, which can begin up to 72 hours after infection.
When a person decides to undergo testing, they should and must receive pre- and post-test counseling from a doctor.
Informational message: HIV-positive status—what does that mean. Treatment

Before a person is diagnosed as HIV-positive, they must undergo additional medical testing so they can begin treatment. The treatment of HIV-infection slows or prevents the reproduction of the virus, which prevents the transition to the stage of AIDS. Only a doctor can prescribe the necessary medication. Every 2-3 months, the quantity of CD-4 cells and the viral load (the number of viruses found in the blood) are tested to determine a person’s status.

Treatment of HIV-infection is called antiretroviral therapy (ARV-Therapy) and it paralyzes the virus and doesn’t allow development of the infection. It is necessary to regularly and correctly take prescribed medicines to prevent the development of HIV and the reproduction of the virus. In this way, a person may live with HIV for a long time without developing AIDS.

It is very important that a person infected with HIV protects their immune system, as it is key in fighting off opportunistic infections, which can interfere with or even prevent the reception of ART-therapy. Also, when a person is in the stage of AIDS, opportunistic infection often lead to death.

Section 4. Sexually Transmitted Infections.

Informational Message: What are STIs?

During unprotected sex (without condoms), not only HIV can be transmitted, but also sexually transmitted infections (STIs).
A STI is an infection which appears after sexual contact with someone who is already infected. STIS are caused by viruses, bacteria, etc. which live in different bodily fluids (sperm, blood, vaginal discharge). These infections are widespread and have serious consequences for one’s health, such as infertility, if they are not treated in time. It is necessary to go to the doctor asap. A person should not try to treat himself or herself, or rely on fold methods.
STIs include Syphilis, Gonorrhea, Chlamydia, Human Papilloma Virus, Trichomoniasis Herpes, Hepatitis A and B, HIV/AIDS, etc. Today there are over 30 known sexually transmitted infections.
Informational message: Signs of infection by a STI:

Unusual discharge from a penis or vagina;
Frequent urinary infections; burning during urination;
Pain in the abdomen or genital area, fever;
Redness, ulcers, or warts in sexual organs or the anal area;
Itching in the genital area;
Inflammation of the lymphatic glands in the genital area;
Pain during sexual contact;

Informational message: The consequences of untreated sexual infections.

Inflammation of genitalia in both men and women, which can lead to the disturbance of sexual functions (including impotence);
Infertility, which develops in 20-40% of men and 55-85% of women with untreated STIs;
Serious complications during pregnancy, such as abortions, still births, the birth of sick babies.
Extra-uterine pregnancy;
Increased risk of cancer of the cervix;
Chronic pain in the sexual organs;
The infections spread to other organs;
Increased risk of contacting HIV/AIDS and Hepatitis B;
The immune system is weakened.

Informational message: Diagnosis and treatment of sexually transmitted infections.

So as to be sure of one’s sexual health, it is necessary to regularly see a doctor once every six months or once per year even if one is consistently using a condoms. If a risky situation happens, such as the condom broke, it is necessary to go to the doctor with your partner asap. IT is not a good idea to wait for symptoms to show up, as very often a sexually transmitted infection has weak symptoms or no symptoms. In order to determine if there is an infection, the doctor must do laboratory work. In order to fully treat the infection, a correct diagnosis is necessary and you must listen to his/her recommendations and share details of your sexual lift. The doctor has the responsibility to respect the principles of confidentiality, anonymity—the patient’s private life remains in the office. At this time, it is necessary to not be afraid of asking the doctor questions as the more a person knows about their body, the less chances they take with their body and the more opportunities they will have for preventing disease. Self-treatment should never be practiced, as there will be negative consequences for the body. Folk remedies should not be used either. A folk doctor cannot cure an infection and cannot make an exact diagnosis.

Section 5. How to protect oneself from infection

To prevent an infection is much easier than treating or living with it!
Group discussion: How can you protect yourself?

The trainer should ask the group which means of protection they know. Discuss their pluses and minuses. If the group doesn’t know a particular method, they should be informed about it. The trainer should not talk about their opinions of minuses and pluses—only the participants should do that.
1.Abstinence.
2. One regular sexual partner.
3. Contraceptive methods (Overview of means and methods for protecting oneself from pregnancy and STIs):
Condoms (male and female). Female condoms are not present everywhere in all countries, and their cost is often expensive, but they are comfortable. The female condom is sold under the name of “Femidom” and is inserted into the vagina before sexual intercourse. The rubber ring at the opening helps keep the condom in place. One advantage is that the condom can be inserted long before intercourse.
Oral contraceptives. Consist of two female hormones –estrogen and progesterone, which prevent ovulation. They also hinder penetration of spermatozoa through changing the composition of mucous membranes in the cervix.
Intra-uterine device (IUD). A metal spiral is placed in the uterus that prevents embedding of the egg.
Spermicides. A chemical means of reducing the activity or killing spermatozoa in the vagina before they reach the uterus. Spermicides can be found in the form of aerosol (mouse), pastes, gels, creams, vaginal suppositories, sponges, and jelly. When spermicide is used together with a condom, the degree of protection increases.
Sterilization. This method requires the surgical severing of the tubes required for the spermatozoid (in men) or ovule (in women) to travel to the location required for impregnation. Reproductive functions are permanently disabled. In women, the fallopian tubes are severed so eggs cannot reach the uterus. In men, the Vas Deferens is severed, which discontinues a man’s ability to ejaculate.
Injectable contraceptives. A woman may receive an injection of the hormone progesterone, which suppresses ovulation. The injection is repeated every 3rd month.
Temperature (Calendar) method. If a woman chooses to use this form of contraception, she must take her vaginal temperature every day in order to determine when she is ovulating (her temperature will be higher than usual). At this time, she must avoid sexual contact or use barrier methods.
Withdrawal method. This traditional method requires that the man fully withdraws his penis from the vagina before he begins to ejaculate.
Emergency contraception. Emergency contraception is taken to prevent pregnancy in the case of sexual intercourse without means to prevent pregnancy, the discovery of a defect in the contraceptive (condom, diaphragm), improper taking of birth control pills, after forced sexual intercourse. Emergency contraception is effective 96% of the time when taking not more than 72 hours after sexual intercourse.
The brand is called “Postinor,” and there are 4 pills in one pack. The first pill must be taken within 72 hours of unprotected sex. The second does must be taken 12 hours later. Emergency contraception is not a method of abortion. If you are already pregnant, the pills will not affect the pregnancy or damage the child.
While discussing the “pluses and minuses” of types of contraception with participants, the trainer could ask participants to vote on what they think is the best means of protection. If the participants choose abstinence, then the trainer should ask the group if that method suits all participants. If even one participant says that it doesn’t suit them, then additional discussion of risks and methods of reducing the risk of contracting STIs is needed until the person determines which method of contraception is best for them. If condoms are chosen, the following questions should be asked:

Where should condoms be purchased?
Which kinds/brands of condoms should be used?
How can a condom’s condition be verified?
How should a condom be used?
How should a condom be stored?

The trainer should demonstrate the process of putting on a condom and select a few volunteers to repeat the process, or ask the participants to provide commentary.

End of first part—conclude and distribute informational materials

Part 2 Risky Behavior (63 minutes)
Exercise -- “Levels of trust,” or “Masha and Sasha” (5 minutes)
Once upon a time, Masha and Sasha lived in the world of young people. They met and fell in love, and their love was unlike any other they had known. They had a clean and trusting relationship—it was really love.
This is Masha and Sasha:

All that had happened in their pasts was not important. They had been casual meetings, superficial relationships, and in general they had little experience. Masha had a short summer romance. Sasha previously had intimate relationships with two girls.

Masha’s ex-romance had been with many girls. He was not a serious person. One of Sasha’s parted from one of his previous girlfriends because she was fickle. Another simply moved to another city and broke-up with him.

Those ex-partners also had previously been in other sexual relationships.

If we extend the chain further, people who are not acquainted with the protagonists will appear. Masha and Sasha probably did not even hear about them. Why are we recalling them now? Because, when we enter into a sexual relationship, even a relationship with someone very close to us with whom we are in love, we come into contact with the micro-flora of all of his previous partners and the micro-flora of their previous partners. This sounds (and can look) terrible, but microbes don’t care—they live and are transferred through a person’s sexual organs.

Also, some of the former sexual partners represented in the diagram could be infected with something and not know it. The correct and consistent use of condoms will help prevent problems with one’s health.

Group discussion: What manner of thinking, what kinds of behavior can expose Sasha and Masha to risk?
For example,

They think that they are not vulnerable, that nothing can happen to them.
They don’t talk about safe sex or they just have sex without protection
They don’t use condoms consistently and correctly
They have sex with more than one partner, or have sex with someone who has many partners
They had a partner which had a lot of other partners and that partner didn’t undergo testing for diseases and infections.
They aren’t faithful, monogamous, long-term partners
They use drugs and alcohol to increase their enjoyment, but don’t think about the consequences.

If we love a person, do with think to doubt them or their words?

Can we tell from a person’s appearance if they have a sexually transmitted disease?

Should only those who have had many partners worry about their sexual health?
Group discussion: Why don’t some people want to practice safe sex? (5 minutes)
What does a person think about when they have sex without some sort of protection?
That person is not thinking about his/her partner. If a person does not want to use a condom with you, that means that he or she has acted that way with other partners.
What does a person think when they agree to have risky sex?
Do we really want to take such a risk? What’s more important—the possibility of living a long and healthy life or our relationship with this person, a relationship which could end tomorrow?