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ACTION WITH YOUTH - HIV/AIDS AND STD
( By International Federation of Red Cross and Red Crescent Societies )

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Skills activities

Saying “no”

Objectives

To develop assertiveness

To find ways of dealing with pressure

Time

45 minutes

Technique

Role play

Materials needed

None








This activity is about being assertive in non-sexual situations and, therefore, very suitable for a target group without sexual experience. It can also be used as an introduction to the ‘I don’t want to!’ activity which is about assertiveness in negotiating safer sex.


Method

1. Ask participants to think of a situation in which someone the same age asked you to do something you didn’t want to.

2. Pick out of the reactions one example, such as: n A friend asks to borrow your brand-new motorbike for a ride far away on a bad road. n A friend asks you to try a cigarette or a joint. n A friend proposes to steal an item in a supermarket.

3. Ask two volunteers to act out this situation in a role play.

4. Discuss the way in which the person in the role play has said “no”.

5. Ask the actors how they felt refusing what the other asked. Was it easy?








Emphasize in the discussion that it is indeed not always easy to say “no”, especially to a friend. It is normal to feel confused or to feel there is something wrong with you when others are putting pressure on you. But you can learn different ways of refusing to do something you don’t like or don’t want to do, while remaining true to yourself and to the things you believe in.


6. Ask the participants to think of different ways of saying “no”.






There are different ways to say “no”, to be assertive:


You refuse politely, and repeat your refusal
You can give a reason for your refusal (but this does not mean you have to apologize!)
You walk away
You give an alternative
You disagree with the other person
You take the offensive
You avoid the situation

7. Have another role-playing session. Ask two volunteers to act another of the situations proposed at the beginning of the activity. Ask them to think of using the different ways of refusal that you have just discussed.

8. Again, discuss with the whole group how well the actors resisted pressure.

9. Review what has been learnt. Ask participants if they would like to do more work in this area.

I don’t want to!

Objectives

To find ways of dealing with pressure To develop negotiating skills

To identify situations in which young people might be at risk








This activity works best with groups which have already some basic information about HIV and STD. You should consider which difficult or sensitive questions may arise during the session and prepare your answers beforehand. Try some of the values and attitudes activities (such as ‘No sex now’) with the group before doing this one. Remember that, ultimately, the decision to have a sexual relationship or not will be made by the young people themselves. This activity will help them explore the choices they have and develop the skills needed to say “no” if they so choose.


Time

90 minutes

Technique

Group discussion

Materials needed

Paper, pens

Method

1. Explain to the group that after learning how to deal with peer pressure (see previous activity) they now will practise being assertive in sexual matters.

2. Divide in small groups of three or four.








This activity can be done with a single-sex or a mixed group. You will need to decide, based on local cultural considerations, which is best for your group. It has worked well in some places to start with single-sex groups and then to bring the groups together to share ideas.


3. Start by having each group think about the kind of messages they have heard that might encourage people to have sex. One person in each group writes the messages.

For example:


“Everyone else is doing it.”

“We’ll keep it a secret.”

“If we don’t have sex, it means you don’t love me.”

“Don’t worry, I’ll be careful.”

“You lead me on! It is your fault.”

“I’ll buy you something nice if you let me do it.”

“I’ve got condoms, so there is no excuse not to.”









If your group is illiterate you may organize this activity without writing down what has been said.


4. Each group reads out (or reports orally) the result of their discussions to the whole group.

5. Have the group divide into pairs – not necessarily male and female. Ask each pair to practise effective negative responses to these lines. Ask them to choose the ones they feel they could use.

6. The group can discuss which of the responses they feel they could use and plan a short role play in which they create a situation where the lines and responses are incorporated.

7. Have one or more role plays (depending on time available), followed by a discussion on the situations and characters portrayed.








This activity is a good one to observe how well the participants can share their own thoughts, feelings or decisions directly with others. Does it seem that they need more practice and discussion in this area? Ask the group how they felt saying no. Do they want to work in this area more?


Not without a condom!

Objectives

To raise awareness about safer sex
To develop negotiating skills
To identify situations in which young people might be at risk

Time

60 minutes

Technique

Brainstorming Role play

Materials needed

A flip chart


Figure

Method

1. First, ask the participants to brainstorm on the concept of safer sex. Note the reactions on the flip chart.








Make sure you get a clear and complete description of safer sex.
The following statements should emerge from the brainstorming:


Always use a condom during vaginal or oral intercourse.
If engaging in anal intercourse, use a special, well-lubricated condom.
For even safer sex, engage in imaginative non-penetrative sex, such as caressing, massaging, masturbation and kissing.

For more details about safer sex, see Section 1: How can you protect yourself from becoming infected with HIV?


2. Then ask the participants to think about some excuses to have sex without a condom. For example:


“I’ll be very careful.”
“I don’t have a condom with me.”
“It’ll destroy the romantic mood.”
“I’ve been tested, I’m negative.”
“I want you now – I can’t wait!”
“A real man doesn’t use condoms.”
“I hate the way a condom feels.”
“When I stop to put it on, I’ll lose my erection.”
“Condoms don’t work.”
“I’m on the pill, you don’t need a condom.”
“I won’t have sex with you if you insist on a condom.”

3. Divided into pairs the participants can practise effective responses to these arguments (same method as for the activity, saying “no”).

4. Ask the participants how they liked this activity.

In addition to this activity you could also try the following role play on negotiating condom use or other methods of safer sex:

Time

30 minutes

Technique

Role play

Method

1. Read the following situation to the group.







Case study


John and Alice are 19 years old. They met each other a month ago and really love one another. Tonight they went out together and had a good time. When they got back to John’s place, they started kissing and caressing. They both feel that they’d really like to have sex. Suddenly Alice realizes that having sex might be risky. She insists that John use a condom










This play can also be used as a case study with homosexual partners. Simply replace ‘Alice’ by a male name.


2. Ask two volunteers to perform the discussion between John and Alice, negotiating condom use – both trying to convince their partner of their point of view.

3. Follow with discussion with the whole group on the situation and characters portrayed. You can ask some questions to lead the discussion:


What could the reasons be for John and Alice wanting to have sex?
If they had unprotected sex, what could the results be?
If they decide not to have sex, what would the result be?
Is this a real-life situation?
What did the group member who played Alice feel like when she kept on insisting on using a condom and refusing sex without one?

4. Conclude by emphasizing the importance of responsible sexual behaviour for the prevention of HIV and other STD.

Condom customer

Objective

To get young people to feel comfortable about buying and using condoms

Materials needed

Some money to buy a few packages of condoms

Time

30 minutes for reporting and discussion








This activity could be organized to prepare activity 22, ‘Instructions for use’. Before starting, make sure there are shops in the neighbourhood where young people can buy condoms. You could also tell shop owners that you are organizing this action as part of a health promotion programme with your youth group.


Method

1. Ask a few volunteers to go and buy packages of condoms, which you need for a condom demonstration for the next activity. Tell them that it is important they go to a shop, instead of buying them from an automatic distributor. You can tell them this the day before you have decided to do this activity.

2. When the volunteers have done their shopping, ask them to report to the whole group on their experience. Ask the following questions:


Where did you buy the condoms?
Where were the condoms displayed? (not on display – behind the counter – on shelves)
Were the condoms easy to find? Why or why not?
Did you have to ask someone to find the condoms?
If so, how did that person react?
How much did the condoms cost?
Do they have different brands?
Was the expiry date OK?
How did you feel doing this activity?

3. Ask the other participants:


Would they feel comfortable buying condoms? If not, why not?
Would they prefer to buy from condom distributors? If so, why?
Where, in their opinion, should there be condom distributors?
What do they think of the price of condoms? Can they afford condoms?

Have a group discussion on these issues.


Adapted from: Skills for healthy relationships, Social Program Evaluation Group, Queens University, Council of Ministers of Education, Canada, 1993.

Instructions for use

Objective

To give young people experience in using a condom correctly and to limit breakages, tears, etc.

Materials needed

A number of condoms; if possible, one condom per participant Models of a penis or alternatives like carrots, bananas, cucumbers, etc. A pictorial description of condom use

(see Appendix IV: Condoms and safer sex, p. 147)

Time

60 minutes








You could organize the ‘Condom customer’ activity before this one. Under information activities, you will find ‘Condoms are cool’ which could also be used as an introduction to this exercise. Read the common questions on condoms (see page 84) and make sure you know the answers!


Method

1. Have the model and the condoms displayed on a table in the middle of the circle of participants.

2. Ask for two volunteers: one holds the model, one demonstrates how to put the condom on and how to remove it.

3. Discuss with the group if the demonstration was correct.

4. Display the pictorial description and review all the steps, from opening the package to disposal of the condom, the final step.

5. Ask the group to divide into pairs. Distribute models and condoms. In each pair, one person holds the model, while the other puts the condom on and then removes it. Distribute a copy of the guidelines on how to use a condom that you will find in Appendix IV: Condoms and safer sex. Review the steps. Ask participants if they have any more questions.

6. Ask the participants what they thought about this exercise.


Figure

Dear Aunt Maggie

Objectives

To develop communication and decision-making skills in personal problems To identify a person’s own values and attitudes related to relationships, sex, STD, HIV/AIDS

To identify ways of dealing with peer pressure

Time

60 minutes

Technique

Group discussion

Materials needed

Pens and paper

A number of copies of the four letters to “Aunt Maggie” (according to the number of participants)

Method

1. Split up the group into four small groups. Explain to the participants that they have to act as an editorial team and have to answer ‘letters to the editor’. Each group receives enough copies of one letter and nominates a reporter.

2. Allow enough time (approx. 15 min.) to discuss the letter and to write the answer.

3. Bring the whole group back together. Ask each reporter to read the letter to his/her team and their answer to it. Encourage and help the group to discuss each letter and answer.

Points to be emphasized in the discussion and in the ‘answers from the editor’

Letter 1

Mark and his girlfriend obviously love each other, but are not ready for a sexual relationship. It should be emphasized in the discussion that the sexual act is not the most important part of a relationship. Love is based on many other things, such as respect and friendship. Mark should be encouraged to withstand the pressure of his peers and hold on to his personal viewpoint: abstinence from sexual intercourse is not abnormal at all, and can be seen as a positive healthy option.

Letter 2

HIV/AIDS and the ways the virus can be transmitted need to be clearly explained to this girl. Her fears about being infected by taking care of someone who might be HIV-positive are not justified. The way she talks about AIDS (‘that killer disease’) expresses society’s taboo of the disease (she does not pronounce the word ‘AIDS’). When giving advice, it should be emphasized that people living with AIDS need our support and compassion. There is no risk of infection when taking care of a person living with AIDS, as long as you are careful in all first-aid procedures (see Appendix V: AIDS and first aid) and you have no unprotected sexual contact with the infected person.

Letter 3

This story illustrates how the use of drugs can keep someone from thinking clearly and can push this person to irresponsible behaviour. It also illustrates the influence of peer pressure on someone’s behaviour. The advice to this boy is to have an HIV test to find out whether he is infected or not. Because of the window period (see Section 1, page 22) he will need to be tested once again in three months’ time. He also needs good counselling on the consequences of the test result and on safe behaviour in the future.

Letter 4

Apparently, this boy feels ashamed and confused about his sexual feelings, as attraction to the same sex is often seen as abnormal, even immoral. Nevertheless, homosexuality is not so uncommon as believed and has been around for centuries in most societies. Some people just hide the expression of their homosexuality because of prejudices and stigma of society.

Homosexual men are often stigmatized as being responsible for the spread of HIV (‘the gay plague’). However, since HIV is spread by both hetero- and homosexual intercourse and by exchange of infected blood, it is clear that AIDS cannot be considered a ‘gay’ disease.

It would be helpful to provide this boy with information on organizations where young homosexual people meet, or with telephone help-lines – if any exist in his country.








You should be aware that, for some young people, this health education programme may be the first opportunity to talk in confidence about their sexual feelings, as many adults will never raise the issue. When discussing the issue of sexual orientation, it is important not to assume that all the young people in your group are heterosexual. Therefore, sensitivity is very important!



Sources: Let’s Face it, Resources for Sexuality Education including HIV within a values framework. Educator’s Handbook, State of Flux, Australia, 1992. Together we can, Jamaica Red Cross (see Appendix VI: Resources).

(Letters to copy for the participants)

Letters to Aunt Maggie






Letter 1


Dear Aunt Maggie,

I have been going out with my girlfriend for a few months now and we are getting on really well. We enjoy one another’s company and have great fun together as we share many interests. You may wonder what the problem is. Well, it’s just that my mates have assumed that we have sex, and in fact my girlfriend and I are quite clear on this one – we don’t. That doesn’t worry us, except when I’m around my friends, they keep making it into a big deal. Any suggestions on how I should handle this?

Mark, 19 years







Letter 2


Dear Aunt Maggie,

I am worried. My uncle has been living in .......(*), and now he’s come back to the yard. He stays in our house. He has always been funny, and now he’s skinny and ill, and is very sad. I am worried that he might have that killer disease. But he hugged me and I washed his clothes for him. I love my uncle, but I don’t want to die. I am afraid of being near him – what should I do?

Martha, 15 years * Fill in the name of a city in your country.







Letter 3


Dear Aunt Maggie,

Last Saturday, I went out dancing in town. I felt very sad because my girlfriend is dating someone else. At the dance, I had too much to drink. Then a guy offered me a new drug, injected straight into your veins. He persuaded me to try it saying that it relieves tension but is not addictive. I shared his needle to inject the drug... Now I am terrified I might have AIDS.

Please tell me what to do!

Desperate boy, 18 years







Letter 4


Dear Aunt Maggie,

I am pretty sure I’m gay and have thought so for a few months now. I haven’t told anyone yet and I don’t think I could tell any of my friends as they scoff at homosexuals.

I’ve heard people describing AIDS as the ‘gay plague’ and I am worried in case I could become ill with it. I am 17 and would like accurate information about how I can protect myself from this disease.

Concerned


We do care about you!

Objectives

To practise basic counselling skills: comforting someone affected with AIDS, dealing with the fear that people have of AIDS

To create awareness of the impact of HIV/AIDS on individual people and households

Technique

Role play Group discussion

Time

60 minutes

Materials needed

None

Method

1. Conduct a brief discussion on the feelings and emotions someone has when he/she has lost a loved one, or when he/she knows that a loved one is ill with AIDS, and on the skills needed to comfort a person in such a situation.

The basic counselling skills are:


Listening carefully (looking at the person who is speaking, not interrupting, summarizing what he/she said).

Creating an atmosphere of trust.

Showing empathy.

Being supportive.

Not judging.

Sharing correct information.


2. Explain to the group that they will be role playing to practise these skills. Read the story of Mai, Lien and Rose, and ask for three volunteers to play the roles of these three girls.

3. Allow a few minutes for them to prepare the play. Ask the other participants to carefully observe the play and the way comfort and advice is given.

4. After the play, evaluate with the whole group the skills that the ‘care-givers’ demonstrated.

5. Ask the actors how they felt when playing their role. What was the most difficult part?

6. Review the important points.






Scenario for role play


Mai and Lien, both 14 and students in the same class, wonder why Rose has not been attending school for several weeks. They know that Rose’s father died six months ago. People say he had TB. Mai and Lien are worried and decide to visit their schoolmate at home.

They find Rose at home, preparing meals for her three younger brothers and sister. Her mother is in the hospital.

Rose is very sad. She tells her friends that the doctor has told her that her mother has AIDS. Her uncle and aunt, who live next door, don’t want to take care of them. They say AIDS is very infectious and they are scared. And they are very angry, because they say if Rose’s mother has AIDS, it means that she has been around with other men.

So, as Rose has to take care of the household now, she will have to leave school.



Figure








This story could also offer an opportunity to talk about the vulnerability of children and women, the stigmatizing of people affected by HIV/AIDS and the violation of their human rights.


At the market place

Objective

To give people an opportunity to practise answering questions in the community about HIV/AIDS, using good listening skills and their knowledge

Technique

Role play

Time

120 minutes

Materials needed

A selection of local costumes and clothes


Figure

Method

1. Set the scene. Ask the group to imagine that they are organizing a discussion in the market place. Different people have arrived to take part and they have many questions.

2. The group dresses up in the costumes and each person takes on a character that might be part of a market-place discussion. For example, an old man, a worried mother, a young, overconfident person, a barkeeper, etc.

3. Each member of the group thinks about the kind of questions that his/her character is likely to ask in this situation.

4. One member of the group takes on the role of the leader of the discussion in the market. As questions are asked, the ‘leader’ makes sure he or she listens carefully to what is being said and tries to answer, using the knowledge gained from information sessions.

5. Rotate the roles so that everybody gets a chance to both ask and answer questions.

6. Lead a discussion on what has been learnt. Some questions to consider:


Were the answers easy to understand?
Which questions were hard to answer and why?
Did the people asking the questions feel they were listened to?
Did the people find it hard/easy to answer questions?
Are there any subjects about which people feel they need more information to be able to answer questions effectively?








The purpose of the session is not to test knowledge, but to enable young people to use their knowledge about HIV/AIDS and related issues, and their listening skills, to answer real questions.

If the group knows each other and works together well, it may be possible for them to give constructive comments to each other. You could also ask everyone to point out areas in which they need more practice.

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