Facilitation Manual

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Aim: To create awareness to participants on HIV/AIDS and stimulate care and support
toward People Living and Affected by HIV/AIDS (including Orphan and Vulnerable
Children, OVC) in order to reduce the spread of HIV/AIDS across the country.
At the end of the session participants will be able to:
    1. Know and understand facts about HIV/AIDS
    2. Know how to protect themselves from HIV
    3. Discover the importance of Care and Support toward People Living With HIV
        and those Affected by AIDS, including Orphan and Vulnerable Children (OVC)

Areas considered:
           Define HIV/AIDS
           Ways of transmission
           Skills to prevent risk which exposes one to HIV/AIDS
           How does HIV/AIDS affect our Community
           Steps to mitigate the impact of HIV/AIDS on People Infected or
             Affected by HIV/AIDS

   1. Define HIV/AIDS:
           Find out the level of understanding or knowledge of participants about
           Ask the participants to close their eyes. Read the statements here-below
             and ask. Those who agree (True) to raise their hands (the rest will imply
             they do not agree (False)
           For each question, record the number of True and False and determine
             the percentage. For instance, for 15 participants if 10 go for True and 5
             for False, it means True has (10:15)% = 67% and False (100-67)% =

Questions                                                    Numbers           Percentage
                                                             True False        True    False
1. HIV means Human Immunodeficiency Virus                    10    5           67      33
2. AIDS can infect only poor people
3. Those infected by HIV don’t know until they take test
4. AIDS means Acquired Infection Disease Syndrome
5. HIV has no cure
6. HIV can be spread by mosquito bite and touching those
living with HIV
7. Women are more at risk of infection than men
8. An infected pregnant mother can pass the virus to her
9. HIV is cured when an infected male adult has sex with a
virgin girl
10. Those infected with HIV/AIDS may live up to 25 years

   The Meaning of HIV/AIDS
      A     -      Acquired
      I     -      Immune
      D     -      Deficiency
      S     -      Syndrome

   Acquired – Disease gotten from someone else

   Immune – In- built system that each human being has to defend or protect him
   from infection so as to keep the body healthy

   Deficiency - Faulty or weakened

   Syndrome – Symptoms or signs

                   AIDS is caused by a small germ called HIV.

                 HIV means Human Immuno-deficiency Virus

          Human – because the virus only lives in human beings and not in animals or

        Immuno-deficiency – because the virus causes our immune system to become
less effective or faulty

          Virus – a very small germ, once it gets into the body it cannot be removed.

Ask: When someone is infected with HIV, what do you think will happen to him?

    Eh! See

          Initially the person shows no symptoms
          Is healthy
       Is a carrier of HIV, but may not know
       Can spread HIV to others
       Can remain so for so many years

       After sometime,
       - The virus multiplies
       - Immune system is rendered ineffective
       - The infected person develops serious illness
       - The infected person becomes AIDS carrier
       - He eventually dies

       2. Ways of transmission
Ask participants to suggest ways a person can be infected with the AIDS virus.

After participants have suggested the ways,discuss using the hints below

   Eh! See

                  - Having sex with an infected partner (about 9 out of 10 people with
AIDS got it through sex with an infected person)
            - From HIV infected parent to an unborn or newly born baby (during birth)
             - Through HIV infected blood (blood to blood contact)
                  - Unscreened Blood transfusion
                  - Injection syringe used on an infected person
                  - Skin-cutting and piercing instruments like needle, razor blade, etc…

       HIV does not show on the face, many people who seem to be healthy may be
       carriers of HIV though there is no sign or symptom shown on their body. This
       calls for HIV test to help one know his or her HIV status.
                   Eh! See
                                           HIV is not spread through
                                           Mosquito bites
                                           Playing, swimming, eating and sitting with an
                                           infected person
                                           Handshakes, sharing of toilets, etc…
       3. Skills that help prevent exposure to risk of contracting HIV/AIDS

        Assess the participants’ attitude, values and beliefs attached to the following (positive)
       life’s principles and encourage them to aspire for such:
                     Good communication
                     Self contentment
                     Mentoring (Choice of good mentor by youth in the community)
                     Abstinence
                     Faithfulness

       Discuss using the questions here-below

Ask participants individually               Why do people misuse sexuality?

              Eh! See

                                   For money
                                   Poverty
                                   Complexes
                                   To seek attention
                                   To prove love
                                   Fear
                                   Not to hurt others’ feelings
                                   To relieve oneself from sexual urge
                                   To prove maturity
   Ask participants individually          What are the consequences of misused sexuality?

                    Eh! See

                                                       Loss of virginity
                                                       Guilt
                                                       Unwanted pregnancy
                                                       HIV/AIDS
                                                       Death (while trying to abort the pregnancy or of
                                                       Prostitution
                                                       Loss of purity towards God
                                                       Emotional disturbance

                                   Hear this!      (Story)

Ask participants individually            How can you refrain from attitudes that lead to misused sex?

                                    Eh! See

                                                       Self contentment about what you have (physical,
                                                        material, and spiritual)
                                                       Be careful about the kind of friends you keep
                                                       Avoid any sex appealing dress or words that can
                                                        lead to rape or any other coerced act
                                                       Constant reading of the word of God
                                                       Avoid watching corrupt movies, songs,
                                                       Avoid reading corrupt books
   Communicate clearly with peers, mentor or
    parents about sex and other dark situation
    encountered in life
   Choosing a good “Mentor”
   Avoid idleness
   Aspiring to things that bring peace and help
    strengthen one an other (Romans 14:19)

Specific Objective
At the end of this session the participants will be able to explain:

       eneral objectives of this exercise
       ask participants to go into two groups
       ask group A to write out the full meaning of VCT. While group B write out the
       benefits of VCT.

Each group to present its findings; other group should contribute where necessary.


VCT     means Voluntary Counseling and Testing. Some times it is also called
Voluntary Confidential Counseling and Testing (VCCT). This is so because every HIV
counseling situation is done in a confidential manner.

Confidentiality means your result will not be disclosed to anyone else except to you

VCT is a situation an individual is willing (voluntary) decides to go for HIV counseling
that will lead to knowing one’s HIV status; and its benefits. Some times it may not lead
to HIV testing.
HIV counseling is an important part of VCT before (pre-test) and after (post-test) HIV
test. It is also an important component of HIV prevention; care and support efforts
aimed at reducing the impact of the infection.

   1       Ask the participants to answer the question by raising their hands. Write
           down their answers and discuss.
Here are some points to consider about going for HIV testing.

   1        Has the person been having unprotected sex?
   2        Has the person had sex with some one who is HIV positive?
   3        Has the person had sex with some one who had STI?
   4        Has the person had sex with a male partner who has had sex with a male
    5       Has the person had multiple sex partners?
    6       Has the person had unscreened blood transfusion?
    7       Has the person shared a needle with a drug user?
    8       Has person had sex with some one who would answer YES to any of the
    9       An individual from 18 years and above
Some times adult minor can go for HIV test. An adult minor is a person that is below
the age of 18 but sexually active. A young person guided by the parent to go for HIV
test can also be tested.

Ask the participants to bring out a plain sheet of paper and a biro. Tell the participants
that the exercise about to be done is to assess them of their risk level. The participants
should write YES or NO only against the question depending on the answer. Tell the
participants to keep their answers as confidential as possible.

   1.      I have had sex at least once?
   2.      Do I currently have a sexual partner?
   3.      my present sexual partner has more than one sexual partner
   4.      How many faithful sexual partners do I have?
   5.      I do not use condom each time I have sex?
   6.      I have been involved in risky sexual behavior
   7.      Do I have sex for money; food; employment; drug; or to pass examination?
   8.      Do I indulge in substance abuse or take alcohol?

    9      I have shared a skin piercing/cutting instruments in the last 6 months with
   some one else
10     I have taken injection before but I do not know whether the needle was re-used
Do not tell the participants to tell you how many YES and NO they have scored. It is
confidential! Tell them the more YES they have the more RISK they are. The more NO
they have the less risk they are.

Pre-test and Post-test Counseling.
 Ask participants if anyone of them has gone for a voluntary counseling and testing
(VCT). If any, let him or her tell the group what happened.


Pre-test counseling means before HIV test is conducted an individual need counseling.
The counselor is expected to assure his/her counselee (the person who has come for a
HIV test) the following:
   1       confidentiality
   2       assessing risk level
   3       update on the facts about HIV/AIDS
   4       test result and explanation of the meaning of each result
   5       how to deal with fears; worries; and anxieties and how to cope with them.
   6       Obtain clients consent before the test is done
   7       Helps in drawing out an action plan after getting result
   8       Provide information on available support system and linkage

Post test counseling means after the HIV test; you need to stay and get your result for
further counseling. The result could be reactive (positive) or non reactive (negative)
Reactive (positive) means that the individual tested for HIV has the virus. While non-
reactive (negative) means the individual tested for HIV has no virus in his/her blood

Group the participants into two groups and ask each to write out 5 benefits of VCT.
Each group will present for general discussion. Correct them when necessary.


Outline the followings as benefits of voluntary counseling and testing:
If positive:
    1        Behavior change.
    2        Positive living to those who are HIV positive
    3        Referral to legal and social aids
    4        Planning for Orphans care
    5        Reduction in the stigma and discrimination
    6        Access to earlier medical care for tuberculosis (TB) and Prevention from
             Parent to Child Transmission (PPTCT).
    7        Access to family planning services.
    8        Make informed decisions regarding marriage and having children
    9        Protect your partner from getting infected or if already infected, being re-
If negative:
         1.      Behaviour change
         2.      Protect yourself from being infected
         3.      Make informed decisions

   1           Many Government hospitals are carrying out HIV test
   2           Privately owned hospitals also carry out HIV test
   3           Stand alone Heart to Heart centres run by NGOs (Non-Governmental
               Organizations) to run HIV test.
    Specific objective:

   To enable participants to understand and be able to explain the significance of the
   window period:

   Time: 1 hour

   Suggested Materials: pen or chalk, black or white board, markers and flip chart

             1. share the objective with the participants.
             2. organize the participants into 2 groups
             3. group A should write out what is WINDOW PERIOD
             4. group B should write out why it is important to know about the window
             5. correct any misinformation that may arise
             6. share the following points to reinforce the learning about the window

          The window period is a time of infection to the time the virus is detected during
       The window period can last between 6 weeks to 3 months. However; different
body may take longer time for the virus to be produced and released into the blood

        During this period; the commonly used test cannot detect the anti-bodies to the
virus. Therefore the test will be negative (non-reactive); even though the individual is

        An individual who feels that he/she has been exposed to the virus should count
off the first 6 weeks before his/her first HIV test.

        Tell the participants that if the individual test result comes up negative.
“Negative” does not mean the person is not HIV positive; it can simply mean that the
infection is in the body; but the anti-bodies the test is looking for have not yet been
released. This is why the person needs to go for a second test. The person must make
sure he/she does not have an unprotected sex.

Ask the participants to learn the words in the box by heart. Give the first 3 participants
who can say it off heart a prize e.g sweet, a biro, etc (optional)
Ask the participants to bring out their writing material. Group them into 3 groups and
ask each group to come out with 5 important points of window period. Each group
should present its points to the rest participants for discussion and corrections. You can
add the under listed.

If some one carries the virus without knowing; he/she can infect another person through
unprotected sex contact

Person who knows the important of window period will be careful about giving and
taking blood.

If a person has been exposed to the virus and takes the test soon after; the test results
may show up negative. The person who does not know about window period may think
he/she is negative and can continue to infect others.

Persons who know about the window period will know that they must take a second test
after about 3 months to know if they were not infected as a result of the suspected
exposure to the virus.

                     IF THERE IS NO CHANGE
                     THERE IS NO LEARNING.

                                    JOHN DEWEY

Persons will know that they must abstain from sex; or practice very safe sex; if they are
to learn whether they were infected at the time that concerns them
Persons who understand the window period can not be deceived by another who
produces a lab report in order to get unprotected sex.

   Never depend on the first test result of an individual; because he/she could be in the
   window period.

   If the person you are explaining the window period to is concerned about exposure
   to the virus that happened on a particular date; use that time as your starting point.

              T       TOGETHER

              E       EFFORT

              A       ACHIEVE

              M       MORE

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Description: HIV Facilitation