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Eduquer aux aptitudes de survie pour pr venir la transmission du VIH SIDA et des Maladies Sexuellement Transmissibles MST

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Eduquer aux aptitudes de survie pour pr venir la transmission du VIH SIDA et des Maladies Sexuellement Transmissibles MST Powered By Docstoc
					FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

First Edition 2004

Teaching Life Skills to Prevent the Transmission of HIV/AIDS and Sexually Transmitted Infections (STIs)

Description of the tool: This tool contains a set of classroom activities for students the purpose of which is to equip them with the knowledge and skills they need to prevent the transmission of HIV, AIDS and STI. It also provides background information and pointers for the teacher on how to teach these activities. Whilst primarily intended for teachers of sixth-grade students, this tool could also be adapted and used for other grades.

The information in this tool was adapted by UNESCO in collaboration with Health and Human Development Programs at Education Development Center, Inc. from the following publication: Government of Myanmar & UNICEF, (2002). SHAPE: School-Based Healthy Living and HIV/AIDS Prevention Education. Yangon. Myanmar: Government of the Union of Myanmar. The full text of the document can be downloaded from UNICEF’s website at: http://www.unicef.org/lifeskills/index_14926.html. Description of the document: The aim of this document is to equip fifth to ninth grade students with the knowledge, attitudes and skills they need to promote healthy living and prevent the transmission of HIV/AIDS. It advocates the active participation and involvement of teachers, students, school principals, education officials, parents and other community members in this endeavour. The content of the programme focuses on a range of health and social issues of importance to children and young people, including HIV/AIDS, personal health and hygiene, growth and development, alcohol and drugs.

This activity falls under Core Component #3 of the FRESH framework for effective school health: skills-based health education. It will have a greater impact if it is reinforced by activities in the other three components of the framework.

FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

First Edition 2004

Teaching Life Skills to Prevent the Transmission of HIV/AIDS and Sexually Transmitted Infections (STIs)1

Section I: Background Information and Instructions for the Teacher Concept
Each activity in this lesson is composed of two main parts: a stimulus activity and a discussion. Stimulus activities are generally designed to last 15 to 20 minutes so that within the confines of a typical 50-minute class sufficient time can be devoted to discussion. The discussion will allow students to learn specific skills, consider particular concepts and gain insights that will help them learn more about themselves, their relationships, their behaviours, and their feelings. Because it is a critical element of these activities, whenever possible students should be seated in a way will facilitate discussion. Activities are primarily intended for use in a classroom or in small group counselling or discussion settings. Many of the activities are aimed at encouraging students to take a look at themselves and their communities, to learn about life skills and share what they have learned with their classmates. An atmosphere of trust and group cohesion must, therefore, be established from the outset. When it is, students often welcome the opportunity to communicate. Nonetheless, if students seem uncomfortable sharing something personal, then allow them to “pass.” Do not oblige them to participate in a discussion. It is also important to begin by establishing some ground rules to ensure that young people respect one another’s opinions and expressions, understand that discussion of a personal nature is confidential and should stay within the group, and know that they have a choice whether or not to share such information.

Structure
The lesson format comprises 10 components: 1) This lesson has a set of subject area specific psychosocial (“life skills”) competencies designed as an aid to the students’ development that centre around the following 10 core skills: i) ii) Problem-Solving Skills Critical Thinking Skills vi) Decision-Making Skills

vii) Creative Thinking Skills viii) Self-Awareness Skills ix) Empathy Skills x) Skills in Coping with Emotions

iii) Communication Skills iv) Relationship Skills v) Skills in Coping with Stress

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FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

First Edition 2004

Whilst a single lesson will not suffice to develop sustainable skills, it will contribute to their development and strengthening so that on completion of the secondary school curriculum, competence in a number of psychosocial skills will be assured. 2) Each activity seeks to achieve a specific objective that offers guidance as to what concepts to stress and what outcomes to expect. They can be measured to enable teachers to assess whether the expected outcomes have been achieved. Student involvement is central to the learning activity, which involves, inter alia, simulation games, role-playing, group activities, and brainstorming. Each activity contains both content and personalized discussion questions. Content questions ensure mastery of the concepts and content of the activity, whilst personalized questions encourage students to apply the concepts they have learned. This latter component is critical because it helps to move students away from simply thinking about what they learn to coming to an understanding how what they have learned can prepare them to cope more positively with the challenges of everyday life. Both types of questions may be used as a starting point for discussions and summary sessions, but are by no means exhaustive. With this lesson, the teacher needs to assess whether the students have achieved the objectives of the learning activities and of the lesson. Guidelines for assessment of the lesson have been suggested to help in this task. These guidelines may be a few key questions or an activity that will require the students to apply what they have already learned. Because students need to know how to put into practice what they have learned, some follow-up activities have been suggested that will enable them to transfer their new knowledge from the classroom into their daily lives. These activities also provide opportunities to apply these new skills within the community, their families and with outof-school youth. Depending on the nature of the follow-up activity, questions that could help the students to analyze their experiences in effecting the follow-up activity and the knowledge, attitudes, and skills gained from these experiences have been included.

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FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

First Edition 2004

Prevention of HIV/AIDS Transmission
Teaching time recommended: three class periods Life skills Competencies – HIV/AIDS prevention At the end of this lesson (with five learning activities), the students should be able to demonstrate skills in the following areas:    Problem Solving: Students will be able to identify factors that may make someone vulnerable to or at risk of becoming infected with HIV. Creative Thinking: Students will be able to identify factors, including behaviours and methods that help prevent infection with HIV. Critical Thinking: Students will be capable of assessing the advantages and disadvantages of various methods of prevention as regards their own behaviour. They will be able to recognize the socio-economic and cultural impact of HIV/AIDS and to weigh up the relationship between substance abuse and infection with HIV. They will also be able to compare traditional care practices and institutional care. Decision-Making: Students will be able to identify those behaviours and methods that will reduce the factors of risk and vulnerability to infection with HIV. Communication: Students will be able to pass on information and discuss issues related to HIV and AIDS in a clear and direct manner. They will be able to ask for help and advice or seek additional information on HIV/AIDS when needed and to demonstrate skills in refusing sexual advances and negotiation for condom use. Self-Awareness: Students will be able to assess personal risk for infection with HIV and what impact infection with HIV would have on their personal goals and ambitions. Interpersonal Relationships: Students will be able to identify the kind of sexual network that may place them at risk for infection with HIV. They will be able to identify the impact of infection with HIV on themselves, their families, communities and society at large and identify social and cultural factors that may be of help in the prevention of AIDS. Empathy: Students will be able to recognize the needs and feelings of people living with HIV/AIDS and will know how to show compassion and support towards them. Coping with Stress and Emotions: Students will be able to distinguish between appropriate behaviour and physical and emotional needs and desires. They will be able to distinguish between peer pressure and personal needs.

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FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

First Edition 2004

No cure has yet been discovered for HIV infection or AIDS. HIV can be transmitted through using needles and syringes contaminated with infected blood, through transfusion of contaminated blood, sexual intercourse with an infected person, and from an infected mother to her baby. However, HIV is not transmitted through casual contact in normal daily activities, such as travelling together, eating and living together. Because the symptoms of AIDS are visible only after a number of years, even though the virus is present, it is not possible to tell whether someone is infected with the virus by merely looking at them. The only way to detect infection with HIV/AIDS is to take a blood test. The following methods ensure protection against transmission of HIV: 1. Refraining from using needles and syringes used by others. 2. Only accepting transfusion of blood that has already been tested negative. 3. Refraining from sexual intercourse with an infected person. 4. Practicing monogamy by being loyal to one’s spouse (given that the spouse is not HIVpositive). 5. Refraining from injection, transfusion, using skin piercing instruments (e.g. tattooing). 6. Refraining from infecting somebody else: seeking advice or counselling if you feel you have been infected.

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FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

First Edition 2004

Section II: Classroom Activities Activity 1
Objective: Students will be able to analyse the need for prevention of HIV infection through intravenous drug use. Flipcharts, chalkboard or story cards

Teaching aids:

Teaching/Learning Activities 1) Ask the students to study the following incident (you may wish to change the names of the characters to match your own culture). “Maung Maung was a 14-year-old student. Being an athlete, he was tall and strong. He had a fairly large circle of friends. The teachers liked him because he was studious. He was not at all interested in taking drugs. One day, a group of friends went on a picnic. In the woods, they played the guitar and danced, and had a good time. As their enjoyment gathered momentum, some of his friends began to take narcotic drugs. He didn’t know where these had come from. Maung Maung didn’t know that some of his friends were addicted to drugs. One of them, Maung Soe Naing, who was a good friend came and tempted Maung Maung by saying “You’ll be happier if you inject drugs into your veins.” Maung Maung felt confused.” 2) Split the students into small groups and ask them to discuss the following questions and answers:       It seems safe if I use their needle. They seem to be free from disease. They are quite healthy. What am I thinking? I won’t think of these things. I’m having fun. Once in a while, just try it to know what its like. I can wipe the needle clean with my handkerchief. It’ll be clean. Probably nothing would happen if I inject just once. Sharing needles and syringes can transmit HIV. Oh! That only happens to addicts. But I’ve just injected this one time only. I can’t be infected. a. Which of Maung Maung’s thoughts were wrong? b. If you were present when Maung Soe Naing was tempting Maung Maung, what would you say to him to prevent him from injecting the drugs? c. If you were Maung Maung, how would you act? Why?

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FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

First Edition 2004

3)

Ask the groups to submit their replies to the whole class and discuss.

Add the comment that not only needles and syringes but also skin-piercing instruments (for example, ear-piercing, tattooing, razors, etc) can transmit infection. Therefore using any such articles that have been used by someone else should be avoided. Even if someone has been infected with HIV, the symptoms may only start to appear after a number of years. You can never be sure whether or not someone is HIV positive just by looking at them. A blood test is the only way to know whether or not a person is infected with the virus. 4) Discuss the following personalized questions in pairs: a) Do you think Maung Maung was thinking rationally or thinking with his emotions? Why? b) How easy is it for you to deal with peer pressure? Please explain. c) If a friend asks you to do something you don’t want to do, what would you say to him or her? d) Would you be afraid that you would lose their friendship if you didn’t do as they asked? How would you feel about that? Please explain. e) Do our friends always think about our best interests? Why or why not? f) Who must always take responsibility in the prevention of HIV transmission? Why?

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FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

First Edition 2004

Activity 2
Objective: To be able to explain that abstinence from sexual intercourse before marriage is one effective method of preventing AIDS. Flipcharts, chalkboard or story cards

Teaching aids:

Teaching/Learning Activities

1)

Ask the students to read the following story. “Maung Ni was a boy who had just reached puberty. He secretly went to see video films, like some of his adult neighbours and was influenced by what happened in the films. He went out and had sex with a local sex-worker. It was only afterwards that he saw some educational films and listened to lectures on HIV/AIDS infection. He became very worried and never did it again. When Maung Ni grew up, he married a well brought-up and trustworthy young woman. Although Maung Ni was faithful to his wife and had no relationships with anyone else, he found out he was HIV/AIDS infected after five years of marriage because what he had once done. He didn’t know that he had become HIV-infected because of what he had only done once. He died of AIDS. The consequences for Maung Ni’s single weakness not only affected him; his wife and child were also infected with HIV and the life of the family was ruined.”

2)

Split up the class into small groups and ask each group to discuss the following questions and write down their answers: a) Did Maung Ni get AIDS at once? Why? b) Why did Maung Ni become infected with HIV? c) What consequences did Maung Ni have to face and suffer because of his earlier risk behaviour? d) What should all of us do to avoid falling into the same situation as Maung Ni?

3)

Ask the groups to submit their replies to the whole class.

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FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

First Edition 2004

4)

Discuss the following personalized questions in pairs: a) Do you think that someone only needs to protect himself from HIV transmission when they go with sex workers? Why or why not? b) When you are in a loving relationship, like Maung Ni and his wife, do you need to use protection? Why? Did love and trust protect them from HIV infection? c) Can you tell if someone is infected with HIV? How? d) What do you think Maung Ni and his wife should have done before they got married? Why? e) Have you ever met someone with AIDS? How would you feel if you met someone like that? f) Can you help someone with HIV/AIDS? How?

g) If someone shows external symptoms, such as skin rashes, can you automatically assume that they HIV-positive? Why or why not?

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FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

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Activity 3
Objective: To be able to make the right decision that monogamy should be practised as a way of preventing AIDS. Flipcharts/chalkboards or story cards

Teaching aids:

Teaching/Learning Activities

1)

Read out the following story: “A man called U Phyu drank heavily. When he became drunk, he was in the habit of quarrelling with his wife and and beating her up. She would get angry with him and usually leave home. The more often his wife left home, the better he liked it, because while his wife was away, he could have sex with other women. U Phyu, who was so bad mannered, unfaithful to his wife and guilty of adultery, found out that he had become HIV-infected sometime during the 15 years of his married life. His wife also became rapidly infected, and so they both died of AIDS after suffering its painful effects.”

2)

Discuss the following questions with the whole class: a) Why was U Phyu infected with HIV? b) How should you behave to prevent yourself from contracting HIV like U Phyu? c) What disease can be prevented by being monogamous in marriage? d) Say as much as you know about the possible adverse effects of HIV/AIDS. (Allow students to speak freely.)

3) Divide students into small groups. Ask them to discuss and then write down their answers to the following questions: a) Why do you think U Phyu was so angry? What do you think could have been the fundamental problem behind his rage? (such as work or money) b) Did U Phyu try to solve his problems rationally? How did he solve them? c) If his wife suspected U Phyu of having risk behaviour, what should she have done? Do you think that she could realistically do this? d) What were the consequences of U Phyu’s choices to solve his problems? What do you think he could have done differently? 4) Gather the groups together and ask them to submit their replies to the class.

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Discuss the following personalized questions in pairs: 9

FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

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a) The relationship between U Phyu and his wife was not a loving relationship and often involved violence. How can someone protect himself or herself from violence, especially sexual violence that may lead to infection with HIV? b) What do you think U Phyu’s wife should have done about her situation? Why? How could she have protected herself from becoming infected with HIV? c) What are some of the reasons why the relationship between U Phyu and his wife was so destructive? Could this have been prevented or avoided? d) There is no mention of U Phyu and his wife having a child. If they did have a child, what do you think the child’s life would have been like? e) If a child is born HIV-negative to parents who are HIV-positive, what is the impact on that child’s life? What is the impact on others in society? f) If a child is born HIV-positive to parents who are HIV-positive, what is the impact on that child’s life? What is the impact on society?

g) After a child is infected with HIV, what happens to him or her? Will he or she become sick immediately?

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FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

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Activity 4
Objective: To be able to explain that a woman who suspects she is HIV-positive should consult a doctor before having a baby. Diagram of the relationship between mother and foetus. Picture of breastfeeding (if appropriate in your culture). Flipcharts or chalkboard.

Teaching aids:

Teaching/Learning Activity 1) Give a short lecture: Explain that HIV can be transmitted from mother to foetus, showing the picture of the umbilical cord connecting the pregnant mother and the foetus. Then show the picture of breast-feeding and explain that infection can be transmitted through the milk. As the infection can be transmitted from mother to foetus not only through the mother’s milk, but also through the umbilical cord, and as it is 30% sure that a baby will contract the disease if the mother is infected, a doctor should be consulted in advance and his advice sought. 2) Split up the students into small groups and ask them to discuss and write down their replies to the following questions: a) If a baby is born to a mother who is HIV-positive, does it mean that the baby will also be infected? Why or why not? b) If a child is born HIV-negative to parents who are HIV-positive, what is the impact on the child’s life? What is the impact on others in society? c) If a child is born HIV-positive to parents who are HIV-positive, what is the impact on the child’s life? What is the impact on society? d) If a baby is born HIV-positive, how long do you think the baby will live? Why? 3) Gather the groups together and ask them to submit their replies.

4)

Discuss the following personalized questions in pairs: a) How do you think mothers become infected with HIV? Do you think that they have risk behaviour? Why or why not? b) What do you think parents should do in order to protect their unborn children from infection with HIV? c) When it comes time for you to start planning your own family, what can you do to protect your family from HIV/AIDS? d) How can you protect your future family from HIV/AIDS now? 11

FRESH Tools for Effective School Health http://www.unesco.org/education/fresh

First Edition 2004

Activity 5
Objective: To be able to identify the ways in which HIV is not transmitted.

Teaching aids:

Flipcharts and chalkboard.

Teaching/Learning Activities 1) Split up the students into groups and ask them to brainstorm and discuss the ways in which HIV is not transmitted.

2) Gather the groups together and ask them to submit their replies. You may wish to add that: HIV is not transmitted by:            3) Daily routine activities Hugging each other Using common toilets Coughing Animals/mosquito bites Tears (from crying) Sweat/perspiration Shaking hands Using the same cutlery and eating together Using the same towels and bed linen Sharing clothes

Discuss the questions in class or in small groups/pairs:

Content questions:

a) Do you have any more questions about HIV/AIDS? (Students may write their questions anonymously on slips of paper). b) What is the most difficult thing to understand about the transmission of HIV?

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Why? c) Who must take responsibility in the prevention of HIV transmission? Why? Personalized questions: a) Do you think that you have enough information and skills to protect yourself from infection with HIV? Why or why not? b) If you are not sure that the information you have on HIV/AIDS is correct or if you have a question, to whom can you talk? Why would you talk to this person? Are they the best source of information? c) What role can you play about informing others in your family and community about HIV/AIDS? 4) How would you start a conversation about HIV/AIDS/STIs with someone else? What would you say? Please give an example.

5)

Discuss the following questions: a) What are some of the ways you can think of whereby a drug user can prevent transmission of HIV? b) Why do you think some people like to inject drugs? Are some of these reasons the same reasons why someone might place himself or herself at risk of HIV infection? c) Can the use of drugs other than injecting drugs place someone at risk for infection with HIV? How?

6) Conduct the following assessment activities to evaluate whether or not the students achieved the objectives of the learning activities in the lesson. Assessment Questions: a. Which ways do you know that will prevent infection with HIV? What do you think is the best way? Why? b. Are all babies born to HIV-positive mothers infected with HIV as well? Why or why not? Please explain. c. How can parents protect their children from HIV infection? Role-play: Divide the students into groups and assign each of the groups one of the following role play themes. The role-play must demonstrate the cause of the problem, the consequences and possible solutions.

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a. Impact of HIV/AIDS on children. b. Impact of HIV/AIDS on relationships such as boyfriend or girlfriend, husband or wife. c. Impact of HIV/AIDS on families. Follow-up activity: Divide the students into small groups. The groups must develop a plan for providing information on the impact of HIV/AIDS on children to their local communities. Whenever possible, coordinate with the local Red Cross chapter or local health office so that the students will be able to carry out their plans.

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Government of Myanmar & UNICEF, (2002). SHAPE: School-Based Healthy Living and HIV/AIDS Prevention Education. Yangon, Myanmar: Government of the Union of Myanmar.

http://www.unicef.org/lifeskills/index_14926.html

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