This section is designed to help you:

- identify the objectives of an HIV/AIDS and other STD health promotion programme with young people;

- identify the needs of your group;

- choose the best methods of working with your group;

- involve community members in your programme; and

- build your programme of activities.

Programme planning

First of all, what do we mean by the word ‘programme’? Programme is used here to mean all the activities and projects you carry out with your own youth group and/or with the community, i.e., your entire HIV/AIDS and other STD health promotion programme. Programme planning is the process of determining the problem that needs to be solved, deciding what you want to achieve, and developing how you want to do it.

Sections 5 (Activities with youth groups) and 6 (Action with the community) provide ideas for planning programme activities. Before the youth group starts working in the community, it is important they learn about AIDS themselves and have time to develop their own ideas for community projects.

This section will describe some questions to ask and things to consider before you begin planning your overall programme.

What do you want to achieve?

What do we want to achieve when undertaking a health promotion programme with young people?

The overall goal is to promote healthy and responsible behaviour that prevents the transmission of HIV and other STD and to develop young people’s attitudes and skills to care for other people.

All the activities described in Section 5 aim to develop these objectives.

It is important to start the programme with activities that give information about HIV/STD and other health-related issues. However, studies have revealed that knowledge alone does not lead to behaviour change. In the context of HIV/AIDS and other STD, this means that knowing the facts about the transmission of the diseases or the ways to protect oneself does not lead to safer sex behaviour. Information activities, therefore, should not dominate a training programme! Good knowledge is only a basis upon which to build the necessary skills and the right attitudes and values.

To adopt and practice safe sexual behaviour, young people need to develop important ‘life-skills’, which include:

self-awareness;
decision-making abilities;
assertiveness (to be able to resist pressure to use drugs or to have sex);
negotiating skills (to insist upon protected sex);
practical skills (for efficient condom use); and
recognizing, avoiding or managing situations that may lead to violence or abuse.

A health promotion programme should always include exercises, such as role playing and drama, that offer the opportunity to practise these skills.

Whether the knowledge and skills a person has learnt are put into practise will usually depend on his or her attitudes and values.

Values represent what a person appreciates and esteems. If young people have learnt to value their health, for example, they will more likely delay sex or practise safe sex.

Attitudes are a person’s feelings towards something or someone. In the context of AIDS, tolerance of diverse lifestyles, rejection of discrimination and prejudice as well as compassion and care for others are the most important attitudes.

Attitudes and values are not easy to teach or to measure. However, there are several ways, such as group discussions, case studies or ‘values-voting’, which can help you explore and influence people’s attitudes and values. Another way of developing attitudes is by personal example. As a youth leader you may act as ‘role model’. If, for example, you want to encourage young people to be tolerant, your own personal behaviour should reflect this attitude.

What are the needs of your group?

What is the HIV/STD and sexual health situation nationally and locally?

For a better understanding of the risks that group members may confront, a knowledge of the local HIV/STD and sexual health situation is essential.

You should, therefore, have some idea of the answers to the following questions:

How important is the HIV/AIDS problem in the area?

How many people are estimated to be infected with HIV? And how many young people are HIV-infected?

How many young people are thought to have STD?

What is the estimated rate of teenage pregnancy?

How important is the problem of alcohol and substance abuse in the area?

Are family planning services and/or STD services available locally?

Are HIV testing and counselling services available?

Do young people use these services? If not, why not? Are they youth friendly? Are they affordable?

Your National Red Cross/Red Crescent Society or your national scout association can collect this information for you through the national AIDS control programme or the Ministry of Health, or through local health services.

What HIV/STD prevention activities already exist in your area?

Make sure you are aware of all HIV/STD activities going on locally. Some schools may organize prevention activities, NGOs may provide HIV/STD education and the national AIDS programme may already be working with young people in your area.

If at all possible, you and your group should work together with these associations. You and they have much to gain from each other. Discuss this with the Red Cross/Red Crescent in your country or with your national scout association.

What is the profile of your youth group?

To set up a programme that really responds to the needs of your youth group, you should have a very good understanding of the world they live in, their beliefs, their level of education and what sort of risks their behaviour might expose them to.

This is called a group ‘profile’. To profile your group, try to answer the following questions:

How do the young people spend their time?

How much education have they had?

How do they earn money?

What kinds of activities do they enjoy?

Where do they gather?

Who do they trust?

Who do they admire?

How do they obtain information about sexual matters?

What do they know about HIV/AIDS?

What information channels reach them?

Who are the adults with an influence on the youngsters (parents, other relatives, teachers, health-care workers, local healers, religious leaders, etc.)?

One way to gather this information is by conducting focus-group discussions with all those participating in your programme.

Why focus-group discussions?

A focus-group discussion is a structured form of group discussion, aimed at gathering information on your programme’s target group: the knowledge the people have on certain issues, their opinions and experiences, their needs.

Figure

Why are focus-group discussions important?

When conducting a focus-group discussion before you start your actual education activities, you involve the youth group in the planning of the programme. In doing so, your programme will have a better chance of really responding to the needs and concerns of your target group. A focus-group discussion allows the group to define the issue – for example, sexual health – in their own terms: how they understand it, and what it means to their own lives. These discussions also encourage the group to come up with proposed actions and solutions which make sense to them and to their community. Finally, focus groups reveal the words and phrases people commonly use in talking about the issue, in this case sexuality.

Later on, the information compiled can be used to evaluate the project and see whether it has made a difference. For example, the focus group at the start of your programme reveals that 25 per cent of the young people think about using condoms when having sex. Once the programme is finished, a discussion to find out whether this percentage has increased is a useful indication of the success or failure of the programme.

Separate focus-group discussions can also take place with other groups that are involved in the programme, such as parents or community leaders.

The guidelines for the whole procedure of focus-group discussions as well as some suggestions for questions are given in Appendix II.

Why choose group work?

Most of the activities in this manual use group work and ‘learning by doing’, rather than a more passive ‘lecture-style’ approach. Around the world, experience shows that young people and adults are more motivated to learn and learn faster when they are actively involved in the learning – when they can process information through questions and discussions, solve problems and practise skills.

Figure

Young people come to a group with a great deal of information and life experience. Working together in a group enables them to share ideas and learn from each other’s experiences. They will soon develop the skills and confidence they need to try out what they have learned within their own community.

The first step when working with a group is to develop a trusting relationship with group members. This means ensuring that they feel they can talk openly and express themselves freely without being worried about criticism. They need to know that information will not be discussed outside the sessions. It is important, therefore, to start your programme with a few of the ‘warm-up’ exercises you will find in this manual, and with setting out some ‘ground rules’ together for group work.

(See Section 5, Activities with youth groups.)

About mixed groups

It is important to try to involve as many girls (young women) as boys (young men) in your programme. This will not always be easy. In many countries, girls are kept out of school to participate in household tasks, which results in a majority of boys in the classrooms or in other educational activities. Girls may also be harder to reach because some parents may object to their participating in group activities because of the content of the programme. In some cultures, it is considered unsuitable to talk about sexuality with young girls. If possible this issue should be raised in a parents’ meeting (see below).

Working with a mixed group is, however, not always ideal. Girls may find it embarrassing to talk freely about issues related to sex in the presence of boys. So dividing the group by sex when discussing certain issues or when doing certain exercises (such as the demonstration of condom use) is sometimes preferable. Eventually, with sustained efforts, it is possible to create an atmosphere where discussions involving both boys and girls are acceptable.

In mixed groups, make sure boys and girls listen and respond to one another’s concerns and watch out for the situations where boys may dominate the discussions!

Who should be involved in your programme?

Parents or other relatives

When talking about ‘parents’ here, we are also including other adults who have a parenting role, such as other relatives or foster parents.

Most parents recognize the importance of HIV/STD education for their children, but many find it difficult to discuss subjects such as sexuality and death, and are happy that others take on this responsibility. However, they may have reservations about some information you give or some of the activities you propose.

Involving parents right from the start can help them to understand the purpose of the programme. Before starting activities with young people, it would be useful to invite parents to a meeting and explain to them what the aims of the programme are and how you will proceed. Parents are often eager to learn about HIV/AIDS and other STD themselves. Such a meeting may provide an excellent opportunity to inform them as well.

Other community members and caring agencies

Religious leaders, social workers or primary health-care workers are often involved in community decisions and participate in support and care for young people. Young people will sometimes prefer to discuss sensitive subjects with these ‘trusted adults’ rather than with their relatives.

In some communities or in some circumstances, specific organizations such as group homes or youth clubs have direct responsibility for the welfare of young people.

You should, therefore, consider involving all these community members when planning a youth health promotion programme. They provide an excellent resource for understanding the values and attitudes of your youth group.

Keep in mind, though, that some community members may have objections to your project. Working in HIV/AIDS and sexual health education often involves controversy because of societal beliefs and prejudices. In general, this problem can be resolved by giving good information about the objectives of the programme.

People living with HIV/AIDS

A personal testimony of an HIV-infected person may have far more impact on a young audience than a lecture about the global impact of AIDS.

People still sometimes deny the existence of AIDS, especially in countries where the rate of infection is low. But when a real person living with HIV or AIDS tells his/her story, the audience is willing to believe that ordinary people are vulnerable to this disease.

When the participants can talk to a person with HIV/AIDS, they learn how HIV-infected people cope with the situation.

How do you build your programme of activities?

Make a selection of activities according to your target group

Section 5 gives you a large choice of educational activities, from which you can select a number. Your choice will depend on the characteristics and needs of your target group. For example, when working with illiterate youth you can only choose activities which do not require any reading or writing skills. When you work in an area with a high rate of drug use among young people, you should focus your activities on this issue.

Always start with warm-up activities to help the group get to know each other, and to build and maintain trusting relationships. The manual offers a choice of six warm-up activities. Pick two or three you particularly like.

Warm-up actions are followed by activities related to knowledge. You should make sure that the group already has good knowledge of an issue before you start working on skills building or discussing values and attitudes related to that issue. Of course, many activities which aim to explore values or develop certain skills will also offer opportunities to provide additional information.

Some examples of programmes of activities

Adapt activities or materials according to your group

Adapting the materials to fit your culture and the age and experience of your group is essential. If the youth members don’t see the activity as relevant to their lives, they cannot learn what you are trying to teach them.

The activities described in this section have been designed for young people aged about 15 or older. However, they have been used successfully with younger teens. You should think about how suitable these materials are for your culture and the age of your youth members.

The names of people in the case studies could be changed to local names. Avoid, however, using the names of people of your own group as this could be embarrassing.

Evaluate what you have done

At the end of each activity, take time to evaluate. Try to answer for yourself the following questions:

How well did the activity go?
Did it accomplish the goal or goals you set?

You can also ask the participants for their opinion:

What is the most important thing he/she learned?
What else would they like to know?
How did he/she felt when taking part in the activity (e.g., role play)?

Evaluating each activity as you go along will help you understand what works best with your group and decide what you need to do next.