This section is designed to help you:

- identify your own worries and concerns about HIV/AIDS and other STD;
- think about the skills needed to work with young people and HIV/AIDS health promotion; and
- think about your role as a peer educator.

Leader preparation

HIV/AIDS and other STD is a new area of work for many youth leaders. Before you start your HIV/STD health promotion programme with a group of young people, you should take some time to prepare yourself first.

Note to the National Societies and other project planners: We strongly recommend that youth leaders receive training before they start to carry out health promotion activities with a youth group. A two-to-three-day residential workshop for example is ideal for an initial training, which can provide the participants with the basic knowledge, skills and motivation to start working as health (peer) educators. Regular follow-up training sessions are essential to share experiences, give support or receive supplementary training.

Learn the basic facts about HIV/AIDS, STD and related health problems, and think about where you can find additional information

The information in Section 1 will help you to answer most of the questions young people may have regarding HIV/AIDS.

With some of the education activities (Section 5), fact sheets are given on specific issues such as the physical development in adolescence, STD and TB.

In the annexes, you will find basic information about the male and female condom, and about HIV/AIDS and first aid.

Of course, you cannot be expected to know everything! If a specific question is raised during a session with young people and you don’t know the answer, it is quite acceptable to say so. But you should add that you will get the answer from a specialist.

New information is regularly available, especially concerning AIDS. For example, the figures on the spread of the epidemic (given in Section 1) change every year. Researchers all over the world make regular progress in treating AIDS.

But when you read about or hear of new information, check that it is correct before passing it on to your youth group. Since the media is always eager to publish news about AIDS, occasionally the information is premature or incorrect.

You can get reliable advice and information from people in a number of places:

the health department of your Red Cross or Red Crescent Society;
your national scout association;
the national AIDS programme;
the UNAIDS office in your country; and
health services in your area.

Use the right words

There is a lot of confusion between the terms HIV and AIDS. But being infected with HIV and being diagnosed as having AIDS are two different things and this difference is important.

For example, an HIV-infected person is not ill and can lead a perfectly normal life. So it is wrong to say: “That person has AIDS”, you should talk about “someone living with HIV” or “infected with HIV”.

When talking about people who are ill with AIDS, the term “people living with AIDS” (which you may see abbreviated to PLWA) is the most appropriate one to use. Don’t talk about the “AIDS virus”. AIDS is not a virus, but a disease process. Don’t say “AIDS test”, but use the term “HIV test” or “HIV antibody test”.

Explore your feelings, values and attitudes, which could affect your work

Your feelings, values and attitudes are shaped by your past experiences, where you grew up, your family, school, peers and religion. You need to recognize this and the fact that you bring these feelings, values and attitudes with you in your communication. They affect the information you give and the way you give it.

Thinking about your own feelings, values and attitudes related to HIV/AIDS and how they can affect your work with HIV/AIDS health promotion programmes is not always easy. To help with the process, try asking yourself some questions.

Look through the manual. Which subjects are you comfortable discussing and which are the ones you would prefer to avoid? If some topics seem difficult, why might that be? Do you need to know more about the subject? Or would your feelings about the subject make talking about it difficult?

A topic you would rather not discuss might be the very one that your group needs help with.

Are there some subjects related to HIV/AIDS and how the virus is passed that you realize you have strong opinions about?

Everyone may not share your opinions about what type of behaviour is appropriate. Leading the HIV/STD activities will involve dealing with attitudes and values that may be different from your own. If your group gets the message that they can only say things you agree with, they will no longer pay attention to the sessions.

Have you already thought about what having HIV/AIDS means to the person infected and also to their family and friends? What are your feelings towards these people?

Maybe you know the facts about how HIV is passed and not passed, but you are still afraid of getting infected from casual contact. This could affect the way you present the facts or you react if you find that a member of your group is infected with HIV.

Be prepared if a member of your group is affected by HIV/AIDS

Considering the number of young people today infected with HIV, it is more than likely that in your group too a participant might be infected or might be worried about infection. In some highly affected countries, you can be sure that some of the participants will have relatives or friends who are infected, are sick or have died.

You should, therefore, be prepared when someone comes to see you to share his or her worries about HIV or to inform you about his or her HIV status. If you notice that a member of your group is reacting in a very emotional way when talking about HIV/AIDS, he or she may need your personal support. No need to say that in such a situation confidentiality must be guaranteed!

What can you do to develop your skills?

If you have not done so in a training workshop, then try some of the learning activities of this manual, such as the quizzes. These exercises can help clarify the facts. (Remember: Section 1 and the fact sheets in Section 5 provide you with the correct information.)

Reflect upon what you feel and think about when you are studying the case studies and statements presented in the values/attitudes activities.

Keep your eyes open for any training opportunities that might help you in your work, such as group leadership or communication skills training.

Have regular meetings with your fellow leaders to discuss and practice answering sensitive questions that will arise in the youth group.

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About your role as a peer educator

Undertaking a health promotion programme with a group of people who are about the same age and have the same background as you is called peer education. You are, therefore, a peer educator.

Peer education has proven to be a very successful method for the promotion of healthy behaviour. Why?

In general, people tend to behave in the same way as their peers: the group closest to them in age, with similar background or interests. This applies to young people in particular. They are more likely to listen and learn from their peers than from adults. Moreover, young people often question the attitudes and values held by adults. This is obvious in sensitive topics such as sex and sexual behaviour, which adults often avoid discussing altogether.

Sometimes this influence of young people on each other, called peer pressure, can be negative and lead to risky behaviour. Think about how young people are often pushed by their peers to drink alcohol, smoke or use other drugs.

Peer educators, however, can use their influence in a positive way: they can serve as a role model by giving accurate information and by promoting norms and attitudes that lead to healthy, responsible behaviour. That is why, in the area of health promotion for young people, peer educators play a very important and responsible role.

Real action

The Ghana and Benin Red Cross Societies organized peer education projects with young apprentices in small trade workshops. The peer educators, aged from 16 to 24, first had three days’ training. Then, with permission from the workshop owners, they held five educational sessions in each workshop. The peer educators worked in pairs and gave each other mutual support. They were also supervised by the project coordinator who met with the whole group every two weeks.

A good peer educator requires a number of skills, for example he or she is: motivated and committed to the programme; able to work in a team; respected, trusted and well liked by the peer group (the peer educator should be someone that other young people turn to spontaneously for advice); capable of respecting confidentiality; a good listener and communicator; and aware of which sources of information or counselling to refer for appropriate help.

Moreover, when working in the area of HIV/AIDS and sexual education, a peer educator should feel comfortable talking about relationships, emotions, sexuality and drugs, as well as grief and death.

For more guidelines on peer education, we recommend the AIDSCAP document: How to Create an Effective Peer Education Project (see: Appendix VI, Resources).

About your role when working with young people who live in vulnerable conditions

When talking about “young people living in vulnerable conditions”, we think of street kids, young people caught up in conflicts, economically exploited youth, young refugees, young people in prisons, young prostitutes, young drug addicts. Their way of life makes these young people vulnerable to all kinds of risks, including infection with HIV/AIDS and other STD.

Prevention activities with these groups are often difficult: they are hard to reach because they may not belong to formal structures such as schools or youth organizations. They also often have their own subculture, which is not easily accessible to ‘outsiders’. Although you may be a ‘peer’ for such a group in terms of age, your social background may be so different that you have little in common with the people you are targeting and you will be considered an outsider.

In such cases, it is important to involve one or more members of the target group in your project team. Their help in designing the programme will go a long way towards developing a good relationship with the young people you want to reach and towards understanding their needs.

Real action

In Colombia, the Red Cross has transformed a van into a mobile clinic to provide primary health care and STD treatment, as well as HIV education, every night to gangs of street youth.

When working with socially disadvantages groups, you should also pay extra attention to the following leader skills:

Take time to gain the trust of the youngsters and respect confidentiality.

Do not judge. Do not put pressure on group members to give up behaviour that you disapprove of (drug use or sex work, for example). Your first objective must be to make risky behaviour safer. A long-term objective may be to create possibilities for these people to change their situation (e.g., taking part in a drug-abuse treatment programme, or finding other employment for them).

Respect the priorities of these people (a daily meal, for example, may be more important than information on STD...).

Be flexible. You have to be aware that your session will not always run as you planned. You may need to adapt the time or the topic you planned to discuss according to circumstances.