Advanced HIV and AIDS Training Course

Whew, the judgement in the air is thick! My mother is even receiving complaints from her friends telling me that I need to stop slacking off. I know, I know, it's been well over a month since I've last updated my blog...but I have a good reason though (Can you feel the excuses coming?)! For the past couple of weeks, I've been very busy with Peace Corps stuff and planning for a 5-day Advanced HIV and AIDS Training Course, which I am facilitating, for my organization.

For the program, my boss requested that I address the human immune system; STIs; behavior change theory; ARVs; reproductive health; and any other topic I could think of. My first step in planning this program, was to conduct an informal needs assessment, as many of the participants in the course would be VCT (voluntary testing and counseling) counselors. I asked questions like: "What does a macrophage do?"; "What is Kaposi's Sarcoma?"; "Could you take a detailed sexual history of a client without feeling uncomfortable, even if your client is an elder?"; "How does HIV attack the human immune system?"; etc. In conducting this assessment, I found that many counselors were very unfamiliar with the signs and symptoms of the most common STIs, they were unfamiliar with the common opportunistic infections, and that they did not really understand how the human immune system and HIV work. Don't get me wrong, counselors are generally good at what they do, but I think the problem was how they were taught to learn and how they were taught the information...it was really a comment about the South African education system.

In South Africa, you have the teacher who has "all" of the information and the learner (South African for student) who is the sponge. In many South African classes (both historically and currently) teachers and students have learned the to memorize and regurgitate information for homework and tests...and then the information is lost. Subjects are not typically engaged and challenged. Students don't question teachers for fear of: looking "stupid", upsetting the teacher, standing out, etc. The various learning styles present in the classroom are not taken into consideration (tactile, auditory, visual, experiential) ****This is where I give a BIG shout out to the many teachers in my life who took this into consideration, particularly those at the PAIDEIA SCHOOL!!!!****

Well, enough of my social commentary, the American school system has its issues too!

So I took the information garnered from the needs assessment, information I picked up from reading about adult learning theory, my learning styles, my desire to pretend that I'm creative, etc. to identify topics to address and ways to address it. Additionally, I took the "boredom factor" into account. Who would want to sit in a class room from 9am to 4pm just looking at my (pretty) face?! (You won't answer that question if you know what's good for you! Except if you are saying that you'd rather do that than sleep and eat!) I wanted there to be a variety of topics so that it wouldn't feel like a 10th grade American history class. I wanted enough "alone time" so that group members wouldn't get sick of each other. I wanted enough group activities so there would be an exchange of ideas. I wanted participants to feel responsible for truly learning and engaging the topics that we'd be discussing. I randomly asked people to facilitate discussions. On the first day I posted questions around the room. I gave space so that participants could answer the questions, and told them that, as they go through the week and see incorrect information on the sheets, correct it.

So here's what happened:

• Statistics were dicussed on how HIV and AIDS are affected the entire population (black, white, colored, Indian, etc) of South Africa. The roles of gender, poverty, stigma and discrimination, access to resources, race/ethnicity were covered. As much as it seems like a "black disease", its really a human disease (hence the "H" in HIV).

• A skit was developed where people acted out the various components of the immune system. Elayna and I developed props for each character. Scripts were designed so that participants could read what the immune system was doing at that particular time (instucting the Macrophage to look through her goggles and find infected cells or pathogens, use her big teeth to eat them and brush them away with her broom).

• Based on the understanding of how each cell works in the immune system, a skit was developed to show how HIV works to attack the Helpper T-cell. This skit helped them to understand what a viral load test and a CD4 test were really looking for. One participant said, a few hours later, that after this exercise, the information that she knew "clicked". It gave her the opportunity to put together the pieces of the whole HIV puzzle.

• Opportunistic infections and the 4 stages of HIV infection were covered. I got people to personalize how someone with an OI might feel, and how this might impact their adherence to ARVs, willingness to disclose their status, and stigma.

• STIs and their impact and association with HIV transmission.

• I used a really cool activity to get people thinking about behaviors that may or may not put them at risk of infection. I broke participants up into groups and had them identify behaviors on a continum (unsure to high risk) that might put someone at risk for infection of HIV and other STIs. Groups were then asked to place their behaviors on note cards and place them on the continum, where they thought they should be. The larger group debated each group's placement decision. It helped people to understand how difficult it might be for the lay person to identify risk-taking behaviors. Participants also learned that some of the behaviors had to be contextualized. For example: deep kissing or "French kissing". Ordinarily, that behavior is not such a big deal in terms of risk, but what happens if someone has an open wound in or on their mouth (dissiminated infection, HSV1 or HSV2 chancre sore, etc.). Some behaviors that were brought up in the behavior cards were "poverty" or "homosexuality". This caused for a good discussion and a GREAT lead up to my full day of discussing stigma and discrimination. Homosexuality in and of itself is not a "high risk behavior". It brought up that groups of people are often associated with diseases, thus leading to stigma and discrimination, so instead of focusing on the group, focus on the behavior and target that.

• I found a GREAT curriculum produced by EngenderHealth, about addressing stigma and discrimination in the health care setting. The activity mentioned above can also be found in this curriculum, although I've done it in my former life without the curriculum. I would highly recommend this one!

• My friend, Setswana 2 Setswana Sister, and fellow PCV, Liz came up from Childline to conduct a presentation on HIV and AIDS and their impact on children. She did a great job! THANK YOU LIZ!!!!!!!
  

Just as we were about to start the 3rd day, my boss comes in and announces the possible Taxi strike that might take place on Thursday and Friday. Because the majority of group participants use taxis, we had to cancel these two days. They've been rescheduled for next Monday and Wednesday (March 5th and 7th). I'll keep you posted!

I do, however, plan on addressing Behavior Change Theory, (based off of one of our many great/heated discussions) the role of men in the prevention of mother to child transmission, we will watch a great movie called "Yesterday" (addressing stigma and discrimination in a rural village in the province of Kwa Zulu Natal), and (my friend, Setswana 2 Setswana Sister, and fellow PCV) LaQuita will come up and facilitate a discussion on ARVs. The last thing we're gonna do is something akin to a post-test. We're going to play a game of HIV and AIDS Jeapordy. The majority of participants have never heard of the game before...so it should be interesting. I think the next two days will be fun and exciting.

Plus, I must give a very BIG THANK YOU to my mother, who helped me out soooo much in putting this program together! Thanks again mom!

OTHER THINGS I'VE DONE:

Helped to celebrate my friend Saziso's 23rd birthday. His party was the hotness. Over 100 people came to the braai. I cooked my amazingly delicious cheese and potato dish, baked beans (Danielle style), garlic bread (bought from the Super Spar), and my scrumbibaliomtious carrot cake with cream cheese frosting! Thanks to all of my friends who helped me prepare the dishes!

Went to Jo'burg with another local NGO called Eduland. I had soooo much fun! That's a whole other conversation we'll have. I'll get back to that one at a later date!

Decided to get a pet. I'm not sure if this is my maternal instinct thing coming out or just a continuing theme of my complete love of animals. I think I'll be getting a bird...a parrot. Through my research, I've learned that many parrots live as long or longer than humans. Since I don't want my children or grandchildren hating me, because they'll have to inherit the bird, he has to live equal to or less than the normal lifespan of a dog. His name will be Lucky Bob Kototsi (last name is respective of the fact that Saziso will probably be keeping him when I leave), or L. Bob , or L.Bo (in reference to the whole J.Lo craze...or have I been gone long enough so that I'm so outdated?).

Well, that's enough for now. I'll be posting soon, but forgive me, because March, in addition to it being the month that the Second Coming of the Lord (me) was born, my mother will be coming for a visit, and I'll be busy with work stuff. I'll do my best though!

Salang Sentle!