HEAT Manual - HIV Education & Advocacy Training

Introduction to the manual Welcome messages

Dear SCORAngels, It is with great honor and excitement that I am writing you this welcome note for the HIV Education and Advocacy Training (H.E.A.T) Manual.

Working on HIV and AIDS have always been the corner stone of our work within our Standing Committee and its raison d’être. This manual was made to make planning sessions on HIV and AIDS easier, and more efficient, whether they are part of the overall HEAT training or as independent sessions during WAD or any other HIV related campaigns. I would like to thank, the coordinator of the HEAT Small Working Group, Yara Hisham, and every single contributor to this manual: Frederike, Hichem, Karin and Maira. If it was not for their hard work for months, this manual would have never seen the light of day. I would also like to thank my successor, Laura Lalucat, for making sure the manual is finalized and shared to every single member in our federation.

With that said, I hope you find this manual useful, and I wish you great sessions everywhere around the world.

Love, Iheb Jemel SCORA Director 2018-2019

Dear SCORA and Capacity Building enthusiasts, I’m extremely excited about this publication as it’s been handled between two International Teams and I’ve been able to whitness all the progress made since the very beggining when the call for the SWG was launched.

Even though, my role in this collective effort to increase the quality of our Capacity Building spaces has been only active in the very last stages of the creation and I can only say we’ve paid attention to final details, to how to convey information and how to make it accessible and encourage the usage of this tool in the best ways possible. Last, a massive thank you to all the passionate members involved on this project and I wish you all a happy reading, facilitation hours and great learning experiences!

Yours, Laura Lalucat SCORA Director 2019-2020

What is a HEAT Training?

The HIV Education and Advocacy Training (HEAT) is a training aimed to provide IFMSA members with tools and skills to deliver various aspects when advocating for HIV & AIDS. Hence a SWG was created to develop a manual to ensure having standardized as well as qualified trainers in the field of HIV & AIDS. As HIV & AIDS is one of the main pillars in SCORA and it is an important issue faced in all IFMSA regions from stigma & dicrimination related issues to lack of basic medical knowledge. This training manual is the fruit of extensive work done by IFMSA members that aims to offer all HEAT trainers a well sought and thorough guide to engage and be part of the fight against HIV. It also presents the necessary medical, social and advocacy related knowledge and provides experienced facilitators with the resources, tools and guidance to effectively facilitate workshops related to HIV. We would like to express our gratitude to those who contributed to the development of the guide.

Lots and lots of love, For any further assistance on the topics covered in the Manual, for any doubt or inquiry you may have, feel free to reach out to da.scora@ifmsa.org On behalf of the HEAT Manual SWG, Yara Osman, HEAT Manual SWG Coordinator and Mohamed Hichem Smaali, Development Assistant for Capacity Building 2019-2020

Description

and objectives

This training has been developed as part of SCORA’s effort in the fight against HIV and stigma. It offers a 3 day cohesive training that tackles the medical, social and advocacy related knowledge in order to shape a new generation of HIV educators. As future health practitioners, it is necessary to provide an introduction to the current SRHR challenges when it comes to HIV and AIDS and also get fully prepared to advocate and take part in the HIV and AIDS response.

Objectives To provide training to future healthcare professionals on HIV and AIDS medical but also social aspects.

To work with trainers to discuss current social and legal barriers in relation to HIV and AIDS and identify strategies to overcome them.

To enable participants to learn the skills to facilitate peer education training on HIV and AIDS in their home countries.

To provide participants with the tools and follow-up available to work on advocacy initiatives with the support of the SCORA International Team.

Agenda Overview The agenda for the HEAT training has been built with the aim of tackling each relevant topic in a comprehensive way and organising the content with a logical and easy-tofollow flow. That’s why the structure of Theme Days enables participants to go in depth into the different topics and build on the knowledge and skills acquired on the previous day integrating all aspects of HIV advocacy during the training.

Therefore, the three Theme Days are:

Medical Aspect

Advocacy

Social Aspect

Proposed agenda Day 1: Medical Introduction History of HIV Knowing HIV Prevention Treatment HIV and language

Day 2: Social Key populations and people most affected by HIV How does stigma and discrimination affect HIVrelated health?

Legal barriers to access the HIV cascade: what needs to change?

HIV and Advocacy How the media shapes our perception of HIV Mapping and Engaging stakeholders Fundraising for HIV response

Sex-positivity in public health strategies and medical consulting

The 90-90-90 Strategy and an AIDS free world by 2030

Role plays: Consultation on prevention, testing and treatment

Integrated Community Approach to HIV Response

How the media shapes our perception of HIV and AIDS

Graduation project

Movie Screening and Discussion HEAT Manual

Day 3: Advocacy

The Sessions The sessions described in the following pages aim to provide the trainers a structure, content to be covered and resources to do so. Please note that are guidelines and proposed ideas to be used. The Goals and Objectives can be tackled with different methodologies and dynamics in addition to the ones proposed. Therefore, trainers have the freedom to use the content of the manual adapting it to the context, their fields of expertise, the baseline knowledge of participants or the target group.

For each day, you will find the proposed session and content organised in the following structure: 1. Description: the session content summarised in a few lines. In other words, what the session is tackling.

2. Goals and objectives: the purpose of the session, the achievement that should be accomplished and more specific targets on how to do so. This point is the core structure of the session and will guide you during it’s preparation.

3. Expected time: the time you should calculate for the session.

4. Methodology: a list of which kind of activities and dynamics the session includes.

5. Outline: The outline of the sessions is basically a tiny agenda/schedule of what will happen during the session. For this, it is always important to keep in mind to allow for some buffer time. This is usually 10% of session time.

Adaptations The information in the guide is applicable in most settings. We advise facilitators to identify what activities and tools can be adapted to be more appropriate to their specific setting and relevant to their participants.

Before they adapt contents, facilitators may need to gather information on local laws and policies related to HIV, available methods of treatment and prevention, barriers to access and other considerations.

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Day 1 Medical Day 1: Medical Introduction History of HIV Knowing HIV Prevention Treatment HIV and language

Day 1 - Medical Aspect 1. Introduction Description: it is essential to start the training with sufficient time to get to understand the aim of the workshop, align expectations and to get to know each other in order to build a comfortable environment for the overall training.

Goals: Goal 1: participants understand the goal and objectives of the training.

Objective 1.1: put the participant at ease and make them comfortable.

Proposed activities for the session Introducing the trainers and the workshop agenda: Setting Ground Rules for the training: brainstorming on which basic principles should be respected during the overall training (for example, respect each other’s opinions, avoid side talks, reach out for help when needed…).

Sharing Hopes and Fears.

Introducing what a safe space is and how it will be ensured during the training.

Transforming expectations into learning objectives: summarize participant's expectations into learning objectives by asking them to write down individually what they want to learn through the training using the SMART objectives method. Trainers can collect the learning objectives and by the end of the training, give them back to participants to check to which extent those were fulfilled.

Ice breakers and getting to know each other activities.

2. History of HIV Description: HIV was discovered during early 20th century and it was thought to be a disease of men having sex with men and it was later on that scientists discovered methods of transmission. During this session we will discuss the journey of HIV’s discovery till nowadays.

Goals: Goal 1: participants gain understanding on the history of HIV and the milestones till nowadays.

Objective 1.1: participants learn the important dates regarding the disease.

Objective 1.2: participants acknowledge the impact and change of attitudes through history.

HEAT Manual - Medical Aspect

Expected time: 45 min Methodology Quiz Presentation Materials: pens, A4 papers

Outline: Timing

Activity

Description

5min

Introduction and explanation of the aim of the session.

The facilitator talks about the different phases that happened from discovering HIV to treatment.

30min

Quiz. Facilitators divide participants into two teams and each team has some papers. On each paper a certain year is written on it and on other papers the answers to the years then participants are given 30 minutes to match the years with events in the correct chronological sequence and then the team with the closest timeline wins. The facilitators wrap up the activity by going through the correct sequence.

10min

Wrap up.

Go through all events and highlight its importance.

Materials If necessary, use the video in Resources 2.

Papers with years and events written on them.

Either by a powerpoint presentation or debriefing with participants.

Resources/materials for follow up: 1. Check the full timeline in SCORA Database: https://cutt.ly/4rhE0Dv 2. [YouTube]. (2018, march 27th). AIDS in the Media, The Early Years [Video file]. Retrieved from: https://www.youtube.com/watch?v=5oWu7FR-hZ0

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3. Knowing HIV Description: What is HIV and what does HIV stand for ? Is AIDS and HIV the same thing ? what are the methods of transmission ? during this session you will be able to know all this information and even more.

Goals: Goal 1: participants increase their understanding of HIV. Objective 1.1: participants understand what HIV is and its methods of transmission along with its stages.

Objective 1.2: participants understand the incubation period, window period and method of diagnosis.

Goal 2: participants increase their understanding on the prevalence of HIV. Objective 2.1: participants gain knowledge on global statistics that include: The number of people living with HIV. The number of people on antiretroviral therapy.

The number of new HIV infections.

The number of AIDS-related deaths.

Expected time: 90min Methodology Quizzes Presentation Materials: laptop, projector, pens, markers, A4 papers

Outline: Timing

Activity

Description

10 min

Introduction Ice breaker or energiser.

Introduce what will be covered and the learning objectives of the session.

15 min

Knowing HIV "Q and A"

Facilitators introduce questions on a presentation or a video covering: What’s HIV and its pathogensis.

What’s the difference between AIDS and HIV and what does it mean to have low viral load.

The stages of the infection.

The difference between a window period and the incubation period.

HEAT Manual - Medical Aspect

Materials

-

Questions in ppt slides/video Check Resources 1.

Timing

Activity

Description

20 min

Transmission: Participants are asked to stand in a line “crossing the while statements are read consisting of line” activity. actions that result in transmission of HIV. If they think the statement is true, they have to jump to the right and if they think it’s false, they jump to the left. After each statement, a short explanation is also given to discuss the statement.

20 min

Diagnosis: “Matching together” or “Who am I” activity.

Facilitators divide the participants into two teams one has a description of each test and another has the name of each test.

Participants’ goal is to match together descriptions and names of the tests.

Facilitators will clarify doubts after each match.

Materials Check Resources 2.

Check Resources 2.

Another activity that can be used is the “Who am I” game: a participant gets the name of a diagnosis method written in a sticky note and gets it sticked in their forhead without reading it. They have to guess which diagnosis method they “are” by asking questions to the group.

15 min

Prevalence The prevalence map

10 min

Wrap up

Facilitators project the UNAIDS prevalence map and they discuss with the participants the conditions in their countries / region in terms of HIV prevalence focusing on the causes of it. Participants can be asked to research their countries’ perspectives before the training.

Check Resources 3.

Go through the content of the session as recap and leave room to clarify concepts and answer questions.

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Resources/materials for follow up: 1. Simon, V., Ho, D. D., & Abdool Karim, Q. (2006). HIV/AIDS epidemiology, pathogenesis, prevention, and treatment. Lancet (London, England), 368(9534), 489–504. doi:10.1016/S01406736(06)69157-5 2. CDC. (2019). HIV Transmission. Retrieved from: https://www.cdc.gov/hiv/basics/transmission.html 3. UNAIDS. (2019). Key populations Atlas. Retrieved from: http://www.aidsinfoonline.org/kpatlas /?fbclid=IwAR1RWjpa9Gf8xMwZLsd6ejzLjl5bg8toj9RXmfrFMBwSjB9FE2w7AeRh4Aw#/home

4. Prevention Description: In this session we will talk about the medical prevention available regarding HIV . who is at risk . what is PEP and what is PrEP ? is there any side effects ? is it a vaccine?

Every question regarding medical prevention will be discussed during this session.

Goals: Goal 1: participants acquire knowledge about Prevention in the HIV field.

Objective 1.1: participants understand and are able to explain what ‘s PreP and its indications.

Objective 1.2: participants understand and are able to explain what’s PEP. Objective 1.3: participants understand and are able to explain different methods to decrease the risk of HIV transmission.

HEAT Manual - Medical Aspect

Expected time: 60 min Methodology Video Game Materials: laptop, projector, pens, markers, A4 papers, flipcharts, sticky notes

Outline: Timing

Activity

Description

Materials

10 min

Introduction

Introduce what will be covered and the learning objectives of the session and play w a video by the CDC about the prevention methods.

Check Resources 1.

50 min

PrEP, PEP , Prevention methods

Facilitators divide the participants into 3 teams : 1. PrEP 2. PEP 3. Prevention methods Each team is given handouts with information explaining each of the items.

They are given 20 minutes to prepare a 10 minute session/activity on the topic assigned to facilitate for the rest of the group.

Check Resources 6. to get information pages to design the handouts.

During the sessions facilitators should take notes of the missing information and at the end they should inform the participants of the information.

5 min

Wrap up

Give feedback on the previous activity and recap going through all the information conveyed.

-

Resources/materials for follow up: 1. Video: CDC [Youtube]. (2006, september 27th). Start Talking. Stop HIV. Music Video featuring Alex Newell. Retrieved from: https://youtu.be/_espkK-vLgc 2. PrEP: a. CDC (2019). Prep, HIV basics. Retrieved from: https://www.cdc.gov/hiv/basics/prep.html b. CDC (2019).PrEP for Preventing HIV | HIV Risk Reduction Tool. Retrieved from: https://wwwn.cdc.gov/hivrisk/decreased_risk/medicines/prep.html c. NIH (2019). AIDS info, drugs. Retrieved from: https://aidsinfo.nih.gov/drugs/406/emtricitabine---tenofovir-disoproxil-fumarate/0/patient 3. PEP: a. CDC (2019). PEP, HIV basics. Retrieved from: https://www.cdc.gov/hiv/basics/pep.html 4. Prevention methods: a. CDC (2019). PrEP for Preventing HIV | HIV Risk Reduction Tool. Retrieved from: https://wwwn.cdc.gov/hivrisk/decreased_risk/medicines/prep.html 12

5. Treatment Description: Is HIV curable? what does it mean to have a low viral load ? what are the available drugs for HIV treatment? During this session we will learn all about HIV treatments available.

Goals: Goal 1: participants understand and are able to explain the available treatments for HIV. Objective 1.1: participants understand and are able to explain what ART is.

Objective 1.2: participants understand and are able to explain what HAART is and the differences between HAART and ART. Objective 1.3: participants understand and are able to explain side effects of available treatment.

Objective 1.4: participants understand and are able to explain how ART and pregnancy are managed.

Expected time: 75 min Methodology Discussion Powerpoint presentation Materials: A4 papers, box, laptop and projector

Outline: Timing 5 min

50 min

Activity

Description

Introduction Introduce what will be covered and the learning objectives of the session.

Treatment

A box with different factsheets inside is put in the middle of the room.

The factsheets should contain the following information: The types of drugs available When to start the treatment Recommendations during pregnancy and pregnant women who never started ART The success of ART What is HAART and the side effects of medication Family planning and ART Mental health and HIV Participants pick a factsheet and read the information by turns. Facilitators discuss with participants their understanding of each topic and provide more details/clarify ideas.

HEAT Manual - Medical Aspect

Materials -

Check Resources 6. to develop the factsheets.

Outline: Timing

Activity

Description

15 min

Regimens

Powerpoint presentation on the regimens available.

10 min

Wrap up

Give space for participants to ask questions, ask them which new informations they learned and recap going through all the information conveyed.

Materials Check Resources 6.

-

Resources/materials for follow up: 1. Chen, W. T., Shiu, C. S., Yang, J. P., Simoni, J. M., Fredriksen-Goldsen, K. I., Lee, T. S., & Zhao, H. (2013). Antiretroviral Therapy (ART) Side Effect Impacted on Quality of Life, and Depressive Symptomatology: A Mixed-Method Study. Journal of AIDS & clinical research, 4, 218. doi:10.4172/2155-6113.1000218. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3786003/ 2. J. Myhre and D. Sifris (2019). When Did HAART Become ART?. Retrieved from: https://www.verywellhealth.com/cart-hiv-combination-antiretroviral-therapy-48921 3. J. Verville (2019). About HAART. Retrieved from: https://www.healthline.com/health/hivaids/understanding-the-aids-cocktail 4. NIH (2019). Fact sheets. Retrieved from: https://aidsinfo.nih.gov/guidelines/html/1/adult-andadolescent-arv-guidelines/10/initiation-of-antiretroviral-therapy 5. WHO (2019). Viral suppression for HIV treatment success and prevention of sexual transmission of HIV. Retrieved from: https://www.who.int/hiv/mediacentre/news/viralsupression-hiv-transmission/en/ 6. CDC (2019). How can HIV impact my mental health?. Retrieved from: https://www.cdc.gov/hiv/basics/livingwithhiv/mental-health.html 7. CDC (2019). What should I ask my health care provider about having a baby?. Retrieved from: https://www.cdc.gov/hiv/basics/livingwithhiv/family-planning.html 8. NIH (2019). Clinical guidelines. Retrieved from: https://aidsinfo.nih.gov/guidelines

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6. HIV and Language (Terminology) Description: This session introduces the participants to inclusive and sensitive language in the context of HIV. Besides a theoretical part, they have the chance to implement the new knowledge right away in an exercise. The session should take place relatively early in the workshop (especially before the sessions that focus on social aspects) so that the participants can apply the learned terminology for the rest of the workshop.

Goals: Goal 1: participants get familiar with the concept of Person-First-Language.

Objective 1.1: participants can explain the Person-FirstLanguage in 1-2 sentences.

Objective 1.2: participants apply the Person-FirstLanguage in the context of HIV & AIDS. Goal 2: Participant increase their awareness on language & terminology in the context of HIV & AIDS. Objective 2.1: Participants have discussed HIV-related terminology in an exercise of at least 10 examples.

Expected time: 60 min Methodology Video Game Materials: laptop, projector, whiteboard, pens, markers, A4 sheets

Outline: Timing

Activity

Description

5 min

Introduction

Explain why the usage of different language and expressions matters so much for the HIV response. Mention some examples how specific vocabulary can influence a political debate and how we look at a problem or at a specific group of people.

5 min

The Denver Principles

Display an abstract of the Denver Principles of 1983 (check exemplary slides). Put the Denver Principles into a timely perspective: - How was the situation in 1983?

- How were people affected by HIV involved?

Emphasise the importance to recognise the community and how they want to be called themselves.

HEAT Manual - Medical Aspect

Materials -

Check Resources 6. to get information pages to design the handouts.

Timing

Activity

Description

10 min

People First Show the participants the video about People Language First Language. Ask if there are any general questions about the concept. Ask participants why and how the concept could be applied in the context of HIV.

30 min

Practice

Ask participants to get together in pairs. Write 2-3 examples of not-recommended language on the whiteboard.

The pairs shall discuss the terminology and come up with a better alternative.

Discuss with everyone and then move on to another round of 2-3 examples. Continue until you have discussed all terminology that you find important

Agreement for HEAT

Discuss with participants the importance of getting aware and used to this new inclusive terminology. If participants agree, commit to try to use this language throughout the workshop from now on.

5 min

Materials Discussion with participants Video screening Resources 5.

Presentation Check Resources to see the examples.

-

Resources/materials for follow up: 1. Exemplary slides for this session: https://docs.google.com/presentation/d/1o5AcS2tn4JdXNY3GMgM2fLE5m9U2o_S5dB49vatzOU/edit#slide=id.p 2. The well project (2019). Why Language Matters: Facing HIV Stigma in Our Own Words.

Retrieved from: http://www.thewellproject.org/hiv-information/why-language-mattersfacing-hiv-stigma-our-own-wordshttps://drive.google.com/open? id=1HHUpGUjSv2PIIcHFy44ljwCyVFMTGR1j 3. UNAIDS (2015). UNAIDS TERMINOLOGY GUIDELINES. Retrieved from:Â https://drive.google.com/open?id=1wDD7EGQqZ37C5Hkq58xPPqScXEgGSlWh 4. UNESCO (2006). UNESCO Guidelines on Language and Content in HIV- and AIDS - Related Materials. Retrieved from: https://drive.google.com/open? id=1TK2NzIMX1Q637s37qnXQZ_BkezcIDI9Z 5. Texas Center for Disability Studies [Youtube]. (2017, sept 27). People First Language.

Retrieved from: https://www.youtube.com/watch?v=lz40q5lydnQ

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Resources/materials for follow up Terminology that should be discussed: Not recommended 1. HIV-positive person 2. High risk group 3. AIDS test 4. Sexual promiscuity 5. Fight against HIV/AIDS 6. Homosexual men 7. Prostitutes 8. Drug addicts 9. Prisoners 10.Vulnerable groups

HEAT Manual - Medical Aspect

Better alternative 1. Person living with HIV 2. High risk behaviour 3. HIV test 4. Having multiple sexual partners 5. Response to HIV and AIDS 6. MSM (men that have sex with men) 7. Sex workers 8. People who use drugs 9. People who live in closed settings 10.Key populations

Day 2 Social Day 2: Social Key populations and people most affected by HIV How does stigma and discrimination affect HIVrelated health?

Legal barriers to access the HIV cascade: what needs to change?

Sex-positivity in public health strategies and medical consulting Role plays: Consultation on prevention, testing and treatment How the media shapes our perception of HIV and AIDS Movie Screening and Discussion

Day 2 - Social Aspect 1. Key populations and people most affected by HIV How does stigma and discrimination affect HIV-related health?

Description: This session is designed for the participants to expand their knowledge in terms of identifying the key populations and people most affected by HIV. Mainly 4 populations will be addressed but the trainers can choose to cover other ones.

The session also aims to determine how stigma and discrimination affect the access to health care for people living with HIV.

Goals:Â Goal 1: participants can identify main key populations when it comes to the HIV and AIDS response.

Objective 1.1: participants can define "key population" Objective 1.2: participants can name at least 4 key populations.

Goal 2: Create an understanding of vulnerability in society.

Objective 2.1: every participant has discussed at least one representation of a key population.

Goal 3: participants have a better understanding of the way stigma and discrimination affect HIV-related health.

Objective 3.1: Participants reflect on the the social obstacles regarding access to treatments.

Expected time: 90 min Methodology Case presentation Scenario presentation Discussion Materials: laptop, projector, post-its

Outline: Timing 5 min

Activity Introduction

Description Introduce the session by explaining how you are going to do a role play exercise.

Volunteers will have to embody each population that they receive in a post-it and they are going to tell us how a typical day for them is like. The others can then ask them questions about their lives.

HEAT Manual - Social Aspect

Materials -

Timing 40 min

Activity In someone else's shoes: Reflection

Description 4 volunteers are given a post-it with a population name and are asked to represent 4 populations and to take some minutes to reflect on how their daily life would be: Transgender young woman MSM young man Young injecting drug user Young sex worker

Materials Post-its

The audience then asks them questions about their personal lives and the facilitator guides the conversation.

40 min

Debrief

Ask the actors how it felt to portray their character. Next, ask how they knew about the character whose role they had to play.

Was it through personal experience or through other sources of information?

Ask the group to identify areas of discrimination experienced by the characters.

Consultation role play

Choose 6 volunteers: 3 Volunteers are going to enact a situation where an HIV-positive MSM is going for his usual check up at the doctor’s.

3 Volunteers are going to enact a situation where an HIV-negative woman is going for her usual check up at the doctor’s.

Debrief

Handouts with scenarios' descriptions written down, Check a sample in Resources.

What makes certain populations key populations ?

Explain how vulnerability is related to risk as a variable associated with an increased risk of disease or infection.

Underline how these key populations are at higher risk of having HIV, statistically.

Highlight the importance of fighting stigma and discrimination among key populations.

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Timing 5 min

Activity Wrap up

Description

Materials

Go through the main highlights of the session and emphasize how stereotypes and prejudices towards certain groups may lead to discrimination and violation of basic human rights.

-

Resources/materials for follow up: 1. UNAIDS. (2016). FEATURE STORY: HIV prevention among key populations. Retrieved from: https://www.unaids.org/en/resources/presscentre/featurestories/2016/november/20161121_ke ypops?fbclid=IwAR0Ey5pJCJfHFnMZ3e2asLCdUju2GQDJ7n2LsPx1PPuWYDUuN-pNbTz9n8Y 2. UNAIDS. (2019). Key populations atlas. Retrieved from: http://www.aidsinfoonline.org/kpatlas/#/home Extra materials: Possible scenario for HIV-positive MSM: A 25 year old man was not welcome by the nurse at the door who reported that the doctor is not available. After a long wait, the doctor accepts the patient, only to inform him that she would not be able to examine him and she refers him to another doctor. The man asks for his treatments nevertheless, but the nurse announces that it is out of stock. Everyone is being rude and portraying sentiments of disgust. The young man feels uncomfortable and leaves. In paradox, the check up goes smoothly for the young woman who is HIV-negative.

3. Legal barriers to access the HIV cascade and what needs to change Description: This session is designed for the participants to reflect on the situation of their countries specifically and the world in general in terms of laws and legislations that cripple the access to the HIV cascade all the while coming up with solutions to better the current situation.

Goals: Goal 1: participants care aware of laws criminalising HIV risk behaviour.

Objective 1.1: participants can recognise what are HIV risk behaviours.

Objective 1.2: participants have a better understanding of the reasons behind these laws.

Goal 2: participants show initiative as to the importance of civil society engagement.

Objective 2.1: participants engage in the creation of change once back home.

HEAT Manual - Social Aspect

Expected time: 30 min Methodology Cross the line activity Discussion Reflection Materials: Flip-charts, markers

Timing

Outline:

Activity

Description

5 min

Introduction

50 min

Cross the line

Participants are asked to take a step every time the statement applies to their country.

Reflection

5 Statements will be read out loud. Every participant will react after the statement.

Participants reflect on differences/ similarities regarding HIV related laws.A discussion is centred around the extent of the effect these laws have on access to the HIV cascade.

Introduce the session by explaining the first activity: participants are asked to stand on one line. Facilitators are going to read some statements.

Materials -

Statements detailed in Resources.

5 min

Small Working Groups

Participants are asked to identify the aspects that need to change and the possible solutions.

-

5 min

Wrap up

Give feedback on the previous activity and recap going through all the information conveyed.

-

Resources/materials for follow up: 1. UNAIDS. (2018). Miles to go, closing gaps, breaking barriers, righting injustices. Retrieved from: https://www.unaids.org/sites/default/files/media_asset/miles-to-go_en.pdf? fbclid=IwAR3mEwjycmQjp1Ew9PEnsv42fC_0rb9vPVPAh5gayG7eRsRw1HoMwrC0pYU Exemplary Statements for the activity: Sexual intercourse between consenting adults of the same sex is illegal in my country.Sex work and other transactional sex is criminalised in my country.

People who inject drugs remain the targets of punitive laws and aggressive law enforcement in my country.

In my country there are laws that criminalise HIV transmission, non-disclosure or exposure.

Law in my country require persons aged younger than 18 years to obtain permission from a parent or guardian before accessing sexual and reproductive health services, HIV testing and treatment, pre-exposure prophylaxis and other health services.

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4. Sex-positivity in Public Health strategies and medical consulting Description: the session is designed to bring the concept of sex-positivity into the workshop. Sex-positivity is a broader concept used in different areas of sexuality education and sexual health-related medicine. For the social determinants of HIV, the concept is very relevant for increasing the access to prevention and testing and to reduce taboo around the topic.

Goals: Goal 1: participants understand the difference between risk-based and sex-positive approach in HIVrelated messages.

Objective 1.1: participants can name one example for a risk-based and one example for a sex-positive prevention message.

Goal 2: Participants understand the importance of sexual pleasure in the context of HIV prevention and HIV-related counselling.

Objective 2.1: participants can name 2 benefits of using the sex-positive approach over the risk-based approach.

Goal 3: Participants learn how to talk about pleasure in a medical setting.

Objective 3.1: participants know at least 2 questions that approach sexuality from a pleasure perspective.

Expected time: 120 min Methodology Presentation Discussion Reflection Materials: laptop, projector

Outline: Timing 10 min

Activity

Description

Brainstorming Ask the participants to name some typical on prevention sentences/messages used for HIV-related messages campaigns (e.g. “Don’t risk HIV”, “Protect with condoms”, “Stay safe”, etc.).

Write them on a whiteboard and separate them to the left and right side according to whether they choose risk-based or sexpositive approach without explaining your method of separation.

Then ask the participants to find out how you decided to put them left or right.

In the end, add the titles “risk-based” and “sex-positive”.

HEAT Manual - Social Aspect

Materials Flipchart/white board to write down participant’s contributions.

Timing 10 min

15 min

Activity Risk-based approach vs. sex-positive approach

Benefits of sex-positive approach in Prevention Counselling Sexuality education

Description Explain the concepts with a definition and some examples of risk-based and sexpositive approach. Emphasise that medical school often teaches us to look at sex as a risk and that sex-positivity does NOT mean to neglect risks, but to approach them in another way.

Discuss with participants what could be the benefits of applying the sex-positive approach in HIV-related education and medical counselling. Write the ideas on a whiteboard and add when arguments are missing.

5 min

The pleasuremeter

Explain that talking about sex-positivity, pleasure plays an important role.

Emphasise that sexual pleasure goes hand in hand with sexual rights and sexual health. IMP: Be cautious not to create a “pleasure imperative”. Having the right to pleasureable sex is not the same as forcing pleasure onto people.

5 min

Wrap up

Give feedback on the previous activity and close the session going through all the information conveyed.

Materials Presentation if needed

-

-

-

Resources/materials for follow up: 1. Exemplary slides: https://cutt.ly/Exemplaryslidessexpositivity 2. Global Advisory Board (GAB) for Sexual Health and Wellbeing. (2018). SEXUAL PLEASURE The forgotten link in sexual and reproductive health and rights | Training toolkit. Retrieved from: https://www.gab-shw.org/resources/training-toolkit/ 3. HIRST, Julia (2012). It's got to be about enjoying yourself: young people, sexual pleasure and sex and relationships education. Sex Education: sexuality, society and learning, 13 (4), 423-436. Retrieved from: http://shura.shu.ac.uk/6758/ 4. IPPF. (2016). Keys to youth-friendly services: Adopting a sex positive approach. Retrieved from: https://www.ippf.org/resource/adopting-sex-positive-approach

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Resources/materials for follow up: Possible benefits of the sex-positive approach: Takes into account why people have sex.

Talking about pleasure and sex-positivity makes sexual practices more visible that are outside the heteronormative thinking (= vaginal penetration).

Strengthening equality and reciprocity in relationships, emphasising the importance of negotiation of sexual practices can help to develop skills to prevent STIs. Sex-positivity is about feeling in control and taking care of oneself and of one’s health, without subsequent regret or post-sex worries over contracting STIs.

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5. Role plays: Consultation on prevention, testing and treatment in exemplary cases Description: this session is designed for the participants to implement all they have learned so far in the workshop in the form of role plays in different stages of HIV-related medical consultation. The role plays are designed to cover three scenarios: talking about prevention, testing and treatment.

Goals: Goal 1: participants combine their acquired knowledge on medical and social aspects related to HIV. Objectives: participants can name...

1.1: at least 3 situations in which an HIV-test makes sense.

1.2: at least 3 HIV prevention strategies.

1.3: at least 2 reasons why an early start of HIV treatment after the diagnosis is important.

Goal 2: Participants gain confidence in HIV-related medical consultation.

Objective 2.1: every participant has played at least one scenario on HIV-related medical consultation in the role of a doctor and received feedback about it.

Objective 2.2: every participant has observed at least one scenario on HIV-related medical consultation and gave feedback.

HEAT Manual - Social Aspect

Expected time: 120 min Methodology Case Presentations Discussion Role plays in groups of 3 Materials: laptop, projector

Timing

Activity

Description

Materials -

5 min

Introduction

Participants will go through typical scenarios of HIV-related health in a medical setting. It’s an interactive session; encourage the participants to use the knowledge that they have acquired throughout the workshop so far. Explain that all together you’re going to revise important aspects and then pause the revision with role plays.

10 min

Role plays

Participants should get together in groups of 3 and introduce the scenarios. There will be 3 roles to play in each scenario: Doctor Patient Observer Each participant should play all roles throughout the session.

Exemplary scenarios for the role plays: A 45-year old man is married to a woman. He secretly meets with men that he doesn’t know to have sex. He has insertive and receptive anal sex and oral sex. Usually he uses a condom, but sex takes place in the dark and he’s not sure that his partners use a condom all the time. He’s afraid someone could find out.

Rounds

A 23 year-old single woman lives alone in the city where she studies.

Sometimes she sells sex in order to pay her university fees. She offers vaginal and oral sex. She usually doesn’t use condoms as her clients pay more for condomless sex.

A 32-year old man is openly gay and in a relationship with another man.

They live in an open relationship.

He uses condoms with other sex partners, but not with his boyfriend.

20-25 min per round

Let the groups of 3 decide who starts in which role. Take the “Patients” aside and tell them their case so that the “doctors” can’t hear it. Then give them 10 minutes to perform the role play with the goal to take a medical history and find out whether an HIV test makes sense. Give them another 5 minutes for the observer and the “patient” to give feedback to the “doctor” and discuss the case.

Discussion: talking about prevention Revise different HIV prevention methods. Ask the participants about the cases they played in Round 1 and which prevention method they think can work for these patients.

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Similar to Round 1. The groups stick with the case they had in Round 1, but the participants should switch roles. Take the “doctors” aside and tell them that they have run an HIV test and it came out negative. They shall tell that to the patient and discuss with them with prevention method works for them to stay safe in the future. Give them 10 minutes to perform the role play and another 5 minutes for the observer and the “patient” to give feedback to the “doctor” and discuss the case.

Discussion: HIV treatment Quickly go over the most important concepts of HIV treatment: combined ART, early start of treatment, undetectable = untransmittable.

Similar to Round 1 and 2, the participants should switch roles for the last time. Tell everyone that the groups stick with the same case, but that in this role play the HIV test had a different outcome. Take the “doctors” aside and tell them that they have run an HIV test and it came out positive. They shall tell that to the patient, take care of the acute situation and make sure they start treatment directly. Give them 15 minutes to perform the role play and another 5 minutes for the observer and the “patient” to give feedback to the “doctor” and discuss the case.

Wrap it up!

Get everyone together and let the participants share how they felt in the role play and what they’ve learned.

Encourage them to share some specific moments they found difficult or especially helpful.

Resources/materials for follow up: 1. UNAIDS. (2018). UNAIDS data 2018. Retrieved from: https://www.unaids.org/sites/default/files/media_asset/unaids-data-2018_en.pdf 2. [YouTube]. (2018, march 27th). Treating HIV: Antiretroviral drugs | Infectious diseases | NCLEX-RN|. [Video file] Khan Academy. (2005 June 26th). Retrieved from: https://www.youtube.com/watch?v=GR9d9wrOl5E

HEAT Manual - Social Aspect

6. The 90-90-90 strategy and an AIDS free world by 2030 Description: in this session, participants will get to learn about what the 90-90-90 strategy is all about and the global goal for ending HIV by 2030 along with the steps taken to make this possible. It is hoped that from this session, they can be able to come up with some campaigns and strategy based on any of the goals to work toward ending HIV in their region.

Goals:Â Goal 1: participants learn the 90-90-90 strategy goals and how they have been achieved in different regions along with the impact.

Objective 1.1: participants discuss some of the strategies they have seen in their regions based on the 90-90-90 strategic model.

Goal 2: participants get to interact on some of the strategies that have been used in their regions in achieving the 90-90-90 strategy that has proven effective.

Objective 2.2: participants gain knowledge on how the HIV is being tackled using the SDG as a framework for eliminating HIV spread by 2030.

Expected time: 30 min Methodology Discussions Presentation Picture presentation Materials: laptop, projector, whiteboard and markers, paper, pens

Outline: Timing

Activity

Description

10 min

Introduction

IIntroduce the session by explaining first what the 90-90-90 model is all about and briefly how it has helped in achieving global reduction of HIV.

10 min

How the 90-90-90 strategy is being achieved in different regions

Pick 3 participants from different regions based on the goals of the 90-90-90 strategy ask them how this has helped promote this campaign in their country and have them explain the problems they think is experienced in achieving these targets.

10 min

Ending HIV by 2030.

Talk to the participants about the HIV goals by 2030 and their relation to the SDGs in eradicating HIV.

Materials Check Resources 1.

-

Check Resources 2. and 3.

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Resources/materials for follow up: 1. UNAIDS. (2019). AIDS and the sustainable development goals. Retrieved from: https://www.unaids.org/en/AIDS_SDGs 2. UNAIDS. (2014). 90-90-90, An ambitious treatment target to help end the AIDS epidemic. Retrieved from: https://www.unaids.org/sites/default/files/media_asset/90-9090_en.pdf 3. UNAIDS. (2018). Miles to go, closing gaps, breaking barriers, righting injustices. Retrieved from: https://www.unaids.org/sites/default/files/media_asset/miles-to-go_en.pdf? fbclid=IwAR3mEwjycmQjp1Ew9PEnsv42fC_0rb9vPVPAh5gayG7eRsRw1HoMwrC0pYU

7. Fundraising for the HIV Response Description: this session aims to put a focus on the importance of investment and fundraising in the HIV response and how to generate funds for your local activity which is a crucial step in any advocacy work. Over the years, overwhelming evidence has emerged that underscores the urgent need to invest now in proven strategies and prevent new infections; not only is it cost-effective but is actually shown to save money as well as countless lives.

Goals: Goal 1: participants get to know of the global funds that are being directed towards the HIV response.

Objective 1.1: participants can name 3 organisations that provide funds for the HIV response.

Goal 2: participants can plan their own fundraising for a local activity.

Objective 2.1: participants are aware of the tips and tricks it takes to plan a fundraising.

Objective 2.2: participants are aware of the potential of using tools like social media for fundraising.

Expected time: 30 min Methodology Presentation Discussion Small Working Groups Materials: laptop, projector, whiteboard and markers, paper, pens

Outline: Timing 10 min

Activity Introduction

HEAT Manual - Social Aspect

Description Participants are introduced to fundraising and how it is a critical part of the HIV response. It is also important to discuss where the investment for the HIV response is coming from and how much more is needed to end AIDs by 2030.

Materials Check Resources 1.

Timing 10 min

Activity Plan your fundraising

Description The facilitator can give instructions verbally.

The participants are divided into Small Working Groups and provided with one fundraising idea and one goal. Their task is to plan an event so that it successfully generates money keeping in mind everything from risk management to securing sponsorships if need be.

Materials Check Resources for Tips and Tricks for fundraising.

After the activity, the participants can be shown some tips and tricks they can use in their future endeavours to close the session.

Resources/materials for follow up: Fundraising ideas for participants: Host a film screening Host a community walk/run/hike Organise a bake sale Hold an auction Hold a car wash Send personal requests [for donations]

Fundraising goals for participants: HIV testing services Antiretroviral therapy Distribution of prevention commodities Legal and Human Rights literacy Legal services in cases of discrimination Awareness campaigns for treatment options Prevention of mother-to-child transmission related services

1. UNHCR. (2017). FUNDRAISING & COMMUNITY ACTIVITY TOOLKIT. Retrieved from: http://www.unanyc.org/adopt-afuture2017/Fundraising%20and%20Community%20Activity%20Toolkit.pdf 2. amfAR, The Foundation for AIDS Research. (2011). Fundraising Toolkit for CommunityBased MSM/HIV Projects.

Retrieved from: https://www.amfar.org/uploadedFiles/_amfarorg/Around_the_World/MSMToolkit.pdf 3. amfAR, The Foundation for AIDS Research. (2014). The Investment Case for Global AIDS Funding: Getting Smarter, Showing Results, Issue Brief. Retrieved from: http://nacc.or.ke/wp-content/uploads/2016/03/Benefits-of-Investing-in-HIV-Final1.pdf 4. Unitaid. (2019). Innovating to end HIV. Retrieved from: https://unitaid.org/assets/UnitaidHIV-Portfolio.pdf

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Day 3 Advocacy

...

Day 3: Advocacy Â

HIV and Advocacy How the media shapes our perception of HIV Mapping and Engaging stakeholders Fundraising for HIV response The 90-90-90 Strategy and an AIDS free world by 2030 Integrated Community Approach to HIV Response Graduation project

Day 3 - Advocacy Aspect 1. HIV and Advocacy Description: this session aims to introduce the concept of advocacy to the participants and make it accessible for them to apply it to a multitude of issues, specifically HIV and AIDs. They are made aware of the various opportunities for youth to be involved in advocacy in their local communities as well as on the international platform and how theirs is an integral role in ending the AIDs epidemic by 2030.

Goals: Goal 1: participants gain knowledge of advocacy basics.

Objective 1.1: participants understand the terms: advocacy, stakeholders, campaigning, lobbying, policy, key populations, evaluation and monitoring.

Goal 2: participants understand the importance of advocacy in dealing with the HIV & AIDS epidemic.

Objective 2.1: participants are able to discuss the role various organisations like UNAIDS have had on the AIDS epidemic and how it is still crucial to curb the epidemic for good in the near future.

Expected time: 60 min Methodology Presentation Discussion Small working groups Materials: laptop, projector, pens, markers, A4 papers, flipcharts, sticky notes

Goal 3: participants know the importance of an advocacy strategy and how to practically implement it.

Objective 3.1: participants know the practical steps it takes to come up with a good advocacy strategy.

Objective 3.2: participants are able to formulate a key message that concisely and clearly summarizes what they are advocating for.

Outline: Timing 15 min

Activity Introduction

Description What does advocacy mean to you?

Participants are asked to answer the question, “What advocacy means to you?” in one word which will lead to a discussion on how advocacy means different things to different people.

The discussion is led to what advocacy means in the practical sense listing out what an advocacy strategy would look like, what it consists of, and why planning one is so important.

HEAT Manual - Advocacy Aspect

Materials Whiteboard to write down the responses Presentation slides.

Timing

Activity

Description

Materials

15 min

Advocacy Tree

The participants are taught the first step of an advocacy strategy which is establishing a long-term goal and objectives (SMART).

They are then introduced to the concept of an advocacy tree which can be drawn by the facilitator beforehand on a flipchart. The different parts of the tree represents different things. The main – the problem, the roots – causes, the branches – barriers and the leaves – solutions. The participants are told that the problem is the lack of coverage of antiretroviral therapy for everyone who needs it and to identify the causes, barriers and solutions to this problem. They write these on a post it and stick it on the appropriate place on the Advocacy Tree.

Whiteboard to draw the tree model/flip chart

15 min

Who can make it happen?

The participants are briefed on understanding influence and the differences between decision makers and influencers and who to choose as their target audience.

Check resources for Tips and Tricks.

What do they need to hear?

The participants are taught about the importance of a key message and how to create one. They are also taught of the tips and tricks of one.

Writing a Statement Activity

An activity where the previously taught skill of creating a key message is employed. The participants are divided into SWGs and are given a scenario and asked to create a key message consisting of a statement, one piece of evidence, a personal story and a call to action. This key message is then narrated by a speaker from each group in under a minute in a plenary-like environment.

15 min

Check resources for Tips and Tricks.

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The participants work in small groups and come up with a key message. They may need paper and pens to work with. The exemplary scenarios can be found under Resources.

Instructions: Please read the scenario below.

Discuss questions 1-5.

Design your group’s one-minute message.

Assign a speaker who will present this message in plenary.

Questions: 1. What are the issues of concern in this situation?

2. In what ways could you advocate?

3. Who is the audience of your advocacy?

4. What are some benefits of advocacy in this situation?

5. Are there any risks that would prevent you from responding?

One-minute message: please design a one-minute message based on the following format and example: One statement (Bringing the HIV transmission rate to zero is possible through the collective and tireless efforts of the global community.)

One piece of evidence (About one third of persons with HIV in the UK do not know that they have been infected).

One case or story (Hauwa was a teenage girl who got married to an older man who was HIV positive and didn’t know his status. She contracted the virus and found out her status after her husband died years later from TB. By that time, she had given birth to 4 children who were all HIV positive …).

One call to action (We call on the state to provide nationwide HIV testing services that are accessible, affordable and confidential).

1 min

Wrap up

HEAT Manual - Advocacy Aspect

The facilitator can show how all the various activities and strategies are linked into one cohesive advocacy strategy. The audience can reflect on what they’ve learnt and how they personally feel about being advocates to end the stigma faced by people living with HIV.

Check resources for Tips and Tricks.

Resources/materials for follow up: Exemplary scenarios for Writing a Statement Activity You and several other students are meeting at your professor’s house for an informal class discussion on the rising spread of HIV in injecting drug users. The TV is playing in the background where a “drug junkie” is carelessly sharing needles and finds out that he’s HIV-positive. The professor catches this and remarks that these people don’t deserve our help and resources and that they brought this on themselves by using in the first place and quotes incorrect statistics to prove his point. He asserts that wasting resources on this key population is of no use and that they can never change.

You arrive to a family reunion picnic with your sister who recently shared with the family that she was diagnosed with HIV. As you make your way around to say hello and offer hugs to family members, your cousin hesitates when greeting your sister, commenting “I’m not going to get it am I?”.

During your weekly basketball league game, the subject comes up of a team member sharing on Facebook that he was going to get an HIV test. This individual is absent from the game this day. Several negative and judgmental comments are expressed by your fellow teammates.

Exemplary tips and tricks for creating a key message: Choosing the right words is decisive in getting the message across.

Use audience-appropriate language.

Balance the rational and the emotional in your message.

Structure, or frame, the issue and solution.

Translate individual stories into larger social and political problems.

Assign primary responsibility to the problem.

Present a clear solution. Spell out the proposal.

Develop images that highlight your values.

Documents to be referred to for making slides: 1. UNAIDS. (2015). UNAIDS Act 2015 Advocacy Strategy Toolkit. Retrieved from: https://www.unaids.org/en/resources/documents/2014/advocacy_toolkit 2. UNAIDS. (2015). On the Fast-Track to end AIDS 2016-2021 Strategy. Retrieved from: https://www.unaids.org/sites/default/files/media_asset/20151027_UNAIDS_PCB37_15_18_E N_rev1.pd 3. UNAIDS. (2018). Miles to go, closing gaps, breaking barriers, righting injustices. Retrieved from: https://www.unaids.org/sites/default/files/media_asset/miles-to-go_en.pdf? fbclid=IwAR3mEwjycmQjp1Ew9PEnsv42fC_0rb9vPVPAh5gayG7eRsRw1HoMwrC0pYU 4. UNAIDS. (2014). 90-90-90, An ambitious treatment target to help end the AIDS epidemic. Retrieved from: https://www.unaids.org/sites/default/files/media_asset/90-9090_en.pdf

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Resources/materials for follow up: IFMSA and Policy Writing - How to be involved in IFMSA advocacy efforts This is a document summarising how policy writing is a crucial element of the work we do in IFMSA and is a useful piece of tool to be included into the discussion/ presentation when deemed appropriate depending on how knowledgeable your audience is in finding out about open calls to SWGs that work on policy papers and how to effectively apply for them. For example, if you feel the participants don’t know about the IFMSA servers (main line of communication we use to open calls and keep the members updated), you can incorporate that into your presentation or where these policy papers are presented (the various external meetings IFMSA sends delegations to). It is a good way to show the advocacy work we do in IFMSA. Policies are accessible here: http://ifmsa.org/policy-documents/ https://ifmsa.org/policy-and-advocacy/how-to-propose-a-policy/

2. How the media shapes our perception on HIV and AIDS Description: this session introduces the participants to how media has been used to portray HIV and AIDS and their impact to the general population. It aims to enable participants to understand the impact of the media in promoting HIV prevention services and disregarding stigma and discrimination toward people living with HIV. It also aims to show the participants on different ways the media can be used to create awareness of the disease and promote treatment.

Goals: Goal 1: Participants get to understand how different portrayals of HIV affects health seeking behaviour among people both for prevention and screening and treatment.

Objective 1.1: Show the participants a slide show of the different ways in which HIV has been portrayed by the media and get their reactions in regards to each image and how it affects health seeking behaviour.

Goal 2: This is aimed at showing the participants ways in which the media can be used to promote awareness on HIV and reduce stigma and discrimination.

Objective 2.1: participants will be asked to name the HIV awareness programs or campaigns in their regions and share with everyone how they handle the issue of awareness.

Objective 2.2: show participants how the media can be used to reduce stigma and discrimination against people living with HIV.

HEAT Manual - Advocacy Aspect

Expected time: 30 min Methodology Presentation Discussion Materials: laptop, projector, pens, markers, A4 papers, flipcharts,

Outline: Timing 10 min

Activity How HIV is portrayed by the media.

Description Show the participants a video or an image slide share of how the media in different parts of the world have portrayed HIV and ask them to give feedback on if it was appropriately portrayed or exaggerated.

Materials Pen and paper.

Participants will have a pen and paper and after each picture they will write I for Inappropriate or A for Appropriate then few of them will be selected at random to give reasons as to why they chose I or A for the different scenarios.

5 min

15 min

Importance of media in creating awareness.

Explain using a few examples of the statistics of how the media can be used to create awareness and why it has such a strong impact in creating awareness.

Check resources for Tips and Tricks.

How the media has been used to create awareness in different regions: select few participants from different regions to give examples in which they have seen the media being used to promote HIV awareness in their region.

How the media has been used as a tool to reduce stigma and discrimination: using few examples from different countries, show the participants how media can be used to reduce stigma and discrimination.

Resources/materials for follow up: 1. UNAIDS. (2014). The Media and HIV/AIDS: Making a difference. Retrieved from: http://data.unaids.org/publications/irc-pub06/jc1000-media_en.pdf 2. Avert.

(2019).

HIV stigma and discrimination.

Retrieved form: https://www.avert.org/professionals/hiv-social-issues/stigma-discrimination Tips and tricks: Make sure to talk briefly about the effects of stigma and discrimination so as to explain how to reduce them.

Include few HIV positive celebrities and politician in the presentation from different countries who have openly come out in regards to their status to help reduce stigma and promote testing.

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3. Integrated Community Approach to HIV Response Description: HIV is not just a health issue, it spans all aspects of life - social, cultural, political, economic and rights issue. The purpose of this session is to show the synergy between the HIV response and social development - and that community response encompasses both issues and is the only viable way to combat the stigma and discrimination that follows HIV/AIDS. The centrality of community-driven response has proven to be at the heart of the HIV response by successfully reaching those who are most marginalized and vulnerable - key populations disproportionately affected by HIV.

Goals: Goal 1: The participants are aware of the importance of the community response in the HIV epidemic.

Objective 1.1: participants can discuss the basics of the community-centred response and its constituents advocacy, health services and research.

Objective 1.2: participants are familiar with some organizations that have successfully funded/supported community-centred responses, e.g. MSF, and their innovative methods in doing so.

Objective 1.3: participants can discuss and appreciate the intricacies that have to be considered in dealing with the HIV epidemic - cultural, political, developmental, social, economic and rights aspects.

Expected time: 45 min Methodology Presentation Discussion Video SWGs Materials: laptop, projector, pens, markers, A4 papers, flipcharts, post-its

Outline: Timing 10 min

Activity

Description

Perspective Video Learning to Listen

Participants are shown a video on TED depicting a story that demonstrates the importance of involving the community in its own response and decision making.

Reflection

The facilitator then leads the discussion into how this is applicable to the HIV epidemic where communities need to manage their own responses in order to achieve the maximum scale.

Materials Check Resources to access the video.

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Timing

Activity

Description

Materials

8 min

Communitycentred response

The model of the community-centred response can be shared where the community itself is the centre of advocacy, service delivery, research and financing. This model is sustainable in the long run, as seen in Namibia where donor funds are expected to phase out by 80% in the coming years.

The concept of community health workers is also introduced - the link between health systems and community responses.

Check Resources to prepare the slides.

15 min

Coming together as a community

Participants are then divided into SWGs and are assigned a key population affected by HIV. Keeping that specific population in mind, the groups have to brainstorm ideas and apply the knowledge they have learnt till then and think of services that would reach and help their key population. The groups then present their ideas and the facilitator can end the activity on the note that everyone’s ideas would be integrated to be holistic as a whole.

Post its with key populations written down are randomly given to participants.

Successful community led responses

The facilitator can showcase some examples of the more innovative ideas some organizations have used in the past to drive forward community-led responses.

Check Resources to see some examples.

10 min

Resources/materials for follow up: 1. UNAIDS & Stop AIDS Alliance. (2015). Communities Deliver: The crucial role of communities in reaching global targets to end the AIDS epidemic. Geneva and Hove.

Retrieved from: https://cutt.ly/7rstqZz Examples of key populations affected by HIV: Men who have sex with men Sex workers Transgender people Adolescent girls Pregnant women (to avoid mother-to-child transmission) Injecting drug users HEAT Manual - Advocacy Aspect

One exemplary case study for “Examples of successful community led responses”Adherence Clubs by Médecins sans Frontières (MSF): In ART adherence clubs, groups of 30 people living with HIV meet every 2 months. The groups provide essential tasks, such as measuring weight and conducting symptombased general health assessments. The results are recorded by a peer educator who acts as the club facilitator. Antiretroviral medicines are pre-packaged and labelled for each participant; they arethen brought to the group by the club facilitator. Any person living with HIV reporting symptoms that suggest illness, adverse side effects or weight loss is referred back to the main clinic for prioritized assessment by a nurse. All club members see a nurse twice a year: once for blood tests, and then two months later for an annual clinical check-up. The club facilitator also is responsible for completing the club register.

In Khayelitsha, South Africa, 97% of club patients remained in care over a period of 40 months. This is compared to 85% of those who qualified for clubs but remained in mainstream, clinic-based care. Club participation reduced loss to follow-up by two thirds and almost halved the proportion of people with a detectable viral load (compared with patients who remained in clinic-based care). A cost-effectiveness study showed the cost per patient year was US$ 58 in the antiretroviral therapy club model, versus US$ 109 in the mainstream model of care.

Definition of a community response: In the context of HIV, a community response is the collective of community-led activities in response to HIV. These activities include: 1. Advocacy, campaigning and participation of civil society in decision-making, monitoring and reporting on progress made in delivering HIV responses.

2. Direct participation in service delivery.

3. Participatory community-based research.

4. Community financing.

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4. Mapping and engaging stakeholders Description: in this session, the participants will get to know who a stakeholder is and the different stakeholders engaged when it comes to fighting HIV/AIDS. They will also know more about how to map those stakeholders and engage them and their advantages and disadvantages and how to overcome these shortcomings when it comes to engaging stakeholders.

Goals: Goal 1: Participants get to understand who is a stakeholder and the different stakeholders involved when it comes to fighting HIV&AIDS. Objective 1.1: place the participants in different groups according to their regions and have them discuss the different stakeholders involved in their region in fighting HIV&AIDS and how they can achieve this.

Goal 2: This is aimed at showing the participants ways in which they can engage the stakeholders in their region in the fight towards eliminating HIV&AIDS. Objective 2.1: participants will be asked to name how the stakeholders can be engaged in their regions.

Objective 2.2: participants will be asked to discuss the advantages and disadvantages of mapping out stakeholders and how to overcome these disadvantages.

Expected time: 45 min Methodology Presentation Discussion Interactive session Materials: laptop, projector, pens, markers, A4 papers, whiteboard

Outline: Timing

Activity

Description

10 min

Introduction

The facilitator introduces the participants to who is a stakeholder and who are the different stakeholders when it comes to tackling HIV&AIDS.

20 min

Identifying stakeholders in the different regions.

Participants will be put in groups where they will identify the different stakeholders in their regions that can be engaged in combating HIV&AIDS and how they can achieve this.

HEAT Manual - Advocacy Aspect

Materials -

Timing 20 min

Activity How to engage stakeholders

Description The facilitator presents different ways to engage with stakeholders.

Materials -

Advantages and Disadvantages of mapping out of stakeholders:Â the participants will be involved in an active discussion with the facilitator to see the advantages and disadvantages of mapping out stakeholders.

Resources/materials for follow up: 1. WHO. (2019). HIV/AIDS: Policy, advocacy and stakeholder mobilization. Retrieved from: https://www.who.int/hiv/topics/vct/toolkit/components/policy/introduction/en 2. McGonigel, M. Nuss, J. (2014).Final Report: HIV/AIDS Strategy Stakeholder Engagement Meetings, 2012-2014. Retrieved from: http://www.dph.illinois.gov/sites/default/files/publications/hiv-strategy-stakeholderengagement-meetings-report-2014-041916.pdf

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Evaluation Description: in order to measure the impact of the training, it’s crucial to conduct a pre and post evaluation. In addition, this will enable to gather data and feedback to incorporate to further editions of the training.

To be able to compare the before and after knowledge of participants, the questions to be asked are the same ones. Even though, you will notice there are specific questions that are only for the pre or for the post questionnaires in order to gather additional data useful for the trainers.

It’s recommended to send the pre questions between one month and two weeks before the workshop and the post questions between one and two week after the workshop.

Contact da.scora@ifmsa.org to get more information on evaluation and the standard forms to be used.

Day 1 What is the importance of knowing the history of HIV ?

When was the red ribbon considered as a symbol of HIV and AIDS? How is HIV transmitted ?Name one drug used in the treatment of HIV ?

What is PrEP and PEP? Why is it important to talk about pleasure in the HIV context?

Day 2 Give an example for a risk-based approach and a sex-positive approach when it comes to promoting condom use Why is it important to talk about pleasure in the HIV context?

Can you name 4 key populations?

Day 3 HIV and Advocacy Define advocacy.

What are some of the ways you can advocate?

How the Media shapes our perception of HIV List some of the ways HIV has been portrayed by the media.

What are some of the campaigns that exist to reduce stigma and discrimination against HIV. (At Least one should be from your region)

HEAT Manual - Advocacy Aspect

Day 3 Mapping and Engaging Stakeholders Who is a stakeholder?

Name 5 stakeholders to engage in fighting HIV stigma.

Name one means of mapping out stakeholders.

Fundraising for the HIV Response Can you name 3 international organizations that provide funding for the HIV response?

The 90-90-90 strategy and an AIDS free world by 2030What does the 90-90-90 strategy say?

Name 2 ways in which this strategy has been achieved in different regions.

What are some of the goals for ending HIV by 2030?

Integrated community approach to HIV Response Name 3 community based HIV services.

Common questions between the pre and post questionnaire From a scale of 1 (lowest) to 5 (highest) how would you rate the following questions: How much do you feel you know about...

The history of HIV? The transmission of HIV? The pathogenesis of HIV? The stages of HIV? The drugs used in the treatment of HIV? The available drugs in prevention?

The methods of transmission ? the legal barriers when accessing HIV health services ?How much do you feel you know about advocacy and HIV? The 90-90-90 strategy?

The media affects HIV? How much do you feel you know about the global funds being mobilized by the international community for the HIV epidemic?

How comfortable are you to...

Talk with correct terminology when talking about HIV? Talk about sex positivity and HIV? Identify and engage key stakeholders of the HIV response?

Explain the community-driven responses in regards to tackling HIV?

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Pre only What do you expect from this workshop?

Is there something specific you are looking forward to know about?

Post only Was your expectations met in the workshop?

What is something that could be done to better?

What is something you are interested to know more about?

What is something that you didn’t like in this workshop?

HEAT Manual - Advocacy Aspect