Download Training Manual - Water Services Trust Fund

HIV AND AIDS TRAINING MANUAL
MAINSTREAMING HIV AND AIDS IN WATER
COMPILED BY CHRISTINE OGARI
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HIV A N D AIDS T R A I N I N G M A N U A L
Contents
I NTROD U CT I O N ................................................................................................................................................ 3
O B J E C T I V E ............................................................................................................................................................. 3
T R A I N E R ’ S A P P R O A C H .......................................................................................................................................... 3
M A T E R I A L S N E E D E D ............................................................................................................................................. 3
I N S T R U C T I O N S ...................................................................................................................................................... 4
DURATION .............................................................................................................................................................. 4
Training manual ...................................................................................................................................................... 5
Introduction .................................................................................................................................................... 5
Reasons for mainstreaming HIV and AIDS in Water ....................................................................................... 5
The Questionnaire .......................................................................................................................................... 5
The Questions and Answers Session .............................................................................................................. 6
List of Abbreviations ............................................................................................................................................. 11
GLOSSARY ............................................................................................................................................................. 12
References ............................................................................................................................................................ 13
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INTRODUCTION
This HIV and AIDS Training Manual module is written for the:

Water Services Trust Fund (WSTF) Field Monitors,

Staff members of the Water Service Provider (WSP),

Public Health Officers (PHO),


Water Kiosk Operators
and others who are responsible for the recruitment, training and monitoring of the
Water Kiosk and/or Public Sanitation Facility Operators.
OBJECTIVE
This module is particularly relevant to the Water Kiosk Operators, who will be engaging with
residents on a daily basis. Some of the people coming to fetch water may either be infected with
HIV or are taking care of someone infected with HIV. Those that are infected are equally
entitled to water just as much as a person who is HIV negative.
The idea behind this module is thus, to integrate HIV and AIDS into the Kiosk Operator Training
Programme, as it is an issue that affects everyone. The training should increase awareness
about HIV and AIDS and rid the stigma associated with it. The association of the need for water
to those affected and/or infected by HIV and AIDS needs to be understood, based on the
reasoning that it is vital for the purposes of continuity of humanity and embracing our
communities immediate needs, in order to prosper economically, socially and culturally.
TRAINER’S APPROACH
The trainer has the flexibility of approaching this topic in a manner that he/she deems suitable,
given that this topic is sensitive to many. However, all topics mentioned below must be
addressed, so that the trainees are well informed by the end of the session. The trainer should
try limiting the discussion to the manual provided. It is likely that the trainees may want to
expound on the topic, however, it is up to the trainer to make sure that the HIV and AIDS
training remains mainstreamed and does not divulge from the primary focus of the training.
A participatory approach is suitable for creating awareness on HIV/AIDS, because it allows the
trainees to voice their views and opinions. It is the responsibility of the trainer to provide
guidance and sufficient information.
MATERIALS NEEDED
1. Flip Chart
2. Markers
3. Pens for trainees
4. Copies of appendices 1,2,3,4 for the participants/trainees.
5. Female and Male Condoms.
6. Kiosk Posters (see Section 8).
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I NSTRUCTIONS
The training manual has been written in 3 different fonts;
1. Bold letters are used for the questions that the trainer is to ask.
2. Italics are used for the instructions for the trainer to do during the session.
3. The normal font is used for the correct answer(s) that the trainer will present to the
trainees after having received their contributions.
This manual must be used with its four (4) appendices:
Appendix 1:
Differences between HIV and AIDS
Appendix 2:
HIV and AIDS Questionnaire
Appendix 3:
HIV and AIDS Questionnaire & Answers
Appendix 4:
Template letter to KEMSA requesting for free condoms
DURATION
The duration of the exercise is approximately 1 hour 40 minutes.
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Training Manual
Introduction
The HIV and AIDS training starts with the Trainer providing an introduction as to why knowledge
on HIV and AIDS is relevant to all.
The Trainer should also explain the link between HIV & AIDS and water. (See text below >>)
Reasons for mainstreaming HIV and AIDS in Water
HIV and AIDS is one of the biggest pandemic in human history. It has killed a huge population
within a duration of 20 years, and a cure is yet to be developed. Ever since HIV and AIDS were
discovered, it has affected people’s lifestyle, whether infected or not. Whether one is rich or
poor, tall or short, man or woman, everyone can become infected and affected. HIV and AIDS has
not spared us in the water sector either. Infact, there is a high chance that we are likely to come
into contact with those that are infected on a daily basis. It is therefore imperative that we
acknowledge the existence of HIV and AIDS, and foster means and ways to accommodate and
care for all who are infected.
1. We should recognise that insufficient access to safe water and poor sanitation increases
the vulnerability of communities to the impacts of HIV and AIDS. Lack of access to
services makes communities vulnerable to disease transmission and to opportunistic
infections, which cause poor health, poor productivity and untimely death. With the
provision of adequate safe water and sanitation services, communities dealing with the
impacts of HIV and AIDS are better able to cope with the effects of the disease.
This issue concerns you and me; after all, you too can be infected by HIV.
The Questionnaire
After introducing the topic, the trainer should provide trainees with the questionnaire (Appendix
2: HIV and AIDS questionnaire). This questionnaire’s primary goal is to open the trainees minds
towards the topic. Also it provides an insight of what they already know as far as HIV and AIDS is
concerned. After the trainees have filled in their answers, the questionnaires should be returned
back to the trainer. The trainer should put them aside for discussion at later time, then proceed
with the training manual, where s/he will broaden their knowledge on HIV and AIDS. When the
training of this manual concludes, the trainer then returns the questionnaires that the trainees
had previously filled. The trainees will be asked if they would have given different answers after
the training. This way, they are be able to assess whether the training had improved their
knowledge on HIV and AIDS, based on how they answered the questionnaire.
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The Questions and Answers Session
The trainer should then proceed by engaging the trainees in a participatory discussion about HIV
and AIDS which is guided by a set of questions. The trainer should ask the questions provided in the
following order:
SESSION’S QUESTION S
I.
WHAT IS HIV?
Take 3 to 4 answers from trainees and write them on the flip chart. Then share with them the
meaning of HIV.
HIV stands for Human Immunodeficiency Virus. It is a condition which reduces the effectiveness
of the immune systems progressively, and thus leaves the individual susceptible to
opportunistic infections.
II.
WHERE WOULD WE EXPECT TO FIND HIV IN THE BODY ?
Note the answers given by the trainees on the flip chart without commenting on them . Then share
with them the answer below.
HIV is found in different body fluids in different quantities. It is most commonly found in blood
and semen as well as vaginal secretions and breast milk. HIV is also present in saliva, but, it is
never in sufficient quantities to cause infection. Studies show that human saliva contains a
chemical that prevents HIV from being infectious. However, when blood, semen or breast milk is
mixed with saliva, they protect HIV from being affected by the saliva and make infection
possible. One is prone to get the disease through oral sex and breastfeeding if the partner has
small breaks and wounds in their gums.
There is a rare possibility that it can be found in tears and urine. Sweat, however is NOT a
carrier of HIV.
III.
CAN YOU NAME THE MAIN MODES OF HIV TRANSMISSION ?
Note the answers given by the trainees on a flip chart.
Explain the three major routes of transmission of HIV are;
 Unprotected sexual intercourse with an HIV infected person.
 Direct infection or transfusion with HIV contaminated blood or blood products through
needle infections and pricks, direct exchange and blood transfusion.
 From an HIV infected mother to her child during pregnancy, childbirth or while
breastfeeding.
Whether mentioned or not, the trainer should state that HIV is not transmittable through
mosquitoes and any other insects, as this is a common myth.
When mosquitoes bite someone, they do not inject their own blood or the previously bitten
person’s blood into their next victim. Instead, they use their saliva as a lubricant so that it can
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suck blood efficiently. Otherwise, the rate of those infected would be far much worse than it is
today.
IV.
HOW
CAN ONE TELL THAT A PERSON IS INFECTED WITH
SYMPTOMS OF HIV INFECTION ?
HIV? WHAT,
IF ANY , ARE THE
Note the answers given by the trainees on a flip chart. Then share with them the answer below.
HIV has no distinct symptoms that are unique to HIV infection. However, 70% of infected people
go through a brief period of flu-like illness anywhere between 2 and 8 weeks after HIV infection.
The flu-like illness goes away by itself. However, one should not immediately assume that they
have been infected by HIV, unless they partook in the activities (modes) discussed in the earlier
question (3).
V.
WHAT IS THE INTERVAL BETWEEN EXPOSURE TO HIV AND INFECTION BY HIV?
Note the answers given by the trainees on a flip chart. Then share with them the answer below.
There is no interval. So long as a person is exposed, he or she is either infected at the time or not
infected at all. As soon as one is infected with HIV, he or she becomes infectious even though the
HIV antibody an HIV test at this time may show a false negative result.
VI.
WHEN SHOULD A PERSON CONSIDER GOING FOR AN HIV TEST?
Note the answers given by the trainees on a flip chart. Then share with them the answer below.
At least every 3 months. Any person who has recently been involved in a high risk situation1
should consider going for counselling and testing (CT)2 whether or not they have experienced a
flu-like illness. A second visit to the CT should be considered after a minimum of 6 weeks. This is
because the immune system may not have produced enough HIV antibodies to be detected by an
HIV antibody test during the initial visit to the CT. This duration between infection and the
presence of enough HIV antibodies to be detected is known as the window period.
VII.
HOW DURABLE IS HIV?
Note the answers given by the trainees on a flip chart. Then share with them the answer below.
An HIV can survive for 7 days at room temperature, and 11 days at 37oC. The virus can remain
active and infectious for between 6 to 14 days even in a body that has been refrigerated in a
mortuary. In dried blood, it remains active for up to 5 days, although the number of virus
particles drops dramatically. However, the assumption of no HIV in dried blood or stored body
fluids from an HIV or AIDS patient. Therefore, in the event of disposing these items such as used
1
High risk situation include;

Engaging in unprotected sexual intercourse with a person of unknown HIV status.

Using unsterilized injections.

Receiving a transfusion of untested blood or blood products.
2
CT is short for Counseling and Testing. Initially it was referred to VCT – Voluntary Counseling and
Testing, but as a directive from the World Health Organization (WHO), The word Voluntary was
dropped.
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needles and syringes, great care should be considered. For maximum effect, it can be destroyed
in 10 minutes at 56oC.
VIII.
WHAT IS AIDS?
Note the answers given by the trainees on a flip chart. Then share with them the answer below.
AIDS stands for Acquired Immunodeficiency Syndrome. It is a set of symptoms and infections
resulting from the damage to the human immune system caused by the Human
Immunodeficiency Virus, what we have come to know as HIV. It is not a hereditary disease but
develops after birth from infection by a carrier of HIV.
IX.
WHAT ARE THE DIFFERENCES BETWEEN HIV AND AIDS?
Note the answers given by the trainees on a flip chart.
Refer to Appendix 1 (differences of HIV and AIDS) for answers.
X.
HOW CAN HIV BE PREVENTED ?
(give all preventive measures and practices short titles)
Note the answers given by the trainees on a flip chart.
HIV can be prevented as follows:



Abstain from sexual intercourse.
Be faithful to one partner.
Correct use of Condoms.
The highest potential of one being infected by HIV is through unprotected sexual relations with
a partner who already suffers from HIV. Precautionary measures should be used in order to
prevent the negative outcome. Popularly used and proved to be the most effective is the male
condom. The condom reduces the chances of one acquiring HIV by at least 98.99%.
Another option is the female condom, which is equally preventive. The use of either depends on
one’s preference but it should be noted that either one is enough and the use of both at the same
time is not required. One of either will suffice.



No Breastfeeding
If a mother is suffering from HIV, and her child was born free of HIV, she SHOULD NOT breast
feed at any circumstances. Breast milk is a channel of HIV transmission, and its transfer from
mother to child will result in the child contracting the disease. The mother should ensure that
other means of feeding the baby are used.
Avoid contact with blood or other body fluids that could possibly contain visible blood. Such as
urine, feaces or vomit. If it cannot be avoided, gloves should be worn.
Cuts, sores, or breaks on both the care giver’s and patient’s skin should be covered with
bandages.
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




Hands and other parts of the body should be washed immediately after contact with blood or
other body fluids, and surfaces soiled with blood should be disinfected appropriately.
Men Circumcision
The foreskin at the front of a man’s penis is favourable breeding ground for HIV. Circumcision
does not prevent the spread but it reduces the chances of HIV finding a host.
This is another set of risk factors: Practices that increase the likelihood of blood contact should
be avoided. Needles and other sharp instruments should be handled according to
recommendation for health care settings.
Proper disposal of sharp objects
It is vital that one ensures that objects such as needles, scalpels and glass, are carefully disposed
of. There is a high chance of contamined items being trapped in these objects which could easily
be transmitted through needle stick injuries. In addition to the increasing statistics of drug
abuse with the use of needles, it is paramount that they are disposed in a manner that will
prevent transportation of one’s contaminated fluids into another person. Do not put caps back
on needles by hand or remove needles from syringes. Dispose of needles in puncture proof
containers, or burn them.
Finally, HIV CANNOT be contracted from casual non-sexual contact with people infected with
HIV. E.g. by shaking hands, hugging or even sharing utensils. If an HIV positive person drinks
water from a cup, the next user, if HIV negative, is not at risk of being infected. Utensils do not
harbour HIV.
REVIEW THE QUESTIONNAIRES THAT THE TRAINEES HAD FILLED IN AT THE
BEGINNING OF THE SESSION.
USE APPENDIX 3. HIV and AIDS answer sheet.
The trainees together with the trainer should review the questions together and see if they would
answer the questions the same as they did before the training.
XI.
WAY FORWARD
As the better informed citizens about HIV and AIDS and also the providers of a vital necessity (water) to people
with HIV and AIDS, what should we do to ensure that HIV and AIDS awareness is increased as well as support
people infected in our community?
Prompt trainees to come up with ideal ways that they can implement in their community.
Please note that each community has different perceptions on how to go about HIV and
AIDS.
Note answers on flip chart and add, if not mentioned, the answers below.

Use of Posters3 (can be placed at the kiosk).
3
Trainer should show the trainees the posters that have been produced by WSTF, and give them the
option to use them at the kiosks, or if possible, they could come up with their own (See Section 8)
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




Free supply of Condoms4 at the Kiosk.
Encourage the community to visit the CT.
Provide guidance to the youth.
Ensure that HIV positive persons are not discriminated against.
Provide water to HIV positive persons, when they visit the kiosk. Remember water is life, and
their lives are equally important as they depend on you and others (children, family members)
may be depending on them.
4
Refer to Appendix 4. This appendix is a letter to Kenya Medical Supplies Agency (KEMSA), which can be
used to request for supply of free condoms. This letter is not mandatory; the company may use one of its
own.
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List of Abbreviations
AIDS:
Acquired Immune Deficiency Syndrome
HIV:
Human Immunodeficiency Virus
CT:
Counselling Training
KEMSA:
Kenya Medical Supplies Agency
PHO:
Public Health Officer
VCT:
Voluntary Counselling and Testing
WHO:
World Health Organization
WSTF:
Water Services Trust Fund
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GLOSSARY
AIDS: This stands for Acquired Immunodeficiency Syndrome. It is a set of symptoms and
infections resulting from the damage to the human immune system caused by the Human
Immunodeficiency Virus, what we have come to know as HIV. It is not a hereditary disease but
develops after birth from infection by a carrier of HIV.
EXPOSURE: the condition of being unprotected when engaging in activities with a partner
who is HIV positive.
FLU: This is short for Influenza. It is an acute highly contagious virus disease that is caused by
any of three orthomyxoviruses (Influenzavirus A, Influenzavirus B, and Influenzavirus C) and that
is characterized by sudden onset, fever, prostration, severe aches and pains, and progressive
inflammation of the respiratory mucous membrane .
HIV: HIV stands for Human Immunodeficiency Virus. It is a condition which reduces the
effectiveness of the immune systems progressively, and thus leaves the individual susceptible to
opportunistic infections.
INFECTIOUS: The capability of causing an infection, that corrupts or contaminates.
IMMUNE SYSTEM: The bodily system that protects the body from foreign substances, cells,
and tissues by producing the immune response and that includes esp. the thymus, spleen, lymph
nodes, special deposits of lymphoid tissue (as in the gastrointestinal tract and bone marrow),
macrophages, lymphocytes including the B cells and T cells, and antibodies.
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References
Dr. Daraus Bukenya et al. HIV/AIDS workplace training Manual: peer education. AMREF. Nairobi
2006.
Dr. Daraus Bukenya et al. HIV/AIDS workplace training Manual: a toolkit for training managers
of workplace programmes. AMREF. Nairobi 2006.
Encyclopaedia Britannica 2008 Ultimate Edition. PC/MAC DVD-ROM.
Internet Sites:
http://www.ruwas.co.ug/Programme%20Components%205.htm
http://unesdoc.unesco.org/images/0015/001566/156673E.pdf
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