1、Comprehensive Peer Educator Training Curriculum: Trainer Manual 10-1DURATION: 270 minutes (4 hours, 30 minutes)LEARNING OBJECTIVES:By the end of this Module, participants will be able to: Understand the “recipe” for positive living for individuals and families; Support clients to have a healthy mind
2、; Recognize common signs of anxiety and depression and provide basic counseling and referrals; Support clients to have a healthy body; Help clients and their partners practice safer sex and prevent new HIV infections; Help clients prevent and seek care for sexually transmitted infections; Work with
3、clients to actively participate in their own care and advocate for themselves (and their children) as a part of positive living.CONTENT:Session 10.1: Introduction: The Recipe for Positive Living Session 10.2: Healthy MindSession 10.3: Healthy BodySession 10.4: Safer SexSession 10.5: Preventing and T
4、reating Sexually Transmitted Infections (STIs)Session 10.6: Helping Clients Be Active Participants in Their Own Care Session 10.7: Classroom Practicum on Positive LivingSession 10.8: Module SummaryMETHODOLOGIES: Brainstorming Large group discussion Interactive trainer presentation Small group work10
5、-2 Module 10 Snowballing Return demonstration Case studies MATERIALS NEEDED: Flip chart Markers Male and female condoms Penis and vagina models Tape or Bostik Small pieces of paper Case study cards for Session 10.7WORK FOR THE TRAINER TO DO IN ADVANCE: Read through the entire Module and make sure yo
6、u are familiar with the training methodologies and content. Collect male and female condoms, penis and vaginal models, and other supplies listed above. Prepare the case study cards for Session 10.7.Comprehensive Peer Educator Training Curriculum: Trainer Manual 10-3SESSION 10.1: Introduction: The Re
7、cipe for Positive Living (20 minutes)TRAINER INSTRUCTIONSMethodologies: Brainstorming, Large Group Discussion, Interactive Trainer Presentation Step 1: Review the Module learning objectives.Step 2: Tape many pieces of flip chart paper along one wall of the training room, so that there is one continu
8、ous sheet of paper. Tell participants that this is an open “graffiti wall.” Ask participants to think how they or people they know live positively with HIV. Give each participant a marker and ask everyone to get up and write what it means to live positively with HIV on the graffiti wall. Encourage p
9、articipants to be creative use words, drawings, songs, etc. to express what it means to live positively with HIV. After about 10 minutes, review what has been written on the graffiti wall as a large group. Remind participants that Peer Educators can be role models to help clients live positively wit
10、h HIV.Step 3: Write the “recipe for positive living” on flip chart. KNOWLEDGE + DETERMINATION TO LIVEwith actions for aHEALTHY MIND + HEALTHY BODY + HEALTHY SOUL= A LONG, HEALTHY LIFEStep 4: Ask participants to discuss what the different “ingredients” in the “recipe” mean and fill in using the conte
11、nt below, if needed. KEY INFORMATION Positive living means having a positive outlook to living and life. It also means living responsibly with HIV and preventing new infections. People living with HIV can live full and healthy lives if they take care of themselves, access care and treatment and feel
12、 supported to make healthy choices. Families can also live positively with HIV, by supporting and taking care of each other. Positive living includes:- Keeping the mind healthy- Keeping the body healthy- Keeping the soul healthy- Preventing new HIV infections- Keeping the whole family healthy.10-4 M
13、odule 10 Peer Educators play a key role in helping other PLHIV live positively and following the “recipe for positive living:”KNOWLEDGE + DETERMINATION TO LIVEwith actions for aHEALTHY MIND + HEALTH BODY + HEALTHY SOUL= A LONG, HEALTHY LIFEComprehensive Peer Educator Training Curriculum: Trainer Man
14、ual 10-5SESSION 10.2: Healthy Mind (35 minutes)TRAINER INSTRUCTIONSMethodologies: Brainstorming, Interactive Trainer Presentation, Large Group Discussion, Small Group WorkStep 1: Ask participants to brainstorm about times when clients may need extra support to cope with their feelings. Record respon
15、ses on flip chart. Then ask participants to brainstorm about the ways people living with HIV can keep their minds healthy and be happy, even during difficult times. Record responses on flip chart. Step 2: Write the words “ANXIETY” and “DEPRESSION” on two separate pieces of flip chart (or use local w
16、ords that make more sense). Ask participants what they have heard about or know about these words. Since these are clinical terms, participants may not know them, although they will know many of the signs and symptoms. Explain using the content below. Step 3: Ask participants to turn to the person s
17、itting next to them. Ask each pair to spend about 10 minutes discussing if they or anyone they know have had anxiety or depression. The pairs can discuss these questions: How did it make them feel? What were the signs? What helped them to feel better? Step 4: Bring the large group back together and,
18、 using the content below to fill in as needed, lead a discussion about the signs of anxiety and depression and what Peer Educators can do to help clients have a healthy mind and live positively with HIV. Step 5: Remind participants that Peer Educators are not trained counselors and that they should
19、always consult with members of the multidisciplinary team, especially trained counselors or social workers, if they think a client needs additional support, is hopeless, or is thinking about taking her or his own life. Review the information on when a client needs professional help and support from
20、the content below. KEY INFORMATIONHelping clients have healthy mindsPeer Educators can help people deal with their feelings about HIV. Clients will often need extra support in dealing with their feelings: After learning they or a family member are HIV-positive When preparing to disclose to friends o
21、r family members When preparing to disclose to a child When starting ART When they become pregnant When they are about to lose a loved one or are grieving the lost of a loved one10-6 Module 10 When they face stigma, discrimination or violence And many other timesThese are all important times for Pee
22、r Educators to provide emotional support, but ongoing support is also needed to help people live positively with HIV in the long term. Helping clients with anxiety and depressionAnxiety and depression are common reactions to living with HIV, especially when people are not feeling well and do not get
23、 the support they need from family, friends, health care providers and their community. Our mental health and our physical health are closely related this is why helping people deal with anxiety and depression can help with positive living. Signs of anxiety: Cannot eat Cannot breathe Shaking and swe
24、ating Heart pounding fast Tingling in the hands or feet Cannot sleep Cannot concentrate on anything Feel “jumpy” or “stressed” Feel worried about many thingsSigns of depression: Feel like you just do not know what to do (helpless or hopeless) Really tired with no energy Cannot find good in anything
25、Do not enjoy the things you used to Sleep too much or not enough Get angry for no reason Cannot eat or eat too much Do not feel like being social with friends or family Do not feel like having sex Talk about running away Think about suicide (killing yourself)What to do when you think a client has an
26、xiety or depression:Peer Educators can watch for signs of anxiety and depression in their clients. Peer Educators are not trained counselors, but they may be able to provide some basic advice to clients on how to deal with feelings of anxiety or depression. Peer Educators should always consult with
27、other members of the multidisciplinary team if they think a client might be anxious or depressed. Peer Educators can also:Key Definitions: Anxiety and DepressionAnxiety is when you feel nervous, have a lot of fear, or do not want to do things that you normally enjoy. Sometimes people also use the wo
28、rd “stress” to describe their feelings of anxiety.Depression is when you feel very sad and hopeless.Comprehensive Peer Educator Training Curriculum: Trainer Manual 10-7 Provide continuous supportive counseling to clients so they feel “heard.” Use good communication skills, such as reflection. Encour
29、age the person to join a PLHIV association and a support group to meet other people living positively with HIV. Link the person with community support services, like groups that provide spiritual support, counseling, home care or nutritional support. Remind clients that they should not use alcohol o
30、r drugs because this will only make things worse. Make a plan with clients to stay hopeful and feel good again. Encourage clients to continue any religious or spiritual practices that make them feel peaceful. Talk with family members (if the client says it is okay to do so) they may be discouraged a
31、nd need support, too. Remind them to provide ongoing support and love to the person. Remind clients that their feelings are normal and they will feel better. Talk with a professional counselor or social worker about the clients symptoms and next steps. Give your client a referral to meet with a coun
32、selor or social worker. Symptoms of anxiety and depression can also be due to a medical illness, so it is important for clients to have a check-up with the doctor or nurse.When the Peer Educator needs to make a referral:Peer Educators should be aware of danger signs that anxiety and depression may b
33、e very serious or out of control and consult with the clinic doctors, nurses, social worker, community-based counselors and spiritual advisors immediately. Remember the principles of shared confidentiality when doing this. Peer Educators should seek help from other members of the multidisciplinary t
34、eam right away when: Clients might hurt themselves or another person. The depression is so bad that clients are thinking about killing themselves. The family cannot cope with the person any more and wants to throw her or him out. Clients cannot eat or sleep (may be due to side effects of ARVs like e
35、favirenz, but may also be anxiety or depression). There is any kind of emotional crisis. Peer Educators can help people find hope and joy, accept their situation, and want to live for the future!10-8 Module 10SESSION 10.3: Healthy Body (40 minutes)TRAINER INSTRUCTIONSMethodologies: Snowballing, Larg
36、e Group Discussion Step 1: Introduce the session by telling participants that we will do an activity about keeping our bodies healthy. Break participants into groups of 4. Note: trainers should adapt the group sizes depending on how many participants are in the training. Give each group 2 pieces of
37、flip chart paper and a marker. Ask each group to write “HEALTHY” on one flip chart and “UNHEALTHY” on the other. Ask the groups to list as many behaviors they can think of that PLHIV should do to keep their bodies healthy on the “HEALTHY” flip chart and things that PLHIV should avoid on the “UNHEALT
38、HY” flip chart. Give the groups 10 minutes. Step 2: After 10 minutes, have each group of 4 join another group of 4. Ask the groups to review and combine their lists onto 2 new pieces of flip chart paper (with the same titles). Participants should not write down each answer more than once.Step 3: The
39、n have the groups of 8 join another group of 8 and combine lists as before. Keep going until there is one large group and a final list of healthy and unhealthy behaviors. Ask for a participant to read through each list to the group. Fill in as needed from the content below. Step 4: Ask Peer Educator
40、s what challenges they have faced in keeping their bodies healthy and practicing healthy behaviors. Discuss how Peer Educators can help clients keep their bodies healthy. KEY INFORMATIONHealthy behaviors: There are many things PLHIV can do to keep their bodies healthy and live positively with HIV, i
41、ncluding: Use condoms and practice safer sex, every time. Get STIs treated right away and tell your partner to get them treated, too. Get a TB test and treat TB right away. Use a family planning method if you want to limit or space children. Go to the hospital or clinic for check-ups, lab tests and
42、to pick up medicines. Never miss an appointment. Take medicines the right way (at the right time, the right number, etc.). Tell the nurse and doctor if there are any changes, even small ones, in your health. Stay busy and active. Get enough rest. Get sunlight and breathe fresh air every day.Comprehe
43、nsive Peer Educator Training Curriculum: Trainer Manual 10-9 Sleep and rest under a treated mosquito net if you live in a place with malaria. Join a PLHIV association and a support group and talk about things openly. Exercise or stretch every day to stay healthy. If bedridden, have a family member h
44、elp with stretches to keep blood flowing and prevent bedsores. Stay clean wash regularly and wash hands often, especially after going to the toilet and before making food. Eat enough good food and take multivitamins (there is more about nutrition in Advanced Module 17). Boil drinking water to make s
45、ure it is clean. Cook food well to get rid of germs. Wash raw fruits and vegetables well with clean water. Keep the house and compound clean, including getting rid of any still water and garbage. Use a germ-killing bleach solution (like Jik, Barakina or Gentian Violet) diluted with water to keep hou
46、sehold surfaces clean.Unhealthy behaviors: Peer Educators should talk about avoiding practices or behaviors that are not healthy. These include: Drinking too much alcohol Using drugs Smoking Sharing medicines or stopping them without talking to the doctor Having unsafe sex Avoiding social contact an
47、d staying alone too much Missing appointments at the clinic Taking traditional medicines that you have not discussed with the doctor Eating too many sugary or fatty foods Not eating enough good foods.10-10 Module 10SESSION 10.4: Safer Sex (60 minutes)TRAINER INSTRUCTIONSMethodologies: Large Group Di
48、scussion, Interactive Trainer Presentation, Small Group Work, Return Demonstration Step 1: Start the session by saying the following statements out loud and asking participants to discuss: People living with HIV have the right to a healthy sexual life. People living with HIV have a responsibility to
49、 protect their sexual partners. Everyone has a right to a healthy sexual life and it is our responsibility to protect our sexual partner(s) by practicing safer sex.Step 2: Ask participants what is meant by the term “safer sex” and why it is an important part of living positively with HIV. Discuss what we can do to practice safer sex. Record answers on flip chart and fill in, as needed, from the content below. Explain that Peer Educators need to help clients
