Games for HIV/AIDS Training - India and Nepal

In its community- and school-based training sessions, INSA India approaches HIV/AIDS as a developmental issue. This calls for spaced facilitation covering aspects of life skills development, HIV/AIDS prevention, life choices, assertive skills building, communication, self-esteem building, social and emotional development, and gender sensitisation. The idea is to enable participants to gain not just knowledge but skills to protect themselves from HIV/AIDS.

Specifically, INSA India's training methodology is structured to enable workshop participants to introspect, empathise, experience and apply concepts promoting integration of HIV/AIDS prevention, care, and support into their existing work. INSA India uses a positive approach - games, puzzles, jokes, simulation, stories, role playing, dances, cultural music - to create a non-threatening training atmosphere. This strategy is designed to encourage participants to really participate in a process of experiential learning. More specifically, the training is characterised by activities that:

• promote positive behaviour through rational inputs and options
• acknowledge the existence of the problem
• stress personal responsibility
• offer different options for behavioural change and risk reduction
• address the needs of particular groups
• provide relevant information about various services and what to do under certain circumstances
• instill confidence about people with problems
• dispel myths and misconceptions so as to offer an environment of support, acceptance, and empathy.

To cite an example of one training activity, students from 36 schools and colleges in Bangalore participated in an inter-school quiz and debate competition in November 2002. The proposition being debated was "Positive living is possible after HIV infection". The purpose of the contest was to create avenues to strengthen an enabling environment that reduces stigma and discrimination and increases collaboration and networking with service-providing NGOs.

Collaboration, in fact, is a key programme strategy. To begin, INSA India identified a group of 33 'core group members' or implementing agents (who are subsequently referred to as PAH CATS), who are spread over 14 states. They implement HIV prevention programmes with adolescents, both through the formal school structure as well as the non-formal schools. The idea is to create a support structure in the schools to promote safe behaviours by clarifying students' doubts anonymously. One strategy used in the school is the placement of a students' question box to make the programme need-based. The INSA India team brings the questions to the office and prepares answers to difficult questions about the physical, spiritual, psychological, social, and emotional realities related to HIV/AIDS. Based on an assessment of the kinds of questions received, INSA India coined the acronym "I CHASE G" to describe its approach to HIV/AIDS prevention education for students:
I= Intellectual Development
C= Communication
H= HIV/AIDS
A= Assertive skills building
S= Social Development
E= Emotional Development
G= Gender

To develop follow-up support for the adolescents/students participating in this education programme, interested teachers and key members selected 'friendly advisors' (FAs) to receive further training and support through school committees. The FAs integrate adolescent health education into their schools' curricular and extracurricular activities. They provide information and support to students about HIV/AIDS, sexuality, cleanliness, and related topics, as well as arrange physician-led sessions for parents in schools about AIDS and infective diseases. FAs also hold meetings, one-on-one discussions, and seminars with outside resource persons for the benefit of other teachers. The 273 FAs have organised themselves into regional and national forums to share strategies.

Each PAH CAT, being based in an existing NGO (through whom the linkage with INSA developed), has also integrated adolescent HIV prevention into the ongoing activities of that NGO. The idea is that participants who are leaders in their organisations have greater reach and increased ability to build strategies and scale up the programmes into other areas. In addition, PAH participants have trained 65 other community-based organisations, such as youth clubs, women's groups, and Self Help Groups, to strengthen HIV/AIDS prevention in their ongoing work. Organisers feel that addressing stigma and discrimination related to HIV/AIDS within the context of other community health and development shows promise if the community as a whole has had discussions and debated these issues. Linking HIV/AIDS within the cultural context and the community history, they say, helps the community reach out to create community "laws" or "codes of behaviour", which includes care of HIV-positive people within the community. This is possible when such discussions begin with a recognised group of people, like self-help groups.

INSA India follows up with every participant trained. First, staff visit past PAH participants to enable on-site facilitation of the process of project implementation. During these visits, demonstration sessions are undertaken to highlight the importance of educational processes for motivating responsible student behaviour. Second, most of the PAH participants are involved in community health and development work in remote communities. Their access to updated information and time to peruse through updated information is limited. Thus, "CATZETTE" newsletters highlighting updated information on HIV/AIDS and related information are mailed to all PAH participants. These newsletters are written in demystified language to foster easy comprehension; emphasis is placed on the need to integrate HIV/AIDS prevention and care into all existing network systems.

HIV/AIDS, Youth, Education.

INSA-India was established in Bangalore city in 1982 with a vision of enabling health and development in emerging nations. Its focus is on training trainers.

The 33 PAH participants have trained 732 principals and 2514 teachers from 259 schools on using the adolescent health approach for integrating HIV/AIDS prevention education. 25,088 students have participated in a 3 year-long spaced programme of integrating HIV/AIDS with promoting adolescent health education. A total of 1072 villages have actively participated in HIV/AIDS prevention education programmes. A total of 38,482 non-formal education students participated in community-based HIV/AIDS education programmes.