All About HIV and AIDS
This lesson provides basic information about HIV and AIDS that can be incorporated into the curriculum. These sessions give a general overview of the disease, explain how it can and cannot be transmitted, and enable students to understand the effects of the disease.
The sessions build on each other and concentrate on addressing students' knowledge about and attitudes toward HIV/AIDS.
Note: Some of these exercises may be disturbing to students, because the realities themselves are disturbing.
The sessions are designed to teach:
- AIDS is a problem, but we have the power to do something about it.
- HIV attacks our immune systems, so people who have HIV should do all they can to maintain a healthy lifestyle that includes good nutrition, exercise, and as little stress as possible. Healthy lifestyles support healthy immune systems.
- It is clear how HIV is transmitted.
- Women are especially vulnerable to HIV infection and need information and skills to protect themselves and their children from infection.
- There are simple and effective ways for everyone to prevent HIV infection.
- The time it takes for HIV to lead to AIDS varies greatly, and our health behaviors can affect that time period. People with HIV/AIDS need to take care of their bodies, mentally and physically.
- Although there is no cure for AIDS, there are many treatments available.
I. The Immune System
By providing specific biological information, this session addresses the concept: HIV attacks our immune systems, so people who have HIV should do all they can to maintain a healthy lifestyle that includes good nutrition, exercise, and as little stress as possible. Healthy lifestyles support healthy immune systems. By the end of the session, participants will be able to describe the functions of at least five components of the immune system and demonstrate how HIV attacks the immune system.
A. Getting to Know the Immune System
Make copies of the diagrams in Drawings of Parts of the Immune System (link above) and pass them out to each student. As the students look at the drawings, ask them in a class discussion what they know about the body's immune system. Lead the discussion by following these guiding questions:
- What is the immune system?
[Answer: The immune system is our body's way of fighting disease. It is highly complex and has more parts than we can discuss today. Understanding some basic facts about the immune system, however, can help us learn both how to prevent disease and how to help slow down disease progression if we are already infected.]
- Our blood cells are labeled by what two colors?
[Answer: Red and white.]
- What is the major function of red cells?
[Answer: Red cells (called erythrocytes) carry oxygen through our system and carry away carbon dioxide.]
- What is the major function of white blood cells?
[Answer: White blood cells (called leukocytes) are our immune cells. Our immune system is made up of white cells that protect us from diseases. Some of the main cells in our immune system are The macrophage : Macro = Big, Phage = Eater. The Big Eater.
This cell eats the invaders or germs (called antigens) and sends a signal to the captain of our immune system that an invader is present and that the immune system army needs to respond.
The T4 Helper Cell (CD4) : Captain of our immune system.
It receives the message from the macrophage when an invader (antigen) is present and orders two more cells (the B cell and the T8 killer cell) to search for, and destroy, the invader. The T4 Helper Cell is also the cell that HIV attacks and destroys. T cells are called "T" because they mature in the thymus gland.
The B Cell : Like a factory.
It identifies the shape of the invader (antigen) and makes antibodies (like keys), which fit the antigen. These antibodies can immediately recognize future antigens of this kind and stop them from making us sick in the future.
The T8 (CD8) or Cytotoxic or Killer Cell :
It is called by the T4 Helper Cell to attack the invader and kill it directly.
- What is an antigen?
[Answer: An antigen is a foreign invader or germ that enters our system. It can be a virus, a bacterium, a fungus, a protozoan, and so forth. Have the group name an antigen common in their community besides HIV. (Examples: cold virus, TB bacteria.)]
- What is an antibody?
[Answer: An antibody is a specialized protein that is a response to an invading antigen. Antibodies are produced by B cells. They work like keys, fitting the shape of the antigen locks. When an antigen enters the system again, it is recognized and attacked by antibodies.]
- What is HIV?
[Answer: The Human Immunodeficiency Virus. The virus that attacks the T4 Helper Cell. When it cripples enough T4 Helper Cells, the rest of the immune system is not called into action. Other antigens invade the body and cause disease. At this point, the infected person develops AIDS , which is Acquired Immune Deficiency Syndrome .]
B. The Cats-and-Dogs Game
The Cats-and-Dogs Game may also be used to reinforce the learning from this section, and to teach students the difference between HIV and AIDS. This interactive exercise is fun. If possible, play this game in an open space to allow for movement. If you like, you can substitute different animals for your class (e.g., lions and elephants, birds and cats).
The game is played this way:
- Ask for one volunteer. Have the volunteer stand in the front of the room. This person is the kitten.
- Ask for six more volunteers. These volunteers are the adult cats. Their job is to protect the kitten. They should form a circle and join hands around the kitten. To show them the importance of their job, try to poke the kitten. You will find that the cats quickly get the point and close ranks to protect the kitten. The adult cats should stand close to the kitten.
- Now, ask for four or five more volunteers. These people are the dogs. Their job will be to get to the kitten. They will try to squeeze or reach beyond the adult cats, doing anything they can (within reason) to get to the kitten.
- When you say "Go!" the dogs try to get to the kitten. Let this go on for a few seconds until the kitten has at least one contact from the dogs. Ensure that the kitten is not hurt.
- Now, with the volunteers remaining exactly where they are, ask: What is the kitten? What does the kitten represent?
[Answer: The kitten is the human body.]
What do the adult cats represent?
[Answer: The adult cats are the immune system. Just like the cats that protected the kitten from harm, the immune system's job is to protect the body from invading diseases.]
What do the dogs represent?
[There may be a few people who say that the dogs are HIV. That is not so. Answer: The dogs stand for the diseases, illnesses, and infections that routinely attack a person's body.
- Now, very dramatically, go to each of the dog volunteers. Explain that these diseases, like pneumonia, colds, or the flu, may attack the human body, but are they able to kill the human body? The answer should be no, the human body gets attacked by germs every day, but the immune system (point to the adult cats) manages to fight them off and protect the body. The human body might get sick (such as the hit or poke that the kitten suffered), but it does not die, because the immune system is strong. Then continue: But suppose I am HIV. I come to this body (the kitten) and I attack and kill the immune system. At this point, touch all but two of the adult cat volunteers and ask them to sit down. Touch each person as you remove him or her, acting as if HIV is killing the immune system. Then continue: Now, will the kitten be protected? Will the human body be safe with the immune system gone? Next, tell the dogs to attack (touch only) on the word "Go!" The dogs are easily able to get to the kitten now.
Summarize the idea that HIV has killed the immune system. This lack of an immune system makes it possible for diseases such as pneumonia, tuberculosis, diarrhea, certain cancers, malaria, and cholera to actually kill the person, rather than just make the person sick. To be sure people have understood, you can ask: Does HIV kill the person? The students should say no. It was the diseases that killed the person. Also, ask someone to tell you the difference between HIV and AIDS. [HIV is the virus that kills the protective cells of the immune system. AIDS is the condition created by HIV in which the body's immune system no longer functions.]
II. Transmission of HIV
This session will focus on HIV transmission to allow for class discussion about how someone can contract HIV/AIDS. HIV can only be transmitted through contact with certain bodily fluids, and therefore the virus can be avoided. Make sure to clarify to the students the activities that cannot transmit HIV as well.
The True-or-False Game
The True-or-False Game is a helpful technique when covering a topic for the first time because it will help you to get an idea of the level of knowledge students already possess. It is also a great way to develop thinking skills, as students will tend to debate to support their position. With a new group, it will also give you a sense of who the unspoken leaders or the most confident students are, as others may watch them for clues regarding the truth of a statement. Here is how the game is played:
- Print the word TRUE in large letters on a sheet of paper. Hang the paper on one wall.
- Print the word FALSE in large letters on a separate sheet. Hang the paper on the opposite wall.
- Clear an open area between the two signs.
- Ask students to gather in the center of an open area. Read one of the bulleted comments from the lists below. There is a list of true statements and a list of false statements defining HIV transmission. Once you read the statement aloud, the students should move to whichever sign they think is correct. If they are undecided, or think it can be both true and false, they should remain in the middle.
- Ask the students, in turn, to explain or defend why they are at the side they chose. It is good to ask for explanations from one side, then the other, as groups will tend to begin a debate about the correct answer. Only after everyone who wants to has spoken should you give the correct answer and additional information.
- Emphasize good communication skills and conflict resolution by suggesting that each side reflect upon the points of the opposing side before stating their own opinions.
- Everyone comes back to the center and the game continues with another question.
True Statements: [activities that can transmit HIV]
"HIV can be transmitted?"
- By receiving a direct blood transfusion of untested blood.
- By sharing needles.
- By coming into contact with blood of an infected person.
- By breastfeeding.
- From mother to infant during delivery.
- From mother to infant during pregnancy.
- Through an exchange of blood.
- Through an exchange of certain bodily fluids.
False Statements: [activities that cannot transmit HIV]
"HIV can be transmitted?"
- By being near a person with HIV.
- By sharing a drinking cup with a person with HIV or AIDS.
- By eating food prepared by a person with HIV or AIDS.
- By hugging a person with HIV.
- By kissing a person with HIV when blood is not present.
- By shaking hands with a person with HIV.
- From a mosquito bite.
- From a dog bite.
III. The Loss Exercise
The Loss Exercise provides a powerful framework for discussing empathy for those experiencing grief or loss, especially those infected or affected by HIV/AIDS.
Before introducing the topic, spend a few moments reviewing some of the issues that you have covered up to this point. Explain that the class is about to do an exercise to help them look at HIV/AIDS from a personal perspective. Ask students to completely clear their desks of everything except a sheet of paper and a pen or pencil. Tell them to number 1 to 5 on their papers. Explain that you are going to read five statements, and they will respond to those statements on their papers. It is crucial to emphasize that no one else in the room will see their papers and the papers will not be collected. The papers will not be used at any later time. The papers are the students' own personal property. Do this exercise slowly and seriously. Participants should feel the full impact of this discussion. One by one, read off the statements and tell the students to write their responses on their papers. Reinforce that it will not be shared with others.
- Write down the name of the personal possession that you love the most . Maybe it is your house, or a special item your grandmother gave you, or a book, or anything else. What one thing that you own means the most to you? Write that thing on #1.
- Write down the part of your body that you are most proud of . Perhaps you really love your eyes, or you are very proud of your hair, or you enjoy your ears the most because they help you listen to music, or you love your voice because it helps you to sing. Write down the one part of your body that you are most proud of on #2.
- Write down the name of the activity you most enjoy doing . Maybe it is going to a religious event, or playing football, or dancing, or some other activity. What do you most enjoy doing in the whole world? Write that activity on #3.
- Write down one secret or very confidential thing about yourself that no one else in the world or only one other person knows about. Every one of us has some secret or private thing that he or she does not want others to know about. Write that personal, private piece of information down on #4. You may abbreviate it so no one will be able to see it by mistake. (Remind the group that no one else will see this sheet.)
- Lastly, write down the name of the person whose love and support means the most to you in the world .
After everyone has finished, explain that you will now go through the list again. As you go through each statement, the students should imagine that they are living through what you are saying.
- Imagine that something terrible happens that causes you to lose the material possession that you love most. Either a theft occurs or a loss of some kind that takes this thing away from you completely. You will never again see the thing listed on #1. Take your pen or pencil and cross out #1 now.
- Imagine that an accident or another unfortunate occurrence causes you to lose the part of your body that you are proudest of. This part of your body is gone, and you will never have it again as long as you live. Cross out #2 now with your pen or pencil.
- Imagine that this same accident or unfortunate occurrence makes it impossible for you to do your favorite activity ever again. You will never again, in your entire life, be able to do the activity you wrote on #3. Cross out #3 with your pen or pencil now.
- Imagine that because of all of the above situations, your secret has been exposed. Everyone now knows what you wrote on #4. It has become public knowledge. Everyone in the school, town, church, mosque, temple, and community knows about what you wrote on #4. Circle #4 with your pen or pencil now.
- Lastly, because of all of these changes (losing your possession, losing your body part, not being able to do your favorite activity, and everyone knowing your secret), the person that you love most in the world leaves you forever. You will never again see this person whom you love and who is your most important source of support. Cross out #5 with your pen or pencil now.
Allow a few silent moments for the participants to truly feel what you have just said.
Students are usually a bit upset and uncomfortable at this point. Give them some time to think about this. Now, ask them to describe in one word or phrase the emotions they are feeling. Write the words on a blank board or flip chart. Keep brainstorming until all of the ideas are exhausted. Your list may include sadness, grief, feeling like killing myself, hopeless, alone, miserable, depressed, angry, blaming others, no reason to continue. Ask the students to take a look at the list that they have just made. Ask them to imagine how these feelings might relate to testing positive for HIV/AIDS. Discuss the links between this exercise and testing positive. Remind the class that they have placed themselves in the position of a person living with HIV/AIDS and allowed themselves to experience the strong emotions that such a person might be living with every day. Discuss what this might mean for the support that they could give to people living with AIDS. How can they help someone in this situation? How would they feel if they or someone they love were involved in this situation?
Frameworks and standards
- National Science Education Standards
- Content Standard C: Life Science
- Content Standard F: Science in Personal and Social Perspectives