Hivaids Module

JFC MUNENE COLLEGE OF HEALTH SCIENCES
LEARNING GUIDE
FOR
HIV AIDS MANAGEMENT
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ACRONYMS
AIDS: Acquired Immune Deficiency Syndrome
ANC: Ante Natal Care
AYP: Adolescents and Young People
ART: Anti-Retroviral Therapy
ARV: Anti-retroviral
BOM: Board of Management
CBO: Community Based Organization
NCDF: National Constituency Development Fund
CEMASTEA: Centre for Mathematics, Science and Technology
GBV: Gender Based Violence
FBO: Faith Based Organization
EMTCT: Elimination of Mother to Child Transmission
FGM: Female Genital Mutilation
HAPCA: HIV and AIDS Prevention and Control Act
HIV: Human Immunodeficiency Virus
HTS: HIV Testing Services
ICT: Information Communication Technology
IDUs: Injecting Drug Users
INERELA+: International Network of Religious Leaders Living or Personally
Affected by HIV and AIDS
ICW KENYA: International Community of Women Living with HIV in
Kenya
KAIS: Kenya AIDS Indicator Survey
KATTI: Kenya Association of Technical Training Institutes
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KEMI: Kenya Education Management Institute
KENEPOTE: Kenya Network of HIV Positive Teachers
KESSHA: Kenya Secondary Schools Heads Association
KEPSHA: Kenya Primary Schools Heads Association
KICD: Kenya Institute of Curriculum Development
KNUT: Kenya National Union of Teachers
KUPPET: Kenya Union of Post Primary Education Teachers
MDAS: Ministries Departments and State Agencies
MoE: Ministry of Education
MoH: Ministry of Health
MIPA: Meaningful Involvement of People Living with HIV
MSM: Men having sex with Men
NACC: National AIDS Control Council
NASCOP: National AIDS and STIS Control Programme
NEPHAK: Network of Persons Living with HIV in Kenya
NHIF: National Hospital Insurance Fund
NGO: Non- Governmental Organization
OVC: Orphans and Vulnerable Children
PCIs: Pertinent and Contemporary Issues
PEP: Post Exposure Prophylaxis
PLHIV: People Living with HIV
PTA: Parents Teachers Association
PrEP: Pre- Exposure Prophylaxis
SAGAS: Semi-Autonomous Government Agencies
SBTD: School Based Teacher Development
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SGBV: Sexual and Gender Based Violence
STIs: Sexually Transmitted Infections
UNAIDS: Joint United Nations Programme on HIV and AIDS
UNESCO…United Nations Educational, Scientific and Cultural Organization
VCT……..Voluntary Counseling and Testing
VMMC…...Voluntary Medical Male Circumcision
WHO…….World Health Organization
WOFAK…...Women Fighting AIDS in Kenya
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TABLE OF CONTENTS
ACRONYMS..................................................................................................................ii
LIST OF FIGURES.........................................................................................................vii
BACKGROUND INFORMATION.....................................................................................1
CHAPTER 1: HIV AND AIDS MANAGEMENT...................................................................2
1.1 Introduction..............................................................................................................2
1.2 Summary of Learning Outcomes...............................................................................2
1.2.1 Exhibit knowledge of HIV situation..........................................................................................3
1.2.8.1 Introduction.....................................................................................................................3
1.2.8.2 Performance Standard.....................................................................................................3
1.2.8.3 Information Sheet............................................................................................................3
1.2.8.4 Learning Activities..........................................................................................................11
1.2.8.5 Self-Assessment.............................................................................................................12
1.2.8.6 Tools, Equipment, Supplies and Materials.....................................................................12
1.2.8.7 References.....................................................................................................................12
1.2.2 Exhibit Knowledge on HIV Prevention....................................................................................14
1.2.8.1 Introduction...................................................................................................................14
1.2.8.2 Performance Standard...................................................................................................14
1.2.8.3 Information Sheet..........................................................................................................14
1.2.8.5 Self-Assessment.............................................................................................................29
1.2.8.7 References.....................................................................................................................31
1.2.3 Relate Human Sexuality to Gender Differences and Family Life.............................................33
1.2.8.1 Introduction...................................................................................................................33
1.2.8.5 Self-Assessment.............................................................................................................46
1.2.8.7 References.....................................................................................................................47
1.2.4 Exhibit Ability to Care and Support PLHIV..............................................................................49
1.2.5 Manage HIV related stigma and discrimination.....................................................................62
1.2.8.1 Introduction...................................................................................................................62
1.2.8.5 Self-Assessment.............................................................................................................70
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1.2.8.7 References.....................................................................................................................71
1.2.6 Integrate PCI in sexual and reproductive health....................................................................72
1.2.8.1 Introduction...................................................................................................................72
1.2.8.5 Self-Assessment.............................................................................................................81
1.2.8.7 References.....................................................................................................................82
1.2.7 Mainstream HIV and AIDS......................................................................................................84
1.2.8.1 Introduction...................................................................................................................84
1.2.8.5 Self-Assessment.............................................................................................................88
1.2.8.7 References.....................................................................................................................89
1.2.8 Apply advocacy and networking skills....................................................................................91
1.2.8.1 Introduction...................................................................................................................91
1.2.8.4 Learning Activities........................................................................................................110
1.2.8.5 Self-Assessment...........................................................................................................110
1.2.8.6 Tools, Equipment, Supplies and Materials...................................................................110
1.2.8.7 References...................................................................................................................111
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LIST OF FIGURES
Figure 1: HIV prevalence by county...................................................................................6
Figure 2: Incidence..............................................................................................................7
Figure 3................................................................................................................................8
Figure 4:illustrates the progression of new infections in Kenya from 2013 to date............8
Figure 5................................................................................................................................9
Figure 6:Incidence of HIV by counties in Kenya..............................................................10
Figure 7..............................................................................................................................11
Figure 8..............................................................................................................................18
Figure 9 Ways by which HIV is transmitted.....................................................................18
Figure 10............................................................................................................................19
Figure 11............................................................................................................................20
Figure 12: It is very important to know your HIV status..................................................23
Figure 13............................................................................................................................23
Figure 14: Condoms are effective in prevention of HIV infection....................................25
Figure 15............................................................................................................................27
Figure 16............................................................................Error! Bookmark not defined.
Figure 18............................................................................................................................39
Figure 19 Sexual and gender based physical violence must be discouraged....................41
Figure 20............................................................................................................................51
Figure 21 Alcohol is legally the most abused drug in Kenya............................................51
Figure 22............................................................................................................................52
Figure 23............................................................................................................................56
Figure 24............................................................................................................................58
Figure 27............................................................................................................................75
Figure 28: Drunkenness may lead to some irresponsible behaviour.................................76
Figure 29: If used well, the mobile phone can be useful in prevention of HIV and AIDS.
...........................................................................................................................................78
Figure 30 If not well used the mobile phone can lead to risky behavior that can lead to
HIV infection.....................................................................................................................79
Figure 31: A resource person is usually better than the trainer in communicating
specialized information such as in HIV and AIDS............................................................83
Figure 32: Orphaned children due to HIV and AIDS end up as street children while
others overburden already impoverished grandparents.....................................................85
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LIST OF TABLES
Table 1: Core Units of Learning..........................................................................................1
Table 2: The top four Countries leading globally in HIV Epidemic as at 2018..................5
Table 4 Tool 3: Team Analysis Tool (with examples)......................................................93
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BACKGROUND INFORMATION
This learning guide will enable the trainee to acquire competencies to undertake various processes in Health promotion Sector. It
provides practical and theoretical learning activities, simplified content, illustrations and self-assessment items to guide the trainee in
the learning process. It also provides links and references for further reading.
Layout of the Trainee Guide

Performance standards: These are obtained from the performance criteria statements in the related unit of competency of the
Occupational Standards (OS)
Information Sheet: This section covers information relating to the specific learning outcome. This information should include but not
limited to meaning of terms, methods, processes/ procedures/ guidelines, Illustrations (photographs, pictures, videos, charts, plans,
digital content links, simulations links) and case studies. This section also provides additional information sources relevant to the
learning outcome e.g. books, web links
Learning activities: This section covers practical activities related to the Performance Criteria statements, Knowledge in relation to
Performance Criteria as given under content in the curriculum Special instructions related to learning activities
Self-Assessment: This section must be related to the Performance Criteria, Required Knowledge and Skills in the Occupational
Standards. This section requires the trainee to evaluate their acquisition of skills, knowledge and attitude in relation to the learning
outcome. A variety of assessment items such as written and practical tests which emphasizes on the application of knowledge, skills
and attitude is recommended
The self-assessment items should be valid, relevant and comprehensive to the level of qualification in the learning outcome
Tools, equipment, materials and supplies: This section should provide for the requirements of the learning outcome in terms of
tools, equipment, supplies and materials. The section should be adequate, relevant and comprehensive for the learning outcome.
References: Information sources should be quoted and presented as required in the APA format
The units of learning covered in this learning guide are as presented in the table below:
Table 1: Core Units of Learning
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Unit of Learning Code Unit of Learning Title
HLT/CU/HIV/BC/01/6/A HIV and AIDS management

Total
Grand total
CHAPTER 1: HIV AND AIDS MANAGEMENT
UNIT CODE: HLT/CU/HIV/BC/01/6/A
Related Unit of Competency in Occupational Standard; Demonstrate comprehensive knowledge of HIV and AIDS management
1.1 Introduction
In this Unit, we shall cover comprehensive knowledge on HIV and AIDS management. It involves exhibiting knowledge of the HIV
situation globally and nationally, knowledge on HIV and AIDS prevention and relating human sexuality to gender differences and
family life. It also encompasses exhibiting ability to care and support PLHIV and AIDS and managing HIV related stigma and
discrimination. It further includes integration of pertinent and contemporary issues in sexual and reproductive health, mainstreaming
HIV and AIDS as well as application of advocacy and networking skills.
1.2 Summary of Learning Outcomes
The following are the learning outcomes that will be covered in this unit;
1. Exhibit knowledge of HIV situation
2. Exhibit knowledge on HIV and AIDS prevention
3. Relate human sexuality to gender differences and family life
4. Exhibit ability to care and support PLHIV and AIDS
5. Manage HIV and AIDS related stigma and discrimination
6. Integrate PCI in sexual and reproductive health
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7. Mainstream HIV and AIDS
8. Apply advocacy and networking skills
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1.2.1 Exhibit knowledge of HIV situation
1.2.8.1 Introduction
This learning outcome will cover current HIV prevalence, incidence and the demographic trends. By the end of this learning outcome,
you will be able to cover the current trends in HIV and AIDS identify the risk factors in various population groups and interventions to
be undertaken to address the current trends.
1.2.8.2 Performance Standard

 Global HIV prevalence and incidence is identified and presented based on UNAIDS global reports.
 Kenya HIV situation is identified and presented based on National AIDS Control Council reports.
 County HIV situation is identified and presented based on National AIDS Control Council reports.
1.2.8.3 Information Sheet

HIV
HIV stands for Human Immunodeficiency Virus. It is the virus that causes AIDS. This virus attacks the body's immune system and
makes it difficult to fight off diseases and infections.
Opportunistic infections
Infections associated with severe immunodeficiency are known as "opportunistic infections", because they take advantage of a
weakened immune system. The immune system is considered deficient when it can no longer fulfil its role of fighting infection and
diseases.
AIDS
AIDS stands for Acquired Immune Deficiency Syndrome. This is the most advanced stage of HIV infection. It occurs when the body’s
immune system is overwhelmed by the HIV and is characterized by the occurrence of opportunistic infections or HIV-related cancers.
HIV Prevalence
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HIV prevalence is defined as the actual number of people living with HIV at a particular point in time. Prevalence is reported as the
number of cases as a fraction of the total population and can further be categorized according to different sub-sets of the population.
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Syndrome
A group of symptoms that consistently occur together
HIV Incidence
It is the number of new (or newly diagnosed) HIV cases. It is generally reported as the number of new cases occurring within a period
of time for example per month, per year. Incidence can further be categorized according to different subsets of the population for
example by gender, by racial origin, by age group or by diagnostic category.
HIV Epidemic
The rapid spread of HIV disease to a large number of people in a given population within a short period of time.
Key Populations
These are populations that are at the highest risk of contracting and transmitting HIV. Key populations in Kenya are female and male
sex workers, men who have sex with men (MSM), and injecting drug users. They also have the least access to HIV prevention, care,
and treatment services because their behavior and practices are often stigmatized and criminalized.
HIV Drug Resistance

HIV drug resistance is the ability of HIV to mutate and reproduce itself in the presence of antiretroviral drugs caused by the
inconsistent use of ARVs. This produces drug-resistant strain of HIV making it difficult to treat.
THE SRUCTURE OF HIV
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LIFE CYCLE OF HIV
GROUP 1 ASSIGNMENT
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HIV EPIDEMIC
History of HIV
GROUP 2 ASSIGNMENT
Global HIV Prevalence
39 million -people globally living with HIV/AIDS by 2022
1.3 million became newly infected with HIV in 2022
630,000 people died from AIDS related illnesses
29.8 million – people accessing antiretroviral therapy
85.6 million people have become infected with HIV and 40.4 million people have died from AIDS- related illnesses since the start of
the epidemic. According to UNAIDS
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TOP 10 COUNTRIES WITH THE MOST HIV CASES
COUNTRY PEOPLE LIVING WITH THE HIV
South Africa 7,600,000
India 2,500,000
Mozambique 2,400,000
Tanzania 1,700,000
Zambia 1,400,000
Uganda 1,400,000
Kenya 1,400,000
Zimbabwe 1,300,000
United States 1,069,947
Malawi 1,000,000
HIV PREVALENCE IN KENYA

The National AIDS Control Council 2021report shows that 4.8% of Kenyans are HIV positive. this translates to about 1.3 million
Kenyans who are living with HIV.
PREVALENCE BY COUNTIES
1. Homa Bay county 19.6% ranked as number 1 in kenya with the highest HIV prevalence
2. Kisumu county 17.5%
3. Siaya county 15.3%
4. Migori county 13.3%
5. Busia county 7.7%
6. Nairobi county 3.8%
7. Vihiga county 3.4%
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8. Kitui county 3.1%
9. Kakamega county 2.5%
10. Kisii county 2.1%
GROUP 3ASSIGNMENT
Figure 1
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1.2.8.4 Learning Activities
1.2.2 Exhibit Knowledge on HIV Prevention
This learning outcome covers facts on HIV and AIDS, myths and misconceptions and ways of HIV prevention. The unit is divided
into three sections which will help trainee understand the facts about HIV and AIDS, demystify myths and misconceptions
associated with HIV and AIDS, and how to prevent HIV infection.
It is expected that the trainee will be able to understand the meaning of key terms including Viral load, HIV signs and symptoms,
HIV testing, treatment and adherence, common myths and misconceptions, modes of HIV transmission and principles of HIV
prevention.

 Myths and misconceptions are identified and dispelled based on facts.
 Modes of HIV transmission are identified and interpreted based on credible sources.
 Ways of HIV prevention are identified and reviewed based on credible sources.
Signs and Symptoms of HIV Infection
HIV symptoms vary depending on the stage of infection. Some people may experience a flu-like illness within 2-6 weeks after HIV
infection; while others may not feel sick during this stage. Flu-like symptoms can include: Fever, headache, chills, rash, night sweats,
muscle aches, sore throat and fatigue.
As the infection progressively weakens the immune system, an individual can develop other signs and symptoms, such as swollen
lymph nodes, unexplained weight loss, unexplained fever, mouth ulcers, chronic diarrhea and cough. However, the only way to
ascertain one’s HIV status is to go for a HIV test.
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Anti-Retroviral Therapy (ART)
ART stands for Anti-Retroviral Therapy or better still, it is the treatment for HIV infection. ART are drugs or the medication that stops
or impairs the reproduction of HIV. It is important to note that ART does not cure HIV and AIDS infection but improves the body’s
immune system by slowing down the replication of the virus therefore increasing the body’s CD4+ cell count. The standard treatment
consists of a combination of at least three drugs. This suppresses HIV multiplication and reduces the likelihood of the virus
developing resistance. ART also encompasses good nutrition, correct and consistent condom use, physical exercise and healthy
lifestyle changes.
Post Exposure Prophylaxis (PEP)
Post-exposure prophylaxis (PEP) is the use of ARV drugs within 72 hours of potential exposure to HIV in order to prevent infection.
PEP prevents HIV in people who have potentially been exposed to HIV through unprotected sex, sexual assault and accidental cuts
and pricks. PEP management includes counseling, first aid care, HIV testing, and administering of a 28-day course of ARV drugs with
follow-up care.
Adherence
Adherence means taking medication or ARVs for the management of HIV infection as prescribed by a health care provider and at the
correct time. It includes the extent to which a person who is HIV positive adheres to their ARVs or medication and also follows a diet
and/or executes a lifestyle that corresponds with the agreed recommendations from their health care provider.
Discordance and Concordance
Discordance is where one partner is infected with HIV and the other partner is not infected while concordance is where both partners
are infected with HIV.
Myths and Misconceptions
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There are various myths and misconceptions associated with HIV transmission. They differ from one community to another .The
following are common myths and misconceptions and the true facts on the same.
MYTH/MISCONCEPTION FACT
 You can be infected with  HIV is only transmitted through unprotected sexual
HIV by sharing a desk or intercourse with an infected person.
sitting next to a person  From an infected mother to her unborn child.
living with HIV.  From sharing sharp objects/instruments
contaminated with HIV.
 Through blood transfusions.
 With all the new HIV  This is false and this attitude has led to reckless
treatment, HIV is no longer sexual behaviour. The younger generation has lost
a big deal. some fear of HIV because of the successful
treatment outcomes that have been realized. This is
causing them to engage in risky behavior leading to
high rates of HIV infection.
 HIV always leads to AIDS  HIV is the infection that causes AIDS. But this
doesn’t mean all HIV-positive individuals will
actually develop AIDS
 With ART, levels of HIV infection can be controlled
and kept low, maintaining a healthy immune system
for a long time and therefore preventing
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opportunistic infections.
 One can be cured of HIV  Having sex with a virgin cannot cure HIV. HIV
by having sex with a virgin infection is incurable but ARVs can help reduce the
HIV virus in the body.
 If one tests HIV negative,  If you or your partner was recently infected with
they do not need to use a HIV, it may not be detected on an HIV test until
condom about three months later. Therefore, condoms must
be used correctly and consistently.
 Condoms also prevent infection from other STIs like
Chlamydia, Gonorrhea and Syphilis. They also
prevent unplanned pregnancies.
 Traditional healers and  To-date there is no cure for HIV; however, ARVs
spiritual leaders can cure suppress the virus and lead to overall good health
HIV and increased productivity.
 One can tell if a person is  One cannot tell if a person is HIV positive based on
HIV positive by looking at how they look. The only definite way of knowing
their physical body your HIV status is to get tested.
 One can get infected with  HIV is only transmitted through unprotected sexual
the HIV virus through intercourse with an infected person.
sharing food, utensils,  From an infected mother to her unborn child.
cutlery, crockery, toilet  From sharing sharp objects/instruments
seats, with a person who is
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HIV positive contaminated with HIV.
 Through blood transfusions.
 Children should not be  Children who are HIV positive are not a danger to
allowed to go to school if anyone. They should be allowed to live a normal life
they are HIV positive and not discriminated.
 You can get HIV from  Insects like mosquitoes do not spread HIV because
being bitten by insects like the virus cannot survive in them.
mosquitoes
 If one is receiving ART  ARV treatment only reduces the amount of virus in
treatment they cannot the blood; it does not prevent one from transmitting
spread the HIV virus HIV. An individual on ARV should still take the
necessary precautions to prevent HIV transmission
to others
 When one acquires HIV  HIV infection is not a death sentence. ARVs are now
infection, their life is over available to manage HIV and help people live a
normal life
 If my partner and I are both  Not all strains of HIV are the same, and being
HIV positive there is no infected with more than one strain can lead to greater
reason to use a condom. complications, or a “super infection”. This can lead
to resistance of HIV to ARV. HIV positive partners
should always use condoms correctly and
consistently during sexual intercourse.
 HIV positive individuals  It is possible to have a child if you or your partner is
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should not have children. A HIV-positive. If a mother is HIV-positive during
HIV positive woman should pregnancy, HIV treatment can improve her overall
not give birth. health and can protect the unborn baby from
contracting HIV before, during delivery and after
birth.
 As long as a partner takes their ARVs correctly and
has an undetectable viral load, the likelihood of
transmitting the infection is markedly reduced.
 HIV is only spread during  All types of sex (oral, vaginal and anal) are a risk
sexual intercourse between factor for HIV transmission, and penetrative anal sex
a woman and a man carries the largest risk.
 It’s safer to use two  Using two condoms is not recommended as the
condoms to prevent HIV friction between the two will easily cause them to
infection break hence increasing the risk of HIV infection. It's
best to only use one at a time.
 You don’t need a condom if  Yes you do. You should use a condom for oral sex
you’re having oral sex because other infections such as gonorrhea,
Chlamydia and herpes can be transmitted through
this way.
Case Study
Dan (not his real name) is a student at Kathekene TVC who has just transferred from another TVC. From the records he has been
transferred from a number of technical colleges. The local church that sponsors his studies keeps intervening and that is how he gets
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admission into them. He is always shabbily dressed and he is withdrawn and does not like to associate with other trainees. In addition,
some of the trainees avoid him as it’s rumored that he is an orphan and lost his parents to AIDS. He is short tempered with violent
tendencies and rarely participates in class activities.
(a) Outline some possible causes of this pattern of behavior portrayed by Dan
(b)How can the issues you have outlined be addressed?
Modes of HIV Transmission
In this section we are going to discuss transmission of HIV.A person can acquire HIV or transmit it through specific ways. Let us discuss
some of these modes of transmission further:
Figure 2
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Figure 3 Ways by which HIV is transmitted
Mother to Child Transmission
What does mother to child transmission of HIV mean?
Do you know that when it comes to children, the mode of transmission is predominantly mother to child and this is also referred to as
vertical transmission?
Mother to child transmission can occur during pregnancy, labor and delivery or while breastfeeding. The risk can be high if a mother
is living with HIV and not on ARVs or not taking their ARVs as prescribed. It is important for all pregnant women to attend Antenatal
Clinic (ANC) and be tested for HIV and if they are found to be HIV positive, start HIV treatment immediately (Test and Treat).
The risk of mother to child transmission of HIV increases significantly if the mother has a high viral load. Therefore a pregnant
mother living with HIV must be adherent to her medication. Furthermore all pregnant women must deliver in a health facility and be
attended to by a skilled healthcare worker. This further reduces the risk of HIV.
Let us discuss how the baby could get HIV.
 In pregnancy
The HIV can be transmitted from the mother to the baby through an injured placenta and the baby gets infected.
 During delivery
HIV virus can get to the baby if the baby has bruises and gets into contact with the mother’s blood or vaginal fluids. This can
be reduced by making sure that mothers deliver in health facilities where there are skilled health workers.
 Breast-feeding
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HIV can be transmitted to the baby from the mother through breast milk if a HIV positive mother has a high viral load. Taking
ARVs lowers the viral load and HIV positive women can breastfeed their infants. It is possible for HIV positive pregnant
women to have HIV negative baby.
Figure 4
Fig. 2.5: A HIV mother on ART can have a HIV negative baby
Sexual transmission of HIV
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Sexual transmission can occur during vaginal, anal or oral sex with an infected partner and when no condoms are used. Penetrative
anal sex poses the highest risk of HIV infection.
Blood Transfusion
One can get HIV through blood transfusion. However, the risk is extremely low because of rigorous screening of all blood products
before transfusion is done.
Sharing needles or syringes
Transmission of HIV can occur after being pricked with a HIV contaminated needle or other sharp object. The risk is especially high
among people who share needles and syringes; for example, those engaging in drug and substance abuse also known as Injecting drug
users (IDUs). There is also a risk when getting tattoos and piercings. It is prudent that one ensures that they get these services in
hygienic environments and that the needles are not shared. Occupational exposure can also occur to health care workers.
In conclusion it’s important to understand that not all body fluids from a person who has HIV can transmit the virus. Those that can
transmit include; Semen, Pre-seminal Blood, fluid, Rectal fluids, Breast milk and Vaginal fluids.
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Figure 5
Fig.2.6: Ways by which HIV cannot be transmitted.
HIV Prevention
The section covers HIV prevention strategies, Testing Services and the difference between discordance and concordance in HIV &
AIDS situation.
Prevention
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Prevention is the act of hindering or obstructing, the HIV virus from entering the body.
HIV infection and or transmission can be prevented through the following:
 Abstinence:
Not engaging in sexual intercourse at all before marriage.
 Being faithful to one un-infected partner
 Not sharing needles or other sharp objects
 Correct and consistent use of condoms
 In case one is raped they should visit a health facility before 72 hours lapse and get post exposure prophylaxis (PEP)
 Prevention of mother to child transmission
 HIV testing
HIV Testing Services
Importance of HIV Testing
Let’s hear what two people shared about this.
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Figure 6: It is very important to know your HIV status
HIV testing is the fundamental step in HIV-prevention as it sets the tone for implementation of medical interventions such as
Elimination of Mother –Child Transmission(EMTCT), Voluntary Medical Male Circumcision (VMMC), and linkage of HIV-infected
individuals to care and treatment.
HIV prevention Interventions
Figure 7 There are a number of steps that one can

take to protect themselves from HIV
infection Interventions to prevent new HIV
infections
Fig.2.10: Sharing information may enlighten

others about HIV and AIDS
The dialogue below, involving two TVET

male trainees, Paulo and Juma. Recently, a
guest speaker had been invited by their
group to talk about prevention and control of
HIV and AIDS but Paulo had missed the
meeting.
Juma: You really missed important information we were taught in our last meeting. We learnt about how to prevent
transmission of HIV.
Paulo: Aha! Zainabu! I am sure I did not miss much. We know HIV is for the promiscuous people and the wayward youngsters.
Juma: You are wrong. HIV can affect all; yourself, your husband, and even your children.
Paulo: What? Is that true? So what should one do?
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Juma: Protect yourself my dear.
Paulo: But how?
Juma: Be faithful to your husband and pray he does the same.
Paulo: But how do l know that we are not already infected?
Juma: The two of you can go for testing together as a first step towards protecting yourselves. Depending on the results, if one
of you is infected or both make sure you use ARV.
Paulo: That’s scary, and what did you say about the children?
Juma: Children, especially those who are sexually active stand a high risk of being infected if they engage in sexual intercourse
with infected partners. Pregnant women can also transmit HIV to their unborn children. They should also be advised to
get tested and treated for any STIs.
Paulo: That is interesting; I now agree that I missed out on very important information. Thank you my friend for sharing it with
me. I will not miss the women’s meeting again.
 From the conversation above, how many methods of preventing HIV can you identify?
We hope that the methods you identified included the following:
 Abstaining from all types of unprotected sexual intercourse/activity

 Being faithful to one partner
 Using pre- exposure treatment
 Elimination of Mother to Child Transmission. (EMTCT)
 Using condoms
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Juma and Paulo have helped us to highlight some of the methods of preventing HIV. Let us learn more about them.
ART for People Living with HIV
Any person infected with HIV should start on ART immediately they confirm their status. These medications reduce the amount of
virus in the body hence keeps the immune system functioning and prevents illness. Another benefit of reducing the amount of virus in
the body is that it helps prevent transmission to others through sex, needle sharing, and from mother-to-child during pregnancy and
birth. All individuals on ARVs should ensure that they adhere to their medication and should be supported to do so.
Condoms
Group 4 assignment: procedures carried out during condom use.
When condoms are used correctly and consistently, they are highly effective in preventing HIV and other sexually transmitted
infections (STIs). Condoms are a key component of comprehensive HIV prevention. Combination of approaches to prevent the sexual
transmission of HIV are recommended, including correct and consistent condom use, reduction in the number of sexual partners, HIV
testing and counselling, delaying sexual debut, treatment for STIs and voluntary medical male circumcision (VMMC)
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Figure 8: Condoms are effective in prevention of HIV infection
Voluntary Male Medical Circumcision (VMMC)
According to the World Health Organization (WHO) VMMC reduces the risk of male-to-female sexual transmission of HIV by
approximately 60%.VMMC should also be offered as part of combination prevention interventions. In Kenya VMMC is offered in all
health facilities.
Elimination of Mother to Child Transmission (EMTCT)
Elimination of mother-to-child
transmission (EMTCT) programmes
provides antiretroviral treatment to HIV-
positive pregnant and breastfeeding
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women to stop their infants from acquiring the virus. Without treatment, the likelihood of HIV passing from mother-to-child is
between15% to 45%.
Fig.2.12: It is important that all pregnant women attend Antenatal Clinic (ANC), get tested for HIV and ensure they deliver in a health
facility.
Pre-Exposure Prophylaxis (PrEP)
Pre-exposure Prophylaxis (PrEP) is a form of HIV prevention in which a HIV negative person at high risk of HIV infection takes daily
antiretroviral medication to prevent HIV infection. In Kenya PrEP is offered as part of combination prevention for those at substantial
risk of HIV infection. PrEP is highly effective when taken consistently and correctly, it is safe and reduces one’s risk of acquiring HIV
by over 90%.
Note:
 PrEP is not for everyone and anybody wishing to take.
 PrEP needs assessment by a health care provider.
 PrEP should only be prescribed by a qualified health worker.
 PrEP should be used with other prevention interventions like abstinence, being faithful to one un-infected partner, using
condoms correctly and consistently.
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Figure 9
31
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Fig.2.13. We trusts that this information on discordance and concordance will be of use to you and the learners that have been
entrusted to you.
Adherence
Adherence means taking ARVs for the management of HIV infection every day and at the correct time. In addition, it includes the
extent to which a person who is HIV positive adheres to their ARVs and also follows a diet and/or executes a lifestyle that
corresponds with the agreed recommendations from their health care provider. Treatment adherence is important because it affects
how well HIV medications decrease the viral load. The lower the viral load, the healthier the person.
Adherence helps to prevent drug resistance. If a person living with HIV (PLHIV) skips a dose of their medication even once, the virus
takes the opportunity to multiply and make more viruses. Skipping your medication or ARVs may lead to development of strains of
HIV that are resistant to medication. As a result, poor adherence leads to treatment failure, and leaves fewer treatment options.
Adherence support
It is important that people living with HIV and AIDS adhere to treatment, clinical appointments, and other health related
recommendations.
Therefore, it is essential to offer support by:
 Facilitating appointment reminders.

 Granting permission to PLHIV to go for appointments.
 Creating supportive environment for taking HIV medicine at the correct time and correct dosage.
 Provide continuous adherence counseling.
 Correct storage by ensuring the drugs are kept in their original container with the preservative to maintain the quality of the
drug.
 Ensure ARVs are not confiscated from PLHIV
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1. Suggest some of the possible modes of HIV transmission and list them down
2. Discuss with a colleague the various HIV related myths and misconceptions.
1.2.8.5 Self-Assessment
Case Study
At break time as the teachers chatted and took their tea, Mr. Juma noticed that Madam Jane was quiet she sat with her eyes closed and
did not participate in the discussion.
He enquired: Madam, you are far too quiet ….is everything okay?
She replied: I am feeling tired and weak and have lost my appetite.
Juma: I thought you saw the doctor three days ago when you complained of being unwell?
Jane: Yes I did and was even put on medication.
Juma: Did you complete the dosage?
Jane: I took the medication for 2 days and when I felt much better I stopped….I am not very good at taking medication.
Juma: Madam, it is important that you complete your medication because even if you feel better after the first 2 days the illness is still
in your body!
Jane : I guess you are right …let me check if the medicine is in my bag….I have to force myself to complete the dose otherwise I
will keep feeling sick and that will not be good at all.
Juma: Madam it is important that you adhere to the doctor’s instructions regarding taking of all medication.
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In this case study, various key issues regarding adherence have come up. The issue of adherence has been alluded to and emphasis
made on the importance of adherence to treatment and/or medication.
1. Activity based on case study
a. From the case study, what are some of the key issues that touch on adherence?
b. What are the forms of non- adherence to ART?
2. Which year was HIV declared a national disaster?
3. What are the possible modes of HIV transmission?
4. When can mother to child transmission of HIV occur?
5. What are ways that HIV cannot be transmitted?
6. What are a few myths you have heard about HIV?
1.2.8.6 Tools, Equipment, Supplies and Materials

 Stationery
 Computer
 Internet connectivity
 HIV and AIDS reference materials
 HIV and AIDS Reports and Data
1.2.8.7 References
(a) National AIDS Control Council, 2016; frequently asked questions on HIV and AIDS; Nairobi
(b) National AIDS and STI Control Programs (2016); Guide for Educational Institutions to Support Learners Living with HIV in
Kenya
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(c) Ministry of Education Science and Technology; (2001) Teaching and Learning in Primary Classroom Core Module; (School
based teacher development SbTD)
(d) Kenya Institute of Education (1999). AIDS Education Facilitators Handbook. Nairobi: KIE
(e) National Aids Control Council, (2013). Certificate in Control and Management of HIV/AIDS. Participants Training Manual –
Certificate. Nairobi: NACC
(f) National Aids Control Council, (2016). Maisha Certification Curriculum for the Public Sector Institutions. Nairobi: NACC
(g) National AIDS and STI Control Programme, (2015). The Kenya HIV Testing Services Guidelines. Nairobi: Ministry of Health
(h) National AIDS and STI Control Programme (2017) Framework for the Implementation of Pre- Exposure Prophylaxis of HIV
in Kenya
(i) National AIDS and STI Control Programme (2016|) Guide for Educational Institutions to support learners living with HIV in
Kenya.
Responses
1. Activity based on case study
c. From the case study, what are some of the key issues that touch on adherence?
 Not following doctor’s instructions
 Lack of support
d. What are the forms of non- adherence to ART?
 Missing of drugs
 Poor nutrition
 Lack of counseling support
2. Which year was HIV declared a national disaster?
 1999
3. What are the possible modes of HIV transmission?
 Sexual contact with infected person without a condom
 Sharing of sharps
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 Mother to child
 Blood transfusion
4. When can mother to child transmission of HIV occur?
 During pregnancy
 During delivery
 During breastfeeding
5. What are ways that HIV cannot be transmitted?
 Kissing
 Hugging
 Mosquito bites
 Shared household utensils
6. What are a few myths you have heard about HIV?
 Sexual intercourse with virgin cures HIV
 Spiritual healing cures HIV
 Herbal medicines cure HIV
 Sexual intercourse with elderly cures HIV
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1.2.3 Relate Human Sexuality to Gender Differences and Family Life
This learning outcome covers human sexuality and aims at equipping the trainee with knowledge to help them understand their
bodies and form correct perspectives and opinions around sexuality and their sexual orientation.

 Effects of nature and nurture on human sexuality are explored based on behaviorist theories.
 Gender differences as they relate to human sexuality are explored based on behaviorist theories.
 Knowledge of reproductive and sexuality education is applied based on credible sources.
 Positive family values are exhibited based on cultural and religious practices and community role models.
 High risk sexual practices are recognized and avoided based on risk level.
 Incidences of HIV infection are linked to gender based on vulnerability.
 Incidences of HIV infection are linked to SGBV based on vulnerability.
Human Sexuality
Human sexuality is the way people experience and express themselves as sexual beings. This involves biological, erotic, physical,
emotional, social, spiritual feelings and behaviors.
Gender:
Either of the two sexes (male or female)
Sexual orientation:
A person’s preferred way of having sex.
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Gender relations
Refer to the way men and women relate to each other individually and in groups in a particular society. It defines power between the
two sexes and whether one has more power than the other.
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Gender inequality
Refers to the disparities, obvious or hidden between individuals on the basis of a person’s sex, authority, opportunities, allocation of
resources among others. It is a situation where men and women do not enjoy the same status and opportunities for realizing their full
human rights and potential.
Gender equality
Refers to the lack of discrimination on the basis of a person’s sex in opportunities, allocation of resources and/or benefits and access to
services.
Gender equity
It is the process of being fair to both men and women, by ensuring that measures are put in place to compensate for social
disadvantages that prevent men and women from operating on a level playing ground.
Gender sensitivity
Refers to the ability to perceive existing gender differences, issues and equalities and incorporate these into strategies and actions.
Gender awareness
Is the ability to understand the socially determined differences between men and women based on learned practices and behavior
which affect the ability to access and control resources.
Sex
Refers to the physiological attributes that identify persons as male or female. It is biological and is manifested in the physical
differences between male and female.
Sexuality
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Refers to those aspects of gender that identify and relate to sex, such as sexual desire, sexual behavior and sexual orientation.
Sexual orientation
It is an individual’s preference for sharing sexual expression on sexual attraction to persons of opposite sex or gender, same sex or
gender, or to both sexes and gender.
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Human Sexuality
The biological and physical aspects of sexuality largely concern the human reproductive functions, including the human sexual
response cycle. Someone's sexual orientation can influence that person's sexual interest and attraction for another person. Physical and
emotional aspects of sexuality include bonds between individuals that are expressed through profound feelings or physical
manifestations of love, trust, and care.
Social aspects deal with the effects of human society on one's sexuality, while spirituality concerns an individual's spiritual connection
with others. Sexuality also affects and is affected by cultural, political, legal, philosophical, moral, ethical, and religious aspects of
life.
Interest in sexual activity typically increases when an individual reaches puberty. Opinions differ on the origins of an individual's
sexual orientation and sexual behavior. Some argue that sexuality is determined by genetics, while others believe it is molded by the
environment, or that both of these factors interact to form the individual's sexual orientation. This pertains to the nature versus nurture
debate. Nature assumes that the features of a person correspond to their natural inheritance, exemplified by drives and instincts.
Nurture assumes that the features of a person continue to change throughout their development as influenced by the environment.
Socio-cultural aspects of sexuality include historical developments and religious beliefs. Examples of these include Jewish views on
sexual pleasure within marriage and some views of other religions on avoidance of sexual pleasures. Some cultures have been
described as sexually repressive. The study of sexuality also includes human identity within social groups, sexually transmitted
infections (STIs/STDs), and birth control methods.
Nature versus Nurture
Nature assumes that, the features of a person innately correspond to their natural inheritance, exemplified by drives and instincts. On
the other hand, nurture refers to the assumption that the features of a person continue to change throughout their development and
modification influenced the environment.
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Certain characteristics may be inherited in humans. These characteristics may be modified by the physical and social environment in
which people interact. Human sexuality is driven by genetics and mental activity. To some extent sexual drive affects the development
of personal identity and social activities. An individual's normative, social, cultural, educational, and environmental characteristics
moderate the sexual drive.
Sigmund Freud believed that sexual drives are instinctive. He was a firm supporter of the nature argument. He identified two broad
groups of instincts - Eros (the life instinct), which comprises the self-preserving and erotic instincts; and Thanatos (the death instinct),
which comprises instincts which invoke aggression, self-destruction, and cruelty. His instinct theory said humans are driven from birth
by the desire to acquire and enhance bodily pleasures, thus supporting the nature debate. Freud redefined the term sexuality to make it
cover any form of pleasure that can be derived from the human body. He also said pleasure lowers tension while displeasure raises it,
influencing the sexual drive in humans. The nurture debate traces back its origin to John Locke and his theory of the mind as a "tabula
rasa" or blank slate. He argues that the environment is where one develops one's sexual drives. That is, the environment determines the
drives that one develops regardless of what is laid down by genetics through inheritance.
Today psychologists are in agreement we are all products of both nature and nurture. Genetics lay the foundations of who we are, and
then the environment modifies or helps us actualize what is laid down by genetics. Certain behavior may be suppressed or made strong
by one’s environment.
Gender differences
A number of theories exist regarding the development and expression of gender differences in human sexuality. Most of them agree
that men tend to be more approving of casual sex (sex happening outside a stable, committed relationship such as marriage), and
hence are more promiscuous (have a higher number of sexual partners) than women. These theories are mostly consistent with
observed differences in males' and females' attitudes toward casual sex. Other aspects of human sexuality, such as sexual satisfaction,
incidence of oral sex and attitudes towards homosexuality and masturbation, show little to no observed difference between males and
females. Observed gender differences regarding the number of sexual partners are modest, with males tending to have slightly more
than one female partner.
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Biological and physiological aspects
Like other mammals, humans are primarily grouped into either the male or female sex, with a small proportion (around 1%) of
intersex individuals, for whom sexual classification may not be as clear. The biological aspects of humans' sexuality deal with the
reproductive system, the sexual response cycle, and the factors that affect these aspects. They also deal with the influence of biological
factors on other aspects of sexuality, such as organic and neurological responses, heredity, hormonal issues, gender issues, and sexual
dysfunction.
Fig. 3.1: The male reproductive system is an example of sex gender identity
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Fig. 3.2: The female reproductive system is another example of sex gender identity
Anatomy and Reproduction
Males and females are anatomically similar; this extends to some degree to the development of the reproductive system. As adults,
they have different reproductive mechanisms that enable them to perform sexual acts and to reproduce. Men and women react to
sexual stimuli in a similar fashion with minor differences. Women have a monthly reproductive cycle, whereas the male sperm
production cycle is more continuous.
Reproductive and sexuality education (RSE)
A rights-based approach to reproductive and sexuality education (RSE) seeks to equip young people with the knowledge, skills,
attitudes and values they need to determine and enjoy their sexuality physically, emotionally, individually and in relationships. It
views sexuality holistically, as a part of young people’s emotional and social development. It recognizes that information alone is not
enough. Young people need to be given the opportunity to acquire essential life skills and develop positive attitudes and values.
RSE covers a broad range of issues relating to the physical, biological, emotional and social aspects of sexuality. This approach
recognizes and accepts all people as sexual beings and is concerned with more than just the prevention of diseases or pregnancy. RSE
programs are adapted to the appropriate age and stage of development of the target group.
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RSE helps young people to:
Acquire accurate information on sexual and reproductive rights, information to dispel myths, and references to resources and services.
Develop life skills including critical thinking, communication, negotiation, self-development and decision-making; sense of self;
confidence; assertiveness; ability to take responsibility; ability to ask questions and seek help; and empathy.
Nurture positive attitudes and values include; open-mindedness, respect for self and others, positive self-worth/esteem, comfort, non-
judgmental attitude, sense of responsibility, and positive attitude toward their sexual and reproductive health.
RSE does not encourage young people to:
 Become sexually promiscuous

 Engage in unusual sex practices
 Engage in sex early in life (early sex debut)
 Become sexual perverts or deviants
Gender Issues in Reproductive Sexuality Education (RSE)
Gender equality is at the very heart of human rights and United Nations values. “Equal rights for men and women” is a fundamental
principle of the United Nations Charter, adopted by world leaders in 1945.
Gender-based inequalities and discrimination deny individuals their sexual rights, routinely resulting in lasting damage to health and
emotional well-being. Gender-based power inequalities are prevalent in many settings and prevent many individuals from making
their independent decisions about if, when and with whom to have sex; whether to use contraceptives; if and when to have children
and how many; and how and whether to seek health care.
Social and cultural norms often deny girls, women, boys and men access to comprehensive information about sexual and reproductive
health. Such norms can perpetuate harmful traditions that cause physical and emotional damage. Cultural expectations and dictates can
deny girls and women the right to make choices about their own bodies, future and prevent their ability to access health care.
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Gender-based violence encompasses all physical, sexual and psychological violence that is rooted in individuals’ gender roles or
identities. Violence against women is the most common form of gender-based violence and one of the most pervasive violations of
human rights worldwide. Gender-based violence can also be perpetrated against boys and men.
Transgender people face complex barriers and discrimination. They are often denied the right to be recognized as a gender different
from that which they were assigned at birth. They frequently face challenges obtaining employment and participating in public arenas,
and health providers are not always accessible or responsive to their concerns. There are others who identify their gender in different
ways, and they too face discrimination and challenges achieving good health and realizing their goals.
Boys and men also suffer as a result of gender norms and expectations. For instance, cultural definitions of what is expected of a man
may prevent men and boys from communicating their sexual and reproductive health needs, adopting safe sexual behaviors and
adopting health seeking behavior.
Examples of Rights on Human Sexuality
 Right to equality, equal protection of the law and freedom from all forms of discrimination based on sex, sexuality or gender
 Right to participation for all persons, regardless of sex, sexuality or gender
 Right to life, liberty, security of the person and bodily integrity
 Right to privacy
 Right to personal autonomy and recognition before the law
 Right to freedom of thought, opinion and expression; right to association
 Right to health and to the benefits of scientific progress
 Right to education and information
 Right to choose whether or not to marry and to find and plan a family, and to decide whether or not, how and when, to have
children
 Right to accountability and redress informational handouts on reproductive and sexuality education, youth-friendly services,
gender issues and sexual rights;
 Sexual rights translated by youth volunteers into simple, youth-friendly language
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 The right to be yourself: be free to make your own decisions, to express yourself, to enjoy sex, to be safe, to choose to
marry (or not to marry) and to plan a family
 The right to know: about sex, contraceptives, HIV and other STIs.
 The right to protect yourself and be protected: from unplanned pregnancies, HIV and other STIs, sexual abuse
 The right to have health care that is: confidential, affordable, good-quality, given with due respect
 The right to be involved: in planning programs, at all levels
 The right to be free of stigma and discrimination: based on gender, class, ethnicity, religion, economic status, age,
(dis)ability or sexual orientation.
Gender Roles
These are the responsibilities learned from the time of birth and reinforced by the society. Since gender is a social construct, the
different roles played by men and women may vary by sex, age, culture, class and regions. E.g.
Women – Child rearing, cook for the family, household chores, weeding, fetching water and firewood.
Men - Provision of family shelter, security, school fees, food for the family, herding cattle among others.
Figure 10
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Fig. 6.1: Different gender roles are community specific.
Men and women play different roles from one community to another although there are common roles across the communities. These
roles inevitably impact on the lives of men and women sometimes in relation to HIV. For example the way femininity and masculinity
is viewed in many African societies.
Femininity
It is a common role associated with;
 Submissiveness
 Passivity in sexual relations.
 Ignorance about sex, in effect restraining women from seeking and receiving information related to HIV prevention.
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In many communities, these expectations limit women’s ability to negotiate for safe sex which increases their vulnerability to HIV.
On the other hand these roles may be used to hold the family together and hence minimizes their vulnerability to HIV.
Masculinity
Is a social norm that assumes that men are knowledgeable and experienced when it comes to sexual issues? This can have the negative
effect of promoting promiscuity and preventing men from seeking sexual health information or admitting their lack of knowledge
about HIV risk reduction.
Such norms cause myths about HIV and AIDS to persist (such as the myth that one can be “cured” by having sex with a virgin or old
woman). Masculinity norms can also pressure men to have multiple sexual partners, which contradicts HIV prevention messages
about fidelity, delaying onset of sexual activity in young people, or reducing the number of sexual partners. These in turn reinforces
risky behavior which may expose the family to HIV and other STIs.
Gender roles may change from society to society and over a period of time.
You may have considered the following:
In most African societies women used to stay at home to take care of the family, but today women work and contribute towards family
support.
In the past women pursued careers such teaching and nursing, while today we find women doctors, engineers, pilots which were a
preserve for men. Gender roles may change as the society evolves.
Gender Vulnerability to HIV and AIDS
The 2015 data on the Kenyan situation and other researches from sub Saharan reveal that women are more vulnerable to HIV and
AIDS than men. Vulnerability of women and girls to HIV infections can be as a result of the following:
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Retrogressive Cultural practices such as wife inheritance, Female Genital Mutilation (FGM), forced marriages among others.
Economic factors (poverty).
Gender based violence
Biological factors
Migrant husbands
Sexual and gender based violence (SGBV)
Meaning of SGBV
Sexual and gender-based violence” is a human rights violation. It is a form of violence that is directed at an individual based on his or
her biological sex, gender identity, or his or her perceived adherence to socially defined norms of masculinity and femininity. This
may take the following forms, sodomy. Sodomy involves performing anal sex upon a person against his or her will.
Figure 11 Sexual and gender based

physical violence must be discouraged
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Men beating women is common Women beating men is on the increase
Women and girls are more prone to SGBV than men because of their femininity and societal roles. The violence against them may be
in form of rape and forced sex, physical assault, emotional abuse, humiliation or intimidation, threats, coercion, arbitrary deprivation
of liberty and economic restrictions.
A number of biological, social, cultural and economic factors contribute to women's vulnerability to HIV.
Biological factors: the female genital tract has a greater exposed surface area than the male genital tract; therefore, women may be
prone to greater risk of infection with every exposure. Younger women are even more vulnerable to HIV infection due to immaturity
of the opening of the womb.
Economic disempowerment: pressure to provide income for themselves or their families can lead some women to engage in
"transactional" sex with men who give them money, school fees or gifts in exchange for sex. In some regions this is particularly true
for younger women who engage in sex with older men. Women who are economically dependent may not be able to insist on condom
use.
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Child marriage: this predisposes adolescent girls to HIV infections and other STI’s
Linkages between HIV AND GBV
GBV and the Risk of Acquiring HIV
Physical and sexual violence have been associated with HIV transmission
Economic violence may increase the risk of acquiring HIV by deepening gender inequalities and increasing vulnerability
Violence against women is associated with an increased risk of acquiring sexually transmitted infections, a risk factor of HIV
Fear of violence prevents women from negotiating or practicing safe sex
Violent sexual assault can cause trauma and injury to the vaginal wall that leads to increased risk of HIV infection.
Experiencing physical or sexual violence may be associated with engaging in “risky sexual behaviour,” such as unprotected sex and
transactional sex.
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Consequences of SGBV
Sexual and Gender Based Violence and HIV (SGBV)
In the previous sub topic you learnt about how the roles assigned to each gender by different societies may contribute to the spread of
HIV. Evidence has shown that GBV contributes to new HIV infections and poor access to HIV treatment and support services for
vulnerable populations mainly women and girls. This topic will help you understand how sexual and gender based violence contribute
to the transmission of HIV.
SGBV can impact seriously on the health of individuals, it is therefore important to find ways of avoiding risky situations that may
lead to SGBV.
Ways of avoiding risky situations that may lead to SGBV.
Suggest some ways of avoiding risky situations that may lead to SGBV?
You may have considered the following:
Delay onset of sexual activity among young people - mature persons is more likely to negotiate for safer sex
Limit the number of sexual partners. Multiple sexual partners may lead to violence due to competition.
Avoid walking in dark alleys alone- this may expose one to attack by sexual offenders
Relate carefully with strangers-avoid being intimate with casual acquaintances.
Dress modestly to avoid provocation.
Responsible use of social media (avoid pornography)
Suggested ways of curbing SGBV
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Sexual and gender-based violence cuts across ethnicity, race, class, religion, education level, and international borders. An estimated
one in three women worldwide has been beaten, coerced into sex, or otherwise abused in her lifetime. Although statistics on the
prevalence of violence vary, the scale is tremendous, the scope is vast, and the consequences for individuals, families, communities,
and countries are devastating.
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SGBV may be mitigated by:
Increased gender based screening and identification to provide counselling and referral of affected persons to relevant service
providers.
Documentation, recording, referral and reporting of cases
Provision of services ranging from medical treatment and psychological counselling to legal representation and vocational training,
Caregivers and teachers should create time to discuss issues of SGBV with learners
Integration of guidance and counselling services, life skills sessions, sexual reproductive Health education in learning institutions
Train on GBV defence skills
Community service learning
Parental engagement
Child Sexual Abuse and the Risk of Acquiring HIV
Child sexual abuse is an important facet of GBV with implications for HIV risk and vulnerability.
Individuals who have been sexually assaulted in childhood may later exhibit a pattern of sexual risk-taking and are more likely to
experience sexual or domestic violence
Individuals who experience coerced sex in their childhood may have an increased risk of acquiring HIV or other STIs later in life.
Boys who witness or experience family violence are more likely to be perpetrators of sexual violence.
Human Sexuality and Family Life
A family is made up of a man and woman joined together in marriage. How marriage is solemnized is of no importance provided it is
recognized by the law of the land. While in Kenya the law prohibits same sex marriages in some countries, especially the western
world, same sex marriages are recognized by law.
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It is important to note that children may come as a result of marriage. Whether children are born into a family or not does not change
the definition of a family. No two families are the same. Each family is unique in its own way. What one family upholds as family
values may differ from another family’s.
Sexual Orientations
While most people are heterosexual (have sex with members of the opposite biological gender), some are homosexual (have sex with
members of the same biological gender).
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Sexual Practices
Sexual practices include vaginal sex, anal sex, oral sex, use of sex toys and masturbation. Some sexual orientations and practices are
more likely to increase the risk of contracting HIV than others.
Human sexuality in the context of HIV and AIDS
We have already discussed in earlier units that HIV is mainly contracted through unprotected sexual intercourse. It is therefore true
that one’s sexual orientation or sexuality has some influence on contracting HIV. Some sexual orientations and practices are riskier
than others.

1. Share with a friend how discussions on sex are carried out in your community. Share your own experiences about how you
were socialized to sex.
2. Consider the two arguments about nature and nurture. Discuss with a friend how the two work together to influence one’s
sexual behavior.
3. With a friend discuss which orientations and practices are more likely to increase the risk of contracting HIV.
4. Some sexual orientations and practices are riskier than others.’ To what extent do you agree or disagree with this statement.
5. In groups or with a friend, discuss the linkages between HIV and SGBV
6. Can you identify other risks associated with SBGV apart from HIV infection?
1. What is human sexuality?
2. What is the difference between sex and gender?
3. What are some gender stereotypes in your community?
4. What are sexual rights that pertain to young people?
5. How can family values help mold children’s future behavior and sex orientation?
6. Which of the following is not a method of mitigating SGBV
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a. Increased gender based screening and identification to provide counselling and referral of affected persons to relevant
service providers.
b. Documentation, recording, referral and reporting of cases
c. Increasing permissive Intimate Partner Violence.
d. Caregivers and teachers should create time to discuss issues of SGBV with learners

 Stationery
 Computer
 Model
1.2.8.7 References
http://www.ippf.org/our-work/what-we-do/Gender-equality
http://www.ippf.org/resource/Sexual-Rights-IPPF-de
Responses
1. What is human sexuality?
 The biological and physical aspects of human reproductive functions, including the human sexual response cycle.
2. What is the difference between sex and gender?
 Gender refers to the two sexes (male or female) Sex while refers to the physiological attributes that identify persons as
male or female. It is biological and is manifested in the physical differences between male and female.
3. What are some gender stereotypes in your community?

Women –Child rearing, cook for the family, household chores, weeding, fetching water and firewood.
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Men - Provision of family shelter, security, school fees, food for the family, herding cattle among others.
4. What are sexual rights that pertain to young people?

 Sexual rights translated by youth volunteers into simple, youth-friendly language
 The right to be yourself: be free to make your own decisions, to express yourself, to enjoy sex, to be safe, to choose to
marry (or not to marry) and to plan a family
 The right to know: about sex, contraceptives, HIV and other STIs.
 The right to protect yourself and be protected: from unplanned pregnancies, HIV and other STIs, sexual abuse
 The right to have health care that is: confidential, affordable, good-quality, given with due respect
 The right to be involved: in planning programs, at all levels
 The right to be free of stigma and discrimination: based on gender, class, ethnicity, religion, economic status, age,
(dis)ability or sexual orientation.
5. How can family values help mould children’s future behaviour and sex orientation?
 Sex education
 Teaching on morals and values
 Religious education
 Role model
6. Which of the following is not a method of mitigating SGBV
e. Increased gender based screening and identification to provide counselling and referral of affected persons to relevant
service providers.
f. Documentation, recording, referral and reporting of cases
g. Increasing permissive Intimate Partner Violence.
h. Caregivers and teachers should create time to discuss issues of SGBV with learners
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1.2.4 Exhibit Ability to Care and Support PLHIV
The learning outcome covers care and support of people living with HIV and all aspects of support including psychosocial,
nutritional management and services. It will also include treatment, treatment adherence, resistance to ARVs and the effect of
alcohol and drug use on adherence to treatment.

 Knowledge on psycho-social support is applied based on MOH NASCOP guidelines.
 Psycho-social support is offered based on MOH NASCOP guidelines.
 Wellness is practiced based on MOH guidelines.
 Enabling environment for HIV status disclosure is created based on credible sources, NACC and NASCOP guidelines.
Psychosocial Support
A general term for any non-therapeutic intervention that helps a person cope with stressors at home or at work.
Disclosure
Disclosure is a process of revealing one’s positive HIV status to another.
Wellness
Act of practicing healthy habits on a daily basis to attain better physical and mental health including Spiritual, Physical,
Emotional, Mental, Occupational, Environmental, Social, Financial and Intellectual.
Facts about Treatment of HIV and AIDS
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All persons who test positive for HIV are started on treatment as soon as possible. The standard treatment consists of a combination of
at least three drugs. The ARVs suppress HIV multiplication and reduce the likelihood of the virus developing resistance so that those
who are positive can live longer healthier lives and reduce the risk of transmission to others. ARVs are provided free at government
and faith based health facilities.
ARVs help reduce the viral load which is the term used to describe the amount of HIV virus in the body fluids and increase the CD4+
count.CD4+ cells are the type of white blood cells that play a role in protecting the body from infections. ARVs are not a cure for HIV
but they lead to people living a longer healthier and productive life.
Like any other medication, ARVs have side effects. Some of these include the following:
 Nausea and vomiting

 Dizziness
 Fatigue
 Headaches
 Rashes
However it is important to note that the benefits of ARVs outweigh the side effects.
Adherence to Treatment
Treatment adherence means taking ARVs when and how one is supposed to as prescribed by the doctor. Treatment adherence is
extremely important because it affects how well HIV medication decreases viral load. For the HIV treatment to be considered
successful, the viral load falls to a level of being undetectable.
Adherence also helps to prevent drug resistance. When one skips doses, one may develop strains of HIV that are resistant to the
medication one is currently taking and possibly even to medication one hasn’t taken yet, leaving fewer treatment options.
Promoting Treatment Adherence
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Before you begin a HIV treatment regime, there are several steps you can take to help you with adherence:
 Talk to a healthcare provider about treatment plan and develop one that works
 Be sure to understand why adherence is so important. When one knows the possible consequences of not adhering to the
treatment plan, this may motivate them to stick to it.
 Get a written copy of treatment plan that lists each medication and describes how and when to take them.
 Learn all the possible side effects of the medication so as to know what to expect and how to manage any problems.
 Adherence can be harder when dealing with life challenges, like substance abuse/alcoholism, unpredictable accommodation,
mental illness, relationship issues, or other issues. Talk to a doctor about any challenges one may be facing that could affect
ability to take ARVs.
Forms of non-adherence
The following are forms of non-adherence that will require support within the school or referral to the health facility.
 Missing any dose of any prescribed drug (one dose of a given drug, a dose of all the three drugs, multiple doses or a whole
week of treatment)
 Not keeping their clinic appointments
 Self-adjustment of the dosage due to side effects and personal beliefs
 Going on drug holiday due to fatigue or stigma
 Sharing of medication with others
 Not observing the time intervals
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 Not observing the dietary instructions
 Not avoiding risky behavior- unsafe sex, substance abuse, multiple partners
 Not attending support groups
 Stopping of HIV medication with a claim of spiritual healing.
 Concurrent use of herbal medicine and ARVs
How to promote adherence in learning institutions:
 Reminding people on treatment to honour their clinical appointments

 Granting permission to go for clinical appointments
 Creation of conducive environment for taking ARVs (training of matrons and nurses on the importance of adherence and
proper storage of drugs, disclosure and confidentiality, sensitizing parents and guardians on importance of disclosure,
confidentiality and adherence)
 Continuous adherence counselling through health clubs and guidance and counselling departments
 Reminding persons on treatment to adhere correct timing, storage and dosage of their medication as prescribed by the clinician
 Adoption of medication aids like pill boxes, pill diaries, watch alarms and treatment buddies.
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Figure 12
Figure 4.2: Pill Box
Importance of adherence to HIV treatment
Adherence to HIV treatment is very important because non adherence would lead to drug resistance. Drug resistance means that the
virus changes its nature such that the drug cannot help reduce the level of the virus in the blood.
Skipping HIV medicine allows HIV to multiply which increases the risk that the virus will mutate (change) and produce drug resistant
HIV. This ultimately leads to treatment failure and makes one more susceptible to opportunistic infections. Treatment failure is
evidenced by increased viral load and decreased CD4 cells while on treatment.
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Figure 13 Alcohol is legally the most abused substance in Kenya
Drug and substance abuse and adherence
Drug and substance abuse can indirectly or directly increase the risk of contracting HIV. In Kenya, HIV prevalence among people
who inject drugs stands at 18.3% while the national average is 4.9%.
Drug and substance use affects the immune system in the following ways:
 May cause dis-inhibition and hence reinforce sexual risk taking. This may further lead to re-infection with different HIV
strains and other STIs.
 May also lead to failure to adhere to medication. This triggers suppression of the immune system and thus increasing the risk
of progression to AIDS.
 Interfere with the liver function and ARVs metabolism (breakdown and elimination). This may interfere with absorption in the
body
Certain ARVs can boost the level of recreational drugs in the body in unexpected and dangerous ways.
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Sharing a needle or any equipment when injecting drugs is dangerous for an individual and for the people the needle is shared with.
This behavior increases the risk of not only HIV infection but also Hepatitis B and C infections.
Figure 14
Fig.4.5: Sharing injection needles and syringes may lead to infection with HIV
It is important for all people on ART to tell their healthcare providers of any alcohol or drug use so as to be referred for appropriate
services including substance abuse treatment plans.
Importance of a balanced diet and physical exercise
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You may have heard of a common statement that “you are what you eat”. Nutritionists agree with this. The essence of this statement is
that our health is influenced by what we eat. The emphasis here is on balanced diet both quality and quantity. This means eating a
wide variety of foods in the right amount to achieve and maintain a healthy body.
Psychosocial support
Psychosocial support addresses the ongoing psychological and social problems of the individual infected or affected with HIV as this
in itself affects all the dimensions of a person’s life: physical, psychological, social and spiritual.
Examples of Psychosocial support include:
Counselling and social support can help people and their careers cope more effectively with each stage of the infection and enhance
quality of life. With adequate support, PLHIV are more likely to be able to respond adequately to the stress of being infected and are
less likely to develop serious mental health problems. Assessment and interventions may be aimed at the acutely stressful phase
following notification of HIV infection, the ensuing adjustment period, and the process of dealing with chronic symptomatic HIV
infection and disease progression through to death.
HIV infection often can result in stigma and fear for those living with the infection, as well as for those caring for them, and may
affect the entire family. Infection often results in loss of socio-economic status, employment, income, housing, health care and
mobility. For both individuals and their partners and families, psychosocial support can assist people in making informed decisions,
coping better with illness and dealing more effectively with discrimination. It improves the quality of their lives, and prevents further
transmission of HIV infection.
For people with HIV and AIDS who must adhere to TB treatment, long-term prophylaxis or antiretroviral therapy, on-going
counselling can be critical in enhancing adherence to treatment regimen (plan).
Indicators of someone in need of psychosocial support
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 Anger: This is natural response to threats which can be caused by internal and external reasons.
 Grief: These are strong emotions and feelings that accompany the loss of someone or something.
 Depression: This is a prolonged feeling of hopelessness and inadequacy.
 Anxiety: Feeling of nervousness, fear or worry that interferes with the ability to sleep or perform other function.
 Stress: Is a state of extreme difficulty strain or pressure.
Psychological, Emotional and Behavioral Signs to watch out for
Psychological, Emotional and Behavioural Signs to watch out for
Age 1 – 6 years Age 6 – 12 years Above 12 years
 Irritable  Fatigue.  Feeling of worthlessness and

hopelessness.
 Cries a lot  Lack of concentration in
class  Unexpressed anger
 Poor appetite
 Suicidal thought  Self-hatred
 Sadness
 Running away from school  Hatred towards parents
 Withdrawal
 Bad conduct  Withdrawal
 Fighting or bullying
others  Indulge in drugs and  Engagement in risky sexual
substance abuse behaviours
 Sleep disorder
 Complain of body pains  Drug and substance abuse
 Restlessness
 Poor school performance  Poor school performance
 Refusing to take drugs
 Withdrawn  Disinterested in school
activities
 Rebellion
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 Identity crisis  Pre-occupied mind
 Regression e.g. bed wetting,  Self-harm (Suicidal thoughts)
suckling
 Poor adherence
Key note
 Children and adolescents experiencing the above challenges find them overwhelming.
 Most of the times they don’t have the emotional capacity to handle the challenges.
 It is important to support the learners to cope with these challenges.
 The symptoms referred to in the table are however not limited to the specific age groups
 Note that learners living with HIV have the same needs like any other children.
How to provide psychosocial support in a learning institution:
 Providing guidance and counselling services

 Organizing schedules and programmes for learners living with HIV, their family members and care givers
 Organizing sensitization forums on psychosocial support for learning institutions and communities including PAs and BOMs
 Building the capacity of the institutional counsellors to support the learners, manage stress and make appropriate referrals to
relevant support systems
People living with HIV can benefit from a balanced diet which helps them to:
 Improve the overall quality of life by providing nutrients the body needs.
 Keep the immune system strong.
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 Feel strong physically, socially and psychologically
 Stay productive and able to do physical activities
 Prevent wasting, manage common symptoms of illness and drugs side effects
 Improve drugs adherence and effectiveness
 Manage HIV symptoms and complications.
 Process medications and help manage their side effects.
Case Study
Juma is a ten year old boy in standard five in Kalamutamu Primary School. He is HIV positive and currently on ARVs. He reported to
the Head Teacher that he had not eaten lunch, had a headache and was feeling dizzy. Juma has lost weight, has wounds that had taken
long to heal and has no one to feed him.
Suggest sustainable interventions to help Juma and other children like him.
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Figure 15 Benefits of physical exercise
Fig. 4.7: Play improves your

physical fitness
Physical fitness boosts the immune

system. Other benefits of physical
fitness are:
 Reduced risks of being

overweight and obese
 Reduced risk of
diabetes, high blood
pressure, heart disease,
asthma, sleep
disorders and other illnesses
 Muscle and bone development
 Higher concentration level as well as directed, behaviour which contributes to improved academic performance.
 Group activities and sports enhance cooperation and form a positive sense of identity as part of a team. This leads to
reduced stigmatization and enhancement of social interaction. Research has shown that improved physical health,
academics and social interaction all contribute to good mental health.
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Disclosure and confidentiality
In a learning institution setting, disclosure may entail a learner revealing status to the teacher or a teacher revealing to a supervisor.
Parents are encouraged to disclose the HIV status of their children to the teacher. However, the teacher to whom disclosure has been
made must observe confidentiality as required by the HIV and AIDS Prevention and Control Act 2006 and Education Sector Policy on
HIV and AIDS and other relevant legislations and policies.
There are three levels of disclosure:
 Non-disclosure - a person does not reveal his or her HIV status to anyone
 Partial disclosure – a person only tells certain people about his or her HIV status
 Full disclosure – a person talks openly in public about his or her HIV status
People living with HIV have the right to decide whether or not to disclose their HIV status. Their decision to disclose and the level of
disclosure they choose must be respected. An Enabling environment for HIV status disclosure should include Trust, Acceptance,
Confidentiality, Care, Support and Empathy
Benefits of disclosure
The benefits of disclosure are many. They include:
 Availability of support systems at home and within the community

 Being granted permission to attend scheduled clinic appointments. This will promote adherence to ART, improved quality of life
and increased productivity
 Being granted permission to bring ARVs to school, ensuring proper storage and adherence
 Appropriate referrals to other relevant services e.g. counselling, nutritional, psychosocial support and medical attention
 Appropriate placement for teachers and learners in line with their care and treatment requirements
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Barriers to disclosure
The biggest barrier to disclosure is stigma and discrimination. Generally, stigma is a process of devaluation that significantly
discredits an individual in the eyes of others (ACORD, 2015). HIV-related stigma, refers to the negative beliefs, feelings and attitudes
towards people living with HIV, groups associated with people living with HIV (e.g. the families of people living with HIV) and other
key populations at higher risk of HIV infection, e.g. sex workers (UNAIDS, 2014)
Figure 16 HIV-related discrimination refers to the

unfair and unjust treatment (act or
omission) of an individual based on his or
her real or perceived HIV status (UNAIDS,
2014). Discrimination can be as a result of
stigma.
Fig. 4.8: The person you disclose your

HIV status to should be one who can
observe confidentiality

1. A lot of issues have been raised on the effect of alcohol and drugs on adherence and treatment. Discuss the relationship
between these and explain why it may be difficult for one addicted to drugs to maintain adherence.
2. Stigma assessment in the community
3. You are provided with a variety of food models. Select different examples of meals that comprise a balanced diet.
4. Carry out a physical exercise activity
1. How do ARVs work in the body?
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2. What is adherence to ART?
3. What are some causes of non-adherence?
4. How can alcohol and drug use affect adherence to ARVs?
5. What is not an indicator of someone who may be in need of psychosocial support
a. Anger
b. Grief
c. Depression
d. Joy

 Stationery
 Computer
 Model
1.2.4.7 References
 Republic of Kenya (2007-2010) Kenya Nutrition and HIV and AIDS Strategy
 Republic of Kenya (National AIDS Control Council
 UNAIDS 2016
 MOE, 2013 Education Sector Policy on HIV and AIDS
 NASCOP, Supporting Learners Living with HIV in Kenya
Responses
1. How do ARVs work in the body?
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 ARVs help reduce the viral load which is the term used to describe the amount of HIV virus in the body fluids and
increase the CD4+ count.CD4+ cells are the type of white blood cells that play a role in protecting the body from
infections. ARVs are not a cure for HIV but they lead to people living a longer healthier and productive life.
2. What is adherence to ART?
 Treatment adherence means taking ARVs when and how one is supposed to as prescribed by the doctor. Treatment
adherence is extremely important because it affects how well HIV medication decreases viral load. For the HIV
treatment to be considered successful, the viral load falls to a level of being undetectable.
3. What are some causes of non-adherence?

 Inaccessibility of ARV
 Lack of social support
 ARV side effects
 Lack of food
 Stigma and discrimination
 Alcohol and drug abuse
 Lack of appropriate HIV information on treatment
4. How can alcohol and drug use affect adherence to ARVs?
a. May cause dis-inhibition and hence reinforce sexual risk taking. This may further lead to re-infection with different
HIV strains and other STIs.
b. May also lead to failure to adhere to medication. This triggers suppression of the immune system and thus
increasing the risk of progression to AIDS.
c. Interfere with the liver function and ARVs metabolism (breakdown and elimination). This may interfere with
absorption in the body
5. What is not an indicator of someone who may be in need of psychosocial support
A. Anger
B. Grief
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C. Depression
D. Joy
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1.2.5 Manage HIV related stigma and discrimination
The learning outcome covers stigma, discrimination and human rights. Stigma and discrimination are some of the key barriers
to effective response to HIV and AIDS. The HAPCA 2006 legal framework under the HIV and AIDS Tribunal addresses HIV
related stigma and discrimination.

 Stigma and discrimination are identified based on Kenya HIV stigma index
 Causes of stigma and discrimination are identified based on Kenya HIV stigma index
 Effects of stigma and discrimination are identified based on legal framework.
 Ways of managing stigma and discrimination are established based on legal framework.
 Human rights for PLHIV are advocated based on legal framework and policies.
HIV-Related Stigma
Refers to the negative beliefs, feelings and attitudes towards people living with HIV and AIDS, groups associated with people living
with HIV (e.g. the families of people living with HIV) and other key populations at higher risk of HIV infection, (e.g. sex workers)
(UNAIDS, 2014)
HIV-Related Discrimination
Refers to the unfair and unjust treatment (act or omission) of an individual based on his or her real or perceived HIV status (UNAIDS,
2014). Discrimination can be as a result of stigma.
Everyone has a right to be treated equally regardless of his/her personal identity. A person cannot take a legal action against stigma
but can take a legal action against discrimination because stigma is a feeling whereas discrimination is an act.
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Types of Stigma and Discrimination
Self-stigma
Self-stigma is referred to as internal stigma and can be perceived. In a perceived self-stigma, a person believes that he or she will be
devalued or judged negatively if other people knew ones HIV status. Perceived stigma stems from denial, feeling of shame and low
self-esteem by a person who is HIV positive.
External stigma and discrimination
Many times there are actual events of stigma and discrimination experienced by people due to their real or perceived HIV status. The
stigma and discrimination emanate externally from the members of the society. Look at what is happening in the picture
below and describe the nature of discrimination that you can notice.
Picture 5.3: A HIV infected student is segregated in class. Stigmatization often leads to discrimination
Figure 25
The propagation of external stigma and

discrimination can be from members of the
household, healthcare workers, staff mates,
friends, teachers, classmates, relatives or those
in charge of a group of employees.
Case Study
Mariko (not his real name) was frequently attacked by prolonged coughs and suspected that he could be having TB. He then decided
to go to a hospital to be tested for TB. At the hospital he was convinced to be tested for HIV also. The test revealed that he had TB and
was also HIV positive. When the members of the church learnt that he was HIV positive, many of them demanded that he be told to
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quit the church, saying that he would bring shame to the church. Mariko tried to put up with these demands for some time but
eventually decamped to another church, where he was warmly accepted. During this time his wife separated from him taking their two
children with her. His health worsened and would frequently ask for help from a close friend, Tayari (not his real name), in the second
church. Tayari was always ready to help and welcomed Mariko to stay with his family when Mariko was too sick and weak to fend for
him. Tayari’s wife did not take the welcome of Mariko kindly and declined to serve him any food. Mariko would eat from the nearby
hotels for the time he was staying with Tayari’s family.
a) What type(s) of stigma and discrimination can you identify in the case of Mariko?
b) Who is propagating the discrimination identified in (a)?
c) What can be done to reduce stigma and discrimination exhibited?
Causes of Stigma and Discrimination

The causes of stigma and discrimination can be put into the following three categories.
a) Lack of knowledge and awareness
b) Societal beliefs and practices
c) Structural causes
Lack of knowledge and awareness
A person who has self-stigma may be lacking knowledge on the basic facts on the progression of HIV infection. For example, the
person may believe that HIV infection is a death sentence. However, the fact is that with ARVs, balanced diet and a positive attitude, a
person can live their entire lifespan with HIV infection not progressing to AIDS.
People who propagate stigma often lack knowledge on HIV prevention. Such people may think that HIV can be transmitted by sharing
utensils, staying close to the infected person, or even through handshakes.
Societal beliefs and practices
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Societal beliefs and practices have contributed significantly to stigmatization of people living with HIV and AIDS. Many of these
practices arise out of certain myths and misconceptions.
For example, in some communities, HIV infection is viewed as punishment for violating certain cultural practices. Certain beliefs and
practices in the religious communities also contribute to stigma and discrimination in the society.
The International Network of Religious Leaders Living with or personally affected by HIV and AIDS in Kenya (INERELA+ Kenya,
2009), observes that religious communities need to approach their teachings and the interpretations of scriptures in such a way that
these do not promote stigma and discrimination.
Structural causes
Social and legal structures (practices, policies and laws) have an impact on stigma and discrimination. The government has the
responsibility of putting in place the policies and laws that address stigma and discrimination. Inadequate implementation of the
government policies and legal framework which may led to practices that condone stigma and discrimination.
Education
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Some people propagate stigma and discrimination due to ignorance of the basic facts about HIV and AIDS. Education therefore equips
people with such knowledge.
Proactive laws and policies
Policies and laws are key in directing peoples’ attitudes and actions. For example, in Kenya, the Ministry of Education has a policy on
HIV and AIDS, in which stigma and discrimination is addressed, this should be mainstreamed in the learning institutions. Other
MDAS are required to mainstream or implement their HIV programmes at the work places and also targeting their stakeholders as
articulated in their performance contracts.
The effects of stigma and discrimination

Individual level
The effect of stigma at individual level arises from both self-stigma and external stigma. These include;
 Reduced access to care and treatment. The person fears being seen going for healthcare arising out of self-stigma.
 Reduced adherence to ART. The person may avoid taking the ARVs in situations where he or she will be noticed by others
 Loss of hope and feelings of worthlessness. This may reduce the ability to realize his or her full potential thus hampering personal
social and economic progress.
 Depression and anxiety- the feelings of anxiety and deep sadness reduce the ability of the person to engage in employment and
personal commitments, thus reducing the productivity.
The effects of external stigma include:
 Loss of opportunities, for example, in employment or promotion.
 Inadequate care and support. Those who should provide care and support may not do it adequately because of the low regard
they have for the person infected or perceived to be.
 Perception of loss of relationships and social standing
Family level
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 Withdrawal of caregiving in the home for fear of being infected or because the person is viewed as not useful to the family
 Loss of reputation arising from self-stigma of the family members or external stigma directed at the members of the family.
 Reduces income, for example when one or more of its members loses employment opportunities due to external stigma.
Society Level
The following effects of stigma and discrimination generally contribute to the spread of HIV infections and its negative impacts.
 Hampering of prevention efforts. For example, the use of a condom is seen as promiscuity.
 Unwillingness to take a HIV test. This results into more people being diagnosed late, when the virus may have already progressed
to AIDS thus making treatment less effective and therefore increasing the likelihood of transmitting HIV to others
 Reduced rate of disclosures.
Human Rights and HIV and AIDS
In Kenya there are laws that address stigma and discrimination under the larger concept of human rights. They include the following:
The Constitution of Kenya
Human rights may be defined as norms that help to protect all people from severe political, legal, and social abuses. An example of
human rights is the right to confidentiality.
Chapter Four of the Constitution of Kenya is about the Bill of Rights in which human rights are stipulated. On equality and freedom
from discrimination, article 27(4) of the Constitution states that “the state shall not discriminate directly or indirectly against any
person on any ground, including race, sex, pregnancy, marital status, health status, ethnic or social origin, colour, age, disability,
religion, conscience, belief, culture, dress, language or birth”. In article 27(5) it is states that “a person shall not discriminate directly
or indirectly against another person on any of the grounds specified or contemplated in 27(4) above”.
Legal aspects of HIV and AIDS
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HIV stigma and discrimination scare away persons living with HIV from filing cases involving violation of their rights in the ordinary
courts. Besides, most persons living with HIV are already heavily weighed down by disease burden which reduces their earning
capacity, thereby making it difficult or impossible for them to commit substantial resources in litigation. HIV and AIDS Tribunal
therefore provide them with a friendly forum where they can expect to get justice without having to spend a lot of money.
HIV and AIDS Tribunal offer their services free of charge. The complainant needs only to write a complaint letter. The Tribunal
offers pro-bono (free) lawyer services to those who require legal service support.
Some discriminatory Acts that require legal redress
Discrimination on account of one’s status is a violation of human rights and hence outlawed.
Case Study
Prof. Masaa (not his real name) is the Head of Faculty of Arts and Social Science and is the supervisor to Prof. Maggie Matime (not
her real name) were lecturers in the same university in the same faculty for the last 12 years. In 2010, Prof. Maggie Matime tested
HIV positive and on informing him of her status, he was at first supportive but later on changed and allegedly started discriminating
against her based on her HIV status by refusing to assign her duties and to recommend her for promotion.
In the scenario above was there violation of any human rights? Suggest ways in which this can be prevented.
Discriminatory acts are commonly found in different areas. Think of several ways and places where discriminatory acts are
commonly found? Did you consider the following?
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Discrimination is dehumanizing
1. Discrimination in the workplace

2. Discrimination in learning institutions
3. Restriction on in-country entry and exit and; abode and lodging
4. Isolation and quarantine
5. Denial of employment and related inhibitions
6. Exclusions from accessing credit facilities and mortgages
7. Coerced HIV testing
8. Coerced post-test disclosure
9. Denial of accident, medical and life insurance covers.
We can also get more examples of the discriminatory acts from HIV and AIDS Prevention and Control Act (HAPCA) 2006.
Chapter 4 of the Constitution on the Bill of Rights

Part 2 of the Rights and Fundamental Freedoms outlines the following:-
1. Every person is equal before the law and has the right to equal protection and equal benefit of the law.
2. Equality includes the full and equal enjoyment of all rights and fundamental freedoms.
3. Women and men have the right to equal treatment, including the right to equal opportunities in political, economic, cultural
and social spheres.
4. The State shall not discriminate directly or indirectly against any person on any ground, including race, sex, pregnancy, marital
status, health status, ethnic or social origin, colour, age, disability, religion, conscience, belief, culture, dress, language or birth.
5. A person shall not discriminate directly or indirectly against another person on any of the grounds specified or contemplated in
clause.
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Confidentiality
The bill of Rights in the Rights and Fundamental Freedoms (31) (c) and (d) states that every person has the right to privacy, which
includes the right not to have information relating to their family or private affairs unnecessarily revealed or the privacy of their
communication infringed.
Privacy guidelines
No person shall record, collect, transmit or store records, information or forms in respect of HIV tests or related medical assessments
of another person otherwise than in accordance with the privacy guidelines prescribed by the Minister responsible for matters relating
to health.
Case Study 1
Mrs. Soo was a teacher of Masomo College for duration of 10 years when her employment was terminated. According to the
complainant after 5 years of her employment, she was requested by the College Principal to submit her medical records for filing in
her employment file. The employment file and medical records were to be accessed by other employees of the college. The
complainant’s medical record contained her HIV Status which was HIV positive. According to the complainant, information regarding
her HIV Status was shared by the Human Resource Management Department to the Head of Department who was her immediate
supervisor. That action led to a series of discriminatory and derogatory actions directed at the complainant by her colleagues in the
college. The discriminatory, derogatory and humiliating conduct worsened after her husband died. Later, Mrs. Soo was terminated as
an employee of the Masomo College but she was neither furnished with a termination letter nor awarded her terminal benefits.
In the above scenario Mrs. Soo’s rights were violated because no person should disclose any information concerning the result of a
HIV test or any related assessments to any other person except with the written consent of that person.
Case Study 2
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It is a Sunday morning in Kiwaraza Boarding School. The school matron is busy checking the girls’ boxes. This is a routine check
that takes place every two weeks after opening school. She has started inspecting Joan’s box.
Matron: (shouting) who is the owner of this box?
Joan: It’s mine.
Matron: (upon seeing some tablets in Joan’s box) what are these?
Joan, come here quickly!
Joan: (Embarrassed) These… These are… They are my… (She starts to cry)
Matron: Stop crying and tell me what these things are!
Joan: (Between sobs) I told you they… they are… my…dru…drugs. They
… (She is unable to explain)
Matron: (Picking the pills) I don’t understand some people! If you are HIV positive then say it! I am taking them to ask the
school administration to confirm if they are really HIV drugs.
Joan: Matron, please … don’t … Please don’t go with my drugs… please … what am I going to do? (She follows the matron
outside pleading, as she passes the other girls, (she hears them whispering in low tones)
Other girls: My goodness….. She has it, she has AIDS
Joan: (she starts to cry all over again)
Discuss the stigma, discrimination and human rights violation portrayed in the case above
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1. Think of a person who says that “I cannot go for ARVs because I do not want to be seen by others”. Identify how this qualifies
as self-stigma.
2. Recall the statement “Many of my schoolmates don’t want me to play with them, saying that I have HIV” cited earlier in this
unit.
Identify the negative impact this has on the student who is being isolated.
2. You have been invited to speak to a group of AYPLHIV on their human rights. Role play this engagement.
1. What do you understand by the following?
a. Stigma.
b. Discrimination.
2. What do you think is the relationship between stigma and discrimination?
Consider the following statement that was cited at the beginning of this unit.
“My head teacher wants me transferred to another school because of my HIV status”.
a. Do you think the practice displayed by the head teacher is based on any law or policy?
b. Which interventions manage HIV related stigma and discrimination at the workplace?
c. From the ongoing discussions suggest ways of managing stigma and discrimination?
3. In your opinion, which are the suitable platforms for educating people on the basic facts on HIV and AIDS, human rights and
existing relevant policies?
4. In your opinion, how can the implementation of HIV workplace policies are enhanced?
5. What is the effect of HIV-related stigma and discrimination at the individual level?
a. Increase access to care and treatment.
b. Increase adherence to ART.
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c. Loss of hope and feelings of worthlessness.
d. Improved nutrition and self-care

 Stationery
 Computer
 Model
1.2.8.7 References
Fatoki, B. (2016). Understanding the Causes and Effects of Stigma and Discrimination in the Lives of HIV People Living with
HIV/AIDS: Qualitative Study. Available at: https://www.omicsonline.org/open-access/
Gray, A.J. (2002). Stigma in psychiatry.Journal of the Royal Society of Medicine, 95(2), 72-76. Available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1279314/
INARELA+ Kenya. (2009). Beyond Stigma: What Faith and Religious Communities must do to end HIV and AIDS related
Stigma. Nairobi: INARELA+ Kenya.
UNAIDS.(2014). Reduction of HIV-related stigma and discrimination.Available at:
http://www.unaids.org/sites/default/files/media_asset/2014unaidsguidancenote_stigma_en.pdf
Responses
1. What do you understand by the following?
Stigma.
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 Refers to the negative beliefs, feelings and attitudes towards people living with HIV and AIDS, groups associated with people
living with HIV.
Discrimination.
 Refers to the unfair and unjust treatment (act or omission) of an individual based on his or her real or perceived HIV status.
2. What do you think is the relationship between stigma and discrimination?
Consider the following statement that was cited at the beginning of this unit.
“My head teacher wants me transferred to another school because of my HIV status”.
a. Do you think the practice displayed by the head teacher is based on any law or policy?
 No- the head teacher did not base its directives on the law or any policy rather he did based on stigma
b. Which interventions manage HIV related stigma and discrimination at the workplace?
 Organizational policies on HIV and AIDs
 Wellness program
c. From the on-going discussions suggest ways of managing stigma and discrimination?
 Creating of awareness to all subpopulations on HIV and AIDS
 Law and policy on HIV and AIDS
 Creating awareness of Human rights
 Wellness program
3. In your opinion, which are the suitable platforms for educating people on the basic facts on HIV and AIDS, human rights and
existing relevant policies?
 Religious gatherings
 Schools
 Medical campaigns
 Social media
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 Chief’s barazas
4. In your opinion, how can the implementation of HIV workplace policies are enhanced?
 Participation by all e.g. in HIV testing
 Regular HIV sensitization at the workplace
5. What are the effects of HIV-related stigma and discrimination at the individual level?
 Reduced access to care and treatment.
 Depression and anxiety-
 Loss of hope and feelings of worthlessness.
1.2.6 Integrate PCI in sexual and reproductive health
In this learning outcome the trainee will learn more about the effects of Pertinent and Cross-cutting Issues (PCIs) such as alcohol, drug
and substance use, culture, religion and media on the spread of HIV.
Trainees are faced with a myriad of challenges owing to the legal, technological, social, political and economic dynamics in the
society. It is important that these challenges are addressed for the well-being of the trainee.

 Cultural practices that increase risk of HIV infection are identified and addressed based on Government of Kenya guidelines.
 Religious practices that increase risk of HIV infection are identified and addressed based on Faith Sector Action Plan on HIV
and AIDS by NACC.
 Negative media influence is addressed based on Regulatory authorities.
 Alcohol and drug use is addressed based on UNODC and NACADA and MOH guidelines.

Reproductive Health: refers to the condition of male and female reproductive systems during all life stages
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Social Media: these are interactive computer-mediated technologies that facilitate the creation and sharing of information, ideas
career interests and other forms of expression via virtual communities and networks e.g. Instagram, Facebook, WhatsApp, Twitters,
LinkedIn, Telegram
Ethnic Culture
The way and pattern of life for an ethnic group of people, not only in the past but also as lived in the present.
An ethnic group of people living together and with shared traditions, history and aspirations. The culture of the people determines
what they want and expect from the men and women in their society.
This is a set of morals, attitudes, values, beliefs, and practices shared by a group of people, but different for each individual group,
communicated from one generation to the next.’ (Matsumoto 1996)
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Some cultural practices that fuel HIV infection are as follows:
 Wife inheritance
 Female genital mutilation
 Gender based violence
 Early marriages/forced marriages
Culture and HIV
In many African cultures there is tolerance for multiple sexual partners, including extra-marital sex by men. Being in a marriage or
monogamous relationship does not necessarily protect one from risk of HIV infection. In polygamous societies, a man can have many
sexual partners but a woman has to be faithful to one. In most African cultures, a married woman is even more vulnerable to HIV
infection because they are considered the property of the man who then can have sex with her without the use of a condom.
Intergeneration sex is common in Africa. Young girls have sex with older men (sugar daddies/sponsors) for money, gifts or status.
Culturally, young girls are found to marry men who are much older than them and more sexually experienced. These older men may
assume that the younger girls are HIV free and often do not use condoms thus exposing them to the risks of HIV infection.
We still find some communities giving in their young girls to marriage. The girls get into polygamous marriages and condom use is
usually out of question. This exposes the young girl to HIV infection because the men do not use condoms.
Some communities still practice FGM although this practice is outlawed in Kenya. FGM leads to early sexual debut and child
marriages increasing the vulnerability of these young girls to HIV, STIs, pregnancy at times associated with difficulties in childbirth
that may lead to long term complications.
Religion and HIV
A religion is a unified system of beliefs and practices relative in terms of what is sacred or secular. Sacred things are considered to be
holy. In religion the forbidden things are also spelt out. Religious beliefs and practices unite a community creating a strong bond. It
involves beliefs in and worship of a supernatural controlling power especially a personal God or gods. Poor role modeling in religious
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matters may result to occultism which is a deviation from the true faith and worship. In most cases people are led into practices such
as sex orgies as a form of appeasing the gods. Some religions may force women to marry somebody against their will, while others
advocate for polygamous marriages. All these practices may contribute to HIV infections and stigma.
Alcohol and Drug Use and HIV
Alcohol is a chemical compound produced by the fermentation of sugars using yeast or other substances. Such sugars are derived from
grains, coconut, fruit juices, cane sugar, potatoes, honey to name but a few. These interact with yeast to produce the active ingredient
called ethanol amongst other chemicals. Examples of alcohol include; beer, wine and brandy and local brews such as mnazi, busaa
and muratina.
Are there other types of alcohol that you know that have not been mentioned?
Alcohol or ethanol slows down the functions of the brain and other parts of the nervous system.
A drug is any chemical substance which when taken into the body will modify or alter the way the body functions from its normal
state or from the abnormal to normal state. Drugs can be orally administered, injected, chewed, sniffed, smoked or applied.
A drug is any substance which when introduced into the body will alter the normal functioning of the body and eventually destroy
the productive life of the abuser (social, physical, mental and spiritual life).
Drug abuse is therefore non-medical use of drugs (alcohol, cigarettes and other chemical substances) that destroy the health and
productive life of an individual. It is a patterned use of a drug in which the user consumes the substance in amounts or in ways which
are harmful to themselves or others.
Effect of alcohol, drug and substance use/abuse on the transmission of HIV
Case Study 1
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About 6 weeks ago, Dungen tested “HIV positive" at a community-based organization where free, rapid HIV testing is offered.
Following the positive test result, Dungen returned to a health facility for a confirmatory test. His blood was drawn for a second HIV
test, which confirmed that he was infected with HIV.
Dungen was initially upset by the results that he was infected with HIV. He told the counselor that there was no way he could have
been infected because he had never engaged in sex. He however told the counselor that he enjoyed social activities. He had been to
several birthday parties especially when he went to college. However, he does not drink alcohol neither does he smoke.
He remembers one day when they were in a party with college mates when he found himself in a house but did not understand how he
ended up there. In the party, they had a lot of fun. All sorts of refreshments were served but he was taking his favorite drink – coke.
At around 8 pm he was called by the D Jay to select the song to be played. Coming back he continued with his drink but it tasted a bit
different but he thought he had had too much. He does not know what happened after that because the following morning, he was in a
friends room and partially naked. When he asked he was told he fainted and had to be helped to the room.
From the definitions above, it is evident that the abuse of alcohol, drug and substance abuse may interfere with the normal functioning
of the body. The interference may have a bearing on the transmission of HIV.
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Figure 17
Fig. 6.4: Drugs are destructive to life. Choose a drug free life
Discussion Questions:
1. What could have possibly happened to Dungen that could have put him at risk of infection?
2. Is there anything he could have done differently?
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Some risky behavior that can increase the risk of getting or transmitting HIV
Figure 18: Drunkenness may lead to some irresponsible behaviour
Use of alcohol and recreational drugs such as marijuana (weed, pot), cocaine, or heroin increases the risk of getting or transmitting
HIV infection. Alcohol and drugs impairs the ability to make rational decisions.
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Drugs and alcohol are said to increase the desire for sex but they remove inhibitions and safeguards, impair judgment and expose the
user to risky sexual behavior such as unprotected sex or risk of rape.
Some of the drug abusers inject themselves to keep high. The syringes are shared without considering the HIV status of the users.
Drugs and alcohol affect the brain, making it hard to think clearly.
Drug and alcohol use depresses the immune system and hence accelerates the progression of infection of HIV to a full-blown AIDS. If
a person is using drugs or alcohol, it can be hard to focus and adhere to treatment.
Case Study 2
Kiwinja: “Githioro, you're one of the brightest friends I have ever had. But recently, you've been missing a lot of classwork and
coming in late in the evenings. This week, you missed a continuous assessment test. You don't seem to be yourself. I know you've
been drinking (or using drugs) a lot. If you're having a problem with alcohol, drugs, or anything else, I'd be happy to help you get the
assistance you need. I'd hate to see you drop out of college."
Githioro: "Hey, I know I've been a little out of control recently, and I have been partying more than usual, but don't worry. I'm
working on getting my act together."
Kiwinja: "Well, I hope you do. But sometimes it's hard to get your act together by yourself. So if you need any help, I just want you to
know that I'm here and I'll listen. I value your friendship and will do anything I can."
What advice would you have given Githioro? Discuss with a friend or colleague.
You may have come up with the following points:
 Avoid excessive intoxication on alcohol and drugs of abuse
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 If you do have sex, use a condom correctly and consistently
 Engage yourself in leisure activities that do not carry potential risk of spiking
 Never accept drinks, foodstuff, sweets and any ready to eat items from strangers
 When out for a drink, keep the company of persons you know and trust
 Be your brother’s keeper, assist those that are abusing drugs to get help (counselling)
Media and HIV
People especially youth spend several hours per day interacting with media, and the vast majority of them have access to a television,
computer, the Internet, a video-game, and a cell phone. Studies have shown that media can provide information about safe health
practices and can foster social networking. However, it is important to guard against misinformation.
Mass media
Refers to any channel of communication that is able to reach thousands or millions of audience at one go. For example newspapers,
radio and television.
Social media
The term “social media” refers to the wide range of Internet based and mobile services that allow users to participate in online
exchanges, contribute user created content, or join online communities. The kinds of Internet services commonly associated with
social media (sometimes referred to as “Web 2.0”) include the following: Blogs, Wikis, Social bookmarking, WhatsApp, twitters,
Facebook, Instagram and LinkedIn.
Media and prevention of HIV
The following media tools can effectively be used in the prevention of HIV:-
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 Internet, Radio, Television, print media, billboards, digital boards, video etc.
The media platforms used in prevention of HIV comprise of:-
 Use of ICT tools widely used by the youth to disseminate prevention messages.
 Recorded messages flashed through commonly used social media sites.
Figure 19: If used well, the mobile

phone can be useful in prevention of
HIV and AIDS.
The benefits derived from adoption of

media platforms in prevention of HIV
include:-
i). Wide outreach of preventive

messages
ii) Networking and access to

online counselling
Receiving message on phone Sending a message on phone
iii) Carrying HIV messages in
popular entertainment sites
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Negative Effects of Media on prevention of
HIV
Figure 20 If not well used the mobile
phone can lead to risky behavior that can
lead to HIV infection.
CASE STUDY 3
Layah: Did you see this article on the
newspapers claiming that cell phones fuel the
spread of HIV among students?
Mayah: What cell phones, how on earth can

it do that?
Layah: they claimed that secondary school

students spend most of their time sending
sexually explicit messages, which encourage
multiple sex partners raising the danger of
contracting HIV.
Mayah: How is that possible they probably just want to deny us access to cell phones in school and that would be a disaster. Are there
any statistics to support their claim?
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Layah: Oh yes, it is really bad, a study by a local university calls it sex texting (sexting) and estimates that 98% of secondary school
students in Nairobi sex text (sext). It adds that 62% of the daily sex texters have multiple partners because it encourages young people
to engage in casual sex.
Mayah: That’s a dangerous trend Layah. I remember ten students in our school who often fell sick, the school nurse referred them to
the neighboring clinic for further tests. Unfortunately they did not report for third term and ended up not sitting for their national
exams.
Layah: Do you think they could have contracted the HIV?
Mayah: I don’t know but I remember they were often on their cell phone in class and did not concentrate much. I also remember they
boasted of their new catch and left the rest of us wondering what they were talking about.
This conversation highlights the dangers of irresponsible use of ICT which may contribute to the spread of HIV and AIDS.
Do you know of other negative use of media that could encourage the spread of HIV? Highlight a few.
i). Negative influence of social media may lead to addiction as well as access to obscene and pornographic materials
ii). Sometimes people share photos and movies on social media that contains violence and sex, which can damage the behavior of
children and teenagers.
iii). Downloading information, videos or pictures is an easy task and can be done within a few clicks hence compromising privacy and
corrupting facts on HIV.
iv). A person’s HIV status can be exposed due to cyber security threat
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1. Identification of religious practices and beliefs that may contribute to HIV infection, stigma and discrimination.
2. What drugs are commonly abused in your locality? Find out from your colleagues the drugs that are often abused in their
locality.
3. Find out some of the cultural practices that make your community different from others.
4. Find out the various uses of social media among your peers.
1. What do you understand by the term culture?
2. Culture affects the daily lives of every individual. What are some of the negative cultural practices that fuel HIV infections?
3. Alcohol and Drug Use are words that you must have heard time and time again. What do you understand by the terms?
4. The following are benefits of social media, which one is not?
a. Wide outreach of preventive messages
b. Networking and access to online counselling
c. Sharing of pornographic content through sexting
d. Carrying HIV messages in popular entertainment sites

 Stationery
 Computer
 Model
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1.2.8.7 References
 Republic of Kenya (2007-2010) Kenya Nutrition and HIV and AIDS Strategy
 Republic of Kenya (National AIDS Control Council
 UNAIDS 2016
 MOE, 2013 Education Sector Policy on HIV and AIDS
 NASCOP, Supporting Learners Living with HIV in Kenya
Responses
1. What do you understand by the term culture?
 The way and pattern of life for an ethnic group of people, not only in the past but also as lived in the present
2. Culture affects the daily lives of every individual. What are some of the negative cultural practices that fuel HIV infections?
 Wife inheritance
 Female genital mutilation
 Gender based violence
 Early marriages/forced marriages
3. Alcohol and Drug Use are words that you must have heard time and time again. What do you understand by the terms?
 Alcohol and Drug Use is non-medical use of drugs (alcohol, cigarettes and other chemical substances) that destroy the
health and productive life of an individual. It is a patterned use of a drug in which the user consumes the substance in
amounts or in ways which are harmful to themselves or others.
4. The following are benefits of social media, which one is not?
A. Wide outreach of preventive messages
B. Networking and access to online counselling
C. Sharing of pornographic content through sexting
D. Carrying HIV messages in popular entertainment sites
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1.2.7 Mainstream HIV and AIDS
This learning outcome will describe what HIV and AIDS mainstreaming, explain why it is necessary and describe how you can
mainstream HIV and AIDS in the workplace, community, families, religious settings as well as identify relevant policies and legal
documents on HIV and AIDS.

 Ability to mainstream HIV issues is demonstrated based on MAISHA certification guidelines.
 Knowledge on policies and legal requirements on HIV and AIDS prevention is applied based on contemporary situations.

HIV Mainstreaming
The process of integrating HIV Issues is to ensure that people have comprehensive information on HIV and AIDS Prevention.
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Figure 21: A doctor giving a public lecture on HIV and AIDS in a school
A resource person is usually better than the trainer in communicating specialized

information such as in HIV and AIDS
Opportunities for Integrating HIV
 Ensuring capacity building on HIV and AIDS within the workplace, church, community, learning institutions.
 Utilization of Guidance and Counselling departments in the learning institution where issues of HIV and AIDS are discussed.
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 Formation of clubs such as Health Club to share knowledge and experiences on HIV and AIDS.
 Creating an enabling environment for persons who are living with HIV.
 Organizing health talks and debates on HIV and AIDS for staff by inviting resource persons.
Misconceptions about HIV and AIDS mainstreaming
To gain a better understanding of what HIV and AIDS mainstreaming is about, it may be helpful to think about what it is not.
Mainstreaming HIV and AIDS is not:
 Providing support from the health sector programmes such as availing first aid kits, emergency room or condom distribution
as the only service
 Trying to take over specialist and technical health related functions such as establishing VCT centres and providing
ART/ARVs by non-health institutions
 Pushing HIV and AIDS into programmes where it is not relevant
 Changing core functions and responsibilities in order to turn all learning institution’s activities into HIV and AIDS
programmes
 Turning Institutions training staff into AIDS specialists, VCT counsellors, peer educators or EMTCT experts.
 Incorporating HIV and AIDS related statistics in school subjects without relating to real life situation
 Staff attending training workshops and seminars year in and out on HIV and AIDS then going back to business as usual
Why is HIV and AIDS mainstreaming necessary?
Education sector serves as a critical platform in the fight against HIV and AIDS as it provides an opportunity to reach trainees,
adolescents and young people, teachers, parents and the community at large. Some of the most vulnerable groups to HIV infections
and effects are in the education institutions. Therefore, there is need for HIV and AIDS mainstreaming in all institutions in the
education sector.
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Figure 22: Orphaned children due to HIV and AIDS end up as street children while others overburden already impoverished
grandparents.
The expected outcomes of HIV and AIDS mainstreaming in the education sector include:
Long term (Impact) Short term (Outcomes)
1. Increased awareness of HIV and AIDS Reduced HIV and AIDS incidence among
among staff, learners and clients and staff, learners and clients
translation of this knowledge into
practice and behaviour change.
2. Policy of non-discrimination on the Improved quality of life of the infected,

basis of HIV status adopted and promotion of HIV and AIDS related rights,
operational PLHIV effectively engaged at all levels,
GIPA principles adhered to
3. Institutional systems modified to Institutional systems enabled to respond to

address specific internal aspects of HIV internal direct and indirect aspects of HIV and
and AIDS AIDS through appropriate policies, strategies,
programmes and activities.
4. Targeted support measures in place to Effective support programmes in place,

address particular aspects of HIV and strengthening institutional and community
AIDS (aimed at reducing vulnerability safety nets and coping capabilities to deal
or enhancing coping abilities) with HIV and AIDS within their context.
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5. Articulation of effects of HIV and AIDS HIV and AIDS policies, activities and M&E
on the institution’s core service delivery reports used to change institutional practices,
service delivery and products for clients to
respond to HIV and AIDS related needs.
6. Institutional strengthening, improved HIV and AIDS becomes part and parcel of
service delivery and national routine functions of the institution. HIV and
development AIDS no longer becomes a threat to core
functions or service delivery as new infections
are controlled, progression to AIDS
suppressed and socio-economic impact
effectively mitigated.
Mainstreaming HIV and AIDS
There are different environments where HIV can be mainstreamed these include learning institutions, communities, workplaces,
religious settings and at household level.
HIV and AIDS mainstreaming in learning Institutions may include the following:
 Appreciate that HIV and AIDS is everyone’s responsibility.

 Create a favorable institutional context, culture and practices.
 Advocate for support and commitment from the management.
 Collect adequate information on HIV and AIDS
 Ensure proper record-keeping
 Make HIV and AIDS one of the priorities and responsibilities for institutional staff.
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 Identify opportunities and make a deliberate effort to build capacity of staff.
Policies and legal documents on HIV and AIDS
While mainstreaming HIV and AIDS in your institution, it is necessary to know the policies and legal documents on HIV and AIDS in
the education sector so that each player knows his/her role.
The following are some of the documents:
 Education Sector Policy on HIV and AIDS MoE, 2013.

 Good Policy and Practice in HIV and AIDS and Education, UNESCO 2008.
 Kenya Vision 2030, Section 4.7 on Gender, Youth and Vulnerable Groups
 Constitution of Kenya: Chapter Four - The Bill of Rights
 The Public Sector Workplace Policy on HIV and AIDS, 2017
 The HIV and AIDS Prevention and Control Act, 2006
 Sessional Paper No. 1 of 2019 Reforming Education and Training Sector in Kenya
 HIV and AIDS Mainstreaming: Guide for AIDS Control Units in the Public Sector in Kenya, NACC, 2011.
 School Guide to support learners living with HIV (NASCOP 2019)

You have been asked by your supervisor at work to talk to your colleagues who have never heard about HIV. Prepare a seven-minute
presentation on HIV and AIDS and present it to your colleagues.
1. What are the possible outcomes of HIV and AIDS Mainstreaming in Institutions?
2. What are the opportunities for mainstreaming in the community?
3. Why do we require HIV Mainstreaming in the Education Sector?
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4. What are the opportunities for mainstreaming in the workplace?

 Stationery
 Computer
 Model
1.2.8.7 References
NACC (June 2011). HIV and AIDS Mainstreaming: Guide for AIDS Control Units in the Public Sector. Nairobi.
UNAIDS (2005). Mainstreaming HIV and AIDS in Sectors and Programmes: An
Implementation Guide for National Responses.
MoEST (2001). Teaching and Learning in the Primary Classroom: Core Module SPRED.
Nairobi
Responses
1. What are the possible outcomes of HIV and AIDS Mainstreaming in institutions?
 Appreciate that HIV and AIDS is everyone’s responsibility.
 Create a favorable institutional context, culture and practices.
 Advocate for support and commitment from the management.
 Collect adequate information on HIV and AIDS
 Ensure proper record-keeping
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 Make HIV and AIDS one of the priorities and responsibilities for institutional staff.
 Identify opportunities and make a deliberate effort to build capacity of staff.
2. What are the opportunities for mainstreaming in the community?
 Ensuring capacity building on HIV and AIDS within the community.
 Utilization of Guidance and Counseling departments in the community
 Creating an enabling environment for persons who are living with HIV.
 Organizing health talks and debates on HIV and AIDS for the community by inviting resource persons.
3. Why do we require HIV Mainstreaming in the Education Sector?
 It provides an opportunity to reach trainees, adolescents and young people, teachers, parents and the community at large.
Some of the most vulnerable groups to HIV infections and effects are in the education institutions.
4. What are the opportunities for mainstreaming in the workplace?
 Ensuring capacity building on HIV and AIDS within the workplace

 Utilization of Guidance and Counseling departments in the workplace
 Creating an enabling environment for persons who are living with HIV and AIDS.
 Organizing health talks and debates on HIV and AIDS for staff by inviting resource persons.
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1.2.8 Apply advocacy and networking skills
This learning outcome offers an experiential learning that focuses on sharing experiences, learning from each other and making new
discoveries on concepts and issues on advocacy and networking. It will equip the trainees with knowledge, skills and attitudes that will
enable them to raise awareness, drum for support and create networks among the trainees.

 Advocacy for HIV and AIDS awareness is conducted based on HIV and AIDS advocacy tool kit by NACC.
 Networks to support PLHIV are established based on NASCOP guidelines.
 Resources for HIV response are mobilized based on activities.
 Community is involved in HIV response based on The Kenya AIDS Strategic Framework.
 Networks of PLHIV are involved in HIV response based on The Kenya AIDS Strategic Framework.
Networking
It is the exchange of information and ideas among people with a common interest.
Resource Mobilization
It refers to an activity that secures new and additional resources for a cause or organization.
Advocacy
Any action that speaks in favor of, recommends, argues for a cause, supports or defends or pleads on behalf of others. Advocacy is a
powerful strategy in awareness creation, recognition and protection of the rights of persons living with HIV. It also magnifies the role
of HIV and AIDS programs in mitigation of HIV challenges.
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To be able to carry out advocacy effectively you need information on HIV and AIDS. This information is available in both print and
non-print materials such as books, flyers, brochures, posters, DVDs and other media. They are easily accessible at NACC and
NASCOP headquarters, regional offices, County and sub–counties and health facilities.
The following are ways of carrying out advocacy:
 Providing information on HIV and AIDS prevention, treatment, care and support
 Promoting attitudinal and behaviour change among community members
 Addressing gender based violence and promotion of positive cultural practices
 Accessing referral facilities for learners and the entire school community, such as treatment, nutrition, guidance and counselling
among others
 Promotion of human rights of PLHIV
 Provision of adequate resources for the HIV response
 Creating a non- stigmatizing environment for PLHIV
 Accessing of current HIV situation through NACC website www.nacc.or.ke
 Integration of HIV sensitization in school forums and activities.
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Above are examples of advocacy messages.
Steps to advocacy
1. Define the problem the advocacy strategy will work to solve.

2. Define the causes of the problem
3. Identify the consequences of the problem to be solved using the ‘Problem Tree’.
4. Carry out further research on the issue identified to be addressed
5. Define SMART objectives
6. Carry out team analysis
7. Identify strategies that can transform the weakness to strengths and threats to opportunities
8. Stakeholder analysis
9. Target audience analysis
10. Identify the best approach to communicate the message
11. Develop messages
12. Audience communication approach tool
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13. Budget
14. Implement
15. Evaluate
The Causes are:
 Related to the issue

 Relevant to the problem solution in the context of the project and the organization.
 Realistic and Solvable.
Notes
………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
Fun with Research

Now that you have your core problem understood from root causes to effects, the next step is to find out what information and data
exists on your core problem. This step will guide your strategy ensuring that the advocacy plan is evidence based.
Tool 2: Research Table
Issue Country Data Global Data Notes
e.g. Increased new infections

among young people aged 15-
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24years
Does your team have what it takes?

At this point that you have your issue dissected and you are armed with existing data, it is now time to self-analyze.
This can be used for your team or an individual.
The objectives of this analysis are:
 To identify the team’s strengths, weaknesses, opportunities and threats to achieving the Expected Advocacy Result.
 To identify strategies that can transform the weaknesses to strengths and threats to opportunities.
Table 2 Tool 3: Team Analysis Tool (with examples)
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Positive Negative
Internal Factors Strengths Weaknesses
Things that are currently going well Things that are not currently working well
Examples  Organization has well trained staff  Professional conflicts of interest

 Staff with many years of experience  Lack of human resource
External Factors Opportunities Threats
These exist now and in the future worth Possible obstacles that exist now and in the future
pursuing and paying priority attention to achieve worth identifying and avoiding towards achieving our
the Expected Advocacy Result expected result
Examples  Laws that can be interpreted to favor  Economic crisis

adolescents  Active opposition to your cause
 Goodwill from the government
Notes
………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………
Defining SMART Advocacy Objectives
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The objectives of this session are to:
 To develop SMART specific objectives for the advocacy project

 To identify the key activities needed to achieve each of the specific objectives.
What you need to know:
1. General Objective – this is the broader long-term goal that guides the specific objectives and key activities of the advocacy
strategy.
2. Specific Objective – Changes expected to be achieved throughout the implementation of the advocacy strategy.
Remember that your objectives have to be SMART
Specific – to avoid different interpretations
Measurable – to monitor and evaluate them
Achievable – realistic with enough time and resources
Relevant – to the problem, goal and organization
Time-bound – there is a specific time frame to achieve them
Examples of Incorrectly Written Objectives
Incorrectly written general objective

To promote public policies that benefit adolescent boys’ health.
Why is it incorrectly written?
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• This general objective is not talking about the main social or health problem to address. The organizations’ staff must ask: Why is it
important to promote public policies? How do public policies benefit adolescent boys’ health?
• This general objective does not provide information about the target population. It is too general.
• This general objective does not explain what kind of public policies to promote.
Improved general objective
To hold meetings with decision makers regarding the gaps in the observance of the Children’s Law in Kenya.
Incorrectly written specific objective
To hold meetings with decision makers regarding the gaps in the observance of the Children’s Law in Kenya.
Why is it incorrectly written?
• This objective is about a strategy or activity, not an expected change in the target population. Why does the organization wish to
hold meetings with decision makers? What is the desired change?
• This objective is not time-bound. What is the time frame in which you expect the change to happen?
• The terminology is not clear. What does it mean by “gaps” in the observance of the Children’s Law?
Improved specific objective
At the end of the three-year project, have the governor and relevant county authorities of Nairobi County sign an agreement that
ensures monitoring of the Law on Children.
Notes
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Stakeholder Analysis
This section will help you understand your stakeholders and partners so that you are able to know who and how to engage for
maximum impact.
Remember that for you to influence key decision makers, you need to understand their priorities so as to build their interests.
HINT: Key questions to ask yourself are:
1. Who are the key decision makers?

2. What action do you want them to take?
Tool 4: Stakeholder Analysis Tool
Interest Influence High Medium Low
High
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Medium
Low
Notes
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NB: As part of your stakeholder analysis, it is important to highlight the exact interests and areas of influence (Political, Social &
economic) that your potential partners may have that would drive your advocacy plan.
Target Audience Analysis
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The target audience for your advocacy plan is identified based on the stakeholder analysis tool. Below, the target audience wheel
describes the spectrum of allies that are necessary for your advocacy plan.
Tool 5: Target Audience Wheel
(Insert the wheel)
HINT:
1. Your active allies: decision makers and influencers who agree with you and are fighting alongside you.
2. Your passive allies: those who agree with you but aren’t doing anything about it.
3. Neutrals: those who are neither for nor against your issue and are unengaged.
4. Passive opposition: those who disagree with you, but who aren’t trying to stop you.
5. Your active opposition: those who work to oppose you or undermine you
Communication Approaches
Once you identify your target audience, the next step is to think about the best way to communicate your message to your target
audience.
Below is an illustration of where you should focus your energies based on the above target audience description.
Tool 5: Communication Approaches
(Insert wheel)
HINT:
 ENGAGE: if your target is fully in favor of your position i.e. you’re on the same side and has high interest in the issue, you
should seek to include them in your advocacy- planning network! They may be able to open valuable doors for you.
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 PERSUADE: if your target is interested and somewhat agrees with your advocacy goal, you should try to persuade them by
increasing their knowledge and showing them that your advocacy objective is the appropriate solution.
 CONVINCE: if your target is on the fence in relation to your advocacy goal but only has medium to-little interest in it, you
should try to convince them by showing that your cause is supported by people or institutions that are relevant to them.
This can include constituents, other decision-makers, power groups or public opinion leaders.
 NEUTRALIZE: if your target is against your position, has a lot of power and is interested in your issue, you may need to
neutralize their influence. This can be difficult— you must avoid unethical practices and putting yourself (or others) at risk.
This does not deserve a lot of your energy, so be careful how much you focus on this in your activities.
 MONITOR: if your target is against your position but has little interest in the issue, you might want to devote a bit of
energy towards monitoring them, especially if they are powerful or influential. They may suddenly choose to move
towards other sections of the spectrum, meaning you will need to rethink your approach.
What do you need to say? - Developing Messages

Now that you know your target audience and where they fall on the spectrum of allies, you need to design messages that are
fully formed so as to they are specific towards expected advocacy outcome.
Here is a quick formula to help you communicate effectively:

 CHALLENGE: package your advocacy issue and what you are doing to address it in a way that will appeal to
your chosen target.
 ACTION: deliver your most important message to the target. What are you asking them to do in support of your
advocacy goal?
 RESULT: share thoughts on why you think this specific action will lead to a positive result for those most
affected by your advocacy issue.
Take it for a spin on the tool below:
Tool 6: CAR Table
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TARGET (Tool 4) APPROACH (Tool 5) MESSAGING
Example: Minister of Foreign Convince CHALLENGE: New HIV infections among

Affairs Adolescents and Young People still contribute almost
more than 40% of Kenya’s new HIV infections.
Despite being a vulnerable population, there are no

specific targets to increase access to prevention and
treatment amongst young people. Health being a
devolved function, county governments are able to
leverage this for county specific programs for the HIV
Response.
ACTION: as the CEC Health for Kajiado County, I ask

you to encourage the county government to actively
lobby for setting aside of more county resources to
support HIV programs for AYPs.
RESULT: with this resource allocation, the county is

able to implement ambitious plans to reduce new HIV
infections and AIDS related deaths amongst young
people, which will be a huge step towards ending the
AIDS epidemic.
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ACTION: ………………………………………………..
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RESULT: ……………………………………………….
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Communication Tools
How you choose to communicate is dependent on the target audience. This means that who you are trying to reach really determines
how you reach them and how you communicate.
For example, data sheets and charts to reach a young person might not be as effective as audiovisuals targeting the same audience.
The target audience can be divided into three:
1. Experts
2. Non-informed Experts
3. General Public
It is important to ensure that your target audience is now organized in this way before selecting the communication approach.
Tool 7: Audience Communication Approach Tool
Experts Non Informed Experts General Public
130
Below is an example of communication approaches that you can use to reach your target audience. It is definitely not exhaustive but
will serve as a guideline.
Remember, You can be as creative as you like with your approaches as long as you get the message across.
131
132
As part of your communication approaches, make sure that you cost all the engagements. The table below can help you (or your
organization) budget your advocacy plan.
Tool 8: Advocacy Budget
Budget Area (e,g Staff, Item description Units Unit Total Comments/Assumptions
Activity, (Transport, cost
Communication) Accomodation)
Once all the tools are filled, you have your advocacy plan ready and you can now hit the road running.
1. Have you ever been in a difficult situation and felt unable to make the right decision to resolve your problem? There are many
challenges that people living with HIV face. Can you mention a few?
2. Can you visualize what a net looks like? Now draw an example of a net (work) using your phone contacts, that is, how your
contacts relate to each other and share with your colleagues.
Networking
When you and I share information on specific matters with our contacts through calling, short messages, emailing, WhatsApp,
Facebook, Twitter among many other modes, that is networking. Networking promotes sharing of knowledge and ideas for skill and
resource enhancement. Social Networking is one of the mostly used medium of sharing information on social matters, HIV and AIDS
included.
HIV and AIDS Networking.
133
As the education sector teachers/trainers, you need to appreciate HIV and AIDS interventions especially those that benefit learners
within institutions. Create avenues that will bring together learners and staff living with HIV and guide them to form social networks,
psycho social support groups such as buddy system groups, peer support and counselling groups, mentorship programs through clubs
and societies among others.
The learners and staff can also be linked to organizations that offer HIV and AIDS services.
Networking in HIV and AIDS interventions involves creation of new opportunities and connections to resource persons, HIV services,
referral facilities, communities of PLHIV for example NEPHAK, WOFAK, KENEPOTE, SAUTI SKIKA, BLAST, KENERELA,
ICW Kenya Unit and collaboration with partners that promote and support HIV and AIDS programs (NACC, NASCOP, and relevant
Government Agencies, NGOs, CBOs, FBOs and Private Sector).
Benefits of networking:
Networking and Partnerships have the following benefits:
 Provide a platform for identifying new partners

 Promote meaningful community involvement
 There is a synergy effect that strengthens work and widens impact
 strengthen advocacy
 Help mobilize resources
 Reduce duplication of efforts and wastage of resources
 Create new platforms for information sharing, benchmarking on best practices and lessons learnt
 Open up opportunities for capacity building
Different HIV and AIDS Advocacy Fora
Have you ever attended any fora where HIV and AIDS issues were being discussed? If yes, what was your contribution and/or how
did you benefit?
134
The following are some of the fora where matters of HIV and AIDS can be communicated:
During these forums, HIV and AIDS information can be shared through speeches by resource persons and sharing of experiences by
PLHIV, IEC materials, mobile testing and counselling outreaches, Edutainment by use of poems, dances and songs with HIV and
AIDS messages.
Resource Mobilization
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Resource mobilization involves the ability of members of an organization to acquire means of facilitation in terms of Human
Resource, Finance and Infrastructure in order to accomplish the organization’s goals. For example in learning institutions it may
involve empowering staff with counselling skills, allocating finances to support HIV and AIDS prevention programmes and providing
appropriate rooms for coordination of HIV and AIDS activities.
Apart from the Government’s contribution towards various HIV and AIDS programs, different partners such as NGOs, CBOs and
FBOs make substantial contributions. Which other such organizations do you know?
You may have mentioned some of the following:
NACC, NASCOP, NEPHAK, WOFAK, KENEPOTE, SAUTI SKIKA BLAST, KENERELA, ICW Kenya and others. This section
will shed light on the role and strategies of resource mobilization for HIV and AIDS programs in your institutions.
The role of resource mobilization for HIV and AIDS programs
Do you think it is necessary for your institution to mobilize resources for HIV and AIDS interventions?
Note that there is no programme, small or big, that can be run without resources, be it human, financial or infrastructural. It is
important for organizations as well as learning institutions to set aside or mobilize resources for HIV and AIDS programmes.
Importance of resource mobilization
 It ensures continuation of your institution’s HIV and AIDS service provision to clients.
 It supports sustainability of your institutional HIV and AIDS programs
 It ensures improvement and scale-up of the ongoing HIV and AIDS services in your institution
 It supplements existing HIV and AIDS budgets.
Resource Mobilization Strategies
For an effective response to the HIV and AIDS epidemic in our communities, the following strategies can be adopted by institutions:
136
 Adopting a Public Private Partnership Approach to support your HIV and AIDS programs. For example, creation of linkages
with financial institutions and business communities to fund your institutional HIV and AIDS activities such as: walks, runs,
music, drama, extravaganzas, mobile advocacy outreaches and proposals for donations.
 Establishment of an institutional kitty where members of the institution and the immediate community can voluntarily give
their donations to support HIV and AIDS programs.
 Initiate partnership with existing Government institutions and private organizations that deal with HIV interventions to support
your institutional HIV and AIDS programs. Such organizations/institutions may include; NACC, NASCOP, NEPHAK,
WOFAK, KENEPOTE, SAUTI SKIKA, and any other NGOs, CBOs and FBOs within the region.
 Involve professional associations such as KESSHA, KEPSHA, KATTI, KCPA and trade unions such as KNUT and KUPPET
for support of your HIV and AIDS programmes.
 Other bodies such as teachers SACCOs, insurance firms and NHIF and some hospitals through their social corporate
responsibility component can also be involved in resource mobilization.
 Develop funding proposals and submit to potential sponsors within the region such as CDF, County Governments among
others
 Initiate income-generating activities through clubs to support HIV and AIDS programs in your institutions. For example
agricultural projects, poultry rearing, canteen, newsletter production and sale among others.
Ensure that PLHIV are meaningfully involved in advocacy, networking, resource mobilization and programme design and
implementation in line with the MIPA Principles as outlined in the Sector Policies.
Concept of Meaningful Involvement of People Living with HIV (MIPA)
Meaningful Involvement of People Living with HIV is a principle that aims to realize the rights and responsibilities of people living
with HIV to fulfil their participation in decision making processes that affect their lives, and by so doing enhance the quality and
effectiveness of the HIV response.
How do you involve PLHIV in your institutions?
137
PLHIV should be involved in advocacy, networking and resource mobilization through meaningful engagement of their communities
and support groups.
The levels of involvement may include:
 Championing stigma reduction

 Extending psycho social support to PLHIV
 Programme planning, development and implementation
 Leadership and support group networking and information sharing.

Advocacy begins by understanding and assessing the issue that you would like to address.
The objectives of these steps are:
Identify a problem and using the problem tree approach, design an advocacy program

 Stationery
 Computer
 Model
1.2.8.7 References
1. MOEST, 2013. Education Sector Policy on HIV and AIDS
138
2. MOEST, 2015. National Education Sector Plan.
3. MSPS, 2010. Public Sector Workplace Policy on HIV and AIDS.
4. NACC, 2016. Maisha Certification Curriculum for The Public Sector Institutions, Unpublished.
Responses
1. What are the benefits of networking and partnership in HIV and AIDS?
 Provide a platform for identifying new partners
 Promote meaningful community involvement
 There is a synergy effect that strengthens work and widens impact
 strengthen advocacy
 Help mobilize resources
 Reduce duplication of efforts and wastage of resources
 Create new platforms for information sharing, benchmarking on best practices and lessons learnt
 Open up opportunities for capacity building
2. Who are the stakeholders in HIV and AIDS?
 NASCOP
 NACC
 CHAK
 WHO
 MOH
 NGOs
 CBOs
3. What is the difference between networking, resource mobilization and advocacy in HIV and AIDS?
 Networking is the exchange of information and ideas among people living with HIV while resource mobilization refers
to an activity that secures new and additional resources for support of PLHIV and advocacy is an action that speaks in
favour of, recommends, argues for a cause, supports or defends or pleads on behalf of PLHIV program
139
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JFC MUNENE COLLEGE OF HEALTH SCIENCES

HIV AIDS MANAGEMENT

ANC: Ante Natal Care

AYP: Adolescents and Young People

ART: Anti-Retroviral Therapy

BOM: Board of Management

CBO: Community Based Organization

NCDF: National Constituency Development Fund

CEMASTEA: Centre for Mathematics, Science and Technology

GBV: Gender Based Violence

FBO: Faith Based Organization

EMTCT: Elimination of Mother to Child Transmission

FGM: Female Genital Mutilation

HAPCA: HIV and AIDS Prevention and Control Act

HIV: Human Immunodeficiency Virus

HTS: HIV Testing Services

ICT: Information Communication Technology

IDUs: Injecting Drug Users

INERELA+: International Network of Religious Leaders Living or Personally

Affected by HIV and AIDS

ICW KENYA: International Community of Women Living with HIV in

KAIS: Kenya AIDS Indicator Survey

KATTI: Kenya Association of Technical Training Institutes

KENEPOTE: Kenya Network of HIV Positive Teachers

KESSHA: Kenya Secondary Schools Heads Association

KEPSHA: Kenya Primary Schools Heads Association

KICD: Kenya Institute of Curriculum Development

KNUT: Kenya National Union of Teachers

KUPPET: Kenya Union of Post Primary Education Teachers

MDAS: Ministries Departments and State Agencies

MoE: Ministry of Education

MoH: Ministry of Health

MIPA: Meaningful Involvement of People Living with HIV

MSM: Men having sex with Men

NACC: National AIDS Control Council

NASCOP: National AIDS and STIS Control Programme

NEPHAK: Network of Persons Living with HIV in Kenya

NHIF: National Hospital Insurance Fund

NGO: Non- Governmental Organization

OVC: Orphans and Vulnerable Children

PCIs: Pertinent and Contemporary Issues

PEP: Post Exposure Prophylaxis

PLHIV: People Living with HIV

PTA: Parents Teachers Association

PrEP: Pre- Exposure Prophylaxis

SAGAS: Semi-Autonomous Government Agencies

SBTD: School Based Teacher Development

STIs: Sexually Transmitted Infections

UNAIDS: Joint United Nations Programme on HIV and AIDS

UNESCO…United Nations Educational, Scientific and Cultural Organization

VCT……..Voluntary Counseling and Testing

VMMC…...Voluntary Medical Male Circumcision

WHO…….World Health Organization

WOFAK…...Women Fighting AIDS in Kenya

Layout of the Trainee Guide

HLT/CU/HIV/BC/01/6/A HIV and AIDS management

CHAPTER 1: HIV AND AIDS MANAGEMENT

UNIT CODE: HLT/CU/HIV/BC/01/6/A

1.2.8.2 Performance Standard

1.2.8.3 Information Sheet

A group of symptoms that consistently occur together

HIV Drug Resistance

THE SRUCTURE OF HIV