Lesson 1
Transmission of HIV

The Epidemic Game

Rationale:

One of the greatest deterrents to the practice of safer sex among teens and young adults is the mindset, "It can't happen to me." This lesson dramatizes the rapid geometric progression possible in the spread of HIV and helps students understand how exposure to possible infection or avoidance of infection is within their control.

AIDS Education Objectives:

1. Students will become aware of the geometric patterns of infection in epidemics and see how rapidly HIV, as well as other sexually transmitted diseases (STDs), can be spread through unprotected intercourse.

2. They will have the opportunity to imagine what it feels like to learn that they have been infected with an incurable, fatal disease, or to imagine what it feels like to learn that they have avoided infection by practicing safer sex.

3. They will learn the difference between casual contact and high risk behaviors.

4. They will learn that a person can not tell by appearance whether someone is infected with HIV.

ESL Objectives:

1. Students will have the chance to discuss, describe, analyze, and write about several topics of current social interest.

2. They will review the use and form of present and past tense verbs and consider which forms are appropriate under the different circumstances presented by the writing assignment.

3. They will practice note taking.

Procedure:

Begin the class by announcing that we are going to have several lessons on AIDS education. Tell students that AIDS is a sensitive and very important issue requiring discussion of sexual and drug-related topics and that it is necessary for every person during these discussions to show complete respect toward classmates and not to embarrass anyone with inappropriate, "street talk" regarding sex or drug use.

1. Now ask students to spend five minutes writing in their notebooks everything they know about AIDS. While they are writing, give each student a card or small piece of paper marked in the following way. For a class of about 25,

a) put a small "v" (for virus--HIV positive) on the back of 2 cards, and "v-IDU" (for virus-injecting drug use) on the back of one card--;

b) put a "c" (for condom use) on the back of 5 cards,

c) put an "o" (for "outercourse," sexual intimacy, without sexual intercourse: kissing, hugging, touching) on the back of 5 cards,

d) put a "no s" (for no sexual relationship at present) on the back of 5 cards.

2. After giving out the cards, ask several students to read what they wrote. Write
HIVAIDS on the board. Explain AIDS is caused by a virus called HIV, which is found in the blood, semen, and vaginal fluid of an infected person. Anyone with the virus can pass it on to another person during sex or when sharing needles. There is no cure for AIDS. Education is our best protection against this disease.

3. Tell students that this exercise is designed to teach participants how people get HIV infection and to practice English conversation on three topics with three different partners. These topics, written in boldface, 3a), b), and c) below, should be put on the chalkboard.

a) ask students to get a partner and discuss (not too loudly) Sex in the Media (TV, movies, magazines, etc.) and How it Affects Us; (if the class members have not had experience working with partners they may require some direction from the instructor to get them paired up); after three or four minutes ask students to shake hands with their partners and move on to a new partner;

b) students should now discuss Sexual Attitudes in This Country Today (the host country, if they are immigrants) Compared With Sexual Attitudes in Your Native Country When You Were Growing Up, (if students are not immigrants, they can discuss Sex Today compared to Sex When Our Parents Were Young); after three or four minutes they should shake hands and move on to a new partner;

c) students should now discuss How Would Your Life Change If You Learned You Were Infected With HIV; after three or four minutes, ask students to shake hands and return to their seats.

4. The next ten minutes should be spent in full class discussion summarizing the major points generated by the students’ discussions with their partners. Put the major points on the board under their appropriate topic headings. Ask students to take notes on this information and other information you will put on the board. Tell them it will be useful later. Explain that good note taking is an important study skill. Good notes summarize complex thoughts in single words or short phrases. Demonstrate this as you write discussion points on the board. If students have more discussion points to relate than time permits, allow 30 seconds for them to add to their notes what they haven’t had the chance to tell the class before moving on to the next topic.

5. At the conclusion of the 10 minute discussion of these three topics, ask students to stand and take out the papers with codes on the back given to them at the beginning of the class. Announce that this is a game (you may need to explain "game") to show how HIV is spread. Explain that the "v" on the papers held by three students represents HIV--transmitted by unprotected sexual intercourse , or by sharing a needle for Injecting Drug Use, represented by the "v-IDU" (put unprotected sexual intercourse and sharing needles on the board, explain that protected intercourse means correctly using a latex condom from start to finish every time you have sex, and that you will talk more about protection later.). Ask these first three students to be seated. Tell them that you are sorry but they are out of the game.

Then ask the three students who shook hands with the first three to sit down also. Explain that for the purposes of this game only, shaking hands represents unprotected sexual intercourse or sharing of needles, the behaviors by which HIV is spread. Make clear that shaking hands in real life is a form of casual contact, which, along with kissing, hugging, touching, insect bites, and sharing toilet seats or eating utensils, can not spread HIV (put casual contact on the board). Then ask the six who shook hands with those already seated to sit. Then ask the 12 who shook hands with those seated to also sit. At this point as many as 24 students may be seated with HIV--perhaps fewer, if some already "infected" became "re-exposed."

Make the point here that it is possible for a person to become infected with HIV from a first and only lover. However, by the laws of chance, the more people a person has risky sex with (or shares a needle with), the greater the chance of meeting a partner infected with HIV and becoming infected too. In the same way, the more people a person’s partner has had risky sex with (or shares a needle with), the greater the partner’s chance of being infected with HIV.

Take time now, with almost all of the class seated and "out of the game" to ask students how they would feel if this were not a game and they had actually become infected with HIV through unprotected intercourse or needle sharing. Point out that just as they could not tell by looking at a classmate if s/he was infected with HIV, so too in real life you can not tell by looking at a person if s/he is infected (put this on the board and explain the s/he notation) and most of those who are infected can not tell that they are without being tested for HIV.

Now ask the students who had a "c" on the back of their paper to stand. Explain that this means that they were able to avoid becoming infected with HIV because they practiced safer sex by using a condom every time they had sexual intercourse. Congratulate them. Write safer sex--use a condom correctly every time on the board.

Next ask those with an "o" to stand. Explain that this means that they were able to avoid becoming infected with HIV because they practiced safer sex by not having vaginal, anal, or oral intercourse but had sexual intimacy without penetration, "outercourse." Congratulate them. Write outercourse on the board under "use a condom."

Finally, ask those with a "no s" to stand. Explain that the "no s" means no sex--they are not involved in a sexual relationship at present. Write abstinence--no sex on the board. Congratulate them. And once again congratulate all who preserved their health. Express your regrets for all those who lost the game and tell the class that you hope that everyone understands and will do what is necessary to avoid HIV infection and stay healthy in real life.

6. Ask if there are any questions or comments.

Homework:

Ask students to copy the following from the board.

1. Describe and evaluate this lesson. How did you feel during the game when you or people you care about became "infected" with an incurable, fatal disease? How did you feel if you avoided infection by practicing safer sex or abstinence? How do you think a young person your age feels when s/he first learns that s/he really has HIV? What did you learn from this lesson?

2. Interview a parent or someone else your parents’ age to learn more about the differences in sexual attitudes and behaviors when they were your age and now. Write a summary of what you learned from the interview.

This interview can be used by younger students to tell their parents that the class will be working on five AIDS lessons and that the ESL instructor hopes parents and students will discuss this work at home.

Point out to students the appropriate verb tenses for these topics and, if necessary, review these tenses: simple past to describe the lesson and how students felt during the lesson, and simple present to describe how a person who really has HIV probably feels; simple past to describe attitudes about sex when your parents were younger and simple present to describe sexual attitudes now.

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