Transmission games

Who has the AIDS virus?

Objective:

• To demonstrate that you cannot tell by looks or profession who has the AIDS virus.

Target Group:

• All groups

Materials:

• Assortment of pictures of people of various races, ages, ethnic groups, and professions

Preparation:

• Cut eight to twelve pictures of a variety of people from magazines or newspapers. Staple or paste on colored paper. Give each picture a description, e.g. "This man is about 50 years old, is a bank manager, and has plenty of money." Then decide if the person has the AIDS virus or not. Write it in large letters on the back. Explain to the group: "This is a game. We do not know if these people have the virus or not. When a person is infected with the virus but does not yet have the virus, there are no symptoms. You cannot see it."

Directions:

• Make two teams, more if the group is large. The game must move quickly, so avoid too many groups. Groups should be small enough so they can discuss their answers.

• Hold up a picture for team # 1. Be careful no one can see the answer on the back. Describe the person in the picture and ask, "Do you think this person has the virus?"

• Ask them to decide as a group. When they answer, ask "Why?" they made that decision.

• Show the answer on the back. If their guess matches what you have written, the team gets a point. Then go to team #2 and so on, using 4-6 pictures for each team.

Explain again:

• "This was just a game. We do not know if these people have the virus or not. The game shows that you can't see when a person has the virus, even when they look clean and beautiful and rich."

Variation:

• On the wall hang two signs:

"These people have the AIDS virus."

"These people do not have the AIDS virus."

Instead of teams, have the whole audience decide who is or is not infected. Put the pictures under the appropriate sign. When all the pictures have been placed, turn them over to see the answers.

By Jo Young, U.S. Peace Corps Volunteer

The spreading of communicable disease

Objectives:

• To illustrate how STD's (1) are transmitted, (2) are not transmitted, and (3) ways to reduce risks of infection.

Target Group:

• Secondary school students, Teachers, Community Groups, Health Care Workers

Group Size:

• 15 to 300

Materials:

• Small blank slips of paper, prevention behavior slips, and risk and infection slips.

Preparation:

• Prepare status" slips for the following: (Example for 150 participants)

Prevention behavior	Risk and Infection
Use condoms everytime	25
risk*	60
abstinence	20
infected with HIV**	5
monogamy	20
children not yet at risk	10
Use drugs but clean needles beforehand	10

*risk slips really serve no purpose other than to give all participants the same number of slips and to let these participants know that they are at risk as well. Risk slips may be labeled more specifically, e.g. "partner looked clean" or "only shared a needle once," etc.

**For younger groups, infected with HIV can be replaced with, for example, infected with the measles, then change the other slips accordingly. Students learn how diseases are transmitted through a population.

Time:

• 20 minutes

Directions:

• Divide the participants into four groups and pass out the blank slips of paper. On the paper, the players must write three names. If a player is in group I, he/she must write the name of one person from groups II, m, and IV. If a player is in group II, he/she must write the name of one person from groups m, IV, and I. If a player is in group m, he/she must write the name of one person from IV, I, and II. And, if the player is in group IV, s/he must write the name of one person from groups I, 11, and m.

• Pass out folded prevention behavior and risk and infection slips and ask the participants not to read them yet. Explain to the participants that they represent a population and that any number of a population is at risk of infection with diseases if anyone else in the population is already infected. Have the participants who have received the slip "Infected with HIV" raise their hands. Have these participants come to the front of the room. Give them reasons for their infection, e.g. too many partners, using dirty needles, infected by husband, etc. Have these students quickly read the names they have written on their slips of paper. Have the participants whose names were read come to the front of the room as they have been infected as well. Then ask the participants still sitting if they have any of the names of the participants who are standing at the front of the room written on their slips of paper. If they do, they must join the standing participants. This is repeated until all of the participants are standing.

• Then ask which of the participants have the slips "Abstinence". Explain that this is the best way to prevent sexually transmitted diseases and that they may take their seats. Then, ask the participants to raise their hands if they have the slip "Use condoms everytime". Explain that if they use condoms everytime they have sex they reduce the risk of being infected. These participants may sit down once again. Ask the participants if they have the slip "monogamy". Explain that there is little risk for disease if they have mutually monogamous partners. These participants may also sit down. If participants have the slip "children not yet at risk", they have not yet thought about having sexual intercourse or using drugs." They may sit down. Finally, if participants have the slips "use drugs but clean needles beforehand" they have also reduced their risk for infection and may also sit down.

• There will still be a sizeable number of participants standing. These participants represent those people in the population who are not yet informed about the transmission of STD's and HIV or choose not to follow the information that is available. Explain that some STD's are painful and dangerous to their health, and that treatment can take a long time. Mention that if they are infected by HIV, there is no cure.

• Have all of the players sit down and, by soliciting their answers, quickly review the transmission and prevention of HIV and STDs.

Shaking STD's

Objective:

• To illustrate through a simulated activity how STD's (1) are transmitted, (2) are not transmitted, and (3) ways to reduce risks of infection.

Target Group:

• Secondary school students, community groups, etc.

Materials:

• 3 x 5 cards, a pencil for each participant, one right handed glove.

Directions:

• Hand out 3 x 5 cards to participants.

• Tell them to write numbers 1-2-3-4-5 down the left side of the card.

• Five people will receive cards which have special instructions on the back.

Person 1:	Do not shake hands.
Person 2:	Shake hands only with person #3.
Person 3:	Shake hands only with person #2.
Person 4:	Shake hands only with a glove on your hand.
Person 5:	After you shake hands, sign the card as "Person 5" and tell that person to sign all future cards as "Friend of Person 5."

• Instruction to Group:

Each participant is to go and introduce him/herself to another, shake their hands, and sign each other's card. Repeat this 4 times until you have five names on your card and then sit down.

Discussion:

• For this activity, shaking hands is symbolic of having sexual contact.

Person 1 was instructed not to shake hands with anyone. This person was symbolically practicing abstinence.

Persons 2 and 3 were instructed to shake hands only with each other. They were symbolically practicing monogamy.

Person 4 was instructed to only shake hands with a glove on his/her hand. This person was symbolically practicing a barrier method, such as using a condom.

Person 5 symbolically had an STD. He/She signed cards as "Person 5" and told those people to sign others' cards as "Friend of Person 5."

What does it mean:

Persons 1, 2, and 3 would not transmit the disease since STD's are prevented with abstinence and monogamous relationships.

Person 4's risk of infection was reduced but not eliminated, by the use of a barrier method such as the glove which was symbolic of a condom.

Person 5 exposed his/her contacts to STD's

STD transmission:

Person 5, please stand up. Everyone now look at your 3x5 cards.

Look at Number 1. If your card says Person 5, please stand up.

Look at Number 2. If your card says Person 5, or Friend of Person 5, please stand up.

Look at Number 3. If your card says Person 5, or Friend of Person 5, please stand up.

Look at Number 4. If your card says Person 5, or Friend of Person 5, please stand up.

Look at Number 5. If your card says Person 5, or Friend of Person 5, please stand up.

Note:

• Not everyone exposed to an STD infected person will contract an STD, but sometimes only one contact is necessary. Rates of infection depend on the particular STD, the type of sexual contact, the sex of the participants, the number of participants, other STD's acting as co-factors, geographic locations, sexual history of partners, as well as other factors.

Variation:

• Ask the persons standing, "How do you feel about being infected?" (surprised, embarrassed, angry, etc.?)

• Ask Person 1, "How did you feel when others tried to shake your hand and you couldn't respond?" (rejected, foolish, bashful, etc.?)

• Ask Persons 2 and 3, "How did you feel when you could only shake hands with each other?" (left out, rejected, special, etc.?)

• Ask person 4, "How did others respond to the glove on your hand when you shook hands?" (surprised, questioned, reluctant to shake hands, etc.?)

• Ask Person 5, "How did you feel knowing you possibly infected all these people?" (embarrassed, sorry, didn't know what he/she was doing, etc.?)

• When did this STD really start to be transmitted?

• Discuss the effectiveness of the following methods to reduce the risks of STD infection:

- abstinence: best, most effective way

- monogamy: effective if neither is already infected

- limited number of partners: reduce risk but still at risk

- limit partners who have multiple partners: reduce but still at risk

- condoms: reduce but do not eliminate possibility of infection

From: Ohio Public School AIDS Manual

The AIDS risk game

Objective:

• A self-teaching/evaluating activity to learn about AIDS transmission.

Target Group:

• Secondary students and adult

Materials:

• One test sheet for each person, colored paper, pencils

Preparation:

• Copy one sheet for each person.

• Cut strips of colored paper the length and width of the "Correct Answer" column, and paste or staple to top of "Correct Answer" column.

Directions:

• Each person writes their answers to questions in the "Your Answer" column, using the code at the top of the question sheet.

• After completing all questions, individuals or groups look to see if their answers are correct.

Variation:

• Draw the activity on a large sheet of paper, big enough to be seen by the whole group.

• Have everyone answer the questions as a group and check the answers as a group.

• Allow time for questions and discussion.

CODE

N = No Risk

R = Risk

PRACTICE	Your Answer	Correct Answer
Abstinence		N
Blood transfusions after screening		N
Blood transfusions using unscreened blood		R
Breast feeding by an infected mother		R
Cleaning blood spill without gloves		R
Coughing		N
Dry kissing		N
Ear piercing with shared needle		R
Hugging		N
Intercourse using an oil-based lubricant and condom		R
IV drug needle sharing		R
Massaging		N
Masturbation		N
Mutually monogamous relationship with an uninfected partner who does not use IV drugs		N
Proper use of condom with nonoxynol 9 spermicide		N
Sharing facilities with an infected person at school or work place		N
Sharing food and utensils, living and toilet facilities with an infected person		N
Sneezing		N
Tattooing		R
Unprotected vaginal sex when one partner is HIV positive or HIV status is unknown		R
Using a shared needle that has been cleaned with bleach		N

From: The AIDSED Center, WHO/UNESCO, Bangkok, Thailand

AIDS problem situations

Objective:

• To spark discussion/thought in problem solving in AIDS related topics.

Target Group:

• Secondary students and adults

Materials:

• Copies of "Problem Situations" and "Form for Solving Problems" for all participants, or write on a flip chart or chalkboard where everyone can read easily.

Directions:

• Explain that in this activity we will do two things:

* examine and discuss some common questions about AIDS transmission

* learn how to look for solutions by using a four-step process.

• Ask participants to read the situations on the "AIDS Problem Situations" list and choose one they would like to work on.

• Ask participants to divide into three groups based on the situation they have chosen to solve. Groups should be about the same size. If not, invite a few people to change groups.

• Using the "Form for Solving Problems," participants should try to solve their problem by the following four-step process. This may be done as a group or each individual may fill out the form, sharing the results with the small group afterwards.

• After sufficient time for small group discussion, a spokesperson from each small group can make a brief presentation to the entire group, describing the process and the solution reached.

Variation:

• Split the group into smaller groups and assign each group a problem to solve. Have each small group give a presentation of their solution, having the groups act out their solutions.

AIDS Problem Situations

1. Supap hasn't had sex with anyone, but she shoots intravenous drugs with her friends. Since reading that AIDS can be passed by sharing IV drug needles and syringes, she wonders if she has gotten the AIDS virus.

2. Porntip dates Anchalee, and they often have sex. Porntip doesn't have sex with others but she thinks that Anchalee does. Porntip also believes that Anchalee may have had sex with someone at increased risk for AIDS. Neither has taken the AIDS antibody test to determine if they have been exposed to the AIDS virus. Porntip wants to continue having sex with Anchalee, but isn't sure what can be done to prevent exposure to the AIDS virus.

3. Mayuree works very hard to maintain good health. She reads about all aspects of health so that she can know the best preventive health practices. Mayuree has received a little information in school about AIDS, but doesn't feel it was enough. She wants to learn more about AIDS and keep current in the future.

Form for Solving Problems

Following the steps in this decision-making process can help you discover the best solutions to most problems. Use this process to help solve the AIDS problem situation you have chosen.

Check the AIDS problem situation you want to solve:

1___ 2___ 3___

Directions:

• After reading the problem situation on the Problem Situations page, answer the questions below.

1. What is THE PROBLEM?

2. What are THE IMPORTANT FACTS about the situation?

3. What are THE POSSIBLE ACTIONS?

4. What is THE BEST SOLUTION?

From: The Ohio Public Schools AIDS Manual

Chain of communicable disease game

Objective:

• To assist in identifying links in the communicable disease chain that can be broken to prevent and control the spread of some communicable diseases, including AIDS.

Target Group:

• Upper secondary school students, adults

Group Size:

• Six people per group

Materials:

• Link/Characteristics game cards (See Appendix II)

Preparation:

• Duplicate the number of sets of cards equal to the number of groups. Cut the cards apart and keep them in individual sets. Number the reverse of each set of cards from 1 to 30.

Time:

• 20 minutes

Directions:

• Divide participants into groups of six, three players per team.

• Place a set of labeled cards, number side up, on the table top in view of all of the players in the group.

• Explain that this game is similar to the game "concentration". (See Prevent AIDS Concentration rules). The first player selects a card by calling a number. The card with that number is turned over and the player must then make a match between a communicable disease chain link and its corresponding AIDS characteristic.

Example:

Transmission (Link) - Unprotected Sexual Intercourse (AIDS Characteristic)

• Each team should select the order in which team members play. Players can consult with team mates if necessary.

• When all of the cards are matched, the game is over.

• Have a large group discussion on the ways they players think the links in the "Communicable Disease Chain" can be broken to prevent the spread of HIV (or other communicable diseases).

COMMUNICABLE DISEASE CHAIN

To cause disease, the agents of infection must travel from one person to another. This creates a cycle which can be visualized as a chain linking all the necessary components for spreading of disease. Understanding and breaking the chain at any one link can prevent further infection.

Image

A. The first link in the chain is AGENT.

THE GERM WHICH PRODUCES AN INFECTION. Most germs can be classified as either viruses, bacteria, fungi, or yeast. Like any life form, germs need a certain environment in order to survive. Some germs need air and die without it. Other germs die when exposed to air. Some germs need moisture and will die if their environment is dry. Warmth is a requirement for many germs, while some can survive in extreme cold or heat (even freezing or boiling temperatures). Certain nutrients (foods) are a must for germ growth, although some germs can survive for years with no nutrients while in the spore stage. All germs must eventually reproduce or they will die out. Antibiotics are chemicals which kill germs either by blocking their use of available nutrients (bacteriocidal) or by preventing reproduction (bacteriostatic)

A. The first link in the chain is AGENT.

 

B. The second link in the chain is RESERVOIR.

The germ reservoir is ANY PLACE GERMS CAN LIVE. Some can live only in humans or animals, while others can survive in inanimate reservoirs such as soil, air, water, food, or any such objects.

B. The second link in the chain is RESERVOIR.

 

C. The third link in the chain is PLACE OF EXIT.

WHERE THE GERM LEAVES THE RESERVOIR. Some germs leave animal reservoirs (humans, dogs, cats, skunks, etc.) through body openings such as the mouth, nose, rectum, genitals and wounds.

C. The third link in the chain is PLACE OF EXIT.

 

D. The fourth link in the chain is the METHOD OF TRANSMISSION.

HOW THE GERM TRAVELS FROM THE RESERVOIR'S PLACE OF EXIT TO ITS DESTINATION. A sneeze can send millions of germs into the air inside tiny droplets. The wind can carry some germ spores for miles. Human feces and urine can contaminate soil or water, especially if these wastes are allowed to enter water supplies without proper treatment. Kissing, sexual contact, or any contact with an infected sore can allow some germs to travel from reservoir to the new host.

D. The fourth link in the chain is the METHOD OF TRANSMISSION.

 

E. The fifth link in the chain is PLACE OF ENTRY.

THE PLACE WHERE THE GERM COMES INTO THE PERSON. Germs enter a new host in many ways. Germs in the air can be breathed in through the mouth or nose; germs in the water or food can enter the mouth and digestive system; and some germs enter through cuts or breaks in the kin. Others enter by direct contact with moist body areas as in most sexual intercourse.

E. The fifth link in the chain is PLACE OF ENTRY.

 

F. The final link in the chain is the SUSCEPTIBLE HOST.

BEHAVIORS, CONDITIONS, ENVIRONMENTAL AND INHERITED FACTORS WHICH MAKE A PERSON MORE LIKELY TO GET A DISEASE.

The condition of your body can affect its susceptibility, or danger of infection. Even when germs enter the body, infection does not always occur. Some people have already had certain diseases and have built an acquired immunity against future infections from that germ. Others have had innoculations which give the body artificial immunity. A body cannot fight some germs by producing antibodies and some germs are just too fast and tough for the white blood cells to handle. Good physical and mental condition, aided by proper nutrition, help the body resist infection. Proper hygiene, no breaks in the skin, and physical or chemical germ barriers are other defenses which help prevent the germ invasion. IF ANY OF THESE DEFENSES BREAK DOWN, THE HOST IS MORE SUSCEPTIBLE TO INFECTION.

F. The final link in the chain is the SUSCEPTIBLE HOST.

The chain of infection model presents opportunities to prevent infection by applying disease facts in choosing our behavior.

 

COMMUNICABLE DISEASE CHAIN AIDS NARRATIVE

Human Immunodeficiency Virus (HIV)

AGENT

Human Immunodeficiency Virus (HIV) is known as the virus which causes AIDS. HIV is the most common and appropriate form used. However, there are several names used for this virus:

• HTLV-III - Human T-Lymphotrophic Virus Type III

• LAV - Lymphadenopathy Associated Virus

• AIDS virus

A. Human Immune System B. Asymptomatic carrier

RESERVOIR

A. The immune system is the body's mechanism for defending itself against harmful germs. For most diseases you acquire immunity (the body's resistance to disease) after exposure to a germ (virus, bacteria, fungi or yeast). When a germ enters the body, the immune system produces antibodies. These antibodies attempt to destroy or neutralize the invading organism.

The immune system includes many body organs and tissues. Human blood is also part of the body's immune system which contains different types of white blood cells (T-cells) that help fight infection.

The Human Immunodeficiency Virus attacks a person's immune system through entering specific T-cells and damaging the person's ability to fight other diseases. Without a functioning immune system, the person now becomes vulnerable to becoming infected by opportunistic diseases which may cause life-threatening illness.

Life-threatening illness that ordinarily would never get a foothold. This illness is called an "opportunistic disease" - using opportunity of lowered resistance to infect and destroy.

B. A large number of people who are infected with the AIDS virus have no signs or symptoms. This asymptomatic reservoirs of infected individuals are capable of spreading the infection through risk behaviors.

Penis, Vagina, Contaminated Blood

PLACE OF EXIT

The human immunodeficiency virus is found in several body fluids (semen, vaginal secretions and blood). During sexual contact an infected person's blood or semen and possibly vaginal secretions exit the body through the penis and vagina. The virus also exits the body through contaminated blood.

• on needles and syringes shared by drug users

• through contaminated blood products

• in blood donated for transfusion

• from pregnant women to unborn child

In 1989 a blood screening program was put into place to protect those receiving transfusions from contaminated blood.

Blood, semen, and vaginal secretions

METHOD OF TRANSMISSION

HIV is transmitted by high risk behaviors:

1. Unprotected sexual intercourse (heterosexually or homosexually)

2. By sharing needles and syringes for intravenous drug use

3. Receiving contaminated blood products

4. HIV positive pregnant women to their unborn infants

HIV is not spread through casual contact - sweat, tears, drinking from the same glass, hugging, etc.

Engaging in risk behaviors or deciding to abstain from risk behaviors are personal choices that will determine if you are a person at risk.

Anus, Penis, Vagina, bloodstream, mouth

PLACE OF ENTRY

Although the HIV is found in several body fluids, a person acquires the virus during sexual contact involving an infected person's blood or semen and vaginal secretions. The virus then enters a person's bloodstream through their rectum, vagina, penis, or mouth. Small (unseen by the naked eye) tears in the surface lining of the vagina or rectum may occur during intercourse thus opening an avenue for entrance of the virus directly into the bloodstream.

Anyone engaging in risk behaviors

SUSCEPTIBLE HOST

The human immunodeficiency virus infects persons who expose themselves to known risk behaviors. Risk behaviors are a matter of individual choice. The epidemic is no longer limited to certain risk groups.

AIDS is everyone's concern.

Chain Links	AIDS Characteristics
Agent	HIV
Reservoir	asymptomatic carrier
Reservoir	human immune system
Place of Exit	contaminated blood
Place of Exit	penis
Place of Exit	vagina
Method of Transmission	unprotected sexual intercourse
Method of Transmission	sharing needles
Method of Transmission	infected pregnant woman to unborn child
Method of Transmission	contaminated blood
Place of Entry	penis
Place of Entry	vagina
Place of Entry	anus
Place of Entry	blood
Susceptible Host	anyone engaging in risk behavior

Image