"TALK TO ME" - Sexuality Education for Parents

Sexually Transmitted Infections and HIV/AIDS

Goal
This workshop will allow parents to become more knowledgeable about sexually transmitted infections and HIV/AIDS and give them the necessary tools to comfortably broach the subject with their adolescent.

Summary
By participating in its suggested activities the parents will become more knowledgeable about HIV as well as other sexually transmitted infections (STIs). The parent will learn more about the asymptomatic nature of these communicable diseases, their long term consequences as well as their modes of transmission. The parent will become aware of the importance of adopting preventive measures. The participants will also reflect on the level of risk of their own sexual practices.

Themes
Symptoms and modes of transmission of STIs and HIV, risky behaviour, asymptomatic character and preventive measures.

Suggested activities
Exposés, discussions, role-playing, Jeopardy!, work in teams.

General objective #1:
The workshop will enable parents to gradually become more knowledgeable about STIs and HIV/AIDS.

Specific objectives:
By the end of the workshop the parents will be able to:
1.1 Name the symptoms usually associated with STIs and HIV;
1.2 Recognize the asymptomatic character of certain STIs, especially among women;
1.3 Explain the main modes of transmission of STIs and HIV.

General objective #2:
The workshop will make parents more sensitive to the issue of protection against STIs and HIV.

Specific objectives:
By the end of the workshop the parents should be able to:
2.1 Establish a list of risky behaviours;
2.2 Recognize their own risks of acquiring STIs or HIV;
2.3 Identify safer sexual behaviours.

General objective #3:
The workshop will give parents the necessary tools to tackle the subject of sexually transmitted infections, HIV/AIDS and the issue of prevention with their adolescent.

Specific objectives:
By the end of the workshop the parents should be able to:
3.1 Outline their own limits and difficulties with STIs and HIV;
3.2 Name the principles which, when respected, make communication easier;
3.3 Discuss STIs and HIV/AIDS with their adolescent.

Procedure

1. "Icebreaker"
The facilitator introduces him/herself and explains the goal and objectives of the workshop. He/she asks the parents to introduce themselves as well by stating three things: their name, a question they always wanted answered about STIs or HIV and a question they feel they would be able to answer on the subject. The facilitator writes the former set of questions on the board.

Length: 5 minutes
Purpose: Introduction
Facilitator's role:

• Showing interest in and enthusiasm for the subject
• Encouraging the parents to express themselves; giving examples

Required material:

• Board
• Markers/chalk

2. Presentation of the fact sheet on STIs and HIV

The facilitator gives all parents a fact sheet on STIs and HIV/AIDS ⁽¹⁾. He/she names various STIs and asks one participant at a time to read the corresponding information out loud. The facilitator reiterates the asymptomatic character of many of these STIs. He/she also ensures that all questions asked during the previous exercise are answered.

Length: 20 minutes
Corresponding objectives: 1.1 - 1.2 - 1.3
Facilitator's role:

• Explaining the goal and the relevance of this activity
• Encouraging the parents to participate
• Answering questions
• Handing out the STI and HIV/AIDS fact sheet downloaded from the Internet ⁽²⁾

Required material:

• List of Web sites references
• Board with questions from the Icebreaker exercise

3. Discussion on STIs and HIV

The facilitator gathers some of the participants' comments on the information they have received so far and leads into a discussion with the following questions:

• What have you learned?
• Did you know all these STIs?
• Did the information surprise you (i.e. the mode of transmission of herpes)?
• Were you familiar with the symptoms of these infections?
• Had you known that these types of infections were asymptomatic in nature, especially among women?
• How do you feel about this information (fearful, angry, worried, indifferent, fearful of sexuality in general, wronged)?
• Do you have any other questions about the information given so far?

Length: 10 minutes
Corresponding objectives: 1.1 - 1.2 - 1.3
Facilitator's role:

• Encouraging the parents to participate
• Answering questions clearly and with precision
• Using vocabulary conducive to a better understanding

Required material:

• None

4. Exercise - discussion on risky behaviour
The facilitator reads a list of statements on STIs and HIV/AIDS (annex #1), and the participants must determine whether or not each statement is true or a myth. The facilitator corrects the answers and completes the information with the help of annex #1.

He/she then opens a discussion using the following questions:

• What do you think of the idea of risk associated with sexuality?
• Which activities represent a high risk according to you?
• What risks would you be willing to take?
• What risks would you refuse to take under any circumstance?
• How would you react upon finding out that your adolescent was engaging in highly risky behaviour?
• Have you already taken risks, as a teenager or as an adult?
• Would you take the same risks today as you did in your adolescence? Why? Why not?

The facilitator ends the exercise by pointing out that the perception of risk varies from one person to the next. Most individuals have taken chances at one point in their lives; it becomes a matter of remembering it as an adult. This awareness can greatly improve the dialogue and one's own understanding, and make communication with one's adolescent more authentic and honest.

Length: 15 minutes
Corresponding objectives: 1.1 - 1.2 - 1.3 - 2.1 - 2.2
Facilitator's role:

• Encouraging the parents to participate
• Answering their questions
• Giving appropriate examples

Required material:

• Annex #1

____________________________

BREAK: 10 minutes
____________________________

5. Brainstorming on safer sexual behaviour
The facilitator asks the parents to name safer sex behaviours and to write them on the board. The facilitator completes the information with the help of annex #2 and explains which steps would need to be taken if one's sexual health was ever compromised (annex #2). The facilitator wraps up the exposé by explaining the importance of consulting a physician and going for regular check-ups as soon as one becomes sexually active.

Length: 10 minutes
Corresponding objective: 2.3
Facilitator's role:

• Encouraging the parents to participate
• Answering questions if need be
• Giving appropriate examples

Required material:

• Board
• Markers/chalk
• Annex #2

6. Jeopardy!
The facilitator suggests an interactive exercise based on the game show Jeopardy! in order to follow up on the content so far and to ensure that it has been assimilated. He/she splits the group in two and begins the game by using statements from annex #3, then writing the points on the board.

Length: 15 minutes
Corresponding objectives: 1.1 - 1.2 - 1.3 - 2.1 - 2.3
Facilitator's role:

• Explaining the rules of Jeopardy!
• Being clear, precise and dynamic during the game
• Listening to the answers and correctly counting the points
• Asking a participant to help write the points on the board

Specific guidelines for this activity:

• Members of both groups must raise their hands before answering
• The team must wait for the statements to be given prior to answering
• A wrong answer entitles the other team to attempt an answer in return
• The answer must absolutely respect the Jeopardy! rules and be given in form of a question

Required material:

• Annex # 3

7. Role-playing/discussion
The facilitator suggests that the parents participate in the role-playing exercise ⁽³⁾. He/she asks the parents to play the role of either parent or adolescent and hands out annex #4 to the volunteers. To encourage participation the facilitator explains that this activity not only allows for an overview of the material but also gives them a chance to practice discussing STIs, HIV/AIDS and prevention with their adolescent.

The facilitator then leads a discussion by asking the following questions:

• Do you feel comfortable bringing up the subject with your adolescent?
• Has this experience allowed you to become aware of the difficulties you may have with it?
• How could you have initiated the dialogue?
• What principles have to be respected during such a dialogue?

The facilitator explains the importance of informing adolescents about sexually transmitted infections and HIV/AIDS. The parents may offer various documents on the subject (pamphlets, flyers) to their teen. The parents should, however, also be able to discuss the positive aspects of sexuality. The facilitator can suggest examples of ways to open up the dialogue:

Some examples:

• Have you read the pamphlets I've given you on STIs and HIV/AIDS?
• Have you ever discussed the subject in school?
• Are there things that you do not understand and that I can explain?
• I would love to tell you about what I've learned in my STI class!

The facilitator may also encourage the parents to participate in the other workshops of the program, specifically in the workshop on attitudes toward sexuality and the workshop on communication between parents and adolescents.

Length: 15 minutes
Corresponding objectives: 3.1 - 3.2 - 3.3
Facilitator's role:

• Encouraging the parents to participate in the role-play while explaining the relevance of this activity
• Volunteering to play a role and setting the example
• Creating a sense of trust
• Using humour to ease the atmosphere
• Answering questions clearly during the discussion

Required material:

• Annex #4
• Pamphlets and flyers on STIs

8. Assignment

The facilitator suggests that the parents create a list of local resources offering STI and HIV/AIDS-related services to give to their adolescent ⁽⁴⁾. The parent could then convey his/her availability and willingness to answer any questions or concerns the adolescent may have.

Length: 5 minutes
Purpose: conclusion
Facilitator's role:

• Clearly explaining the assignment as well as its relevance
• Encouraging the parents to complete the assignment

Required material:

• List of Internet references

Oral evaluation

The facilitator wraps up with some of the following questions:

• How did you feel throughout this workshop?
• What was your specific interest in this workshop?
• What have you learned?
• How will what you learned help you? Please tell me about it?

Length: 5 minutes

Facilitator's role:

• Encouraging the parents to respond
• Noting comments to improve future workshops

Required material:

• None

Written evaluation
The facilitator distributes the written evaluation to the participants (annex #5).

Length: 5 minutes
Facilitator's role:

• Encouraging the parents to fill out the evaluation
• Distributing annex #5

Required material:

• Annex #5

Annex #1

Statements relative to STIs and HIV/AIDS.

Please indicate whether the following statements are true or false (myths) and explain why:

1. Only people with multiple partners are at risk of catching STIs.
   It only takes one partner.
   
2. The risk of becoming infected is greater with a person you do not know.
   Knowing a person does not prevent the transmission of an STI or HIV.
   
3. A person would always know if he/she were infected.
   Several STIs have no symptoms at all.
   
4. STIs only affect sexually active adults.
   Any sexually active person, including adolescents, is at risk of catching STIs or HIV.
   
5. STIs are often transmitted by a simple handshake.
   STIs are transmitted through direct skin to skin contact (ie. Herpes and HPV) with an infected area or the exchange of body fluids with an infected person. It is possible to pass the infection to your sex partner even when you have no sores. The areas of skin not covered by the condom are not protected.
   
6. HIV can only be transmitted through blood.
   HIV can be transmitted through body fluids such as semen, vaginal fluids, breast milk or blood.
   
7. HIV can be transmitted through saliva.
   The amount of HIV contained within saliva is insufficient to transmit the virus.
   
8. People with bad hygiene are more susceptible to STIs.
   Cleanliness is not a guarantee.
   
9. Only homosexual men are affected by HIV.
   People of any sexual orientation are at risk of catching STIs or HIV.
   
10. All STIs can be treated with antibiotics.
    Viral STIs cannot be treated with antibiotics.
    
11. People with STIs have loose morals.
    Any sexually active person can contract an STI or HIV.

Risky behaviours:

• Having unprotected (vaginal, oral-genital or anal) sex;
• Assuming that there is no risk of acquiring an STI just because your partner has no visible symptoms;
• Assuming there is no risk of infecting a sexual partner just because you have no symptoms;
• Not notifying a partner if you are diagnosed with an STI for fear of being judged, criticized, left, stigmatized, ridiculed, etc.;
• Continuing to engage in sexual activity during the course of STI treatment;
• Having multiple sexual partners, or sexual contact with a person who has or has had many sexual partners;
• Using alcohol or drugs reduces your ability use a condom effectively or to make healthy sexual choices;
• Sharing or using unclean needles for tattooing, injecting drugs or bodypiercing; or having sexual contact with a partner with these risks;
• Having a new sexual partner;
• Engaging in anal sex (males as well as females);
• Sharing sex toys without cleaning them or without using a condom;
• Having a partner who has or has had a sexually transmitted infection (STI);
• Using sheepskin (natural membrane) condoms; these condoms are not recommended for use to protect against HIV.
• Storing condoms in warm places and not watching if past expiry date.

Annex #2

A) Preventive measures and safer sexual behaviour are achieved by:

• Being open and honest about your attitudes, values and decisions about sex AND respecting those of others.
• Talking to your partner about STIs and about using contraception to prevent pregnancy.
• Choosing abstinence, the only sure way to avoid an STI and pregnancy.a loving partner will respect your decision.
• Reducing the number of sexual partners.
• Choosing safer environments to lower the risk of being raped.
• Avoiding alcohol/drugs that cloud good judgement.
• Never sharing needles for drugs, tattoos or body piercing and never sharing sex toys without cleaning them.
• Never taking a partner's sexual health for granted, and do not rely on visible symptoms as indicators of STI.
• Having regular check-ups for a complete STI and HIV screening before and throughout your sexual relationship even in the absence of symptoms.
• Using a condom in a monogamous relationship with a new partner until it is determined that neither partner has a sexually transmitted infection (some STIs have no symptoms). This "safer" sex practice, protects against most STIs.
• Using a latex or synthetic male condom (also female condom, latex barrier or dental dam) correctly and consistently.
• Using a male condom without the spermicide Nonoxynol-9 (N-9) is the best STI and HIV barrier. However, a condom lubricated with N-9 is better than no condom at all.
• Using only water-based lubricants with condoms. Oil-based lubricants (i.e. petroleum jelly) may weaken the latex and promote breakage.
• Choosing less risky sexual activities (ie. kissing, hugging, massaging, fondling) than sexual intercourse.
• Suspending all sexual contact with an infected person until the end of treatment.
• Advising your partner of any diagnosis as quickly as possible (to avoid re-infecting).
• Seeking a regular Pap smear (this is not an STI test). The Pap smear is important for all sexually active young and adult females.

B) Steps to take when sexual health has been compromised (screening is confidential and free):

• See your doctor or go to a clinic to undergo a medical exam - STI and HIV screening tests. Know which STIs you are being tested for. There are special tests for different kinds of STIs. If you have symptoms, visit your health care professional right away to get tested.
• Advise your partner(s) of any positive diagnosis as quickly as possible (your doctor or nurse can help you with this).
• Refrain from any sexual contact during the treatment period.(includes oral sex)
• If you are pregnant or planning to get pregnant, ask your health care professional to screen you for STI and HIV.
• If you have had unprotected sex or your contraception failed (i.e. the condom broke) an emergency oral contraceptive is available through your doctor, public health clinic and, in some provinces, at your pharmacist's. It must be taken within 72 hours.
• Whatever your circumstances, seeking reliable and accurate sexual and reproductive health services from a health care professional is an important step in maintaining good health and well-being.

Some infections are easily cured, but others, if not treated, can have a serious effect on your health. Some infections have no cure, but can be controlled.

Annex #3

Game: jeopardy - some examples of statements
(not to be presented in order)

Anal or vaginal intercourse without a condom. Answer: What is high-risk behaviour? An oral relation when there are visible lesions, cuts or wounds. Answer: What is high-risk behaviour? Blood, sperm, vaginal secretions, pre-ejaculatory fluid and breast milk. Answer: Which body fluids contain sufficient doses of HIV for transmission? Using a latex condom with water-based lubricant during sexual intercourse. Answer: What is safer sexual behaviour? Using a latex barrier for oral sexual relations. Answer: What is safer sexual behaviour? HIV/AIDS only affects homosexuals. Answer: What is a myth? It is possible to catch HIV through a handshake. Answer: What is a myth? An STI caused by a bacteria capable of leading to infertility in women. Answer: What is chlamydia? Burning on urination, discharge, pain in the testicles. Answer: What are the possible symptoms of chlamydia in men? This STI often presents no symptoms at all. Answer: What is chlamydia? Skin to skin contact is often sufficient for the transmission of these STIs. Answer: What is Herpes and what is Human Papillomavirus (HPV)5? An STI which manifests itself through painful lesions on the genitals. Answer: What is herpes? An STI which may have no symptoms or can manifest itself through visible genital warts. Answer: What is HPV? A viral STI responsible for cervical cancer. Answer: What is HPV?

Annex #4

Role-playing

Role-play #1:
You overhear your 13 year old daughter offer her support to a friend who has just been diagnosed with herpes. This situation worries you. You decide to discuss it with your daughter.

• What can you tell her?
• How do you tell her?

Role-play #2:
You hear your son tell a friend that his new girlfriend has already had gonorrhea, but he doesn't seem to know what it is.

• What can you tell him?
• How do you tell him?

Role-play #3:
You are watching a report on HIV/AIDS when your adolescent leaves the room stating that he/she has heard enough about it at school and doesn't feel concerned by the issue.

• What can you tell him/her?
• How do you tell him/her?

Role-play #4:
You find out that your daughter has been taking the pill for a while. However, you don't know anything about her sex life (i.e. number of partners).

• What can you tell her?
• How do you tell her?

Role-play #5:
You have a 13 year old son. Your condoms have also been mysteriously disappearing for some time now.

• What can you tell him?
• How do you tell him?

Role-play #6:
Your son is very reckless and has always enjoyed taking risks in all areas of life. This behaviour worries you, and you fear that he will adopt the same attitude when it comes to his sex life.

• What can you tell him?
• How do you tell him?

Annex #5

Please complete the following questions:

1. What is one thing you learned about _______________that you did not know before?

2. What questions or concerns do you still have about _______________?

3. Will you do anything differently as a result of learning about____________?

Yes _____ No _____

Please tell me about it:

 

4. I'd like to tell the facilitator:

 

Frequently Asked Questions

1. How do I protect my adolescents from the dangers of STIs⁶?
Prevention remains the only effective way to stay healthy. It is important to advise one's teenagers about the risks associated with certain sexual practices (see annex #1). The workshop on communication offers practical tips on how to broach the subject with one's adolescent.

2. Can one catch an STI even when having intercourse for the first time?
Absolutely! STIs may be caught during any first sexual experience regardless of one's partner's age, gender, status, ethnic background or sexual orientation. STIs do not discriminate!

3. What is the first thing to do if my adolescent believes to have become infected⁷?
Because most STIs present no visible symptoms it is recommended that a health professional be consulted as soon as possible if your teenager has engaged in sexually risky behaviour. In the event of a positive result it is important that the adolescent's sexual partner be advised so that he/she may be treated as well. In some cases the previous partners should also be notified. You may want to discuss this with your doctor.

4. Can my adolescent be treated if he/she catches an STI?
Several bacteria-based STIs (chlamydia, gonorrhea) can be treated with the help of antibiotics. STIs caused by viruses (genital warts, herpes, Hepatitis) require more specific interventions for the symptoms to be treated. A health professional should be consulted as soon as possible so that appropriate treatment may be obtained and further complications avoided.

5. Can one die as a result of an STI?
In most cases, no. Only Hepatitis B and C as well as HIV/AIDS may eventually lead to death. Other STIs may be treated, or their symptoms at least controlled.

6. If my adolescent becomes sexually infected can he/she transmit this STI to other family members?
This is very unlikely. Most STIs are transmitted through direct skin to skin contact with the infected area (herpes and genital warts) or through the exchange of body fluids during unprotected sex (oral, vaginal, or anal) with an infected person. Regular family interactions are considered low risk for the transmission of STIs. In an effort to prevent transmission, it is recommended that personal objects such as razors and toothbrushes not be shared.

Web site References

http://www.phac-aspc.gc.ca/std-mts/index.html
Health Canada's web site offering information on STIs (Chlamydia, Gonorrhea, HPV, Herpes); How to Use A Condom.

http://www.phac-aspc.gc.ca/std-mts/publications-eng.php#education
Workshops on Chlamydia, Gonorrhea, Herpes, including FAQs and references.

http://www.thebody.com/cdc/factadol.html
Centre of Disease Control (CDC)'s web site providing information on teens and STIs, including HIV and AIDS.

http://www.ashastd.org/
American Social Health Association (ASHA)'s site in collaboration with The Centre for Disease Control (CDC); contains information on STIs.

http://www.sxetc.org/
A teen-produced web site that talks about love, sex, abstinence, contraception, AIDS, STIs, drugs, drinking, violence and health.

http://www.region.peel.on.ca/health/hsexual/htmfiles/stdsafer.htm
Peel Health's web site offering tips on safer sex.

http://www.region.peel.on.ca/health/hsexual/htmfiles/bstds.htm
Peel Health's web site on STIs.

 

__________________________________

¹ The facilitator may consult the list of Internet references for information and statistics on STIs and HIV/AIDS.

² Variation: The facilitator may also use flyers or pamphlets on STIs and HIV/AIDS.

³ Variation: this exercise can be carried out as a discussion rather than a role-play.

⁴ Parents may consult the list of Internet references for more information on available resources.

⁵ HPV: Human Papillomavirus is sometimes called the Wart virus.

⁶ Refer to annex #2A for information on prevention measures.

⁷ Refer to annex #2B for information on the necessary procedures following risky behaviour.