Peace Corps

• Subject(s): Environment & Health, Science, Mathematics
• Grade Level(s): 6–8, 9–12

Overview

Students will investigate what HIV/AIDS is, how it is caused, the effects of the disease, and how to prevent it. ("HIV" stands for Human Immunodeficiency Virus. "AIDS" stands for Acquired Immune Deficiency Syndrome.)

Background Information

This lesson provides basic information about HIV and AIDS that can be incorporated into the curriculum. These sessions give a general overview of the disease, explain how it can and cannot be transmitted, and enable students to understand the effects of the disease. The sessions build on each other and concentrate on addressing students' knowledge about and attitudes toward HIV/AIDS. These sessions avoid using fear tactics or blame of any group for the infection. Messages of fear and blame have caused people to avoid the topic of HIV/AIDS rather than confront it. In addition, these sessions clarify commonly held myths about AIDS. The ultimate goal of the sessions is to get students to a position of hope and affirm their ability to respond intelligently and effectively to the pandemic that affects the world today. Note: Some of these exercises may be disturbing to students, because the realities themselves are disturbing.

Objectives

The sessions are designed to teach:

• AIDS is a problem, but we have the power to do something about it.
• HIV attacks our immune systems, so people who have HIV should do all they can to maintain a healthy lifestyle that includes good nutrition, exercise, and as little stress as possible. Healthy lifestyles support healthy immune systems.
• It is clear how HIV is transmitted.
• Women are especially vulnerable to HIV infection and need information and skills to protect themselves and their children from infection.
• There are simple and effective ways for everyone to prevent HIV infection.
• The time it takes for HIV to lead to AIDS varies greatly, and our health behaviors can affect that time period. People with HIV/AIDS need to take care of their bodies, mentally and physically.
• Although there is no cure for AIDS, there are many treatments available.
• Early treatment of other sexually transmitted diseases (STDs) can dramatically reduce the risk of infection with HIV.
• Protecting the human rights of people living with HIV/AIDS not only helps them to live positive and productive lives, but also helps to prevent HIV transmission in our community.
• Knowledge, attitudes, and skills need to be used together to help us practice behaviors that reduce risks for HIV and lead us to a healthier life.

Materials

• Life Skills Manual

Procedures

I. Getting to Know the Immune System

Ask the students in a class discussion what they know about the body's immune system. Lead the discussion with these guiding questions:

1. What is our immune system? [Answer: A complex network of interacting cells, cell products, and cell-forming tissues that protect the body from pathogens and other foreign substances. The system includes the thymus, spleen, lymph nodes and lymph tissue, stem cells, white blood cells, antibodies, and lymphokines. Understanding some basic facts about the immune system can help us learn both how to prevent disease and how to help slow down disease progression if we are already infected.]
2. What are the two types of blood cells?
   [Answer: Red (erythrocytes) and white (leukocytes).]
3. What is the major function of red cells?
   [Answer: Red cells, called erythrocytes, carry oxygen through our system and carry away carbon dioxide.]
4. What is the major function of white blood cells?
   [Answer: White blood cells, called leukocytes, are our immune cells. Our immune system is made up of white cells that protect us from diseases. Some of the main cells in our immune system are
   
   

   ?The macrophage: Macro = Big, Phage = Eater. The Big Eater.
   This cell eats the invaders or germs (called antigens) and sends a signal to the captain of our immune system that an invader is present and that the immune system army needs to respond.
   
   ?The T4 Helper Cell (CD4): Captain of our immune system.
   It receives the message from the macrophage when an invader (antigen) is present and orders two more cells (the B cell and the T8 killer cell) to search for, and destroy, the invader. The T4 Helper Cell is also the cell that HIV attacks and destroys. T cells are called "T" because they mature in the thymus gland.
   
   ?The B Cell: Like a factory.
   It identifies the shape of the invader (antigen) and makes antibodies (like keys), which fit the antigen. These antibodies can immediately recognize future antigens of this kind and stop them from making us sick in the future.
   
   ?The T8 (CD8) or Cytotoxic or Killer Cell:
   It is called by the T4 Helper Cell to attack the invader and kill it directly.

5. What is an antigen?
   [Answer: An antigen is a foreign invader or germ that enters our system. It can be a virus, a bacterium, a fungus, a protozoan, and so forth. Have the group name an antigen common in their community besides HIV. (Examples: cold virus, TB bacteria.)]
6. What is an antibody?
   [Answer: An antibody is a specialized protein that is a response to an invading antigen. Antibodies are produced by B cells. They work like keys, fitting the shape of the antigen locks. When an antigen enters the system again, it is recognized and attacked by antibodies.]
7. What is HIV?
   [Answer: The Human Immunodeficiency Virus. The virus that attacks the T4 Helper Cell. When it cripples enough T4 Helper Cells, the rest of the immune system is not called into action. Other antigens invade the body and cause disease. At this point, the infected person develops AIDS, which is Acquired Immune Deficiency Syndrome.]

II. The True-or-False Game

The True-or-False Game is a helpful technique when covering a topic for the first time because it will help you to get an idea of the level of knowledge students already possess. It is also a great way to develop thinking skills, as students will tend to debate to support their position. With a new group, it will also give you a sense of who the unspoken leaders or the most confident students are, as others may watch them for clues regarding the truth of a statement. Here is how the game is played:

1. Print the word TRUE in large letters on a sheet of paper. Hang the paper on one wall.
2. Print the word FALSE in large letters on a separate sheet. Hang the paper on the opposite wall.
3. Clear an open area between the two signs.
4. Ask students to gather in the center of an open area. Read one of the bulleted comments from the lists below. There is a list of true statements and a list of false statements defining HIV transmission. Once you read the statement aloud, the students should move to whichever sign they think is correct. If they are undecided, or think it can be both true and false, they should remain in the middle.
5. Ask the students, in turn, to explain or defend why they are at the side they chose. It is good to ask for explanations from one side, then the other, as groups will tend to begin a debate about the correct answer. Only after everyone who wants to has spoken should you give the correct answer and additional information.
6. Emphasize good communication skills and conflict resolution by suggesting that each side reflect upon the points of the opposing side before stating their own opinions.
7. Everyone comes back to the center and the game continues with another question.

True Statements:

• You can get HIV by receiving a direct blood transfusion of untested blood.
• Although Africa has been more affected by AIDS than any other part of the world, HIV infection rates are rising in many other regions.
• Although many people do not have access to expensive drugs to treat AIDS, there are medicines that can slow down disease progression.
• You can get HIV by sharing needles.
• You can get HIV by coming into contact with blood of an infected person.
• Breastfeeding can spread HIV from mother to child.
• A mother can pass HIV on to her infant during delivery.
• Although treatments to slow the progression of HIV/AIDS exist, there is still no cure for AIDS.
• HIV can be transmitted through an exchange of blood.
• In (country name), about (percent) of adults are infected with HIV. (Use UNAIDS website to update statistics for whatever country you wish to focus on.)
• HIV can be transmitted through contact with semen and/or vaginal fluids.
• HIV is the virus that causes AIDS.
• You cannot get HIV by kissing a person with HIV when blood is not present.

False Statements:

• There is a new drug that can cure AIDS.
• You may get HIV being near a person with the virus.
• You can tell that someone has HIV by looking at the person.
• Since everyone who has AIDS dies of it, it is better not to know if you have it.
• You may get HIV by eating food prepared by someone who has HIV or AIDS.
• No one has AIDS in our country.
• It is safer to wear two condoms instead of just one.
• The condom has small holes in it which HIV can pass through.
• Hugging a person with HIV may expose you to the virus.
• You may get HIV by shaking hands with a person with HIV.
• HIV can be spread by mosquitoes.
• If a person looks healthy, then he or she does not have AIDS.
• You may get HIV by drinking from the same glass that a person with AIDS has used.
• It is safe to have sex just once without a condom.
• You can get HIV from a dog bite.

After clarifying the true and false statements, lead a discussion using questions, such as:

• Do you believe that HIV/AIDS has affected our community? Why or why not? What evidence do you see of the effects of AIDS in our society?
• What other things have you heard about HIV/AIDS in our community that you think might be untrue?
• Do you think that everyone who has HIV/AIDS knows that he or she has it? Why or why not?
• Would people hide the fact that they or someone in their family has HIV/AIDS? Why or why not?
• What can we do to help protect ourselves from HIV/AIDS?
• What can we do to help our community fight HIV/AIDS?

III. Understanding the Math

Through a simulation, students will be given the opportunity to experience the rapid growth in the number of HIV+ people and translate this into mathematical terms, focusing on exponential functions.

A. Rapid Spread (Part 1)

This activity is designed for a group of 50 students.

Pass out 50 cards?3 cards with the letter A on them and 47 other cards with various letters. Students receive one card each. You need to know which student is holding the A cards. Students exchange their card with one other person and then take their card back. Repeat the exchange with different partners. Do the exchange two or three times. Students need to remember with whom they have exchanged cards.

Now ask the three students with A cards to stand up. Next, anyone who did the first exchange with one of these three must stand; then anyone who exchanged with any of the six now standing must stand, etc. (for the total number of exchanges).

Sensitively announce that this simulation represents the rapid transmission of the HIV virus and that the students standing are representative of those persons infected in the population of 50 people?infected by the initial three A-card holders.

Graphing It:

x = the number of encounters
y = number of people infected

a) Complete a table

x	y
0	3
1	6
2	12
3	24

b) Graph y = f(x)

c) Explain y = (3) 2^x

B. Rapid Spread (Part 2)

Collect the cards. Substitute two "condom" cards and two "stop" cards for four of the cards. Now return the cards to the students and repeat the process of exchanges. After the exchanges, ask students holding the A cards to stand up. Students who exchanged with any of these must stand. However, if the students who had contact with the A cardholders are holding a condom card or a stop card, they may sit down, because they are not infected. The condom card represents a person who used a condom for protection, and the stop card represents someone who elected abstinence.

Graphing It: Generate a chart, then graph and compare the rates of growth.

Further Thoughts: What would happen if five people were originally infected? Have students generate a table, graph, and form the equation.

Discussion:

• Why use condoms?
• What happens to the infection rate after further exchanges?
• How many exchanges would it take before 40 people were infected? Tie this problem into logarithms.
• Extend the question to include the number of students in the school ? in the town.
• Review percentages, percentage decrease after condom use, etc.

Ask the group what they learned from this game. Put their answers on a flip chart. Possible answers:

• HIV can be transmitted very quickly and easily.
• You cannot tell if someone has HIV.
• Using a condom can reduce your risk of HIV.
• Having contact with one person is the same as having contact with all the partners of that person.

Ask the people with the A cards how they felt to discover they were HIV positive. Ask the people with the condom cards or the stop cards how it felt not to be infected at all and to sit down.

Note: It is important to emphasize that this is a representative exercise. People cannot transmit HIV by simply greeting each other. They would have had to have sex (or other contact with bodily fluid). Also, be careful that this exercise does not set a tone of blaming the victim.

Lastly, ask the group how they could have avoided infection in this game. Possible answers:

• They could have refused to play (Abstinence).
• They could have insisted on seeing their partners' cards (Testing).
• They could have greeted only one partner (Risk reduction. Being faithful).

IV. The Loss Exercise

The Loss Exercise provides a powerful framework for discussing empathy for those experiencing grief or loss, especially those infected or affected by HIV/AIDS.

Before introducing the topic, spend a few moments reviewing some of the issues that you have covered up to this point. Explain that the class is about to do an exercise to help them look at HIV/AIDS from a personal perspective. Ask students to completely clear their desks of everything except a sheet of paper and a pen or pencil. Tell them to number 1 to 5 on their papers. Explain that you are going to read five statements, and they will respond to those statements on their papers. It is crucial to emphasize that no one else in the room will see their papers and the papers will not be collected. The papers will not be used at any later time. The papers are the students' own personal property. Do this exercise slowly and seriously. Participants should feel the full impact of this discussion. One by one, read off the statements and tell the students to write their responses on their papers. Reinforce that it will not be shared with others.

1. Write down the name of the personal possession that you love the most. Maybe it is your house, or a special item your grandmother gave you, or a book, or anything else. What one thing that you own means the most to you? Write that thing on #1.
2. Write down the part of your body that you are most proud of. Perhaps you really love your eyes, or you are very proud of your hair, or you enjoy your ears the most because they help you listen to music, or you love your voice because it helps you to sing. Write down the one part of your body that you are most proud of on #2.
3. Write down the name of the activity you most enjoy doing. Maybe it is going to a religious event, or playing football, or dancing, or some other activity. What do you most enjoy doing in the whole world? Write that activity on #3.
4. Write down one secret or very confidential thing about yourself that no one else in the world or only one other person knows about. Every one of us has some secret or private thing that he or she does not want others to know about. Write that personal, private piece of information down on #4. You may abbreviate it so no one will be able to see it by mistake. (Remind the group that no one else will see this sheet.)
5. Lastly, write down the name of the person whose love and support means the most to you in the world.

After everyone has finished, explain that you will now go through the list again. As you go through each statement, the students should imagine that they are living through what you are saying.

1. Imagine that something terrible happens that causes you to lose the material possession that you love most. Either a theft occurs or a loss of some kind that takes this thing away from you completely. You will never again see the thing listed on #1. Take your pen or pencil and cross out #1 now.
2. Imagine that an accident or another unfortunate occurrence causes you to lose the part of your body that you are proudest of. This part of your body is gone, and you will never have it again as long as you live. Cross out #2 now with your pen or pencil.
3. Imagine that this same accident or unfortunate occurrence makes it impossible for you to do your favorite activity ever again. You will never again, in your entire life, be able to do the activity you wrote on #3. Cross out #3 with your pen or pencil now.
4. Imagine that because of all of the above situations, your secret has been exposed. Everyone now knows what you wrote on #4. It has become public knowledge. Everyone in the school, town, church, mosque, temple, and community knows about what you wrote on #4. Circle #4 with your pen or pencil now.
5. Lastly, because of all of these changes (losing your possession, losing your body part, not being able to do your favorite activity, and everyone knowing your secret), the person whom you love most in the world leaves you forever. You will never again see this person that you love and who is your most important source of support. Cross out #5 with your pen or pencil now.
   
   Allow a few silent moments for the participants to truly feel what you have just said.

Students are usually a bit upset and uncomfortable at this point. Give them some time to think about this. Now, ask them to describe in one word or phrase the emotions they are feeling. Write the words on a blank board or flip chart. Keep brainstorming until all of the ideas are exhausted. Your list may include sadness, grief, feeling like killing myself, hopeless, alone, miserable, depressed, angry, blaming others, no reason to continue. Ask the students to take a look at the list that they have just made. Ask them to imagine how these feelings might relate to testing positive for HIV/AIDS. Discuss the links between this exercise and testing positive. Remind the class that they have placed themselves in the position of a person living with HIV/AIDS and allowed themselves to experience the strong emotions that such a person might be living with every day. Discuss what this might mean for the support that they could give to people living with AIDS. How can they help someone in this situation? How would they feel if they or someone they love were involved in this situation?

Framework and Standards

Standards

National Science Education Standards

• Content Standard F: Science in Personal and Social Perspectives
• Content Standard C: Life Science

Mathematics

• Algebra