HIV, AIDS and sexually transmitted infections - care, support and prevention - AIDS action  

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Starting the discussion: steps to making sex safer
  >  Part 3: Working with groups 
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Part 3: Working with groups

Starting the Discussion: Steps to Making Sex Safer

Understanding people's behaviour
Communicating for change
Working with groups
Assessing change
Teaching tools
Check your facts
Resource list




Building on Knowledge


1 Finding the gaps


2 Check your beliefs


3 Talking about sex


Thinking about Risk


4 Risks and results


5 Most risk/least risk


6 Taking the risk and passing it on 


Exploring Attitudes and Feelings


7 Agree/disagree


8 Thinking about sex differences


9 Talking about making sex safer


10 Digging deeper


Practising New Skills


11 Learning about condoms


12 Using role play 


Problem-Solving and Decision-Making


13 Change takes time


14 Using picture codes


15 Open-ended story


16 Barriers to change


17 Using drama




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  Part 3: Working with groups


The group activities in this section aim to help people to:


build on knowledge - to review what they know and believe to be true about HIV, sex and relationships


think about risk - to consider how they weigh up different risks, and to accept that HIV is a personal and serious issue


explore attitudes and feelings - to reflect more deeply about their lives and relationships, men's and women's roles, and fears and hopes about change


practise new skills - to learn about using condoms correctly, and to communicate better about what is best for themselves and their sexual partners


solve problems and make decisions - to define problems and barriers to change in their relationships and communities, and to find realistic ways to overcome them.

Working with groups


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  Part 3: Working with groups



Many of the activities described in this guide involve writing things down. This can be difficult when working with non-literate groups. Try to think of ways around this problem - instead of leaving out useful activities. Use drawings to represent the words, or make sure that you take notes, so that you can repeat people's points instead of asking them to read and write.


Talking about sex and HIV can be very difficult. Carrying out listening surveys and focus group discussions can help in the preparation of the education programme, and in getting the discussion going (see Part 1).


It often helps to discuss issues in separate groups for men and women, especially activities about words used for sex, or men's and women's roles. But remember to give men and women opportunities to discuss these issues together, and do role plays. These activities are about practising for real life!


Some activities bring up very emotional issues for people, about their sexual experiences or their fears about having HIV. Remember that some of the people in the group may already know that they are HIV-positive. If needed, provide opportunities for counselling or sources of further information.

Before you start, it is also very useful to spend time reviewing the facts and your own feelings about HIV (see Part 6). Check Part 2 for tips on how to plan and run interesting training sessions.


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Building on knowledge

Telling people what they know already is a waste of time. It is better to assist them to build on their knowledge and encourage them to explore and question what they believe about HIV, sex and sexuality.
Activity 1:  Finding the gaps 

Aim:            to help people identify their own gaps in information about HIV and safer sex
Materials   chalkboard or large sheet of paper and marker pen 
Time:          about 1 hour  

  1. Ask the group to name all the different ways in which they think HIV is spread, both sexually and non-sexually. Write the different suggestions down as a list on a chalkboard.

  2. Draw two columns next to the list with the headings True or False.

  3. Then ask people to decide whether to place a tick in the true or false columns next to each suggestion.

  4. Use this information as the basis for a discussion about HIV spread, asking people to think about how it might be possible to reduce the risk of transmission, and whether it would be difficult.

See Part 6 for a summary of the main ways in which HIV is spread.

Finding the gaps


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Activity 2:  Check your beliefs 

Aim:           to help people consider their beliefs about HIV/AIDS 
Materials statements on HIV/AIDS written on small cards, at least one card for each person
Time:         about 45 minutes 

There are many beliefs about HIV and AIDS, the way that HIV is spread, its causes, and how it can affect a person. People also have their own beliefs about sex and sexuality and about what should and should not be done.  

  1. Prepare for the activity by writing statements on small cards which reflect common beliefs.

  2. Give each person one card. 

  3. Ask each person to discuss the statements on their card with another group member. Ask each person to read out their statement, stating what he/she thinks about it. Invite other people's opinions, and discuss the conclusions reached.

In a group of non-readers, follow the same procedure, without the cards. Ask people what they think about various issues, and use these as the basis for discussion.

Common beliefs about HIV and AIDS
You can become infected with HIV by having sex for money.
If you wash yourself after sex you will not get infected with HIV.
You can become infected with HIV from oral sex.
You will not get HIV by having sex with a virgin.
Donating blood can give you HIV.
You can get HIV from mosquitoes.
Condoms will stop you becoming infected with HIV.
If you stick to one partner you won't become infected with HIV.
You can't get AIDS from a person who appears healthy.
Anal sex carries a risk of HIV.
People with HIV should stop having sex.
People with many sexual partners are most at risk of HIV infection.
Putting prostitutes in prison will stop HIV.
All hospital patients should be tested for HIV


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Activity 3:  Talking about sex

Aim:           to discuss the words used to describe parts of the body associated with sex and sexual activities
Materials  large sheets of paper and marker pens 
Time:         about 1 hour 

Talking about sex is often very difficult, but it is important for people to find ways to discuss sex more openly with their partners. It is often helpful to speak in people's first language, acknowledge that they may find the activity difficult, and invite men and women to form separate small groups. 

  1. Ask the participants to form separate small groups of men and women and give each group a large sheet of paper and a pen.

  2. Ask participants to think of the different words that can be used to describe the 'sexual' parts of the body. These words may be either liked or disliked.

  3. Ask each group to write down these words in two columns headed male and female. Allow about 5 minutes for this.

  4. Then do the same for sexual activities.

  5. After each group has finished ask them to pin up their lists.

  6. Invite participants to look at each other's lists and identity words they do not know or are unsure about.

Invite participants to discuss the following issues: 


How did people feel about discussing the words?


Are there words on the list that group members do not like? Which are these? Why are they not liked?


Where did people learn these words?


Can any of these words be used as insults?


Talking about sex


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Thinking about risk

Life is a risky business for everyone, but some risks are more serious than others. Many people are reluctant to accept that HIV is a real and personal risk in their own lives.

People need opportunities to:


think about why they take risks in work or friendships as well as sex


explore the links between taking risks and the results of these actions in both the short and longer term


think about how the possible results of actions affect whether or not they do something


accept the reality of risk and the need for change.

 Thinking about risk


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Activity 4:  Risks and results

Aim:     to help people explore different kinds of risk in their everyday lives 
Time:   about 45 minutes  

  1. Invite participants to think about the following on their own for a few minutes:

    'Think back on your own life and identify any occasion when you took a risk - related to sex and relationships, to work, to money, or to alcohol, for example. It may have been a small risk or a big one that was very important to you at the time.'


What factors influenced your decision to take a risk?


What were your feelings at the time?


What was the result of taking that risk? Was it good or bad?


Do you generally take risks?


How do you view risk taking in others? How does risk taking among your friends affect you?


How does this affect your attitude towards the risk of HIV? 

It may be helpful to write these questions on the chalkboard. 

  1. After a few minutes ask everyone to choose a partner and share as much of their situation as they wish. Each person should talk for a few minutes and then listen to their partner's story.

  2. Invite everyone to join the full circle. Encourage them to explore links between how people deal with risk and ways in which this may affect their responses to HIV/AIDS.

It may be useful to make the following points:


We often feel that it is OK to take risks if they turn out well. We might be praised for our courage! But we tend to blame others if they take risks and things go wrong.


We are generally much less harsh in judging ourselves than we are in judging others. Is this fair?


We are all taking risks all the time.


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Activity 5:  Most risk/least risk 

Aim:           to encourage people to consider sexual activities involving most and least risk of HIV
Materials  3 large cards: one with 'most risk' written on it; one with 'least risk'; and one with 'don't know'; 
                  small cards, 3 for each person pens, one for each person

Time:         1 hour 

  1. Give each person three small cards and ask them to write down three sexual activities, one on each card. Stress that these can be anything they have heard of.

  2. Make an imaginary line on the floor. Put the most risk card at one end of the line and the least risk card at the other end. Put the don't know card away from the line.

  3. Collect the cards and shuffle them.

  4. Then invite people to form pairs, with someone of their own sex if they prefer. Give each pair three cards and ask them to decide where to place their cards on the line according to whether they think the activity has a high risk of HIV, a low risk or is in the middle. Ask them to explain their decision. They can use the don't know position if they are unsure or feel that the card does not give them enough information to make a decision. Anyone can disagree with the position of a card and move it to another place.

  5. When all the cards have been placed,. identify the cards where everyone agrees. Where people disagree, provide the necessary factual information for them to decide. During the discussion, raise the following issues: 


What do the most risky activities have in common?


What do the least risky activities have in common?


Are there any local sexual practices which might be at the low risk end? How could these be promoted? How could high risk activities be made safer?

  1. Encourage participants to consider why people have unprotected penetrative sex. Emphasise that a number of safer sex options exist if people want to be sexually active and avoid HIV and unwanted pregnancies.


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Activity 6:   Taking the risk and passing it on 

Aim:           to help participants understand the risk of HIV and how it might feel to be infected themselves

Materials:   small cards folded into 4, one for each person; 3 cards have 'X' written on the inside, and 3 other cards are marked with a 'C'
Time:         about 45 minutes 

  1. Give each person a card. Take care to give the X cards to people in different areas of the room.

  2. Ask people not to look at their cards. Explain that a few cards are marked with an X, and that during this exercise, the people with X cards are infected with HIV.

  3. Remind everyone that, just as no-one knows who has an X card, it is impossible to tell if someone has HIV. Explain that during this exercise, exchanging cards with someone represents having sexual intercourse with them. Show what you mean by exchanging cards -give your card to a person, and take theirs.

  4. Ask everyone to exchange cards with another person. Repeat this two more times.

  5. At this point, ask people the following: .What did it feel like to know that you might have got an X card? .Would you tell anyone? .Did anyone refuse to exchange cards?

  6. Ask everyone to look at their cards, and for those with a X to stand up. If you handed out 3 X cards, then 3 people should stand up.

  7. Ask them to describe their response to having an X card.


Would they tell anyone?


Would they try to change their behaviour, and have safer sex?


How easy or difficult might this be?


How do the women feel?


How do the men feel?


Are there any differences?


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  1. Ask anyone who has exchanged cards with the people standing to stand up as well. About nine people will stand up: explain they are also now infected with HIV. Repeat this one or two more times. By the end most people will be standing up.

  2. Pause for a moment so that people can see how the number has increased.

    Then ask the group standing up if anyone has a C on their card. If they do have a C card, this means they used condoms to protect themselves and do not have HIV, so they can sit down again.

    Ask these three people to describe their reactions to this news.

  3. Then ask everyone to discuss what this activity made them feel about people with HIV.

  4. Make sure these points are raised in the discussion:


At the beginning only three people had X cards, but within a short time, they were passed around the room.


Each person had several partners, which is realistic given that many people have more than one partner over a few years.


Just as no-one knew that they had an X card, most people with HIV don't know they are infected, because they are still healthy and have not had an HIV test.


HIV does not spread as easily in real life - sometimes a person may not be infected by having unprotected sex with someone with HIV. But the risk is high.

  1. People often experience strong emotional reactions to this activity. Remind everyone that this was only a training exercise. Invite people to say what they felt about the game in a few words.


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Exploring attitudes and feelings

It is helpful to carry out a few activities which help people to think about their attitudes to men's and women's roles in the community and in sexual relationships, and how these might be linked to the risk of HIV.

They also need the opportunity to think more deeply about their thoughts, feelings and fears about other people, and whether they make unfair assumptions about people who have HIV, or those who have sex outside marriage or sell sex for a living, for example.

Doing these activities can help people to understand that blaming others for HIV may be a way to avoid acknowledging their own risk and making difficult changes in their own sexual relationships.

 Exploring attitudes and feelings


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Activity: 7  Agree/Disagree 

Aim:           to start discussion about attitudes to HIV and its effect on relationships
Materials  3 large cards, one with 'agree' written on it, one with 'disagree' on it and the third with 'not sure' on it
Time:         about 1 hour   

  1. Put the agree and disagree cards where everyone can see them at opposite ends of the room, with the not sure card in the middle.

  2. Explain that you will read out a series of statements. When the statement has been read everyone should decide what they think, and go to whichever card represents their view.

  3. Read the first statement. When everyone has moved to their chosen card, ask them to choose one person near to them and explain why they are standing where they are, and then to listen to the other person without getting into a discussion.

  4. Then ask them to explain why they chose their position with someone on the other side of the room.

  5. Repeat the activity, using the next statement.

After several statements, invite people to say how they feel about:


listening to, without discussing, other people's opinions


explaining their views to someone else


any changes in their opinions.

Attitudes towards HIV and AIDS 

AIDS is a problem caused by prostitution (or foreigners or homosexuals). 
It is wrong for church workers to provide information about condoms.
People should feel ashamed or guilty if they have a sexually transmitted infection.
People with HIV shouldn't have sex or marry; 
I don't think that anyone in my family will get HIV 
I feel OK about working with someone with HIV 
I would not tell my partner if I had a positive HIV test result. 
Most sex workers try to persuade clients to use condoms. 
Women with HIV should not get pregnant. 
Women are responsible for spreading HIV 
Men get a sexually transmitted infection at least once in their lives.


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Attitudes about men and women

Married women should only have one sexual partner. 
It is OK for men to have sex outside marriage. 
Women have weaker sexual desires than men. 
Condom use is a sign of caring not of distrust. 
Women should fulfill men's sexual needs. 
Women should not initiate or discuss sex - that is the man's role.
Men show their masculinity by having many partners. 
Women need male family members to look after them.

Attitudes about men and women


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Activity 8:  Thinking about sex differences

Aim            to begin discussion about the advantages and problems of being a man or woman
Materials:   large sheets of paper and marker pens 
Time:         about 45 minutes  

  1. Invite participants to form separate small groups of men and women.

  2. Give each group a large sheet of paper and a pen.

  3. Ask each group to think about the following: 


How do men expect women to behave, especially in sexual relationships?


How do women expect men to behave, especially in sexual relationships?


What are the problems for men?


What are the problems for women?

  1. Allow about 20 minutes for discussion (5 minutes for each topic).

  2. Ask someone in each small group to present the main points to the whole group, and then invite discussion.

The following points are useful to explore: 


What are the main differences between men and women?


Are there any similarities between men's and women's roles?


Is there anything women in the group would like to change about existing roles for themselves and for men?


Is there anything that men in the group would like to change about existing roles for themselves and for women?

Thinking about sex differences


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Activity 9:  Talking about making sex safer

Aim:           to explore how men and women feel differently about safer sex, and to find ways to make discussion easier
Materials:   chalkboard or large sheets of paper and marker pens 
Time:         about 45 minutes 

  1. Invite participants to form small groups of men and women, and hand out sheets of paper and pens to each group. Introduce the activity and write a few safer sex ideas on the board (such as those agreed by participants in Activity 5). Remind people that safer sex means any activity that reduces the risk of HIV, and includes condom use and non-penetrative sex. Add 'saying no' to the list.

  2. Ask the women to write the heading: Is this easy or difficult for women? Why? Ask the men to write the heading: Is this easy or difficult for men? Why?

  3. Ask the groups to discuss each item on the list, and write down the main points. Allow about 10 minutes for this, or more if necessary. 

  4. Invite everyone back together and ask someone in each group to report back on the discussion. Make a list on the board of women's and men's feelings about why having safer sex is difficult or easy.

  5. Discuss the similarities and differences between the men and women. Then encourage people to suggest ways of making discussion about safer sex easier.

At the end, ask a few people to do a role play about negotiating safer sex where a woman acts like a man, and a man like a woman. Discuss what it felt like to do this. This role play often makes people laugh, and helps them to relax after a difficult activity.


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Activity 10:  Digging deeper

Aim:     to help people critically examine their feelings about the personal impact of HIV and AIDS
Time  about 30 minutes 

HIV is still rarely talked about openly, and people are fearful of losing their homes, jobs and families if they test HIV positive. Both men and women often feel that they cannot tell their partners, because they fear rejection or feel guilty.

The problem of stigma is growing in communities where more and more people have HIV and are becoming ill with AIDS. Families are already burdened by poverty, and feel despair and sadness at watching their loved ones die. They need support but are being shunned by the community. In order to help people to 'dig deeper' into their responses to this issue, they need to critically examine their feelings about people with HIV or AIDS. Be careful to question people's prejudices and fears and remind them that HIV can affect anyone.

  1. Start the exercise by asking: 'What does a person with HIV mean to you? 

  2. Whatever the responses to this question, the trainer must ask the question 'Why? ' and invite different people to respond.

    The question 'Why? ' is repeated after every answer, and in this way people will explore their real feelings about the problem.

  3. Finally the trainer asks:
    'Is this a real problem?'
    'How can this problem be solved?'

Digging deeper


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Practising new skills

People need opportunities to learn skills useful for reducing their risk of HIV such as communicating and making decisions about sex, and using condoms.

Activity 11:  Learning about condoms

Aim:           to introduce condoms and practise how to use them correctly 
Materials:   a supply of condoms, penis models or medium sized carrots 
Time        about 40 minutes  

  1. Give one condom in its packet to each participant. If this is too expensive, hand out as many as you can to the group.

  2. Invite group members to check that the condom is not past its expiry date, and to open the packet and take out the condom. Encourage them to stretch and play with the condom.

  3. Split the group into same sex pairs, and give each person a few minutes to talk to their partner about what they feel about handling a condom. 

  4. Once back in the main group, invite people to make any comments. 

  5. Demonstrate condom use on the carrot, clearly and explicitly. Using a vegetable often helps people to feel less embarrassed.

  6. Then ask people to try doing it themselves. For many people, this exercise may provide their first opportunity to handle condoms. Encourage discussion about what was difficult and what might help them to use condoms with a partner. The activity generally makes people laugh, as they cope with their embarrassment, anxieties and negative feelings.

See Part 6 for details on using condoms correctly.


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Activity 12:  Using role play

Aim:     to help people practise communication skills and solving problems with others
Time:   about 1 hour 

During a role play, two or more people pretend they are in a certain situation and act out how those people might behave in that situation. Role play involves people in the group, not real actors.

The trainer guides the group through the steps described below and listens, observes, and comments only when requested. It is useful for the trainer to summarise what happened during the role play when the group discussion is over.

Role play involves three steps: 

  1. The trainer describes an important problem or situation. Two or three people are asked to volunteer to 'act out' the situation. This should take 5 to 10 minutes at the most.

  2. Participants discuss what happened during the role play. 


Is this a real problem?


Can it be solved, and if so, how?


How did the role players deal with it?

  1. Participants make suggestions for overcoming the problem.

The role play can then be acted again, perhaps by different members of the group, to show a possible solution.

Using role play


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Practising assertiveness and negotiation skills

In personal relationships, it is very important for both women and men to learn how to ask for (be assertive about) protection during sex. This is often very difficult, particularly for women. Many men are unwilling to practise safer sex and women are not in a position to be able to insist. Role play is one method that can help women to practise skills in saying 'no' and negotiating safer sex. Men often need to practise communication skills such as listening and asking open questions.

Negotiation involves making a decision with someone else, where both people consider their different opinions together, without one simply deciding for both. Negotiation involves each person being able to express herself or himself and listening to the other. Both need to be respectful, caring and willing to compromise.



Example 1  Negotiating condom use

A man and a woman want to have sex. The woman suggests using condoms, but the man does not want to. They discuss why it is not a matter of trust, but safety. The woman encourages her partner, saying that they can make it enjoyable. The man agrees to try it.

Questions for discussion

Did they take time to think about their opinions before having sex, get advice from each other, and consider the consequences of their different options?

Did they listen to and respect one another?

Is faithfulness (or trust or honesty) enough to protect people?

Was the woman right in suggesting condoms?

What worked well in resolving the problem?

If the man respected the woman's choice this time, is it fair to say that next time she should do as he wants, if he doesn't want to use condoms?


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Example  2.  Negotiating 'No sex' 

A young man and woman have been involved for a few months. They have not yet had sex. He would like to, but she is uncertain, saying that she needs to wait until she is sure. After some discussion, he agrees to wait.

Option A They start talking about other things and leave to meet friends, implying that they can still have a good time together without having sex.

Option B They leave to go have a drink. After a couple of beers, he tries to seduce her. Though feeling less confident, she says that beer should not make them change their minds and she suggests going to sit with friends.

Questions for discussion 

Is it OK for a woman to refuse to have sex with her boyfriend?

Why did he agree? (For men) Would you agree? 

Do men sometimes feel pressured to have sex? 

Do men prefer to marry a woman who is a virgin? If so, why? 

Do women think men are always after sex, and how do they feel about it?

For option B: What should the couple do when, after alcohol or drug use, reasonable discussion becomes difficult?

More role play topics

A young man who refuses to believe that HIV is a problem for him.
A woman trying to convince her boyfriend to seek treatment for a sexually transmitted infection.
A man convincing his friend that having many girlfriends is not cool. 
A man trying to persuade his friend to tell his wife that he has HIV.
A community leader trying to convince a group that condoms are unnecessary if people stick to one partner.
A parent dealing with a child's question about sex. 
One religious worker challenging another's views on condom use. 
A woman being encouraged by her sister to tell her husband that she is HIV positive.


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Problem-solving and decision-making

Many barriers prevent people from making their sexual relationships safer. These barriers exist in people's personal relationships and families, as well as in communities and at the national level.

Both men and women often feel pressure to behave in particular ways. Men and women have different experiences and skills and people live in different situations. Some may find it easier to consider reducing their risk than others. Women may find it more difficult, because of common beliefs about their roles and duties in sexual relationships.

People need the chance to think about how to change their own relationships. It is also important to discuss what changes are needed in the wider community to create a more supportive environment for making sex safer, and for people living with HIV or AIDS.

Problem-solving and decision-making


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Activity 13:  Change takes time 

Aim:           to help people explore how change occurs in stages over time
Materials:   statements on safer sex written on small cards at least one card for each person,
                  a large piece of paper and a marker pen

Time:         about 1 hour 

This activity helps people to talk about the four main stages in making changes in their personal lives: thinking about change, accepting the need to change, trying to make changes and maintaining the change.  

  1. Prepare for the activity by writing statements on small cards which reflect common views and beliefs. Then draw a line on the large sheet of paper. Write no change at one end of the line and changing for good at the other end of the line.

  2. Give each person a card. Ask them to put it on the line at the point which represents commonly-held views, either towards the no change end or the changing for good end.

  3. Encourage participants to comment on the different positions, and invite them to discuss how change can be encouraged.

Common views on condoms 

People are not really interested in safer sex.
Most women are willing to use condoms. 
Some men have thought about trying to use condoms. 
People are talking more about the risk of HIV. 
Most people think HIV couldn't happen to them. 
Men don't care about safer sex. 
Most men use condoms sometimes but not always. 
People always use condoms and are happy about that. 
Women are scared of mentioning condoms to their husbands. 
Condoms reduce men's enjoyment. 
People don't need to use condoms with their regular partner. 
It's not right to use condoms. 
It's very difficult for women to buy condoms. 
Many people don't really know how to use condoms properly


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Activity 14:  Using picture codes 

Aim:           to help people to discuss problems and how to solve them 
Materials:   a 'picture code' is a poster-sized illustration without words which shows a situation about which people
                  may have strong feelings.

Time:         about 1 hour 

The illustration should clearly describe the situation (e.g. a young woman being approached by an older man; a young woman buying condoms; a woman visiting an STD clinic). 

  1. Put the picture code where everyone can see it - on the ground or fixed to the wall 

  2. Guide the group through a series of questions and encourage discussion: 


What is happening in the picture?


Does this happen in real life?


Why is this happening?


What does the picture make you feel?


Do any problems or benefits arise from this situation?


What are the root causes?


What can be done about it (to make it happen more or less)?

  1. At the end of the discussion, summa rise what has been said.

Using picture codes


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Using picture codes
Using picture codes Using picture codes


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Activity 15:  Open-ended story

Aim:     to help people consider the wider changes needed to enable individuals to reduce their risk of HIV
Time:   1 hour

An open-ended story is short and stops at a point where decisions are needed. The story should present a real life situation and raise issues which people can easily understand.

Tell a short story which reflects life and behaviour in the community. Be careful not to create stories which stereotype women or stigmatise people with AIDS.

Example A 

'Mary is the wife of a man who has recently died of AIDS. She is sick now and her young children are unable to care for her. Her elderly mother depends on Mary for food and shelter and cannot care for the children. Mary's relatives live in the neighbouring country. People in the village are afraid of AIDS and few of them visit Mary or help her with household tasks such as collecting wood or water. The hospital is far away and in any case, Mary would be unlikely to be given a bed because there are too many other sick people in the district. Also, people have reported that the health workers are worried about visiting people with AIDS.'

Questions for discussion

What could people do to help Mary? 
What could people do about the children who will shortly be without a mother? 
What could the community do for the grandmother?


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Example B 

Here is another example, about a woman called Helen, which could be adapted to any situation:

'We live in town, and my husband runs a small business selling vegetables. He has many friends and I suspect that he likes to spend time with girlfriends too. As the bread winner of the family I suppose that he feels free to do what he likes. I think he has a sexually transmitted infection too, although I cannot be sure and of course I cannot ask. He is sometimes violent if I ask too many questions.

There are many things on my mind this year: shortages, the drought, rising prices and the fear of getting a sexually transmitted infection, this problem of AIDS... and now I'm pregnant again.'

Questions for discussion

What is happening at home? 
How does Helen feel? 
What advice can we offer Helen? 
What do you think her husband should do?

Encourage people to discuss the problem and suggest solutions. They may also have stories to tell the group.



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Activity 16:  Barriers to change

Aim:             to help people to identify problems that can and cannot be solved
Materials:     large sheet of paper and marker pen or chalkboard
Time:           about 1 hour

  1. Ask the group to choose a topic or a problem about which they need to talk, such as HIV/AIDS. Draw a circle in the centre of a large sheet of paper and write the problem in the middle.

  2. Now invite the group to think of and name possible causes of the problems from personal to community and national level, including unsafe sex, menís and womenís sexual roles, many sexual partners, health service weaknesses, low incomes, government refusal to accept the problem of HIV, people travelling for work etc. Ask them to think of links between the causes too. 

  3. Write down all the causes mentioned by the group and draw arrows which point towards the problem in the circle. If the cause is unclear, invite the person to explain. 

  4. Invite people to discuss each cause and circle the ones where they feel change is  possible. Encourage discussion about how they could help to do this. 

Be careful not to allow people to blame others - for example the realistic solution to prostitution is not to try to stop it, but to persuade male clients to use condoms and improve womenís opportunities. Likewise, it is not possible to stop people migrating for employment, but they can be included in education campaigns.

Barriers to change


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Activity 17:  Using drama 

Aim:     to raise awareness and encourage debate about issues affecting the community 
Time:   1-3 days preparation for a performance of about 30 minutes 

Drama usually involves several people, who tell a story through acting out different roles. Local professional actors and/or community members can take part. They are involved in deciding the theme, doing preparatory research, and in writing and rehearsing the story.

Using drama

Why drama is helpful 

Drama is very enjoyable! It combines education with entertainment, and can raise awareness and change attitudes by: 


engaging people's attention and emotions


reflecting local issues and people's usual behaviour and attitudes as well as emphasising strategies for change


responding to current problems, and to what people are saying and thinking about an issue


openly addressing difficult issues e. g. commercial sex, condom use, communication problems between parents and adolescents, or men and women, and debates about sex education.


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But take care! Drama can fail or even do harm if:


the message is inappropriate, outdated or blames groups or individuals, such as women, sex workers, traditional healers, or people with HIV


the language offends the audience


the message fails to reflect the reality of people's lives


it tries to cover too many complicated issues


the audience is not given a chance to respond to the drama


too much emphasis is put on entertainment and the message is lost


the same drama is performed too often in one place without changing the story.

Drama can be used to:


state a problem e.g. isolation of people with AIDS


expose the root causes of a problem e.g. why young people do not know about sex


show how to reach possible solutions e.g. setting up a local home-based care project


show the benefits of solving problems e.g. benefits of making a will.

Preparing for a drama presentation 
A drama group is formed, perhaps by a local community theatre organisation or club. It helps if someone who has more experience acts as co-ordinator. 

  1. The group makes a plan of action, including when and how often to meet. Financial arrangements may need to be discussed.

  2. Next the group carries out a listening survey (see Part 1). This will help them plan a story line based on real-life concerns and language.

  3. Then the group needs to decide about: 


the drama's aims - what they want to achieve and show key messages and theme


writing up the story and the sequence of presentation


working out the characters, their dialogue and actions through practising in pairs or groups


songs, slogans, mime, dance or puppets which could be used to highlight certain issues


obtaining costumes and props, arranging a time and venue, and organising sufficient publicity.

  1. Rehearse frequently in front of a small audience if possible, and use their feedback to revise the play if necessary.


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After the performance 
It is important to get feedback about a drama performance by: 


having informal discussions with the audience -one member of the cast or the co-ordinator needs to be prepared to lead a discussion at the end and answer people's questions


listening carefully to questions asked by the audience, and watching their reaction and level of participation.

It is also useful to know where to refer people for further information or counselling.

Revise the drama story as necessary when new information becomes available.

Suggested ideas for drama 

Communication problems between parents and adolescents.
Non-participation of men in AIDS education.
Sexual abuse of young girls by older men.
Refusal by men to use condoms.
Reluctance to accept that a family member has HIV.
A woman is being sacked by her employer because she has HIV, but her colleagues are defending her.

Using drama



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