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Sensitizing youths in Sexual Reproductive Health;Lesson 1: HIV/AIDS,Lesson 2: STIs,Lesson 3: Pregnancy,Lesson 4: Contraceptives.

Training early school leavers aged from 15-25 years in the period of 3 months, the training will be practical(hands on) following 20%40%80%

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Introduction This manual is intended to equip the Graben Orphanage Foundation Africa facilitators with the necessary skills and knowledge to train participants on priority sexual and reproductive health topics. The topics covered in this manual include HIV/AIDS, sexually transmitted infections (STIs), pregnancy and contraceptives. These SRH topics were chosen carefully by GOFA, due to their urgency and frequency of many of these health issues among the program participants. Each of these lessons should run for one to two hours and trainers should feel free to spend more or less time on any of the sessions, depending on the needs of the audience. Within this manual you will find simple and easy-to-use lesson plans on: Lesson 1: HIV/AIDS OBJECTIVES: By the end of this session participants will be to explain the ABC method of preventing HIV transmission and the benefits of each component. Participants will be able to correctly demonstrate a male and female condom demonstration and explain why condoms should be used including preventing both infection and reinfection of HIV along with STI prevention. Explain that we will be discussing ways to prevent HIV transmission. The most common method to teach HIV prevention in Uganda is the ABC method, which focuses on abstinence, being faithful and consistent and correct condom use to stop the spread of HIV. It is important to expand upon this method to drive home the importance of adopting safer sexual practices and reducing risk-taking behaviors. Lesson 2: STIs Session Goal: To increase participants’ knowledge regarding how common STIs are spread, how to avoid contracting STIs and what their common symptoms Give the following information for STIs: Sexually transmitted infections, or STIs, (which were once more commonly referred to as sexually transmitted diseases or STDs) are infections spread from man to woman, from woman to man and between two people of the same sex through body fluids including semen, vaginal fluids and blood through sexual intercourse. They can also be spread from mother to child. A person may have more than one STI at a time. STIs may or may not have any particular signs or symptoms. When there is no clear indication of an infection, a person is referred to as being asymptomatic. Usually however an STI is indicated by open sores, bumps, blisters, itching of the external sex organs and change in vaginal discharge for girls/women. Some STIs can cause very serious complications and even death. It is very important to be aware of how STIs are acquired as well as the signs and symptoms. If they are detected and treated early, they do not cause serious problems, but when not detected or treated, the infection may spread and cause complications such as sterility (infertility). It is possible to become infected even after only one act of sexual intercourse with an infected person. Remember, anyone can get an STI; not just commercial sex workers or people with “loose morals”. Most men can tell when they have an STI because there are usually clear signs. Women, however, often have an STI without knowing it because there are often no signs of infection. STIs are relatively easy to contract, and so it is important to know what they are, what they look like and what you need to do to get them treated. The following includes the basic information you need to know about STIs. Lesson 3: Pregnancy Lesson Goal: To inform participants about how pregnancy happens in the female reproductive system and how the menstrual cycle is related to pregnancy. Reproductive Maturation 
 Although human beings are fully sexually differentiated at birth, the differences between males and females are accentuated at puberty. This is when the reproductive system matures, secondary sexual characteristics develop, and the bodies of males and females come to appear more distinctive. 
Female puberty usually begins at about 8–13 years of age; the reproduction maturation of boys lags about two years behind that of girls. The physical changes of female puberty include breast development, rounding of the hips and buttocks, growth of the hair in the pubic region and the underarm, and the start of menstruation. For boys, physical changes include enlargement of the testes, development of pubic hair, growth of the penis, the onset of wet dreams (usually at about 11 or 12 years of age), deepening of the voice, the appearance of facial hair, and a period of rapid growth. The Menstrual Cycle (Menstruation or “period”) The major landmark of puberty among females is the onset of the menstrual cycle, the monthly ovulation cycle that leads to menstruation (loss of blood and tissues lining the uterus) in the absence of pregnancy. The first menstrual cycle, or menarche, occurs at the average of 12.8 years but it may start earlier or several years later. After the menstrual period the lining of the womb starts to build up and prepare itself to receive a fertilized egg. If no fertilized egg reaches the womb within 2–3 weeks, the lining of the womb breaks down, and bits of tissues leave the womb during the menstrual period about a week later. Lesson 4: Contraceptives OBJECTIVES: after the session, participants will be able to: • Identify at least three common family planning methods • Describe the benefits of family planning use • Identify at least three common side effects of family planning methods. Barrier methods such as the male and female condom block the man’s sperm from reaching the woman’s egg. They can also protect against STDs and HIV. The male condom goes over the erect penis right before sex, and should only be used once. The female condom can be put into place a few hours before sex. Barrier methods only work well if they are used correctly—always ask a health worker the best way to use a barrier method. Hormonal Methods such as injections, pills and implants prevent the woman’s ovary from releasing an egg, make it harder for the sperm to reach the egg, and keep the lining of the womb from supporting a pregnancy. • Very effective in preventing pregnancy, but do not protect against STIs or HIV, and can cause side effects like nausea, headaches, changes in your monthly bleeding and changes in mood • Birth control pills: come in packs of 21 and 28 pills. A woman must take one pill at the same time every day. If she forgets a pill or does not take them at the same time, she is more likely to have unwanted side effects or get pregnant. • Implants are small plastic rods that a health worker inserts just under the skin. They can last or between two to five years. They can be removed at any time by health professional and you can get pregnant right away. • Injections are hormone shots that are given every one to three months. After stopping, it might take up to a year to be able to get pregnant and for your monthly bleeding to return to normal IUDS are small objects that are inserted into the womb and prevent the sperm from fertilizing the eggs. They can be left in for as long as 10-12 years, but when you get the IUD you should talk to the health worker about how long it can be left in. The IUD must be inserted and removed by a trained health professional. You can get pregnant as soon as it is removed by a qualified health professional. You should not use an IUD if you have an STD or are in danger of getting an STD. Natural Methods require the cooperation of both partners and an awareness of your body in order to be effective. • Breastfeeding: effective in preventing pregnancy if and only if the baby is less than six months old AND monthly bleeding has not returned AND the baby feeds every six hours. If one of these is not true, you can get pregnant even if you are breastfeeding. It is best to start another form of birth control within a few months of giving birth. • Mucus method: check the mucus in your vagina to tell when you are in your fertile times and you do not have sex during your fertile times. To do this, every day you insert a clean finger into your vagina and put some mucus onto your finger. If the mucus is brittle and does not stretch, you are not in your fertile time. If the mucus is flexible and you can open your thumb and pointer finger together and apart without breaking the mucus, you are in your fertile time and should not have sex or should only have sex with a condom. • Counting days method: You count the days between your monthly bleedings to know when your fertile time is (10-18 days after period begins) and don’t have sex during that time. Best to use the mucus method and counting days method at same time. Give a counting days method demonstration using a calendar or moon beads (6) • Withdrawal: the man withdraws his penis before he ejaculates so that the sperm is spilled outside of the woman’s vagina. This method is difficult and sometimes there is still some sperm spilled inside so you still have a chance of getting pregnant. Permanent Methods: there are two surgeries that you can get to permanently prevent pregnancy. A man can get a vasectomy in which the tube that carries sperm to the penis is cut. The man will still be able to ejaculate and feel the same sexual pleasure, but there will be no sperms in the semen. A woman can get a tubal ligation in which the tubes that carry the egg to the womb are cut. This operation is more serious than the one for the man. The woman will still be able to feel sexual pleasure. Excerpt from the Article: Condom use infrequent despite rising HIV rates Despite nationwide efforts to increase HIV awareness and common fears of unplanned pregnancy, young, sexually active Ugandans continue to have risky sex without using condoms consistently, spurring new measures to promote the prophylactic. Only 36.2 percent of women and 52.9 percent of men between 20 and 24 used a condom during their last sexual intercourse in the past 12 months, according to the National AIDS Indicator Survey, launched on 18 September. Among those who had more than two partners in the past 12 months, only 23.4 percent of women and 30 percent of men reported using a condom during their last intercourse. The research also reveals that a majority of young Ugandans lack comprehensive knowledge about HIV; just 39 percent of men and women aged 15 to 24 have all the facts on how HIV is spread and how it can be prevented. The country's HIV prevention strategies have been called into question following a rise in HIV prevalence from 6.4 percent to 7.3 percent over the past five years. Uganda has long relied on the ‘ABC-plus’ model, which includes abstinence, being faithful and condom use, as well as measures to prevent the mother-to-child-transmission of HIV and, more recently, methods such as medical male circumcision. Government officials say there is a need for more focus on condom use for young people. "The students should go for protected sex... It's the only way to reduce HIV prevalence rates in the country," David KihumuroApuuli, director general of the Uganda AIDS Commission, told IRIN/PlusNews.

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Photo of Lauryn White

To me this is a great idea because starting the education early is always a good idea. I think if the education on these topics are taught earlier then the youth will be able to make more informed decisions in their future. More informed decisions can lead to a healthier lifestyle in general.

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