FACT or fiction? A FILM AND EDUCATION PACK

HIVsport Publications CONTENTS

FACT or fiction? AN HIVSPORT FILM AND EDUCATION PACK ...page 5

FILM 1 ‘In touch’

Understanding HIV and AIDS ...page 7

Taking responsibility for children ...page 11

FILM 2 ‘Dribbled to a second chance’

Injecting drug use ...page 13

Challenging stigma and discrimination ...page 15

FILM 3 ‘Goal for hope’

How HIV is tansmitted ...page 19

The importance of role models ...page 23

FILM 4 ‘Play it safe’

Knowing your HIV status ...page 25

The global impact of HIV ...page 27

FILM 5 ‘Whizzkids United’

Gender equality ...page 29

What is counselling and support? ...page 31

APPENDIX ONE: HOW TO TREAT BLEEDING INJURIES ...page 33 APPENDIX TWO: SELECTED ONLINE RESOURCES ...page 34

HIVsport would like to thank those who contributed to this film and education pack, with particular thanks to all the young people who entered the competition and made films, to EuropeAid and our partners for their support. FACT or fiction? AN HIVSPORT FILM AND EDUCATION PACK This film and the associated education pack have been produced by HIVsport as part of the Millennium Development Goals Realisation project, funded by the European Commission’s Europeaid programme.

ABOUT THE PROJECT • Create, through sport, greater public The objective of this project is to awareness of the global epidemic of encourage young people and educators HIV and AIDS from Europe (Bulgaria, Romania, Italy • Provide education and training to and the UK) and Southern Africa to people in all roles in sport around take action to deal with problems HIV and sexual health in their communities in support of • Support sports-related HIV and realisation of the United Nations sexual health education projects Millennium Development Goals (MDGs). See www.un.org/millenniumgoals. Our lead partner is the Open Education THE FILM ...page 5 Centre Foundation in Bulgaria. The We asked young film-makers to tell us project website can be found at their idea for a 5 minute short film www.mdgproject.com. Please click on that would show how sport can raise the Union Flag symbol for the English awareness about HIV and AIDS, keeping language version. in mind that the purpose of the film is to educate young people in Europe and Southern Africa. Above all, we wanted ABOUT HIVSPORT young people to tell their stories in HIVsport uses the ‘Badge of Hope’ to the way they wished so that they could raise awareness of HIV and AIDS and speak directly to other young people promote sexual health and wellbeing across the world. We then commissioned in sport. The organisation works in 10 short films, which were judged by a partnership with professional sporting panel of professional filmmakers, young associations, umbrella HIV and sexual people and HIVsport and other sexual health organisations, the media, health and marketing experts. The medical and corporate bodies to: result is, ‘Fact or fiction?’ featuring five short films from Africa and Europe. THE EDUCATION PACK Each film deals with two different The films are: issues concerning HIV and AIDS and how 1. In Touch by Timmins Langeveldt sport can help raise awareness and FILM 1 2. Dribbled to a Second Chance by Apostu educate young people about HIV and Emilia, Blajin Oleg and Toma Ioana AIDS. The education pack supports the 3. Goal for Hope by Danny Lurie films and focuses on the two topics ‘In touch’ by 4. Play it Safe by Takudzwa Mukiwa for discussion that are raised at the 5. Whizzkids United by Whizzkids United beginning and end of each film. TIMMINS LANGEVELDT Country: Zimbabwe ...page 7 Topic for discussion (1): Understanding HIV and AIDS

WHAT IS HIV? It is one or more of these infections HIV stands for Human Immunodeficiency which will ultimately cause death. Virus. The virus weakens the body’s immune system – the system that fights Syndrome indicates that the disease against infections. HIV eventually results in a variety of health causes AIDS, or Acquired Immune problems. Deficiency Syndrome. Left untreated, AIDS will cause the death of the person infected with the HIV virus. IS THERE A CURE FOR HIV INFECTION? No, there is no cure as yet for HIV infection. However, advances in WHAT IS AIDS? medical treatment over the past twenty AIDS stands for Acquired years means that the infection can Immunodeficiency Syndrome. be successfully treated in the vast majority of people who have the virus. The full name for AIDS - Acquired Recent research has shown that if Immunodeficiency Syndrome – describes treatment commences at the right time three features of the infection: and is continued according to correct procedures then the person is likely Acquired indicates that it is not an to have a life span equivalent to inherited condition. someone who does not have HIV. These are good reasons to be optimistic Immune deficiency indicates that the but it should be borne in mind that body’s immune system breaks down. A HIV infection is still an extremely person with HIV becomes vulnerable to serious long-term medical condition a range of opportunistic infections that currently requires expensive which normally the body could fight off. health and social care management, similar to diabetes and other complex You cannot tell if someone has HIV between 2009 and 2010 alone. It is WHAT IS THE SITUATION IN ZIMBABWE? health conditions. just by looking at them. At the early estimated that at least 6.6 million In a report written in September 2010, stages of the infection the person people in low- and middle-income USAID, the US Government Department infected will probably not notice any countries are receiving HIV treatment. responsible for international WHO IS AFFECTED? change in their health, but they can This is an increase of more than 1.35 development, stated that Anyone can become infected with the still transmit the virus. The only way million over the previous year. In The first reported case of AIDS in HIV virus. HIV does not discriminate to find out if a person has the HIV low- and middle-income countries 47% Zimbabwe occurred in 1985. By the in any way. According to UNAIDS, the virus is through a simple blood test. of the 14.2 million eligible people end of the 1980s, approximately 10 coordinating body for the global living with HIV were on antiretroviral percent of the adult population response to HIV and AIDS, there were therapy at the end of 2010, compared was infected with HIV. This figure 2.7 million new HIV infections in WHAT IS THE GLOBAL RESPONSE TO to 39% at the end of 2009. rose dramatically in the first 2010, including an estimated 390,000 HIV AND AIDS? half of the 1990s, peaking at among children. This was 15% less than Millennium Development Goal 6 commits Universal access to treatment (defined more than 36 percent between 1995 in 2001, and 21% below the number the world community to Combat HIV/ as 80%, or greater coverage) has been and 1997. Since the late 1990s, of new infections at the peak of AIDS, Malaria and Other Diseases. achieved in Botswana, Namibia and prevalence has been consistently the epidemic in 1997.The number of Specifically, for HIV and AIDS this Rwanda, while Swaziland and Zambia declining. With a national adult people becoming infected with HIV is means to: have achieved coverage levels prevalence of 15.3 percent at continuing to fall, in some countries between 70% and 80%. Across cities and the end of 2007, Zimbabwe was more rapidly than others. HIV • Halt and begin to reverse, by 2015, villages in sub-Saharan Africa, from one of the 10 highest-prevalence incidence has fallen in 33 countries, the spread of HIV/AIDS Harare to Addis Ababa to rural Malawi countries in sub-Saharan Africa. 22 of them in sub-Saharan Africa, the • Achieve, by 2010, universal access and South Africa’s Kwazulu Natal According to national estimates, region most affected by AIDS. to treatment for HIV/AIDS for all province, introducing HIV treatment prevalence decreased to 13.6 those who need it has dramatically reduced AIDS-related percent in 2010. The epidemic has The number of people living with HIV mortality. In low- and middle-income reduced life expectancy, deepened is now estimated to be approximately countries globally, treatment has pervasive poverty among vulnerable 34 million. The number is increasing ARE THESE GOALS BEING MET? averted 2.5 million AIDS deaths since households and communities, each year as more people are being According to UNAIDS the most dramatic 1995, the majority in the past few skewed the size of populations, treated and living longer, but it also increases in antiretroviral therapy years. undermined national systems, and reflects the continued large number of coverage have occurred in sub-Saharan (Source: UNAIDS World AIDS Day Report weakened institutional structures. new infections each year. Africa, with a 20 percent increase 2011, p. 19). (Source: USAIDS Zimbabwe HIV/AIDS Health Profile).1

According to UNAIDS, 59 percent of people infected with the HIV virus are now on treatment and this is responsible for the large drop in deaths from AIDS in recent years. Clearly, with a life expectancy of just 42 years, the situation in Zimbabwe is still extremely serious, but with continued investment in health care, political will and international support there are reasons to be more optimistic about the future. ...page 9 1 See http://www.usaid.gov/our_work/global_health/ aids/Countries/africa/zimbabwe_profile.pdf FILM 1 ‘In touch’ by TIMMINS LANGEVELDT Country: Zimbabwe ...page 11 Topic for discussion (2): Taking responsibility for children

In the film we saw a lot of discussion overwhelmed by this situation. about children and how they can become The majority of these children more educated about HIV. According to have no extended family networks USAID: to rely on following the death of their parents. Children in Zimbabwe are affected by the epidemic by contracting The elderly have also been the disease from their mothers affected by the AIDS-related and/or by losing a parent to the deaths of their grown children disease. At of the end of 2009, who had previously supported approximately 1 million children them, and, according to the under age 18 had been orphaned United Nations Children’s Fund by AIDS, according to Ministry (UNICEF), 40 to 60 percent of of Health and Child Welfare orphans in Zimbabwe are now cared (MOHCW) estimates. The Government for by their grandmothers. The estimates that one in four percent of orphans and vulnerable children under 18 has lost one or children (OVC) reached by support both parents to HIV. An estimated services has been declining due 152,000 children under age 15 to the impact of hyperinflation are HIV positive, and, according on national budgets, further to UNAIDS, HIV is the underlying burdening those caring for cause of more than one-third of children orphaned by HIV. all deaths among children under (Source: USAID Zimbabwe HIV/AIDS age five. Health Profile).

The traditional extended family Children living with HIV in Eastern and other support systems are and Southern Africa. UNICEF, the lead international body With millions of children made for children and young people, reports vulnerable by the epidemic, care and that an estimated 2.5 million of support to help them survive and be those living with HIV at the end of protected from abuse and exploitation FILM 2 2009 globally were children under are nowhere near adequate. Where the age of 15, with 1.6 million of data is available, the percentage of them residing in Eastern and Southern children receiving external support ‘Dribbled to a second Africa (ESA). More than 90 percent remains low: Only in Swaziland (41 of these infections occurred during percent) and Botswana (31 percent) are pregnancy, delivery or breastfeeding. significant numbers of vulnerable and chance’ by orphaned children being reached. In In hyper-endemic countries, HIV most other countries in the region, has reversed hard-won gains in the only around 20 percent or less (7 APOSTU EMILIA, BLAJIN reduction of child mortality. In percent in Tanzania) of these children Southern Africa, between 12 and 52 receive some sort of external support. percent of all child deaths are caused (Source: UNICEF).2 by HIV/AIDS. OLEG AND TOMA IOANA

In 2009, an estimated 370,000 children HOW CAN SPORT HELP? globally were newly infected, 130,000 In the film we saw how the Community Country: Romania of them in Southern Africa. Compared Arts Project football programme to 2004, the number of newly infected provides a space for children and children in Southern Africa decreased young people to spend time together, Topic for discussion (1): by 32 percent, largely as a result play football and to learn about HIV of scaled up programmes reducing the and AIDS from each other. The football ...page 13 transmission of HIV. project also provides a refuge for Injecting drug use children who are suffering physical or emotional abuse at home. The film Re-using or sharing needles, syringes WHY IS IT AN ISSUE? ORPHANED AND VULNERABLE makes clear that many of the children and drug preparation equipment is a CHILDREN (OVC) According to the UNAIDS 2011 report, are orphans the project can give highly efficient way of transmitting in Eastern Europe and Central Asia, As of 2009, more than 10 million these children a sense of family where HIV and other infections such as there was a 250% increase in the children in the region had lost everyone is equal. hepatitis. number of people living with HIV from one or both parents to AIDS, and 2001 to 2010. The Russian Federation millions more have experienced One point of controversy in the film If injecting steroids (or any other and Ukraine account for almost 90% deepening poverty, lost education is where the coach says that he drug) a clean needle should always of the Eastern Europe and Central and discrimination. For a generation encourages sexual abstinence among the be used and disposed of safely after Asia region’s epidemic. Injecting of children and adolescents, HIV and children. HIVsport does not support use. There is a very small risk of a drug use remains the leading cause AIDS have redefined the very meaning of ‘abstinence only’ programmes as these needle-stick injury resulting in HIV of HIV infection in this region, childhood. have been shown to fail to prevent transmission which is why needles must although considerable transmission The risks faced by children whose the transmission of HIV. We prefer be safely handled and dis­posed of. also occurs to the sexual partners lives are affected by HIV and AIDS are the term ‘sexual responsibility’ to of people who inject drugs. There is well documented. The virus adds an mean that everyone should be take HIVsport does not condone the taking little indication that the epidemic extra burden on already poor families, responsibility for their own sexual of illegal or non-pre­scribed drugs. has stabilized in the region, with new reducing their capacity to care for health and that of their partner(s). However, people who inject illegal HIV infections and AIDS-related deaths their children. It causes households Being empowered to make informed drugs often have chaotic lifestyles continuing to increase. After slowing to fragment, and makes children decisions, including understanding of and may be unable to make clear and in the early 2000s, HIV incidence in susceptible to abuse, exploitation, HIV, is part of sexual responsibility. rational choices about their health, Eastern Europe and Central Asia has thus leading to undue risk-taking. been accelerating again since 2008. discrimination and crime. 2 http://www.unicef.org/esaro/5482_HIV_AIDS.html FILM 2 ‘Dribbled to a second chance’ by APOSTU EMILIA, BLAJIN OLEG AND TOMA IOANA Unlike most other regions, AIDS- HIV/AIDS cases discovered in related deaths continue to rise in 2009 are among young persons Eastern Europe and Central Asia. aged 15 to 29. Among adults, Country: Romania sexual transmission is prevalent ...page 15 (3/4 of the newly discovered WHAT IS THE SITUATION IN ROMANIA? HIV/AIDS cases). In 2009, the Topic for discussion (2): According to the UNGASS Report of testing services provided for March 2010, vulnerable groups highlight that IDUs (Injecting Drug Challenging stigma/discrimination Romania is one of the few Users) are may be one the most countries in Central and South- vulnerable groups to HIV/AIDS. Eastern Europe with a significant The increased vulnerability of WHAT IS AIDS RELATED STIGMA AND alongside other forms of stigma and number of people affected by HIV/ IDUs is demonstrated by the slow DISCRIMINATION? discrimination, such as racism, AIDS. According to the National increases in HIV newly diagnosed AIDS-related stigma and discrimination stigma based on physical appearance, Report of the HIV/AIDS Monitoring cases among this population. (whether real or perceived as real) homophobia or misogyny and can be and Evaluation Department in Among the children, the vertical refers to prejudice, negative directed towards those involved Romania, at the end of 2009, a transmission is responsible for attitudes, abuse and maltreatment in what are considered socially cumulative total of 16,162 cases 20 new cases of HIV/AIDS in directed at people living with HIV unacceptable activities such as of HIV and AIDS infection had been 2009. In conclusion, the sexual and AIDS. The consequences of stigma prostitution or drug users. recorded, while 10041 persons were transmission of HIV continues to and discrimination are wide-ranging: Stigma not only makes it more difficult living with HIV/AIDS. The majority lead the epidemic among adults. being shunned by family, peers and for people trying to come to terms of the cases were diagnosed at the Injecting drug use remains as a the wider community, poor treatment with HIV and manage their illness on a age when they were children (<14). major risk factor especially for in healthcare and education settings, personal level, but it also interferes Currently, the majority of the the capital city Bucharest where an erosion of rights, psychological with attempts to fight the epidemic people living with HIV in Romania it is estimated that 1% of the damage, and a negative effect on the as a whole. On a national level, are adults (the 17- 21 years being population is injecting heroin. success of HIV testing and treatment the stigma associated with HIV can the most prominent group), while a (Source: UNGASS Country Progress AIDS stigma and discrimination exist deter governments from taking fast, relatively low number of children Report, Romanian, March 2010).3 worldwide, although they manifest effective action against the epidemic, are living with HIV. themselves differently across whilst on a personal level it can make 3 http://www.unaids.org/en/dataanalysis/ countries, communities, religious individuals reluctant to access HIV Almost 50% of the newly discovered monitoringcountryprogress/progressreports/2010countries/ romania_2010_country_progress_report_en.pdf groups and individuals. They occur testing, treatment and care. Factors that contribute to HIV/AIDS- virus on to other people, who in turn experts agree that the chances of it activity is strongly recommended for related stigma include: are afraid to get tested and so on. happening are much less than one in most individuals infected with HIV. This is how an epidemic spreads and a million. HIV cannot be transmitted • HIV/AIDS is a life-threatening breaking this ‘cycle of silence’ is through normal bodily contact such as Participation in regular exercise/ disease, and therefore people react crucial in any strategy to effectively might occur in tackling an opponent. sports can have significant beneficial to it in strong ways tackle HIV and AIDS. The ways this can It cannot be caught by sharing shower effects both psychologically and with • HIV infection is associated with be done include: and toilet facilities, or through regard to boosting the immune system. behaviours (such as homosexuality, • Raising awareness of HIV and AIDS sharing a glass of water or cutlery. Similarly, progressive resistance drug addiction, prostitution or through the media training (circuit weight training) promiscuity) that are already can also help to develop muscle mass, • Providing education about HIV and stigmatised in many societies WHAT SHOULD I DO IF A TEAM MATE muscle strength and play a key role in AIDS • Most people become infected with HIV HAS HIV? maintaining bone mass. through sex, which often carries • Having laws and policies to prevent Discovering that someone you know moral baggage discrimination against people living has HIV can be a bit of a shock. Unquestionably, regular physical with HIV and AIDS (plwha) It is just something many prefer exercise has definite benefits for • There is a lot of inaccurate not to think about. Unfortunately people living with HIV and is an information about how HIV is • Encouraging people to talk about there is still a lot of stigma and effective means of ongoing management transmitted, creating irrational HIV and AIDS with their family, discrimination against people who are of the condition. There may be times, behaviour and misperceptions of community and work colleagues HIV positive. such as when starting on a treatment personal risk • Empowering plwha to advocate for regime, when it is best to limit and demand rights, such as effective • HIV infection is often thought Normally this is because people do the amount and degree of physical treatments, employment and access to to be the result of personal not really understand HIV and are activity. HIVsport recommends that other social resources irresponsibility frightened by it and turn that fright the appropriate amount of physical • Religious or moral beliefs lead • Building the capacity of civil into hatred or anger against people activity be discussed with medical some people to believe that being society organizations which provide who are living with it. These feelings supervisors. (Source: ­Sport, HIV and infected with HIV is the result of services for plwha and campaign on are natural but only make matters AIDS: the facts).5 moral fault (such as promiscuity behalf of plwha worse. Remember that HIV cannot be or ‘deviant sex’) that deserves • Encouraging high profile individuals, caught while playing sport, sharing to be punished. (Source: Avert: such as sportsmen and women to speak changing facilities or in normal A NOTE ON THE USE OF LANGUAGE International HIV and AIDS charity).4 out about HIV and AIDS. social situations so in fact, there is At the very end of the film it says nothing to worry about. If you know that ‘Alex is now close to becoming of someone who is HIV positive then a famous basketball player and an HOW CAN AIDS-RELATED STIGMA AND HOW CAN SPORT HELP? the right thing to do is just to treat idol for those who suffer from HIV’. DISCRIMINATION BE CHALLENGED? In the film we saw how the main them as you would anyone else. HIVsport prefers to use the phrase Stigma can be a very powerful response character was shunned by his ‘living with HIV’ rather than to to the HIV and AIDS epidemic and is girlfriend and his other friends, use words such as ‘suffer’ as this present in every country and region but was accepted into the basketball CAN I PLAY SPORT IF I AM HIV POSITIVE? can help to reinforce notions of where HIV is found, and therefore team. Sport can be a very effective Most definitely yes! HIV infection is victimization. Likewise the terms exists in every country in the world. way to help challenge stigma. Not not a reason to prevent anyone from ‘infection’ or ‘condition’ rather than Unless stigma and its consequence, only can high profile stars such as taking part in sports activities. ‘disease’ which can also have negative discrimination, is challenged, a Didier Drogba and others provide great There has been at least one Olympic connotations. vicious circle emerges whereby people publicity, but at a local level sport Gold Medal Winner who was HIV positive who think they may be infected may go can be a place where everyone is made so it is no barrier to participation into denial, refuse to get tested and to feel welcome. at any level. will therefore not get the treatment they need. In the meantime they are The good news is there have been no Anyone who is diagnosed HIV positive ...page 17 highly infectious and can pass the confirmed cases of any­one catching HIV should take advice from their doctor while taking part in sport and medical but generally, regular physical 4 http://www.avert.org/hiv-aids-stigma.htm 5 Available for free download from www.hivsport.org FILM 3 ‘Goal for hope’ by DANNY LURIE

Country: South Africa ...page 19 Topic for discussion (1): How HIV is transmitted

In the previous two films we have at risk as homosexual partners. HIV touched upon the subject of how HIV does not discriminate in this way. is transmitted without going into the Condoms are currently the best way to details. In this film we take a closer reduce the risk of becoming infected look. Knowing how HIV is transmitted, with HIV or giving it to someone else and just as important, how it cannot during sex. HIVsport acknowledges that be transmitted, is the starting point young people and adults make their in HIV/AIDS education. own decisions about who they have sex with, but we believe that all choices HIV can only be transmitted from one must be with respect to your own person to another by an exchange of health and the health of your partner. bodily fluids. The bodily fluids in Using a condom is a mark of respect. question are:

• Semen 2. Drug injecting with a contaminated • Vaginal fluid needle - Sharing a needle with someone • Blood else is high-risk behaviour and a potential cause of HIV transmission. • Breast milk If, for any reason, you are injecting steroids (or any other drug) you In reality there are only four ways should always use a clean needle and in which this can happen, and each of dispose of it safely after use. There these can be prevented. is a very small risk of a needle-stick injury resulting in HIV transmission 1. Unprotected sex (without using a which is why all needles must be condom) - This is by far the most safely handled and dis­posed of. common means of transmission and HIVsport does not condone the taking heterosexual couples are similarly of illegal or non-pre­scribed drugs. 3. Blood and blood products - Due It is perfectly safe to play sport with NOTES FOR DISCUSSION to advances in medical screening, someone who is HIV positive. In the film we see one of the children there is negligible risk that ...page 21 saying: transmission could occur through a consequence of millions of deaths and blood transfusion or during an organ WHAT’S THE SITUATION IN SOUTH a hyper prevalence of HIV infection “Even if a person with HIV eats and transplant. Virtually every country AFRICA? within the remaining population. This leaves and leaves saliva on plate you now has effective screening mechanisms USAID reports that: situation started to change in 2010 won’t catch AIDS, but if you clean the to ensure this does not happen and is With the highest number of infections when the South African Government plate you won’t catch AIDS. But if you no reason to avoid surgery or to have in the world, South Africa is one of launched a major HIV counselling and make contact with blood of a person a transfusion when recommended by a the countries most severely affected testing campaign (HCT). Since its with AIDS you may get AIDS”. qualified physician. by the AIDS epidemic. The country’s implementation, the HCT campaign first HIV infection was reported in has had a notable impact on the In fact no-one ‘catches AIDS’ as AIDS 4. Mother to Child Transmission - 1982. According to the most recent availability and uptake of HIV testing is a syndrome of other infections Children can become infected from estimate by the Joint United Nations and treatment. However, the challenges that is caused by HIV. It is also not their mother particularly during Program on HIV/AIDS (UNAIDS), South facing the country are immense and are possible to catch HIV from saliva. childbirth or through breastfeeding. Africa’s total number of people made worse with the high levels of TB However, this risk can be reduced living with HIV/AIDS (PLWHA) now co-infection which threatens to derail Also in the film we see the young boy markedly provided the mother’s HIV stands at 5.6 million, and the current HIV prevention strategies. identifying ‘tears’ as a bodily fluid. He status is known in advance. (Source: epidemic is now stable. While the According to UNAIDS statistics, 55% of is correct but it should be noted HIV ­Sport, HIV and AIDS: the facts)6. number of PLWHA has stabilized in people with HIV are on treatment. cannot be transmitted through tears. recent years, South Africa continues Other bodily fluids are NOT infectious. to face a generalized hyper epidemic These include: Saliva; Urine; Tears; due to high HIV prevalence. There are Sweat; Faeces and Vomit. numerous modes of transmission and drivers of the disease. There is no evidence to suggest that HIV can be transmitted through any of South Africa’s HIV epidemic is these fluids. generalized and also considered hyper endemic due to the high rate of HIV There must also be a transmission prevalence and the modes and drivers from one person to another, which of HIV. Also, the country is one of is why the mere presence of blood, the few where maternal and child for example, a cut, does not pose a mortality has increased since the risk provided that it is dealt with 1990s, and AIDS is the largest cause appropriately. Please see Appendix 1 of maternal mortality. It accounts for how to deal with wounds caused for an estimated 42.5 percent of through playing sport. maternal deaths, according to the World Health Organization (WHO), and for 35 percent of deaths in children under 5. (Source: USAID: South Africa ...page 20 HIV/AIDS Health Profile).1 For many years the South African HIV CANNOT be transmitted in any other Government was in denial about the way, such as shaking hands, sharing existence of HIV as a cause of AIDS. As a cutlery, cups and glasses, using the result, the epidemic was allowed to get same toilet and kitchen facilities etc. out of control with the 1 http://www.usaid.gov/our_work/global_health/aids/ 6 Available for free download from www.hivsport.org Countries/africa/southafrica_profile.pdf FILM 3 ...page 23 ‘Goal for hope’ by DANNY LURIE Country: South Africa Topic for discussion (2): The importance of role models

Role models come in many different guises. to gain the attention of children and, Some may be high profile international therefore, help to educate them about stars such as German international HIV and AIDS. As someone living with HIV footballer Michael Ballack or the himself Coach Tebogo is an especially Brazilian ace, Ronaldinho,2 who both now brave and important role model who is work to raise HIV and AIDS awareness able to talk from personal experience among young people. Certainly there is about HIV. evidence that high profile endorsements can get the attention of young people and give much needed publicity to campaigns. HOW CAN SPORT HELP? Grassroots Soccer, who helped to make the film, run a large number of projects However, it is not just superstars who in South Africa, using football as the can be effective role models: everyone medium through which to engage young can be, especially local sport coaches. A people. Grassroots know the importance coach or trainer plays a special role in of the coach in the success of their the lives of young people who are often programmes, saying: on the verge of discovering themselves, including their sexuality, and the world Many coaches are also counsellors, around them. In some parts of the world mentors, role models, informational where parents may have died from an AIDS- resources for their communities, and related illness, the sport coach may well organisers of innovative prevention be seen as a surrogate parent, a constant activities. in a young person’s life. Someone who is trusted, looked up to and learnt from. In Coaches take on this diversity of the film we see how Coach Tebogo is able functions mainly through their 2 http://www.michael-ballack.com/?120A0A2 and http:// relationships with their players/ www.unaids.org/en/media/unaids/contentassets/documents/ pressrelease/2011/10/20111019_PR_Ronaldinho_en.pdf students. Football programmes have FILM 4 ‘Play it safe’ by TAKUDZWA MUKIWA Country: United Kingdom Topic for discussion (1): Knowing your HIV status ...page 25

In the discussion about the first film, are also free of sexually transmitted ‘In Touch’, we said that HIV could now infection. For this reason, treatment be thought of as a serious infection is now believed to be the best means that could be treated successfully to stop the spread of the infection. provided the HIV positive person had However, as we saw in the second film, a c c e s s t o t h e c o r r e c t H I V t r e a t m e n t a n d ‘Dribbled to a second chance’, people care. For information, HIV treatment may be afraid to be tested due to the is often termed Anti-retroviral stigma attached to HIV and AIDS and treatment (ART) and consists of a the discrimination that people may be daily regime of taking medication to subject to if others know of their HIV counter the virus. If taken regularly, status. In the past, when treatments translated the unique relationships so that messages make sense in the medication can reduce an individual’s were not available there was also coaches have with their players to HIV face of the real struggles and tough ‘viral load’ to a very low amount that resistance to being tested as there prevention: just as coaches provide choices that youth face’ (Source: is undetectable in blood. However, seemed to be no point in knowing about support, advice, and motivation to Grassroots Soccer, Using Football the virus does still survive in some something that could not be treated. their players, they can do the same for HIV/AIDS prevention in Africa).3 parts of the body and can multiply Now that treatments are more widely for young people in a prevention again if treatment is stopped or not available this reason is not so valid. program, in many cases becoming Coaches are a powerful influence in the taken correctly. In the latter case, caring adults who set a positive lives of many young people. They have the resistance to drugs may occur and the There is now much more emphasis being example. Coaches can help guide young ability to shape other people’s lives in individual may need to change his/her placed on ‘Knowing your HIV status’ people through the challenges they many ways. How they choose to do that is treatment programme. as this knowledge will enable the face, can personalise the infection, a matter of urgent concern for everyone individual and health professionals making vivid the human cost of HIV involved in promoting education about The good news is that research is to develop a treatment programme that and depicting a way that youth HIV and AIDS. showing that when a person has an will enable the HIV positive person understand the individual reality undetectable viral load, that person to get the right treatment, to stay of the epidemic. Coaches can also 3 http://www.grassrootsoccer.org/wp-content/uploads/ has a very low chance of transmitting healthy themselves and, importantly, individualise prevention messages F4_HIV_Report.pdf t h e v i r u s t o s o m e o n e e l s e a s l o n g a s t h e y to reduce the risk of transmitting HIV. This is policy not just in the UK but is increasingly the strategy being ...page 27 adopted by international agencies such as UNAIDS and the World Health FILM 4 Organisation (WHO). It is also an ethical policy since it offers a positive choice for health to the HIV ‘Play it safe’ by positive person. TAKUDZWA MUKIWA WHAT’S THE SITUATION IN THE UK? In the film it was stated that there were an estimated 86,000 people living Country: United Kingdom w i t h H I V i n t h e U K . O t h e r e s t i m a t e s p u t the figure closer to 100,000 to take account of people who are HIV positive Topic for discussion (2): but do not know their status. It is thought that about 30,000 people fall into this categor y, m eaning that they The global impact of HIV can unwittingly pass on the virus to their sexual partner(s). While these In this film we see that there is a lot of develop rare opportunistic infections figures make the UK a low prevalence work going on to engage with the African and cancers that seemed stubbornly country, there is mounting concern community in London and to educate men resistant to any treatment. At this that infection rates are continuing in particular about the importance of time, AIDS did not yet have a name, to rise in certain communities. It having an HIV test and ‘knowing your but it quickly became obvious that is thought that this is due to the status’. The film gives an idea of how all the men were suffering from a lower levels of publicity surrounding HIV became a global epidemic as people common syndrome. HIV and AIDS since the advent of travel around the world. treatments in the 1990s. However, as The discovery of HIV, the Human in other countries, people do still Immunodeficiency Virus, was made die from AIDS-related illnesses, According to the international HIV/AIDS soon after. While some were especially if their HIV status is not charity, Avert: initially resistant to acknowledge discovered until a very late stage, the connection (and indeed some hence the importance of testing at The origin of AIDS and HIV has puzzled remain so today), there is now clear the earliest opportunity. scientists ever since the illness evidence to prove that HIV causes first came to light in the early AIDS. (Source: Avert website).4 W hile it re m ains the case that anyone 1980s. For over twenty years it has been the subject of fierce debate and can become infected with HIV, in What is clear is that HIV, the virus the cause of countless arguments, the UK there are two main ‘at risk’ that causes AIDS, spread as people moved with everything from a promiscuous groups. These are ‘men who have sex around the globe. Migration, tourism, flight attendant to a suspect vaccine with men’, and members of the African people who travel extensively for work, programme being blamed. So what is community. The term ‘men who have sex and other forms of international travel the truth? Just where did AIDS come with men’ is used across the globe have helped to transmit HIV globally. from? as way of describing this particular What is certain is that HIV and AIDS are group as many of these men do not The first recognised cases of AIDS truly global phenomena that affect every identify as being ‘gay’, which is occurred in the USA in the early country in the world. While some regions as much a cultural construct as a 1980s. A number of gay men in New se x u a lity. York and California suddenly began to 4 http://www.avert.org/origin-aids-hiv.htm such as sub-Saharan Africa have been The UNAIDS Global Map of HIV Prevelance worst affected, it is wrong to think of shows the global distribution of HIV ...page 29 HIV and AIDS simply as ‘someone else’s’ and AIDS. The red areas son the map show problem. It is the temptation to figure the highest levels of concentration FILM 5 p e o p l e l i v i n g w i t h H I V a s t h e ‘ o t h e r ’ t h a t while the whiter area shows the least. has helped to lead to many preventable infections as people thought they were The map can be downloaded from: ‘Whizzkids United’ by not at risk just because they did not see themselves as being a member of a http://www.unaids.org/globalreport/ particular ‘at risk’ group. HIV_prevalence_map.htm WHIZZKIDS UNITED

T h i s fi l m s h o w s h o w a l l p a r t s o f t h e world are connected with each other, and that HOW CAN SPORT HELP? Country: South Africa we are part of a global community where As the film shows, football is a things happening in places far away may place where men come together and it have an impact upon us at home. This is is this group that it is especially Topic for discussion (1): why it is important to think of HIV and important to reach with the message AIDS as being a global virus and the of ‘Get tested: know your status’. ‘global’ includes us! It is also why HIV The African Nations, UK football Gender Equality and AIDS require a global response as tournament provided a site where it is not possible for any one country African men living in London could to tackle it on its own. HIV and AIDS come and play football while at the According to the 2011 UNAIDS global including by working with men and is a serious worldwide epidemic that s a m e t i m e g e t h i g h q u a l i t y i n f o r m a t i o n estimates, women comprise 50 percent of boys to change norms related to affects us all wherever we live. about HIV and AIDS. people living with HIV. In sub-Saharan fatherhood, sexual responsibility, Africa, women constitute 60 percent decision-making and violence, and of people living with HIV and the by providing comprehensive, age- proportion of women living with HIV has appropriate HIV/AIDS education for been increasing in the last 10 years. young people that addresses gender norms. Gender inequalities are a key driver of the epidemic in several ways: Violence against women (physical, sexual and emotional), which is The World Health Organisation says: experienced by 10 to 60 percent of women (ages 15-49 years) worldwide, Gender norms related to masculinity increases their vulnerability to HIV. ca n e nc o u rag e m e n t o h ave m ore se x ua l p a r t n e rs a n d old e r m e n t o h av e se x u a l Forced sex can contribute to HIV relations with much younger women. In transmission due to tears and some settings, this contributes to lacerations resulting from the use higher infection rates among young of force. women (15-24 years) compared to young men. Norms related to femininity Women who fear or experience violence can prevent women – especially young lack the power to ask their partners w o m e n – f r o m a c c e s s i n g H I V i n f o r m a t i o n to use condoms or refuse unprotected and services. sex. Fear of violence can prevent women from learning and/or sharing HIV/AIDS programmes can address their HIV status and accessing harmful gender norms and stereotypes treatment. Gender-related barriers in access to AIDS, TB and malaria and to MDG 3 on promoting services prevent women and men from gender equality and women’s empowerment. accessing HIV prevention, treatment and care. FILM 5 THE SITUATION IN KWA-ZULU NATAL Women may face barriers due to their lack Kwa-Zulu Natal, the province of South Africa of access to and control over resources, w he re t h is fi l m w a s m a d e, h a s a n e sp e cia lly h igh ‘Whizzkids United’ by child-care responsibilities, restricted level of HIV prevalence. In 2010, statistics mobility and limited decision-making power. published by Avert show that 39.5% of attendees at pre-natal clinics were HIV positive.6 As the WHIZZKIDS UNITED Socialization of men may mean that they film says, 1 in 7 young people aged 15 – 24 are will not seek HIV services due to a fear HIV positive in this province. The situation of stigma and discrimination, losing is clearly serious, but as in other parts of Country: South Africa their jobs and of being perceived as South Africa there is also cause for cautious ...page 31 “weak” or “unmanly”. optimism, as UNAIDS reports in June 2011: The provincial government has put in Topic for discussion (2): Women assume the major share of care- place integrated programmes to address giving in the family, including for HIV, TB, breast and cervical cancer, those living with and affected by HIV. poverty, food security, and a range of What is counselling and support? This is often unpaid and is based on the other health and social services. assumption that women “naturally” fill this role. “By bridging HIV services with other Counselling is a key part of HIV especially who someone may want to tell, services the community needs we believe prevention and treatment programmes. and who they should not tell. Programmes can support women in their that we can help South Africa to reach our It is usually a confidential one-to-one care-giving roles by offering community- national targets of reducing the number discussion between a trained counsellor In the film we saw two of the children based care and support, including by of new HIV infections by 50% by 2015 and and someone who may be concerned about going for counselling and being able to increasing men’s involvement. in significantly expanding the number of their HIV status. It is usually offered in access a range of health services. This people on antiretroviral treatment,” said advance of having an HIV test, although is especially important where so many Lack of education and economic security Dr Zweli Mkhize. “Our model is working.” this is not always the case. Counselling children are orphans and vulnerable and affects millions of women and girls, whose will often cover issues such as: may have no other safe place to access H I V p r e v a l e n c e w a s 3 9. 5 % i n 2 0 0 9 i n K w a Z u l u - literacy levels are generally lower than • possible risk factors this sort of help. Natal, the highest in South Africa. men and boys’. The integrated approach adopted by the • lifestyle choices and behaviours

provincial government of KwaZulu-Natal Many women, especially those living • the benefits of having a test HOW CAN SPORT HELP? has already contributed to increasing with HIV, lose their homes, inheritance, • t r e a t m e n t s a n d s u p p o r t a v a i l a b l e The WhizzKids United Health Academy is the uptake of HIV testing reaching 2.9 possessions, livelihoods and even their in the event of a positive result the long-term component of the programme million people in the Province as of end children when their partners die. This which gives the behavioural interventions of June 2011. It has also expanded access • confidentiality of test results forces many women to adopt survival sustainability. Opened on June 1st, 2010, to lifesaving antiretroviral therapy to strategies that increase their chances of the health centre is located in front of 489 801 in 518 sites in the Province and Counselling is important as having a test contracting and spreading HIV. Educating the Edendale Hospital. It is a holistic in reducing the rate of infections from can be stressful, even when there are girls makes them more equipped to make adolescent-friendly healthy facility mother to child from 21% five years ago to lots of options for treatment available safer sexual decisions. (Source; WHO).5 operated in partnership with the KwaZulu- 7 in the event of a positive result. 2.8% in 2011.(Source: UNAIDS). Natal Department of Health.

HIV/AIDS progra m mes that prom ote and invest in If a person is found to be HIV positive, The Health Academy offers a full range gender equality contribute to both Millennium support maybe required as the news can 6 http://www.avert.org/south-africa-hiv-aids-statistics. of sexual health services including HIV Development Goal (MDG) 6 on combating HIV/ htm cause emotional difficulties and strong Counselling and Testing, an Orphans and 7 http://www.unaids.org/en/resources/ feelings, such as anger. Advice on how Vulnerable Children (OVC) support and presscentre/pressreleaseandstatementarchive/2011/ 5 http://www.who.int/gender/hiv_aids/en/ september/20110929psintegrationkzn/ to deal with the news is also important, feeding scheme, one-on-one sexual health APPENDIX ONE: HOW TO TREAT BLEEDING INJURIES HIVsport recommends taking the following precautions in the event of a cut occurring through playing sport as other viruses, such as hepatitis, have been known to affect whole teams where poor health and safety measures were in place:

• Insist that your team has a proper, well-stocked first aid kit. • All blood and body fluids should be considered as having possible risks (e.g. of hepatitis infection) regardless of circumstances. • The prompt reporting of injuries, particularly bleeding is in the best interests of all concerned. • All injuries, especially bleeding wounds, should receive proper and adequate first aid using proper equipment – for example, gloves. Clean blood from wounds with soap and water and apply an antiseptic. • Any skin injuries, for example abrasions, cuts, or wounds should be covered during sports activities. counselling, psychological support for important gap in an adolescent’s day: the • Remove athletes with bleeding injury HIV positive youth and sexual assault time between the end of school and the (not necessarily minor cuts or crisis referral. In addition, the health return of their parent or guardian from abrasions) from the event as soon as centre also features antiretroviral work, which has been identified as a high- possible. treatment (ART) as well. Alongside risk period for drug and alcohol use and • Change out of blood soaked kits and health services, the Health Academy also sexual risk behaviour. ensure they are properly washed. provides many recreational activities, • Water containers should be available academic support groups and its very own individually for each player in contact Mixed Gender Football League. OBJECTIVE sports. Athletes should use squeeze The objective is to build gender equality water bottles that do not require The Whizzkids United Mixed Gender Football on the football pitch in order to develop contact with the lips. League is an after-school football league it off the football pitch. By providing • Appropriate protective equipment, that provides township youth with a rare a healthy after-school recreational including mouth protectors, should be (especially for young girls) opportunity opportunity for under-resourced schools, used at all times in contact sports. to play organized sports. Boys and girls Whizzkids United strive to develop young • Any equipment contaminated with blood play together on the same team with football players of both genders to should be removed from the sports special rules designed to promote gender become role models and ambassadors in activity and either sterilised or equality. The league matches also fill an their families, schools and communities. disposed of. (Source: Whizzkids United website).8

8 http://www.whizzkidsunited.org/health-academy ...page 32 http://www.whizzkidsunited.org/mixed-gender-league ...page 33 APPENDIX TWO: traditional movement games with HIV and SELECTED ONLINE RESOURCES AIDS prevention and education. There are thousands of web sites dedicated to HIV and AIDS. Here are just a few that will help support education programmes. SPORTANDDEV.ORG www.sportanddev.org The international platform for sport HIVSPORT and development www.hivsport.org HIVsport works in partnership with professional sporting associations, TACKLE AFRICA umbrella HIV and sexual health www.tackleafrica.org organisations, the media, medical and Tackleafrica uses football coaching to corporate bodies to: educate young Africans about sexual health, relationships and HIV. • Create, through sport, greater public awareness of the global epidemic of HIV and AIDS TERENCE HIGGINS TRUST • Provide education and training to www.tht.org.uk people in all roles in sport around Terrence Higgins Trust is the HIV and sexual health leading and largest HIV and sexual • Support sports-related HIV and sexual health charity in the UK. health education projects UNAIDS www.unaids.org AVERT United Nations co-ordinating body. www.avert.org Epidemiological data and information on Provides a wide range of information, the global AIDS response. including basic factual information about HIV. AIDS and sexuality as well as specific areas of the site for young people WHIZZKIDS UNITED and a choice of educational resources, www.whizzkidsunited.org including downloadable booklets and WhizzKids United provides HIV/AIDS quizzes both for adults and young people. prevention, care, treatment and support to youth worldwide through the medium of football. GRASSROOTS SOCCER www.grassrootssoccer.org Grassroots Soccer uses the power of YPEER soccer to educate, inspire, and mobilize www.youthpeer.org communities to stop the spread of HIV. Youth Peer Education Electronic Resource (Y-PEER) is a web site aimed at supporting the development of youth KICKING AIDS OUT peer education in Eastern Europe and www.kickingaidsout.net Central Asia. Kicking AIDS Out offers an innovative, inclusive, high energy approach that links sports, physical activity and ...page 34 Open Education Centre

This project is funded by the European Union