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«ILO/USDOL HIV/AIDS Workplace Education Programme for Trinidad and Tobago ILO Subregional Office for the Caribbean Copyright © International Labour ...»

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Gonorrhoea Males: A cloudy (thick, grayish-yellow) pus-like discharge from the penis and a burning sensation during urination. Some males show no signs of infection.

Females: Usually no signs of infection. Some women have a puslike vaginal discharge, irregular bleeding, painful urination and lower abdominal pain.

If left untreated, a pregnant woman with gonorrhoea can pass the germ to the baby’s eyes during birth, possibly causing blindness.

Genital Herpes Both sexes: Caused by the herpes simplex virus and transmitted through direct skin-to-skin contact during vaginal, anal or oral sex. Although some people have no symptoms, most experience an itching, tingling or burning sensation, which often develops into painful, blistering lesions on or around the genitals and anus.

Symptoms may appear two to ten days after exposure and last two to three weeks. Some people have no symptoms.

There is NO CURE for genital herpes, but the blisters can be controlled with medication. If left untreated, recurring outbreaks of the painful blisters occur in 33 per cent of persons infected. May increase the risk of cervical cancer and can be transmitted to a baby during childbirth.


Both sexes: Symptoms appear ten days to three months after contracting syphilis. A painless chancre sore appears on or in the genitals, anus, mouth or throat. If initially left untreated, a skin rash will develop, often on the hands and soles of the feet, three to six weeks after the chancre appears. It then usually disappears. Other symptoms may include hair loss, sore throat, fatigue or mild fever.

–  –  –

Chancroid Both sexes: Symptoms include soft, painful sores that bleed easily on or around the entrance to the vagina, penis or anus. May also cause enlarged, painful lymph nodes in the groin, and slight fever.

Note: Many females have no symptoms; some females may have pain upon urination or defecation, rectal bleeding, pain during intercourse or vaginal discharge.

If left untreated, people with chancroid are highly susceptible to HIV because the sores bleed easily and allow the virus to enter the body via the bloodstream.

Genital warts Both sexes: Genital warts are the result of a virus spread during sexual contact. They often grow together in little clusters on and inside the genitals, anus and throat. Depending on the location, they can be pink, brown or gray, and soft; or small, hard and yellowish-gray.

If left untreated, genital warts disfigure the genitals.

Trichomoniasis Females: This is a vaginal infection that is most often contracted through sexual intercourse, but can also be transmitted through moist objects such as wet clothing, towels or washcloths. Symptoms include a burning sensation during urination and an odorous, foamy discharge, along with a reddening and swelling of the vaginal opening.

Males: Men usually have no symptoms but may have a slight discharge and/or lesions, and experience itching.

If left untreated it can cause urinary infections.

–  –  –

PID affects the fallopian tubes, uterine lining and/or ovaries. It is usually caused by untreated STIs that enter the reproductive system through the cervix, such as Chlamydia or Gonorrhoea. While symptoms vary from person to person, the most common symptom is pain in the pelvic region. Other symptoms may include frequent urination and/or burning during urination, sudden fevers, nausea or vomiting, abnormal vaginal discharge and/or pain or bleeding after intercourse.

If left untreated, pelvic inflammatory disease can cause infertility or ectopic pregnancy.

–  –  –


This game is designed to demonstrate graphically how quickly Sexually Transmitted Infection can be passed from person to person


Two pieces of paper, condoms for half the group, CD or cassette player (or radio).


Step 1: Write “STI” and “Clinic” on two pieces of paper.

Designate a small area in the room as the clinic, and place the “Clinic” sign there. Using chairs or other objects, form a square measuring nine feet by nine feet (three metres by three metres).

Step 2: Ask for about ten volunteers and give the “STI” card to one of them, telling that person that he or she has a Sexually Transmitted Infection. Give the condoms randomly to half of the participants. The game can be played with more or fewer people, but condoms should always be given to half of them.

Step 3: Explain that everyone must circulate in the square while the music is being played. As soon as the music stops, the person with the STI card grabs the nearest person.

If they have a condom on them, they do not contract the STI and are released to continue the game. If they do not have a condom, they contract the infection and must retire to the ‘clinic’ for treatment. The game continues until only those with condoms are left in the square and transmission of the STI has stopped.

–  –  –

Step 5: Provide information on where workers can obtain access to STI treatment services.

Activity 5: Names and symptoms of STIs


To familiarize participants with the different Sexually Transmitted Infections, symptoms and problems that result if they are left untreated


The presence of STIs during sexual relations greatly increases the chances of HIV being passed from one person to another.


Step 1: The Peer Educator should read the section in this handbook on STIs for background information.

–  –  –

Step 4: Clarify that these signs and symptoms do not include the signs and symptoms of AIDS. Remind participants that many people with STIs do not have any signs or symptoms, and that people can have more than one infection at a time.

–  –  –

Signs in females:

• Unusual bleeding

• Lower abdominal/pelvic pain

• Abnormal vaginal discharge (white, yellow, green, frothy, bubbly, curd-like, pus-like and odorous)

• Swelling and/or itching of the vagina

• Painful or difficult intercourse Step 5: Tell participants that untreated STIs can eventually cause serious, sometimes life-threatening, complications. Read through the list of complications of untreated STIs (if

–  –  –

Some STIs can increase the risk of HIV transmission as much as tenfold. This is because of the open sores associated with genital ulcers and other infections. HIV infection may also increase transmission of some Sexually Transmitted Infections, due to the body’s weakened immune system.

Activity 6: STI treatment for partners


To increase understanding of the importance of prompt treatment of STI by participants and their partners


If people with Sexually Transmitted Infections do not ensure that their partners get treatment as well, they risk getting the infection again if they continue to have unprotected sex with the same person.


Step 1: Ask for two volunteers to act out the parts of a client of an STI clinic and the clinic worker.

Step 2: Ask the volunteers to perform a one-minute role-play

following this story line:

Robert, a car mechanic, finally gets the courage to go to the clinic and check out a red sore on his penis. The clinic worker examines him and tells him he has an STI. The clinic worker tells him to bring in his wife 29 and any other sexual partners for treatment. Robert is very embarrassed and worried. He tells the clinic worker that he thinks this would be impossible. She explains that it is very important to keep the STI from spreading to others.

Step 3: Ask participants the following questions. (Make sure that each question is thoroughly answered before moving on to the next one).

• What happened here?

• Why does this happen?

• What problem does this cause?

• When it happens, what can be done?

• Why is it important to treat people with Sexually Transmitted Infections and their partners?

Step 4: Summarize some of the issues raised by the participants (such as poor communication between couples, personal denial, and overwhelming embarrassment).

Step 5: Provide information on where workers can obtain access to STI treatment services.

–  –  –


A Sexually Transmitted Infection, if not properly treated, cannot get better and can even get worse. This exercise helps participants think about the implications of treatment.


Step 1: Write each of the following statements on five different

sheets of paper:

• A “I thought I had an STI. But now, thank God, my symptoms are gone. I don’t have to worry anymore.”

• B “I’m sure I had an STI. But I got some antibiotics from a pharmacy friend, so I’m feeling better. I didn’t even have to finish all the medicine.

• C “My male partner has a discharge and probably has an STI. Since I have no symptoms, I’m sure I didn’t get it.”

• D “I think I might have an STI, but I’m too nervous about going to the clinic.”

–  –  –

Step 2: Divide participants into three to five groups. Give one of the prepared statements to each group and ask them to read through their problem situation carefully. Ask them to imagine that one of their friends was in this situation and to consider what advice they would give them.

–  –  –

B • Not taking all the prescribed antibiotics is bad, because although the symptoms may have disappeared, you may still have the STI in your system.

• Stopping the antibiotic halfway through its course enables the STI to develop a resistance to the antibiotic, which means that subsequent use of this antibiotic will be less effective.

C • You can have an STI without having symptoms.

• You may have passed on the STI to your partner.

D • You should muster up the courage to go to the clinic for a check-up.

• You should be concerned if you or your partner is having unprotected sex with someone else. You should be using condoms.

E • The symptom may have gone but the STI might still be there.

• You may think you are saving money but you may not be if the medicines are not the right ones and do not do the job.

• You should use condoms. Getting an STI is a warning sign that you are vulnerable to getting HIV.

• You should go to the clinic and get checked.

32 Step 4: Ask the participants to reflect on the exercise and share

the lessons learnt. Mention the following:

• You can have an STI without having any symptoms and can pass it on to others.

• You should take the full treatment prescribed for the treatment of STIs.

• You should use condoms in the future to avoid getting an STI again.

• You should go to a clinic for proper treatment when you suspect that you might have contracted an STI.

Step 5: Provide information on where workers can access STI treatment services.

I.3 Alcohol/Drug Use and HIV Substance use and HIV infection Alcohol can reduce an individual’s inhibitions and thus lead to high-risk behaviour. In places where alcohol is served, such as bars and clubs, sex workers may also be present. Alcohol can reduce a person’s resolve to avoid unprotected sexual intercourse and use condoms. A person may intend to use a condom but forget if too drunk. Also, alcohol consumption can impair motor skills and reduce the likelihood of condoms being correctly used, if used at all.

Marijuana, cocaine, crack cocaine, and ecstasy are, like alcohol, associated with social gatherings and tend to reduce the fear of sexual infections and, consequently, reduce one’s resolve to use condoms for protection.

Although not currently a widespread problem in Trinidad and Tobago, it should be noted that injecting drugs (most commonly heroin) is one of the most direct ways of transmitting HIV and other infections, such as hepatitis. This is largely because needles and syringes are often shared between users and blood from one user gets mixed with the drugs and is then injected directly into the veins of another user.

33 Activity 8: Alcohol Abuse


To create an understanding of the negative impact of excessive alcohol consumption


Alcohol consumption is considered a risk factor for HIV and other STIs. This is especially true if consumption is excessive.

Alcohol consumption tends to impair judgment. Those who intend to use condoms may lose their resolve after drinking.

Negotiating condom use with a drunken partner is very difficult. Alcohol is also related to violence against women.


Step 1: Read aloud or have one of the participants read aloud the following story and then ask the related questions listed below.

A young construction worker was working at a job site near the entrance to a large secondary school. He often watched the teenage schoolgirls walking by on their way to and from school. Sometimes they would stop and talk to him. There was one in particular whom he found very beautiful and sexy. Her name was Brenda. Though he had several girlfriends in town, it was Brenda he dreamed of having, but she always politely rejected his advances. It seemed to him that Brenda became more beautiful and sexy as each day went by. But no matter how hard he tried to convince her, Brenda said she wasn’t ready and was not going to go with him.

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