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Start where people are at

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HealthWiki > Health Actions for Women > Chapter 5: Preventing Sexually Transmitted Infections (STIs) > Start where people are at


When you are starting a conversation about STIs, it is almost always helpful to begin by asking people what their concerns are and what they already know. Many people today know something about HIV (Human Immunodeficiency Virus), because it is the STI that causes AIDS (Acquired Immunodeficiency Syndrome). Millions of people all over the world have died from AIDS, and millions more are infected with HIV now. Because AIDS has been so deadly in the past but is now survivable, most countries have programs to teach people about preventing and treating HIV.

2 women speaking in a small group.
Since so many people have heard of HIV, I often ask what they have learned about how to prevent it.
Yes, what they know about HIV applies to most other STIs, so it’s a good starting place.

Women are especially vulnerable to STIs and STIs are especially harmful to women if they are not treated. Some STIs can cause severe illness, infertility, problems with pregnancy, and even death. STIs can also cause serious health problems and lifelong disabilities in babies born to women with untreated infections. Supporting women to develop their ability to express their needs is key to helping them prevent STIs. Gender boxes and Communication is powerful can help you work with women learning to speak up. Also, you can adapt most activities in this chapter to focus on STIs in general or only on HIV.

a woman speaking.
When I gave my first STI talk, I talked mostly about the risks of unprotected anal or vaginal sex. I noticed people were only half listening, and they were whispering among themselves. Afterwards, some women came up to me. They took all the free condoms I was handing out, but that wasn’t their main interest. The thing that was on their minds was a man they had seen with sores on his lips. I wish I had asked them at the beginning of the meeting what their concerns were! I would have talked more about signs of STIs that you can see.
ActivitySecret questions


Sometimes people feel uncomfortable asking questions about STIs in a group. This activity can make it easier for people to ask about things they are concerned about, or do not want to admit they do not know. This activity works best when everyone in the group knows how to write. It can work with a group of both women and men, as well as with only women or only men.

  1. Ask everyone to write down at least one question about STIs on a small piece of paper. Collect the papers and put them in a bag or hat. No one will know who asked which question, and you can also add questions you think people would like to ask but are too shy to ask even privately.
  2. Review the questions and choose some to answer. You can do this at the beginning or end of a meeting, or you can make it the focus of the whole meeting. You can also save some questions for another meeting. But explain what you are doing so no one feels her questions were ignored.
    a woman speaking while holding a mobile phone.
    I ask people to send a text message or call me before the meeting and leave their questions on my voicemail. They trust me not to reveal who asked what.

  3. Depending on the question, you might simply answer it, invite someone else to answer it, or use it to start a discussion. You can invite a health worker to join you to help answer questions.
  4. a box with a slot in the top and the word "Questions" on the side.
    Keep a box where people can put questions they do not want to ask aloud. Take questions from the box to read and discuss at each meeting.

a woman speaking.
I always remind the group that there is no such thing as a stupid question, and that if one person has a question, chances are many others have the same concern.