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Health Education
Level 8 Planning Guide
2006
Section 3
Units of work suitable for assessment with
AS 90709 Analyse an international health
issue
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Achievement Standard
Achievement Criteria
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Explanatory Notes
3 For an identified health issue the student must clearly state the health
topic being analysed as well as give examples of significant data to state
why it is a health issue.
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9 Explain in-depth means to present accurate and detailed supporting
evidence.
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HIV/AIDS – a national or international
health issue
Introduction
This unit of work has been developed for external assessment using AS 3.2
Analyse an international health issue. It could also be used for AS 3.1 if the
focus remains on New Zealand. The MOH resource (2003) HIV/AIDS Action
Plan: Sexual and Reproductive Health Strategy, downloadable from
www.moh.govt.nz would provide excellent material if using HIV/AIDS as a
learning context for AS 3.1.
The unit outline described here is generalised and teachers should adapt and
extend it to the particular focus chosen.
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Resources
• Contact the New Zealand Aids Foundation librarian with any specific
requests ph (09) 3033124. They are amazingly helpful.
• Ministry of Health, 2003 HIV/AIDS Action Plan: Sexual and
Reproductive Health Strategy. www.moh.govt.nz
• Hughes T., 2003. The HIV/AIDS epidemic in New Zealand:
Environmental Scan. New Zealand AIDS Foundation, Auckland.
• Davis, P. (Ed). (1996). Intimate details and vital statistics: AIDS,
sexuality and the social order in New Zealand. Auckland: Auckland
University Press.
• Worth H. et al, 2001 Silence and Secrecy: Refugee Experiences of HIV
in New Zealand. Institute for Research on Gender, Auckland University,
NZ.
• UNICEF, 2002. Young People and HIV/AIDS: Opportunity in Crisis.
www.unicef.org
• Tasker G. (Ed)., 2000. Social and Ethical Issues in Sexuality
Education. Section 5 HIV/AIDS. Christchurch College of Education
• NZAF report on: World AIDS conference, 2002. AIDS New Zealand;
Issue 50.
• UNAIDS, WHO. Aids Epidemic: Update December 2003(download from UN
website listed).
• AIDS Explained Mark Thomas, 1999. Department of Molecular
medicine, School of Medicine, Auckland, New Zealand
• Leadership and Partnership: The New Zealand Response to the
HIV/AIDS Epidemic. Briefing to members of the New Zealand
Parliament. Prepared by the New Zealand AIDS Foundation, Update
May 2003.
• Mandatory testing and exclusion of HIV positive immigrants and
refugees. NZAF, April, 1999).
Useful websites
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ISSUE: The Spread of HIV/AIDS in Sub-Sahara Africa
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5. Describe the implications of • World Vision: A Global Challenge
HIV/AIDS transmission at Powerpoint presentation reinforces
personal, interpersonal and concepts discussed so far, with powerful
societal levels. messages on personal and interpersonal
implications
Using a variety of strategies such as
brainstorming, class discussions, • Avert.org AIDS around the world
watching relevant videos and
independent research, have students • UNAIDS, WHO. 2004 Report on the
describe in detail the implications of global AIDS epidemic: Executive
HIV/AIDS. A good idea to introduce the Summary
exploration of ethical issues at this point
which can be elaborated on later when
• Beacon folder background information.
looking at recommendations.
• Social and Ethical Issues in Sexuality
Education Section 5, Activities 2 & 4
6. Looking at recommendations for • UNAIDS, WHO. 2004 Report on the
prevention and/or treatment of global AIDS epidemic: Executive
HIV/AIDS in Africa. Summary. Excellent comprehensive
source of information on
Analyse what needs to happen to ensure recommendations.
positive outcomes in relation to the
transmission of HIV and support for those
living with HIV/AIDS in Africa. Students
need to identify and justify priorities for
action using the framework of the Ottawa
Charter and a range of health promotion
strategies. All priorities for action need to
be linked to the determinants described
when looking at the factors contributing to
the spread of HIV/AIDS in Africa. Can be
done as a jigsaw activity similar to
determinants jigsaw, but alter groups so
students not looking at same determinant
as before.
7. Putting it all together • 2004/5 Exam Papers
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Prior Learning: Resources:
Health Determinants, Health Promotion, Level 3 Beacon Folder, World Vision “A
Interpersonal Skills Global Challenge”, HIV/AIDS – Ministry of
Health booklet, various websites
Unit: Investigate an International Health Issue: HIV/AIDS
Unit Aim: By the end of the unit students will demonstrate an Key Area of Learning: Sexuality Education
understanding of HIV and AIDS, factors that influence and
contribute to global effects of the AIDS epidemic. Students will also Duration: 25 – 28 periods
investigate and analyse the implications of HIV/AIDS for people at a
personal, interpersonal and societal level. Class Level: Year 13/Level 8
-9-
Level Learning Outcomes Processes/Activities/Strategies Underlying Concepts Assessment
Students will: Opportunities
8A4 Investigate and understand the definition of HIV/AIDS Continuum activity (SEI) Learning Journal
What is HIV/AIDS? Hauora
HIV/AIDS.
(identifying the effects of
8C2 Demonstrate an understanding of various terms signs, symptoms HIV/AIDS on a person’s hauora
relating to HIV/AIDS. differences between HIV/AIDS in a holistic view.)
Demonstrate a clear and accurate understanding of physiological processes
the signs and symptoms, the process of transmission
modes of transmissions
and various effects of HIV/AIDS. Learning Journal
Identify the demographic groups who become Who gets it?
8C2 infected with HIV globally International statistics (www.who.org)
Investigate the global regions where HIV/AIDS is
prevalent NZ statistics – orientation and gender
8D2 (pg 12 MOH book)
Research global regions of HIV/AIDS and investigate
NZ epidemiology (Beacon folder) Attitudes
the implications on specific societies in those regions Jigsaw Activity
Video: All About Eve (Inside NZ) & Values
(developing respect for the
World links (OHT – Report on Global rights and opinions of others in
AIDS) respect to HIV/AIDS and
HIV Transmission Card Game developing a sense of empathy
with people with HIV/AIDS.
World Jigsaw Activity*
8C2 Investigate and analyse the prevalence of HIV/AIDS Why is Africa so hard hit and how does
throughout the Sub-Sahara region in Africa. Africa compare with the west?
Compare and contrast the prevalence of HIV/AIDS in Individual African countries’ endemic
8D1 Africa with the rate of infection in Western World infections (www.avert.org website)
Video: HIV/AIDS in South Africa Practice Exam
(2004 Level 3
(Assignment 2001) Socio-Ecological
8D2 Exam)
World Vision: A Global Challenge Perspective
8D1 Identify and explain how the Determinants of Health Western world health determinants that
contribute to the widespread infection of HIV/AIDS affect HIV/AIDS rates (identifying factors that
globally, with specific focus on Africa influence HIV transmission and
8D3 Determinants of Health in Africa that actively contribute to the health
contribute to widespread infection of other societies by
(Report on Global AIDS) investigating equity
discrepancies between African
nations and Western society’s
8A3 Describe the implications of HIV/AIDS transmission How does HIV/AIDS affect society? treatment of HIV/AIDS.)
at personal/interpersonal and societal levels. Personal, interpersonal and societal
8C2 Explore the ethical issues relating to HIV/AIDS in implications
Africa and NZ. World Vision: A Global Challenge
How do Africa and Western world differ in
8D1 Health Promotion
their treatment of HIV/AIDS?
(investigating and exploring
Costs and availability of drugs options available for countries
Mandatory testing with people with a high rate of
Mandatory reporting HIV/AIDS infections.)
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Mandatory disclosure
8D1 Critically examine the HIV/AIDS policies and What are countries doing about HIV/AIDS
practices adopted in various countries, particularly now?
Essential Skills Communication Skills 1 2 3 4 5 6 7 8 9 Social & Cooperative Skills 1 2 3 4 5 6 7 8 9 10 11
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Background Information
Adapted from: Sample Assessment for Health Scholarship developed in February
2003.
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‘Under the United Nations High Commission for Refugees(UNHCR)New
Zealand has a commitment to accepting 750 refugees annually, selected under
various criteria including women at risk, medical/disabled and family
reunification. This number does not always include family members who arrive
later under the family sponsored categories, nor asylum seekers who are
granted refugee status in New Zealand each year. Our overall commitment,
when these refugees are included, is actually around 1,250 refugees a year
which is around 2.5% of the annual NZ Immigration Programme’. (From: World
Refugee Day Speech by Hon. L. Dalziel, 2001)
Permanent Residence: Not compulsory to have HIV or AIDS test for migrants. But
migrants are asked if they have ever suffered from AIDS or AIDS related condition.
If migrant answers yes or if tests positive for HIV or AIDS in other tests, they can
be declined. However Immigration. Service can still allow entry for humanitarian
reasons.
Refugees: Given full medical tests including those for HIV, AIDS and TB once
they arrive in New Zealand – the test is voluntary but to date there have been no
refusals to have the tests. They are entitled to the same public health support as
New Zealand citizens.
Asylum Seekers: Tested only if they sign a consent form. While they are making a
case to stay in NZ they can get public health support.
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b) The major health determinants and their impact on well-being for refugees
diagnosed HIV positive when living in New Zealand
Many of the refugees arriving in New Zealand are from countries of high HIV/ AIDS
prevalence. It is important to be aware of the health determinants that most
significantly contribute to their vulnerability to HIV/AIDS infection in their countries of
origin, and also the major health determinants and the impact of these on all aspects
of well-being, for those refugees diagnosed as living with HIV/AIDS when they take
up residency in New Zealand These determinants may inter-relate and compound
the issues in relation to HIV/AIDS.
An HIV positive diagnosis can have devastating effects on refugees in New Zealand
who are already coping with having fled from their own homes, communities and
countries. As forced migrants, refugees not only suffer displacement but are also
compelled to live in new settings and conditions not of their own choosing. HIV is
generally regarded as a source of shame and fear among most refugee groups in
New Zealand. There is a common perception that HIV is a punishment from God.
Thus their spiritual wellbeing in terms of their sense of self is deeply affected.
Similarly, they often lose their hopes and aspirations for a new and better life as their
experience of people living with HIV/AIDS in their country of origin has been very
negative in terms of general health and life expectancy.
If their emotional well-being is adversely affected by feelings of fear, shame and guilt
this may mean they choose not to tell anyone in their community that they are HIV
positive. They may suffer from depression.
Fear and shame can have a serious impact on their relationships and may result in
partnership break-ups. This is an issue particularly for women, anxious about
rejection if they tell their partner and the difficulty of negotiating condom use to keep
their partner safe if they don’t tell. Their social support networks are thus non-
existent or very limited within their own community and language barriers make it
difficult for them to access social support within the wider community. They have left
most of their family behind in Africa and many are in New Zealand on their own.
Isolation (social exclusion) compounds their fear and depression.
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c) An example of an ethical dilemma and conflicting perspectives in relation to
containing the spread of HIV/AIDS in New Zealand.
The rights of New Zealanders should come before the rights of immigrants and
refugees.
HIV is a killer disease and the government has an obligation to prevent any
unnecessary entry of infectious diseases into New Zealand.
Refugees already are a high cost on the public systems of health, education and
social welfare. People living with HIV/AIDS will increase the burden to the
taxpayer even further.
Statistics clearly show that the increase in the rate of HIV infection in recent
years is a result of arrival of people from countries of high HIV prevalence (may
use graph data here)
We have had cases such as that of Mwai, where one HIV positive individual
infected several New Zealand women with devastating effects.
There would be many negative outcomes for refugees as to send them back to
their country of origin could result in their death. They would be unlikely to
receive the level of care from their country of origin compared to New Zealand
People living with HIV can still be useful productive members of society, actively
contributing to the economy.
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It would be inconsistent to single out HIV infected individuals as opposed to
people with other conditions who may place a similar cost on the health system
e.g. people with cancer.
There are logistic issues such as where testing would take place; whether the
elderly and young would also be tested; how specimens and data would be
managed.
Screening and excluding infected individuals from New Zealand may create a
false sense of security amongst residents. This would run contrary to public
health aims as residents may be less consistent in their practices of ‘safer sex’.
The belief that prospective immigrants infected with HIV are a danger to public
health and safety would set a precedent that all people living with HIV should be
similarly viewed. HIV/AIDS is a very specific disease .It is not casually transmitted
and is different from other diseases such as TB which can be transmitted through
the air. It is certain behaviours that put people at high risk of infection ie just because
a person is living with HIV/AIDS does not make them a risk to public health. In
addition, the rate of infection is lower for HIV than for many other infectious diseases
(for example, the hepatitis B virus) that also can cause death. The exclusion of HIV
infected immigrants reinforces the message to the public that HIV is casually
contagious, or that avoiding certain people will give protection, thus increasing
discrimination and isolation for people living with HIV/AIDS. Prevention measures
designed to prevent the epidemic from spreading must counteract incorrect
information about ‘risk groups’ and ‘risky behaviours’ that are present in particular
communities. All people must adopt safer sex practices to prevent transmission of
HIV, not just those currently infected.
Education requires financial resources and policies that divert funding to large scale
testing programmes may limit this and other health promotion strategies.
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d) Making a difference
education about the specific nature of HIV and it’s transmission and the need to
dispel myths about this for all sectors of the community
the New Zealand data on groups most at risk, (men who have sex with men,
refugees and immigrants from areas of high HIV prevalence)
the impact of positive HIV/AIDS diagnoses for refugees
human rights issues
economic considerations including the provision of appropriate health services
Justifications for priorities according to how benefits could accrue could include:
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OHP 1: HIV/AIDS Determinants
In Sub-Sahara Africa
ECONOMIC
• Lack of national financial resources means govts
cannot provide adequate health and education
services and increases widespread poverty
ENVIRONMENTAL
• Lack of access to adequate housing, clean water
• High density population living in poverty, which
facilitates spread of diseases such as HIV
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CULTURAL
• Moral beliefs about monogamy for women but
polygamy for males
POLITICAL
• Prevalence of war making many people refugees
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SOCIAL
• Lack of personal economic resources
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OHP 2: The Effects of HIV/AIDs
In Sub-Sahara Africa
PERSONAL
• Sickness and physical effects of HIV infection
• Death
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INTERPERSONAL
• Family members have to care for sick relatives
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OHP 3: Recommendations for
HIV/AIDS
In Sub-Sahara Africa
ECONOMIC
• Increase in global AIDS funding to Sub-Sahara
Africa and ensure funds are actually delivered;
according to World Vision, out of the $10 billion
promised annually for the African AIDS crisis in
2001, to date only $3billion has actually been
paid up. In contrast, after Sept 11, $40billion
was allocated to the war on terrorism.
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out of reliance on international economic
assistance
ENVIRONMENTAL
• Developing infrastructures at local and regional
levels with adequate housing, water facilities,
schools and hospitals
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people with microcredit and income generation
schemes
SOCIAL
• Social support structures put in place to assist
families with HIV-positive members
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CULTURAL
• Implementation of factual education programs to
dispel myths of HIV transmission and causes
that target specific cultural beliefs and values;
combat stigma of ‘bad spirits’ or a ‘vengeful God’
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POLITICAL
• Create policies to help reduce the vulnerability
of people by including access to education,
prevention services and enabling the
empowerment of women
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