Healthy Sisters:
Straight Talk for Sisters
E VENT G UIDE AND M ATERIALS FOR F ACILITATORS
LTG A SSOCIATES , I NC .
i
T ABLE OF C ONTENTS
Healthy Sisters: Introduction .............................................................................. 1
Healthy Sisters: Event Guide ............................................................................... 3
Welcome to Healthy Sisters! ...................................................................................................... 3
Effective Facilitation ................................................................................................................... 4
Healthy Sisters: Conducting an Event ................................................................ 15
Overview of the Event .............................................................................................................. 15
Working with the Campus Champion ....................................................................................... 16
Setting up an Event ................................................................................................................... 17
Event Preparation ..................................................................................................................... 18
Healthy Sisters: Educational Content ................................................................ 23
Background Material for Section 3: Sexual Health Facts.......................................................... 23
Background Material for Section 4: Understanding and Assessing Risk .................................. 34
Background Material for Section 5: Using Condoms ................................................................ 37
Background Material for Section 6: Defining Healthy Relationships ....................................... 42
Background Material for Section 7: Creating Healthy Relationships ....................................... 45
Healthy Sisters: Event Curriculum ..................................................................... 47
Section 1: Setting the Stage (25 minutes) ................................................................................ 47
Activity 1.1: Pre-test and Introduction (15 minutes) .......................................................................... 47
Activity 1.2: Fantasy Name Icebreaker (5 minutes)............................................................................ 49
Activity 1.3: Sisters Code (Rules of Conduct) (5 minutes) ................................................................... 50
Section 2: Talking about Sex and Sexuality (20 minutes) ......................................................... 51
Activity 2.1: Whatchamacallit? (20 minutes) ..................................................................................... 51
Section 3: Sexual Health Facts (110 minutes)........................................................................... 53
Activity 3.1: The Facts about STIs (45 minutes) .................................................................................. 53
Activity 3.2: HIV/AIDS Discussion (15 minutes) .................................................................................. 54
Activity 3.3: STI Fact or Fiction (20 minutes) ...................................................................................... 55
Activity 3.4: HIV/STI Bingo (30 minutes)............................................................................................. 56
Section 4: Understanding and Assessing Risk (60 minutes) ..................................................... 59
Activity 4.1: Sexual Networks (20 minutes) ........................................................................................ 59
Activity 4.2: Risk Continuum (20 minutes).......................................................................................... 59
Activity 4.3: Getting Tested (20 minutes) ........................................................................................... 61
Section 5: Using Condoms (75 minutes) ................................................................................... 63
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Activity 5.1: Male Condom Demonstration: O.P.R.A.H. (10 minutes) ................................................ 63
Activity 5.2: Male Condom Practice (10 minutes) .............................................................................. 63
Activity 5.3: Male Condom Race (10 minutes) ................................................................................... 64
Activity 5.4: Female Condom Demonstration: O.P.A.L.-T. (15 minutes)............................................. 65
Activity 5.5: Condom Negotiation for Safer Sex (30 minutes) ............................................................ 66
Section 6: Defining Healthy Relationships (120 minutes) ........................................................ 69
Activity 6.1: Healthy Relationships Discussion (30 minutes) .............................................................. 69
Activity 6.2: Relationship Influences (30 minutes).............................................................................. 70
Activity 6.3: Choosey Lover (30 minutes)............................................................................................ 70
Activity 6.4: Reality Checks for Unrealistic Expectations (30 minutes)............................................... 72
Section 7: Creating Healthy Relationships (110 minutes) ........................................................ 75
Activity 7.1: Sex and Intimacy Discussion (30 minutes) ...................................................................... 75
Activity 7.2: Improving Communication in Relationships (10 minutes).............................................. 76
Activity 7.3: Active Listening (20 minutes) ......................................................................................... 76
Activity 7.4: Healthy Conflict Resolution for Couples (20 minutes) .................................................... 77
Activity 7.5: Advice Columnist (30 minutes) ....................................................................................... 78
Section 8: Putting It All Together (25 minutes) ........................................................................ 81
Activity 8.1: Review Questions (5 minutes) ........................................................................................ 81
Activity 8.2: Planning for Action (10 minutes) .................................................................................... 81
Activity 8.3: Post-test and Closing (10 minutes) ................................................................................. 82
Post-Event: Tying Up Loose Ends .............................................................................................. 82
Healthy Sisters: Event Materials ....................................................................... 83
Event Preparation Worksheet .................................................................................................. 84
Sample Flyer.............................................................................................................................. 85
Activity 1.1: Sign In Sheet ......................................................................................................... 87
Activity 3.3: STI Fact or Fiction Materials ................................................................................. 89
Activity 3.4: HIV/STI Bingo Materials ........................................................................................ 95
Activity 4.1: “You and Your 4 Sexual Partners” Case Study .................................................... 143
Activity 4.2: Risk Continuum Materials................................................................................... 145
Activity 5.5: Condom Negotiation Role Playing Scenarios ..................................................... 157
Activity 7.1: Hill Harper Excerpt .............................................................................................. 159
Activity 7.5: Advice Columnist Questions ............................................................................... 161
Healthy Sisters: Participant Handouts ............................................................. 163
Activity 3.1: “Basic STI Facts for Women” .............................................................................. 165
Activity 3.3: “Common Misconceptions About STIs and HIV/AIDS” ....................................... 167
Activity 4.2: “The Risk Continuum”......................................................................................... 169
Activity 5.5: Condom Information Cards ................................................................................ 171
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Activity 6.1: “Healthy Relationship Checklist” ........................................................................ 175
Activity 6.2: “Couples that Have Influenced Me” ................................................................... 177
Activity 6.3: “Risky Traits in Potential Dates and Mates” ....................................................... 179
Activity 7.4: “Healthy Conflict Resolution for Couples” ......................................................... 183
Activity 7.4: Ways to Resolve Conflict Cards .......................................................................... 185
Activity 7.5: “Resources for Healthy Relationships” ............................................................... 189
Activity 8.3: “Phenomenal Woman” by Maya Angelou .......................................................... 191
Healthy Sisters: Evaluation and Feedback Forms............................................. 193
Healthy Sisters Event Pre-test ................................................................................................ 195
Healthy Sisters Event Post-test and Feedback Form .............................................................. 199
Healthy Sisters Event Facilitator Report and Feedback Form ................................................ 203
Healthy Sisters Answer Key for Questions 1 – 28 ................................................................... 205
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T ABLES
Table 1: Dos and Don’ts of Facilitation ........................................................................................... 7
Table 2: Communication Jammers ................................................................................................. 8
Table 3: Stages of Group Cohesion ............................................................................................... 10
Table 4: Event Summary ............................................................................................................... 20
Table 5: Event Summary Day Two ................................................................................................ 21
Table 6: Basic Facts about STIs ..................................................................................................... 27
Table 7: Common Misconceptions about Sexually Transmitted Infections and HIV/AIDS .......... 31
Table 8: Risk Continuum ............................................................................................................... 35
Table 9: Strategies for Conflict Resolution ................................................................................... 45
Table 10: Comparison of Risk Behaviors and Levels ..................................................................... 60
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F IGURES
Figure 1: Bacterial STI rates by age, sex, and racial groups in US, 2010 ....................................... 25
Figure 2: Student risky behaviors on HBCU campuses, 2006 ....................................................... 34
Figure 3: New HIV infections among African Americans in the US, 2009 .................................... 36
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A CKNOWLEDGEMENTS
The Healthy Sisters: Straight Talk for Sisters program was created by LTG Associates, based in
Takoma Park, MD. The Healthy Sisters: Straight Talk for Sisters program was created by LTG
Associates, based in Takoma Park, MD. The original foundation and inspiration for the
intervention was the Healthy Love Workshop created by SisterLove under the leadership of
Dázon Dixon Diallo.
Portions of Healthy Sisters were also derived from Native STAND, which was developed by the
Centers for Disease Control and Prevention/Division of STD Prevention, the Indian Health
Service National STD Program, and the National Coalition of STD Directors.
The LTG Associates, Inc. team included Cathleen Crain, MA, and Nathaniel Tashima, PhD, LTG
Managing Partners and Project Monitors; John Ogawa, PhD, Project Director; Sonya Ross, BS,
Project Coordinator; Emma Williams, MHS, Research Associate; K. J. Doneby Smith, PA-C, MAA,
Research Associate; Pamela Rao, PhD, Senior Research Associate; Kristen Hudgins, PhD,
Research Associate; and, John Hannay, MTS, MCHES.
We would also like to thank Dana Cropper Williams, MPA, MHR, Director of Training, National
Coalition of STD Directors, who provided her expertise and experience in the development and
testing of the program.
This project was funded by the Division of STD Prevention, NCHHSTP, Centers for Disease
Control and Prevention.
For additional information about the curriculum, adaptation, or evaluation contact: C. Crain,
LTG Associates, telephone: 301-270-0882; email: partners@ltgassociates.com.
Healthy Sisters: Introduction
This document contains information and materials for conducting an Healthy Sisters: Straight
Talk for Sisters Event on your campus. The Healthy Sisters program is intended to increase HIV,
STI, and unintended pregnancy prevention awareness and behaviors among young African
American women, and ultimately to promote healthy relationships. A Healthy Sisters Event is
designed not only to educate participants, but also engage them in discussions of issues that
influence the development of healthy relationships and women’s decisions about their
reproductive and sexual health.
The authors believe that if women are provided with good information, tools, and support
around healthy relationships and sexuality, and if they feel empowered to respect themselves
and their partners, that better relationships will result and fewer women will contract STIs or
experience unwanted pregnancies; those are the ultimate goals of Healthy Sisters, and your
facilitation and mentoring will be key to them being realized. The Event is divided into two
parts: the first is focused on STI/HIV understanding and prevention; the second is focused on
developing healthy relationships. Over the Event, it is expected that the conversation will move
back and forth between these interrelated topics even as you move through the curriculum.
While it is important that young women understand the facts about specific STIs, their
prevention and their treatment, it is critical that you as the facilitator keep bringing the
conversation back to decision making about healthy relationships and sexuality. A woman who
is focused on developing strong, healthy relationships and who respects herself and her partner
will make good decisions about choices of partners and activities. Those are the key concepts in
Healthy Sisters; a woman respecting herself and her partner and making decisions that reflect
that vision. Some women may already be there and some may not get there during Healthy
Sisters; you will help them to have the tools for those respectful relationships for the future.
A Healthy Sisters Event is a series of activities and group discussions that engage participants in
developing healthy relationships and safe sexual behaviors. It is intended to be interactive and
engaging rather than didactic. A key part of Healthy Sisters is to develop support for healthy
decisions. This is purpose of both the Workshop and of the follow-up activities that you will
help to design and implement. The curriculum includes approximately 12 hours of activities
including significant time for discussion. You can decide how the time will work best for your
audience and your context. The curriculum as presented here is intended to be conducted over
two days. If this is not practical in your setting and you decide to present it in more sessions, it
is important to ensure that there is enough time at each session for women to feel comfortable
discussing sensitive issues and to have those discussions. To ensure maximum participation and
comfort level, Events should have no more than 12 participants.
This Healthy Sisters Event Guide contains information for planning and organizing a Healthy
Sisters Event. In this guide the educational content section includes all the background material
that is to be conveyed to participants during the Event. The Event curriculum section outlines
the materials, steps, and timing necessary to facilitate the Event. The three month follow-up is
not programmed; you will decide how to structure the time to best encourage women’s healthy
decision-making and to reinforce their support of one another.
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HOW TO READ THIS GUIDE
The text throughout the manual has been formatted to indicate the type of information it
contains, as illustrated in the following examples:
1.
Instructions for activities are numbered.
 Lists of tasks to be performed by the facilitators are preceded by a check mark.
 Items, topics, or questions to be covered in the section are bulleted.
“Suggestions for ways that facilitators might present information are formatted as bold
paragraphs in quotation marks.”
Key points are called in in boxes with broad borders.
Facilitator notes and side comments are enclosed in boxes with narrow borders.
Unless otherwise specified, materials and handouts used in the activities are provided in the
Event Materials.
The Healthy Sisters curriculum is grounded in the principles of adult learning; each Event should
be conducted to reinforce them:
 Needs assessment: participation of the learners in naming what is to be learned –
this has been thoughtfully carried out in the planning of Healthy Sisters.
 Safety in the environment and the process. We create a context for learning. That
context can be made safe.
 Sound relationships between teacher and learner and among learners.
 Sequence of content and reinforcement.
 Praxis: action with reflection or learning by doing.
 Respect for learners as decision makers.
 Ideas, feelings, and actions: cognitive, affective, and psychomotor aspects of
learning.
 Immediacy of the learning.
 Clear roles and role development.
 Teamwork and use of small groups.
 Engagement of the learners in what they are learning.
 Accountability: how do they know they know?
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Healthy Sisters: Event Guide
This section of the Event Guide presents an introduction to the Healthy Sisters Event and
offers suggestions for effective facilitation.
Welcome to Healthy Sisters!
This program was created by LTG Associates for the Centers for Disease Control and Prevention.
LTG Associates is a minority- and woman-owned consulting firm that focuses on issues of
access, appropriateness, and quality of health and human services. Healthy Sisters was
originally modeled on the Healthy Love Workshop created by SisterLove. The intervention has
grown in scope to focus on healthy femininity, healthy sexuality, and healthy relationships, and
now includes information from a variety of resources, all of which are cited in the manual.
Healthy Sisters: Straight Talk for Sisters is different from other programs because it:
 Focuses on developing and sustaining relationships that are healthy and centered on
self and other respect;
 Addresses issues of healthy femininity and self-determination;
 Addresses a full range of reproductive and sexual health issues;
 Acknowledges participants’ desire to explore the realities that influence their
reproductive and sexual choices and options;
 Integrates self-help theory and techniques that respect each person’s ability and
right to heal and empower herself;
 Reflects our belief that collective wisdom and experience provide valuable teaching
and learning opportunities; and,
 Respects the cultural traditions of people who throughout time have gathered to
support one another in times of crisis and growth.
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Effective Facilitation
Your Role as a Facilitator
The Healthy Sisters Workshop is intended to be facilitated by a team that will include a sexual
health expert and a counselor with relationships expertise. Working together, using your
individual and joint expertise, will make the workshop and follow-up activities the best for the
men who participate. Your role as a facilitator is to ensure that each participant receives the
information she needs to make informed choices about her body, her life, and her
relationships. During the workshop you will encourage participants to share their experiences,
knowledge, and ideas. Your role is not to tell participants how to address every issue, but to
help keep the discussion on track, ensure correct information is disseminated, and make sure
that everyone has an opportunity to speak. A representative of your university, or Campus
Champion, will be assisting you with implementing the program and will act as a liaison with
LTG Associates and the CDC.
As a facilitator you should strive to connect with the group and not be above it in any way and
take an egalitarian approach to setting the mood. Try to make sure all participants are
comfortable with you and allow them to speak their opinions freely. During breaks you should
allow participants to talk about whatever they want amongst themselves, and you should
participate in those conversations and engage with the women. Try to avoid being an aloof
facilitator at the front of the room. Be open and honest when you don’t know something … do
not pretend that you know everything. Admit whether you are or have confronted the same
issues. It is helpful to explicitly state that, “I have / have had to deal with these same things.”
Let them know that most women struggle with these same issues. In the Event, strive to create
an atmosphere that says that you and the participants are a united group on a journey of
exploration together.
Confidentiality
As a facilitator leading Healthy Sisters Events, you will deal with information of a highly personal
nature. Educators are bound by the same ethics of confidentiality as are any professionals
dealing with similar issues. Program participants must feel comfortable that the facilitators and
other participants will maintain confidentiality, and it is important that you foster this attitude
in the workshop. Simply put: information revealed during the course of the Event should not be
discussed or shared outside the Event.
Informed Consent and Evaluation Protocol
As a facilitator you will be asked to help evaluate the Healthy Sisters program. This is an
important step for tracking how well the curriculum is working for participants. To do this we
will have the participants complete surveys before and after the Event. This will show what they
knew before the Event and what they learned by participating. They will also complete an
online follow-up survey three months after the Event. The three surveys allow the creators of
the Event to assess what information participants are retaining over time.
The first step in the evaluation process is for participants to read the Informed Consent
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document. This document describes the Healthy Sisters program and the purpose of the three
evaluation surveys.
Participation in the evaluation is optional. However, those who choose to participate must sign
the informed consent before completing the surveys. Remember to collect the signed forms
before giving out any surveys. The signed forms must be returned with the completed surveys.
It is very important to administer the pre-survey before starting the Event. Just as important is
conducting the post-survey immediately afterward. Please remember to allow enough time for
both of the surveys and to emphasize the importance of each participant providing thoughtful
answers. You will then collect both sets of surveys and the signed consent forms in an envelope
and give them to the Campus Champion.
Facilitator Competencies
The following competencies1 are fundamental to leading a successful Healthy Sisters Event:





Oral communication: speaking clearly, succinctly and effectively
Feedback: offering appropriate, non-judgmental feedback for improvement
Active listening: using non-verbal actions that make verbal communication more effective
Teambuilding: knowing the characteristics of teamwork and encouraging them in others
Adult learning: understanding different learning styles and how adults acquire and use
knowledge, skills, and attitudes
Qualities of an Effective Facilitator
An effective facilitator should also have the ability to be:








Patient
An active listener
Respectful of others’ opinions and ideas
Confident without being arrogant
Flexible
Knowledgeable of the topic
Cognizant of group dynamics
Self-aware
 Non-judgmental
As a facilitator, you should be able to:
1
For more information, see Vella J (2002). Learning to Listen, Learning to Teach: The Power of Dialogue in
Educating Adults, Revised Edition. San Francisco: Jossey-Bass, chapter 1.
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 Initiate activity. Although facilitators should have the ability to develop shared
responsibility and leadership in the group, they should also be willing to step in and
move activities along when no one else is doing so.
 Monitor and support. Facilitation is about providing the group with information and
helping them to have meaningful conversations. This allows them to process
information in ways that are most likely to result in using the information and in
gaining peer support for healthy, mature decisions. The facilitator is the monitor and
supporter for these conversations, focusing and gently directing without being at the
center of the conversation. If you find yourself voicing your opinions or participating
actively in the conversation, you need to think about your role as facilitator.
 Distinguish and control personal views. Facilitators should be able to separate their
personal views, needs and interests from those of the group or members; they
cannot be promoting their own agenda or having “an axe to grind.” On rare
occasions, a facilitator may need to step out of her role to express personal needs
and opinions, allowing her co-facilitator to lead during that time. However, this
should be the exception, not the rule.
 Value and respect each Event participant as an individual. While keeping the focus
on the group and its activities as a whole, facilitators should also be attentive to
individual needs and mutual respect.
 Emphasize positive aspects of the Event. Facilitators should be able to take negative
expressions of anger, sadness and/or depression and refocus them in a positive,
constructive direction, thereby benefiting the individual and the group. This can
often be accomplished by drawing attention to complementary strengths and
resiliencies rather than allowing a group to focus on negativity and/or powerlessness.
 Manage emotional responses to the materials and the group interactions.
Facilitators must be aware and ready to manage the emotions that participants may
experience when talking about healthy relationships and healthy sexuality. Anger,
sadness, and even withdrawal from the conversation are all possible. Your
responsibility is to help the participants to actively deal with their emotions while
ensuring that the group is able to move forward. And, in the event of deep or
intractable emotions, to help the participant to find professional support.
 Encourage Event participants to identify and evaluate alternatives for themselves.
At the heart of Healthy Sisters is the support for individuals making the best decisions
for themselves. Facilitators should not decide what is right for any given participant.
Rather, they should encourage participants to create solutions for their own
challenges and assert their strengths. The reality is that subsequent to the Events,
when a participant finds herself in a situation with high sexual health risks or is
making decisions about building relationships, the facilitator is not going to be on
hand to intervene or help. Therefore, facilitators must strive to assist each participant
in building capacity to know and implement her own answer.
Table 1 summarizes your role. You should encourage participants to express their own thoughts
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and decisions, and to have discussions with others. This allows them to make their own
decisions and find their own solutions to challenges in their lives.
Table 1: Dos and Don’ts of Facilitation
A Facilitator Does
Communicate trust, openness, and empathy
Accept people as they are
Listen, clarify, and help people see
alternatives
Give support and encouragement to positive
actions
Validate people without being phony
Respect confidentiality
Realize people may have their own ways of
handling problems, not all problems can be
solved, and not everyone wants to be helped
Refer troubled individuals to a professional,
such as a counselor, for assistance
Have a realistic understanding of the barriers
to resolving problems that exist in the real
world
A Facilitator Does Not
Dominate, preach, tell people what to do
Judge people, try to change them
Give advice, offer solutions
Listen with a casual, wandering attitude
“Rescue,” i.e., do for a person what he/she should do
independently
Repeat anything that was said or about other people
Put people down or criticize them for doing things
differently
Attempt to provide services beyond what he/she is
qualified to provide
Expect all problems to be resolved quickly and easily
Adapted from ETR Associates’ Resource Center for Adolescent Pregnancy Prevention (http://recapp.etr.org/recapp)
Communication Styles
As a facilitator you should be aware of the communication styles that you, or others, exhibit.
There are three primary communication styles: passive, aggressive, and assertive.2
 Passive: reserved, apologetic, soft spoken
 Aggressive: loud, boisterous, unwilling to compromise
 Assertive: confident, determined, open-minded
All three types are likely to be shown by Healthy Sisters participants. Certain types of body
language are characteristic of each form of communication. Watch for them, and, if necessary,
make subtle adjustments to accommodate them. Here are some examples. Passive
communicators may not make eye contact. Their responses may not be clear or direct. Ask such
a participant clear, direct questions that elicit a specific response.
Passive communicators may not make eye contact. Their responses may not be clear or direct.
2
Adapted from Communication Styles by Christopher Heffner. Available online at
http://online.cit.edu.au/toolboxes/EmploymentServices/content/resources/03_effective_communication/03_esta
blish/doc/page_004_pass_aggress.doc (accessed April 4, 2012).
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Ask such a participant clear, direct questions that elicit a specific response.
Aggressive communicators may be excessively animated, shake their fists, or speak over others.
They may be seen as trying to intimidate others into seeing or doing things their way. Ask such
participants to consider opposing viewpoints. Suggest that they brainstorm their ideas briefly
with the group.
For a facilitator, adopting an assertive communication style is the goal. Ask clearly and directly
for what you want. State your feelings without becoming aggressive. Use these strategies:
 Be firm, but not loud or angry
 Speak in a calm and consistent tone
 Take responsibility for what can and cannot be done
 Be willing to compromise
It is very easy to fall into communication style traps and other challenges that will keep you
from communicating effectively. These traps are called “communication jammers.” Table 2 is a
list of communication jammers that can be used as an aid for planning ahead to avoid or defuse
them if they should occur during an Event.
Table 2: Communication Jammers
Jammer
Description
Warning/
Telling someone that continuing a
Threatening
particular behavior will have negative
consequences
Pressuring
Trying to convince another person to
do something based on facts,
information, or logic
Moralizing/
Telling someone what they should do
Preaching
Ridiculing
Blaming, name-calling, being sarcastic,
shaming, putting down
Directing/
Telling someone to do something
Ordering
Advising/
Giving advice or providing answers for
Recommending
a problem
Consoling
Dismissing a problem by offering
meaningless assurances
Lecturing
Trying forcefully to prove your point
by providing many facts without
discussion
Example
“If you don’t start using condoms you’re
going to end up with a disease or get
pregnant.”
“One in four teens that have sex gets an
STD, so protect yourself.”
“I think the best thing for you to do is get
on birth control.”
“I can’t believe you had sex with him so
quickly.”
“Don’t try to figure it out, just do it.”
“If I were you, I would break it off with
him. I don’t think he is good for you.”
“Don’t worry about that, I am sure
everything will be all right.”
“The facts clearly show that STDs/HIV is
prevalent. Don’t you know…?”
Adapted from NativeSTAND: Students Together Against Negative Decisions (www.nativestand.org)
Active Listening
Listening means paying full attention. Avoid being so distracted by the responsibilities of being
the Event facilitator that you become preoccupied and miss important things that the women
share. Active listening is important because it makes people feel valued and allows for clearer
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communication. Some aspects of active listening are described below.
Clarification: Ask questions to ensure you understand what is being said. Some example
phrases are:
 Could you say more about that?
 What do you mean by that?
 Why do you think/feel that is the case?
Paraphrasing: Restate the key content of the message to make sure it is understood correctly.
Some example phrases to begin a paraphrasing statement are:
 What I am hearing from you is …
 Let me understand. You are saying …
 So, you felt that …
Responding: It is also important to respond to the unspoken messages that you perceive
through tone, body language, facial expression, etc. You might want to give a statement that
demonstrates your understanding of the unspoken communication. For example:
 It seems like you feel angry about that. Is that correct?
 It seems like you felt hurt by what was said. Is that correct?
 You seem to be confused or not in agreement with what was said. Is that correct?
Asking: You also may simply ask about the speaker’s emotional state:
 How do you feel about that?
 How does that make you feel?
 What feelings or emotions does it bring up for you?
Encouraging Participation
The following questions can be asked when there are lulls in the conversation or to engage
participants who have not been speaking up. To encourage discussion, ask questions such as:
 “How would you deal with that?”
 “Has anyone ever had that experience?”
 “What have we missed?”
To wrap up a discussion, ask questions such as the following:
 “Do you think we have spent enough time on this topic?”
 “Are we ready to move on to the next section?”
If someone is having trouble articulating her thoughts, ask a clarifying question. Never put
words in someone’s mouth. Use the format: “What I hear you say is….” For example, “I hear
you saying that black femininity is [restate what you heard]. Am I correct?” Then you can move
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on with a discussion about it.
Avoid asking, “What do you think?” Framing the question this way will more likely yield a
socially desirable answer, and thus participants won’t express their own thoughts or feelings.
Women will tend to tell you what they know, intellectually. A facilitator should strive to get
them to talk about their feelings. As a follow-up you may say, “That’s what you said, but how do
you feel about it? For example, a woman may say, “Well, I know I’m not supposed to have
unprotected sex, I’m good.” The facilitator could say, “That’s great that you know that. But how
do you feel about that? What makes that a challenge for you?” or “How will you plan for your
own safety at your next encounter?”
Managing Group Dynamics
When you bring a group together they will go through a number of stages throughout their
time together (see Table 3). Your role as facilitator will be to encourage an appropriate level of
openness, camaraderie, and bonding that is supportive and promotes learning.
Table 3: Stages of Group Cohesion
Stages
Facilitator Actions
Forming
Welcome participants, create safe environment
Storming
Discuss purpose, clarify roles and address
conflicts openly
Norming
Foster supportive environment
Performing
Elevate rising leaders, continue supportive
environment
Adjourning
Create closing ceremony, ensure continuation
through group leaders if necessary
Possible Group Responses
Uncertainty and/or excitement
Testing, challenging perceived
authority
Task oriented, cohesion forms
High outcomes, minimal challenges
that are solved by the group
Uncertainty, withdrawal, excitement,
and/or sense of completion
Adapted from Tuckman B (1965). Developmental Sequence in Small Groups. Psychological Bulletin, 63(6): 384-99.
Group Management
The following are general suggestions for handling difficult situations, such as disagreements
between participants or introduction of an inappropriate or unrelated topic.
 Do not let two or three individuals argue a point. Say, “You each have valid opinions
and thoughts.” Encourage different points of view and remind participants that it is
okay to disagree. Affirm people for offering ideas and sharing experiences.
 Keep the rules of conduct for the workshop posted visibly, and refer back to them if
needed.
 If participants are slow to respond, try one of the suggestions in the section above,
“Encouraging Participation.” Avoid telling them how to answer every question. The
idea is to foster discussion.
 Try to draw out those who are “under-participating.” Make eye contact with a
reticent person, call him by name, and encourage him to give his contribution to the
conversation: “Chelly, what are your thoughts on this subject?”
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 If a participant asks a question or makes a comment that is off-topic, let her know
whether this is something that will be covered later in the workshop and put it in the
Parking Lot. If not, tell the participant that you may be able to get more information
after the workshop, or refer her to other resources.
The following are general suggestions for handling a domineering participant.
 Encourage individuals who are dominating the conversation to allow others to speak
by breaking eye contact with them. Turn to someone else in the group, call her by
name, and ask for her input.
 Allow the participant to express herself.
 Offer to speak with the participant after the workshop or put the issue in the Parking
Lot.
 If appropriate, ask for feedback from the group, but be careful not to allow the group
to gang up on the individual.
 If necessary, refer to the ground rules established at the beginning of the workshop.
Tips for Handling Difficult Situations
The following are general suggestions for handling difficult situations, such as a domineering
participant, introduction of an inappropriate topic, or disagreements between participants.
 Allow the participant to express herself.
 Offer to speak with the participant after the Event.
 If appropriate, ask for feedback from the group, but be careful not to allow the group
to gang up on the individual.
 If a participant asks a question or makes a comment that is off-topic, let her know
whether this is something that will be covered later in the Event. If not, tell the
participant that you may be able to get more information for her after the Event.
 If necessary, refer to the ground rules established at the beginning of the Event.
Honoring the Principles of Adult Learning
In each section of the Healthy Sisters Event, you will find the principles listed below woven into
the content and process. We have particularly emphasized the following principles:
 Safety in the environment and the process. We create a context for learning. That
context can be made safe.
 Sound relationships between teacher and learner and among learners.
 Sequence of content and reinforcement.
 Praxis: action with reflection or learning by doing.
 Respect for learners as decision makers.
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 Ideas, feelings, and actions: cognitive, affective, and psychomotor aspects of
learning.
 Immediacy of the learning.
 Teamwork and use of small groups.
 Engagement of the learners in what they are learning.
 Accountability: how do they know they know?
Both as you prepare for an Event and as you conduct the Event with your co-facilitator, please
refer back to these principles and use them to make your Event successful for each of the
participants. It is particularly important to remember that at the end of the Event, each young
woman reenters her social sphere with the tools you help her to develop or strengthen. If you
use these principles actively in the Event, she will be better prepared to use the tools and resist
negative forces.
In Summary
 Your role is to facilitate the discussion among participants, not to lecture them. Keep
the participants engaged and the conversation moving along.
 Keep the discussion focused on the topics. Do not allow the conversation to become
sidetracked into discussing individual problems or personal issues.
 Feel free to offer suggestions or ideas if the group seems stuck, but do not simply
give them information or answer questions without discussion.
 Discourage individuals from dominating the conversation. Try to draw out those who
are less talkative.
 Encourage different points of view. Remind participants that it is okay to disagree.
 Affirm participants for offering ideas and sharing experiences.
Campus Resource and Referral List
You will need to create a list of your campus and local resources that you will use for the Event.
The lists should be printed and distributed to the Event participants. Under the bullets below
are some examples of resources and referrals you may want to gather and share. Each resource
should include contact information, location, hours of service, and website (if available).
 Counseling (on campus and off campus)
 Mental health
 Substance abuse
 Reproductive health
 Health
 Campus health center
 Local health centers
 HIV/AIDS/STI testing sites
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 Others?
 Women’s support services
 Domestic and intimate partner violence and rape crisis services
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Healthy Sisters: Conducting an Event
This part of the Healthy Sisters Event Guide describes all the steps needed to conduct a
Healthy Sisters Event, including logistics, recruitment, and preparation.
Overview of the Event
The specific goals of a Healthy Sisters Event are to:





Promote healthy relationships and open, effective communication;
Promote healthy femininity;
Promote self and other-respectful behavior;
Increase self-awareness of one’s risk of contracting a sexually transmitted infection;
Encourage the adoption of attitudes and behaviors that promote sexual health;
 Reinforce a sense of agency and self-efficacy regarding relationships and sexual interactions.
A Healthy Sisters Event lasts about 10 hours and is divided into eight sections with multiple
activities. Each begins with either a statement of purpose or a set of learning objectives.
Activities that structure the Event and keep it moving forward have a statement of purpose.
Activities that teach Event topics have learning objectives.
Sections 1, 2, and 8 give the participants a chance to get to know each other and to do
paperwork. The remaining five sections provide education and information on healthy
relationships and on STI prevention. Participants’ newly acquired knowledge is reinforced
through a variety of activities that allow them to review the material and practice the skills they
have learned.
The Event Materials contains many of the documents that will be used throughout the Event.
The package does not include some materials, such as STI brochures and resources lists, which
are best obtained locally. Your Campus Champion can help you with this.
A NOTE ABOUT BREAKS: The times suggested for each activity are approximations for planning
purposes. The actual time an activity takes will depend on the number of participants, their
level of knowledge of the topics prior to attending the Event, and their comfort with and
interest in discussing them with each other. Therefore, the curriculum is presented as a series
of activities without imposing breaks or other structure on the flow. As facilitator, you should
determine the appropriate timing of breaks based on the progress through the curriculum and
the energy and comfort level of the participants.
As noted, the Workshop has been designed to be flexible in the numbers of sessions over which
it will be completed. It may be conducted over two days or in more sessions so long as the
comfort of the participants with the materials, with one another, and with discussions of
sensitive topics is not compromised. We recommend that if conducted over two days that the
two topics be separated for continuity. We also recommend that steps be taken to ensure that
participants return for the second day or subsequent sessions so that they receive the
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maximum program benefit. The two parts of the Event, without extended discussions, breaks or
lunch, time out to:
 STI Prevention & Healthy Sexuality: 4 hours 50 minutes of active time; and,
 Healthy Relationships: 4 hours 15 minutes of active time.
Note also that after each section there are discussion prompts that are intended to expand the
conversation. These discussions are very important, but will also affect the timeline for the
activities; you will need to determine when to wrap them up and move forward.
Working with the Campus Champion
You may be assisted in your efforts by a Campus Champion. This may be the person who
recruited you for this project. If your campus has a Champion, she or he will:
 Help you identify a co-facilitator;
 Help you coordinate Events;
 Answer questions from participants that you are unable to answer;
 Review evaluation findings to determine how effective the program is on your
campus; and,
 Suggest improvements when needed.
Before each Event, you as the facilitator should contact the Campus Champion for help with
Event recruitment, scheduling and promoting. He or she will provide supplies. After each Event,
let her/him know that you completed the Event. Indicate when you will return the supplies and
participant evaluation forms. Share any thoughts, feelings, concerns, or suggestions with the
Champion. He/she depends upon your feedback and ideas to help make sure that Healthy
Sisters remains a viable, fun, and effective teaching program.
You should plan to meet periodically to review the Events. Talking with the Campus Champion
also gives you a chance to debrief. Events sometimes trigger feelings and reactions that deserve
further exploration. Many facilitators learn more about themselves as a result of their work.
They may also come to personal decisions about their own life choices. In this way, the Healthy
Sisters Event can be a life-affirming and empowering experience for facilitators, as well as for
participants. Meeting with the Campus Champion is also a chance to think about ways to
improve the next session.
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Setting up an Event
Recruiting Participants
Recruiting participants for an Event may happen through a variety of means depending on the
campus. In order to have the Events for both men and women be most effective, it is best if
every student has an opportunity to participate. There are a variety of ways in which you may
be able to develop this level of participation on your campus; here are some suggestions:
 Make Healthy Sisters part of Freshman orientation program;
 Make Healthy Sisters a requirement of living in a campus dorm; and,
 If you have a freshman health educational requirement, make Healthy Sisters a part
of it.
The eventual goal is for every student at your campus to have participated in an Healthy Sisters
or Healthy Brothers Event. Your campus will be able to build on the core competencies of the
Events and relate them to other campus programs for better outcomes.
General Recruitment
If making Healthy Sisters part of general education or campus life requirements is not possible
on your campus, then there are many ways to recruit students to participate. The first step is to
determine how students on your campus learn about activities like this Event. Communication
strategies could include printed fliers, email lists, social media, campus or local radio stations,
or making announcements in class. Make a list of influential people who could encourage
students to participate. If possible, use existing social structures to encourage women to
participate. For example, leaders of a sorority or an athletic team could encourage women to
participate. Sometimes resident assistants are required to provide educational workshops to
residents. If so, recruiting and supporting you in carrying out this Event might help them meet
those requirements. Popular professors may be willing to promote the Event at the beginning
or end of their classes, or to allow you to speak to their classes about it. Students in majors such
as health sciences may be the first to indicate interest in participating, but students who are
likely to know less about the subject may be more likely to benefit.
Framing the Event
The Event should be presented as a chance for young women to exchange ideas about
relationships and sexual health. They will talk about how to establish and maintain healthy
relationships and how to help other young women on campus do the same. Although not
required for every implementation, the pilot Events included a free tote bag containing a
variety of types of condoms and resource materials. The pilot Events also had free meals/snacks
as a time to socialize. These aspects of Healthy Sisters have been very popular, and providing
free condoms and information resources is an important part of the model. Check with your
Campus Champion about your institution’s decisions about these aspects of presenting Healthy
Sisters.
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Event Preparation
An Event Preparation Checklist is included in the Event Materials. It includes a list of materials
you will need to assemble before each Event, as well as a timeline for making arrangements in
advance as needed.
Advance Preparation
The following tasks need to be completed prior to offering an Healthy Sisters Event and should
be initiated several weeks in advance.
Before each Event, make sure that you have all the necessary audiovisual equipment and that it
is working properly. This will include a computer that can play music, videos, and PowerPoint
documents. The videos and PowerPoint documents will be provided to you on a USB drive. You
should select some music and prepare a playlist for use during the Event.
 Reserve a space to conduct the Event that offers privacy since much of the
information in this Event is personal and confidential. If possible, request that the
tables be arranged for a conference or in a “U” formation.
 Schedule the Event at a time and location that is likely to be convenient for students.
 If needed, promote the Event widely and long enough in advance to ensure that
anyone who might be interested has an opportunity to hear about it and plan to
participate.
 Find out what STI and HIV testing services are available on or near campus. Find out
how to schedule appointments. (This information will be used in Section 5.)
 If the Event is voluntary, ask participants to confirm that they will attend. Send them
reminders about the workshop in advance. Aim for 5 to 12 participants per
workshop.
 As necessary, prepare the Event materials (e.g., STI Bingo, risk cards) by printing
them on cardstock and cutting apart the questions. If possible, laminate them for
future use.
 Obtain easel pads, stands, and markers. Pads with self- sticking sheets are best; if not
available, obtain tape for posting sheets during the Events (see Event Preparation
Sheet in Workshop Materials).
 Obtain copies of the consent form, educational handouts, and data collection
instruments.
Day of the Event
The following tasks should be completed early on the day of the Event.
 Bring a watch or clock to help keep the activities on time.
 Post the Event name where it will be readily visible to participants as they arrive from
different locations.
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 Check to make sure the room is arranged appropriately. Make sure it will be easy for
everyone to hear each other. Lay out note pads or notebooks, pens, index cards, and
pre-tests on the tables.
 Place a Question and Answer drop box in the back of the room and hang a “Parking
Lot” sheet on a wall in the room for recording thoughts and ideas that arise during
the Event.
 Make sure the computer, projector, and/or other A/V equipment are set up and
working.
 Prepare easel pads and materials for activities that will be needed throughout the
day.
 Place the sign-in form and a pen on a table or attach it to a clipboard in a location
where participants can sign in as soon as they arrive.
 If the Event is a requirement, be sure that the sign-in form contains the information
that will allow the student to receive credit for completion.
Event Summary
Table 4 (next page) provides an overview of the Event. Written materials in the “Event
Materials” and handouts in the “For Participants” columns are provided at the end of this
document. Items in those two columns that are presented in parentheses [“(“and “)”] must be
locally provided.
Generally, it is good to stay relatively close to the timing for each of the sections. However,
encouraging participants to ask questions and have focused discussions in the safe space that
you will develop is an important part of the Event. You will see discussion prompts at the end of
many sessions which are intended to encourage women to synthesize what they have learned
in the session and then visualize using the information in their lives. This is an important feature
of the Event and should not be cut short in order to remain rigidly on time. An important
lesson in developing and piloting this curriculum is that for many, there have not been the
opportunities to learn about and discuss the topics in this Event. Therefore, it is important to
ensure that the time for real learning is provided.
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Table 4: Event Summary
Section
Time Event Materials
1: Setting the
25
 Sign in Sheet
Stage
 (easel pad wall sheets), (large
envelope)
 (name tags), (markers)
2: Talking about
20
 (easel pad wall sheets)
Sex and Sexuality
3: Sexual Health
110  (easel pad wall sheets)
Facts
 STI Fact or Fiction Materials
 STI Bingo Materials
 (small prizes)
4: Understanding
and Assessing
Risk
60
5: Using
condoms
75
DAY 1 TIME
290
 (easel pad wall sheets)
 “You and Your 4 Sexual
Partners” case study
 Risk Continuum materials
 (sticky notes), (pens)
 Get Yourself Tested video (on
USB drive)
 (male & female condoms)
 (penis and pelvic models)
 Condom Negotiation Role
Playing Scenarios
(4 hours 50 minutes)
For participants
 Event Agenda
 Pre-test
 “Basic Facts about STIs For Women”
 (local STI brochure)
 “Common Misconceptions about STIs
and HIV/AIDS”
 (local testing brochure)
 “The Risk Continuum”
 (local testing information)
 Condom Information Cards*
IF TWO DAY EVENT, END DAY ONE HERE
If you use a two day schedule, begin day two with a reorientation to Healthy Sisters, remind
participants of the “rules” that they created on the first day, then, orient them to the topics
for the second day.
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Table 5: Event Summary Day Two
Section
Time Event Materials
6: Defining
120  (pens), (scissors), (glue), (tape),
Healthy
(magazines/newsprint with
Relationships
photographs of young men),
(index cards), (musical playlist
and audio equipment)
7: Creating
110  Hill Harper excerpt
Healthy
 (easel pad wall sheets)
Relationships
 Advice Columnist questions
 (paper), (pens)
8: Putting It All
Together
25
 (large envelope)
 Facilitator Feedback Form
DAY 2 TIME
255
4 hours 15 minutes
TOTAL TIME
545
9 hours 5 minutes
For participants
 “Healthy Relationship Checklist”
 “Couples That Have Influenced Me”
 “Risky Traits in Potential Dates and
Mates”
 “Types of Intimacy”
 “Healthy Conflict Resolution for
Couples”
 Ways to Resolve Conflict cards
 “Resources for Healthy Relationships”
 (brochures and other materials listing
local resources)
 (goodie bags)
 “Phenomenal Woman” by Maya
Angelou
 Post-Test
NOTES:
 Easel pads (and masking tape unless pads with self-sticking sheets are available) and
markers will be used in most sessions.
 Sticky notes and pens should be available throughout the Event for participant use.
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Healthy Sisters: Educational Content
This Healthy Sisters educational content is provided for you to review before the Event and for
your reference during the Event. DO NOT present this material verbatim during the Event.
You should know the material and be able to explain it in your own words at the relevant
points in the curriculum. Note that all sections highlighted in blue are hot links to Event
materials and/or content.
Background Material for Section 3: Sexual Health Facts
The material in this section supports the activities in Section 3: Sexual Health Facts (pp. 53 57). Do not read it to the participants.
Sexually Transmitted Infections (STI)
Sexually transmitted infections are caused by bacteria, parasites and viruses.
 Bacteria are micro-organisms that seek to use your body to survive. In most cases
bacteria can be cleared from the body by antibiotics.
 Parasites are organisms that live on or inside your body, causing irritation or harm.
The two most common STI parasites are scabies (tiny mites that live under the skin)
and pubic lice (small insects that live on pubic hair and ingest blood).
 Viruses are microscopic organisms that take over cells in the body often causing
disease. Strictly speaking, viruses are not curable, although they can sometimes be
controlled by medications or cleared by one’s immune system. Acquired Immune
Deficiency Syndrome (AIDS) is caused by the human immunodeficiency virus (HIV),
and is also a sexually transmitted infection. HIV/AIDS is covered in more detail in the
next section.
Note: The term “sexually transmitted infection,” or STI, has gradually been replacing the older
term “sexually transmitted disease,” or STD. A person can be infected, and therefore able to
infect others, without having a disease. The term STI therefore covers both cases.
Symptoms of STIs that women may experience include:
 Unusual smell or discharge from the vagina;
 Pain in the pelvic area;
 Burning or itching around the vagina;
 Bleeding between menstruation; or,
 Pain from deep inside the vagina during intercourse.
Symptoms of STIs that men may experience include:
 Unusual drip or discharge from penis;
 Pain when urinating;
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 Pain in the scrotum (“ball sac”); or,
 Blisters or sores on the penis or scrotum.
Additional symptoms that may occur in men and women are:
 Feeling the need to urinate often;
 Swelling or redness in the throat;
 Flu-like feeling with fever, chill and body aches;
 Swelling in the groin or pelvic area;
 Warts in the genital area; or,
 Yellowing of the eyes or skin (jaundice) along with darkened color of urine.
The following are some other important facts about STIs:
 While the symptoms of STIs vary from person to person, the most common symptom
of an STI is “NO SYMPTOM.”
 The two most common STIs are HPV and Chlamydia.
 STIs can infect not only the vagina and penis, but other areas of sexual contact such
as the rectum (through anal sex) and the throat (through oral sex).
 Douching or using any type of vaginal cleansing method before or after sex will not
reduce the risk of pregnancy or getting an STI.
 Once a person has been exposed to an STI, urinating, douching, and washing will not
prevent disease.
 If caught early, most bacterial STIs can be cured with a pill (antibiotic) with little or no
long-term consequences. This makes it very important to get checked after any risky
sex, so these infections can be detected and treated early.
 The viral diseases (HIV, HPV, HSV, Hepatitis B and C) are NOT CURABLE, although
some symptoms can be treated.
For all STIs, it is important to be seen promptly by a health care provider as soon as symptoms
occur, or if notified by a sexual partner that she/he has been diagnosed with an STI. It is
important to abstain from oral, anal, or vaginal sex when an STI is being investigated or treated.
Further, because many STIs have no immediate symptoms, it is important for anyone who is
sexually active without using protection or with more than one partner to be regularly tested
for STIs. These tests can be conducted during routine medical appointments or through special
STI clinics, often sponsored by non-profit community groups and/or local public health
departments. However, do not assume that a routine physical or an annual Pap smear includes
testing for sexually transmitted infections; be sure to request STI testing. The CDC website
contains additional information on STIs (http://www.cdc.gov/std/phq.htm) and a list of testing
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sites (http://hivtest.org) around the country.
Figure 1, below, shows rates by age, sex and racial group for three bacterial STIs.3 The rates for
chlamydia and gonorrhea are much higher for Blacks of all ages than for other groups. Part of
the disparity between races is likely due to the sources of these data. Nonetheless, these data
underscore the importance of chlamydia testing for African American young women.
Figure 1: Bacterial STI rates by age, sex, and racial groups in US, 2010
Table 6 provides an overview of the causes, symptoms, and complications of several of the
more common sexually transmitted infections.
3
Source: Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2010. Atlanta: U.S.
Department of Health and Human Services, 2011.
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Table 6: Basic Facts about STIs
Name
Additional (nonsexual)
means of transmission4
From mother to child during
Gonorrhea
birth.
(bacteria)
Syphilis (bacteria)
In rare instances, through
close body contact, saliva,
blood; from mother to child
during pregnancy.
Chlamydia
(bacteria)
From mother to child during
birth.
Genital Herpes
(virus)
Via direct skin contact with an
ulcer; from mother to child
during birth.
Hepatitis B (Hep B)
(virus)
By exposure to blood or
(more rarely) saliva; from
mother to child during birth.
4
Symptoms
So what?
Curable?
May have no symptoms.
Sometimes a yellow discharge from
the vagina and pain when
urinating. In more advanced cases,
pelvic pain and fever.
Inflammation of the fallopian tubes
causing Pelvic Inflammatory Disease
(PID). Can cause infertility or lead to
ectopic pregnancy (pregnancy in the
tubes) which can be life-threatening. Can
infect newborn during birth.
Yes, with antibiotics,
but if damage has
occurred, it will not be
reversed.
Initial symptoms include painless
ulcers on the genitals. Later
symptoms include rash, swollen
glands and hair loss. Can lead to
deterioration of eyesight and/or
brain function in very late stages.
Most frequently no symptoms
occur. Rarely, clear discharge from
the vagina, sometimes with pain in
more advanced cases.
If left untreated it can lead to heart, liver,
joint and central nervous system
disorders, including blindness. Can infect
a fetus.
Yes, with antibiotics,
but if damage has
occurred, it will not be
reversed.
Inflammation of the fallopian tubes
causing Pelvic Inflammatory Disease
(PID). Most common cause of infertility in
US. Can lead to ectopic pregnancy
(pregnancy in the tubes) which can be
life-threatening. Can infect newborn
during birth.
The infection goes into remission after an
initial outbreak and then periodically
reoccurs, gradually diminishing over
time. Can infect newborn during birth.
Yes, with antibiotics,
but if damage has
occurred, it will not be
reversed.
In a small number of cases, may become
chronic (never completely heal) and
develop into liver disease and/or liver
cancer, often leading to early death. Can
infect newborn during birth.
No, but most cases
resolve in 3-6 months.
Fever; blisters and ulcers on
genitals, anal area or mouth;
varying degrees of pain at areas of
the sores, initially lasting 1-2
weeks.
Many people have no symptoms,
but others experience jaundice
(yellowed skin and eyes), dark
urine, fatigue, nausea, and
vomiting.
No, but drugs can
suppress outbreaks
and help manage pain.
Other than vaginal, oral or anal sex, contaminated hands, or sex toys.
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Hepatitis C (Hep C)
(virus)
By exposure to blood
particularly when injecting
drugs, less often from sharing
toothbrushes or razors; from
mother to child during
pregnancy or birth.
Many people experience jaundice
(yellowed skin and eyes), dark
urine, fatigue, nausea, and
vomiting.
HIV Infection (virus)
From mother to child during
pregnancy.
Human Papilloma
Virus (HPV) (virus)
From mother to child during
birth (although serious
consequences are rare).
Nongonococcal
Urethritis (NGU)
(various bacteria)
Pubic Lice (Crabs)
and Scabies
(parasite)
Almost exclusively spread via
sexual contact.
Initially, there may be no
symptoms or a flu-like illness;
symptoms often don’t develop
until several years afterward, and
relate to specific illnesses that
occur due to the breakdown of the
immune system.
There are many strains of HPV.
Most people experience no
symptoms, even when cancer is
present. Some strains produce
genital warts (flesh-colored
growths). Other strains can cause
genital or anal irritation or
bleeding.
Milky urethral discharge, pain or
burning sensation when urinating,
irritation of the vagina.
Trichomoniasis
(parasite)
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Acquired through skin-to-skin
contact and sharing personal
items (underwear, towels,
etc.).
Almost exclusively spread via
sexual contact.
Intense itching, mites in the pubic
hair (around the vagina and
vagina), and skin rashes (in the case
of scabies).
Itching or irritation inside the
vagina, burning after urination or
ejaculation, or some discharge
from the vagina.
Unlike Hep B, most cases of Hep C (75%)
become chronic (never completely heal).
Of those, a minority will develop into
liver disease and/ or liver cancer, with a
smaller number leading to early death.
Can infect newborn during pregnancy or
birth.
Over time, HIV destroys the immune
system and progresses into AIDS, during
which physical wasting, cancer,
pneumonia, and other life-threatening
diseases occur; early death often follows.
Can infect newborn during pregnancy.
Certain strains of HPV can cause cancer
in the area infected, especially cervix,
anus, or throat. Most common cause of
throat cancer in US.
If the cause is actually chlamydia or
trichomonas, complications relate to
those conditions.
No, but treatment can
help suppress the virus
and related symptoms.
A healthy diet and
abstaining from
alcohol are advised.
No, but use of a multidrug regimen can slow
disease progression
and manage
symptoms. Unpleasant
side-effects are
common.
Depends – both
genital warts and HPVrelated pre-cancer or
cancer can be treated.
Genital warts often
recur. Treatments for
cancer are intense, but
cure rates are high.
Yes, with antibiotics.
Extreme skin irritation, and surface
wounds on the skin which may lead to
other bacterial infections of the skin.
Yes, medicated
shampoos and lotions
kill the lice.
Can cause infection of the fallopian tubes
or prostate; rarely, infertility. Can cause
pregnancy problems, e.g., preterm
delivery, premature rupture of
membranes, and low birth weight.
Yes, with antibiotics.
Healthy Sisters Event Guide
HIV/AIDS
HIV stands for ‘human immunodeficiency virus” and AIDS stands for “acquired immune
deficiency syndrome.” HIV is the virus that leads to AIDS. HIV is spread through unprotected
sexual contact with an infected person. Over time, HIV damages the immune system so that
people become vulnerable to infections that healthy people usually fight off. When the immune
system is so damaged that these particular infections start to occur, the HIV-positive person is
now said to have AIDS.
When symptoms of illness do appear, they will vary from person to person. The most common
are swollen glands, fever, and diarrhea. In some women, recurrent, hard-to-treat yeast
infections and cervical cancer may be related to HIV infection. Of course, people can have some
of these symptoms or diseases without having HIV.
Not everyone who is exposed to HIV becomes infected. General level of health, the amount of
viral exposure, and the particular sexual behavior engaged in play a part in resisting infection.
Most important may be the fact that having any other STI makes the risk of contracting HIV
higher. However, it is important to know that it is possible to become infected with a single
sexual exposure, even a first-ever sexual contact, if barrier protection (condoms, dental dams,
etc.) is not used. Within a few weeks after becoming infected with HIV, some people experience
flu-like symptoms with a low fever and general malaise (feeling ill) for one to two weeks.
However, a person who becomes infected with HIV may not have any apparent symptoms for
years (the average number of years varies depending on immune response and lifestyle).
There is no timeline for how long it takes HIV to develop (“progress”) into AIDS. Various factors
beyond the strength of the immune system can influence the time between HIV infection and
the development of AIDS, such as:
 Age (older people tend to progress to AIDS more quickly);
 Having an STI already (can make one progress to AIDS more quickly);
 Nutritional status;
 Stress;
 Initial strength of immune system;
 Drug adherence;
 General physical condition; and,
 Gender (women generally progress faster than men).
Misconceptions about STIs
Table 6 (next pages, starting on an odd page for printing purposes) provides a review of
common misconceptions about STIs and HIV/AIDS.
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Table 7: Common Misconceptions about Sexually Transmitted Infections and HIV/AIDS
Misconception
Fact
You can’t get an STI from oral sex.
All STIs can be passed by anal, oral, or vaginal sex.
You can’t get an STI from anal sex.
All STIs can be passed by anal, oral, or vaginal sex.
You can’t get an STI the first time you
If your first sex is with someone who is infected and you do
have sex.
not protect yourself by using condoms, your risk for getting
an STI is high.
You can’t get an STI from sex in a pool
Chlorine in the water does not protect you from the
or hot tub.
internal spread of STIs, and it can break down condoms.
A woman can’t get an STI / can’t pass
Birth control pills protect from pregnancy, but provide NO
an STI if she is using birth control pills.
PROTECTION from STIs.
You can’t get an STI if you have sex
Position does not matter: STIs can be spread anytime there
standing up.
is sexual contact.
You can’t get an STI if you urinate or
STIs can enter the body immediately, so urinating or
wash the genitals after sex.
washing is not effective.
You can’t get herpes if your partner has Herpes virus can be spread even when there are no visible
no visible sores / is not having an
signs and the person isn’t experiencing symptoms of an
outbreak.
outbreak.
You can’t get an STI if you only have
If your partner has or has previously had other partners,
one partner.
she could have an STI and pass it to you.
You can’t get an STI from a woman who If the woman has NEVER had any kind of sexual contact
is a virgin.
including vaginal, oral or anal sex, it is unlikely that you
could get an STI from her. However, some women count
only vaginal sex when they say they are a “virgin.”
STIs are passed only by semen, so
This is inaccurate on two counts. First, there is a small
withdrawal before ejaculating will
amount of pre-ejaculate that a man cannot control and
prevent a man from passing an STI to
may not be aware of. This fluid can pass STIs. Second, some
his partner.
STIs like herpes and syphilis can be passed by skin lesions
(sores) whether the man ejaculates or not.
You will know it if you have an STI.
Many STIs do not have symptoms, especially in the early
stages.
You can tell if your partner has an STI.
Many STIs do not have symptoms, especially in the early
stages.
Only people who have sex with multiple If your partner has or has previously had other partners,
partners have STIs.
she could have an STI and pass it to you.
If your partner has been tested and is
STIs are not always passed in a predictable way, and not
negative that means you don’t have an every STI has a 100% accurate test. So the only way to
STI.
know your own status is to get yourself tested.
STIs can be cured with medicine, so it’s Some STIs are not curable at all. Even STIs that are curable
no big deal to get an STI.
with antibiotics can cause permanent damage if the
infections are not treated in the early stages.
If you have a sports physical or a
Unless you requested STI testing, it is likely that you did
regular check-up with your medical
NOT get tested for any STIs.
provider and were not told that you
have an STI, then you’re clear.
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If your partner has had a pap smear and
was not told that she had any STIs, then
she is clear and you are too.
There are 100% accurate tests for every
STI.
If your partner shows you her negative
HIV test result, then she does not have
HIV.
If STI symptoms go away, the STI has
gone away or been cured.
Once you’ve had a particular STI, you
can never get it again.
You can get STIs from toilet seats.
You can get STIs from regular kissing.
HIV is only passed by anal sex.
Only gay men get HIV.
Condoms protect against all STIs.
Condoms break easily, so they are
ineffective in preventing STIs.
Two condoms are better than one for
preventing STIs.
Plastic wrap is as good as a condom for
preventing STIs.
A lot of men can’t use condoms due to
size issues or allergies to latex.
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Unless she asked for STI testing it is likely that she did NOT
get tested for any STIs, except indirectly for HPV.
No test is 100% accurate. Some STIs, especially HIV, can
take weeks to months to show up on a test. Others like
herpes or oral cancer from HPV virus are hard to detect
unless there are symptoms.
HIV tests are tricky. While HIV usually shows up on tests
within a couple of weeks, it can take as long as 6 months.
Having a negative test 3 weeks ago may mean that she
doesn’t have HIV, OR it may mean she has it, but it hasn’t
shown up on the test yet. Also, if your partner had a risky
contact after the HIV test, she could have picked up HIV
after the test.
Some STIs, especially herpes and syphilis, have stages
where they produce no symptoms, but they are still
present and can cause illness/symptoms in the future
unless they are treated.
Except for hepatitis B, a person can get the same STIs over
and over either because the body does not build up
immunity to the disease (gonorrhea, chlamydia, syphilis,
trichomoniasis) or because there are so many strains of the
disease that there is still risk of infection with different
strains (HIV, hepatitis C, HPV).
STI organisms do not live long on dry, cold, smooth
surfaces. It is extremely unlikely that you will get an STI
from a toilet seat.
Unless a person has a herpes type 2 sore on the lips (which
is possible although most cold sores are from herpes type
1), it is unlikely that you will get any STI from regular
kissing.
Worldwide, more cases of HIV were spread through
heterosexual contact and vaginal sex than any other mode
of transmission.
Condoms do not protect against STIs that can be passed by
skin-to-skin contact: herpes, syphilis, genital warts, scabies
and pubic lice.
Condoms are tested for quality and seldom break if they
are used correctly.
Two condoms increase friction levels and thus increase the
risk of breakage.
Plastic wrap is more porous and can allow some types of
infections through.
Condoms are available to fit all sizes of penises, and men
who are allergic to latex can use polyurethane or
polyisoprene condoms.
Healthy Sisters Event Guide
A Word about Preventing Unintended Pregnancies
The only way to be completely certain of avoiding an unwanted pregnancy is to abstain from
sexual intercourse with a male. For those who do not choose abstinence, there are numerous
birth control options on the market to meet their needs. Also, condoms, when used
appropriately and consistently, can be effective in preventing both unwanted pregnancy and
most STIs. It is important to understand that birth control methods that do not include a
barrier (e.g., the pill, Depo-Provera) are not effective prevention against HIV and other STIs.
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Background Material for Section 4: Understanding and Assessing Risk
Risk
It may not be possible to avoid risk totally, but individuals need to be conscious of the risks they
do take, make choices intentionally, and make a personal commitment to reducing the risk of
contracting or transmitting an STI as much as possible.
The primary consideration when assessing risk is the potential for bodily fluid exchange. It is
important for participants to know the various bodily fluids they may encounter during any
activity, and which of those could contain a high enough concentration of the virus, bacteria or
parasite to infect another person.
A study in 2006 of students on HBCU campuses (see Figure 2) found that 52% of students
reported engaging in at least one risk behavior during the previous 12 months.5 Despite the fact
that over half of them had engaged in at least one risk behavior, nearly two thirds of the HBCU
students in the study considered themselves to be at low risk for contracting HIV!
Figure 2: Student risky behaviors on HBCU campuses, 2006
Table 7 (next page) provides some examples of behaviors at different levels of risk, along with
explanations for how the level as determined.
5
Source: Thomas et al. (2008) HIV Risk Behaviors and Testing History in Historically Black College and University
Settings. Public Health Reports, S3 (123):115-125.
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Table 8: Risk Continuum
Examples
Abstinence, hugging, massage, masturbation,
No Risk fantasy, phone sex, cybersex, dry kissing,
unshared sex toys
Sexual stimulation of another’s genitals using
Low Risk hands as long as there are no cuts or other
skin breaks
Giving or receiving oral sex with a condom or
Low Risk
dental dam
Receiving oral sex without a condom or
Low Risk dental dam
Low Risk
Low Risk
Low Risk
Low Risk
Medium
Risk
Medium
Risk
Medium
Risk
Medium
Risk
High Risk
High Risk
Sharing sex toys with cleaning or use of new
condom
Tongue kissing
Insertive or receptive vaginal sex with a
condom
Insertive anal sex with a condom and
lubrication
Giving oral sex without a condom or dental
dam
Sharing sex toys without cleaning or use of
new condom
Sexual stimulation of another’s genitals using
hands that have cuts or broken skin
Receptive anal sex with a condom and
lubrication
Insertive anal sex without a condom
Insertive or receptive vaginal sex without a
condom
Receptive anal sex without a condom
High Risk
Explanation
No bodily fluids are exchanged.
Risk of bodily fluid exchange is very low
(though cuts on the hand would increase
the risk of infection entry).
Use of a barrier usually prohibits exchange
of bodily fluids.
Receiver is at lower risk than giver, partly
because saliva is not known to transmit
HIV.
Cleaning or condom use limits fluid
exchange.
There is some risk of exchange of bodily
fluids
Condom use limits fluid exchange if used
correctly and for the entire time.
Condom use limits fluid exchange if
used correctly and for the entire time
Giver is at higher risk than receiver.
Fluids/bacteria/viruses can be transferred.
Cuts could allow bacteria/viruses to enter
the skin.
Cuts could allow bacteria/viruses to
enter the skin.
Fluids/bacteria/viruses can be transferred.
Fluids/bacteria/viruses can be
transferred.
Anal mucous membranes are especially
susceptible to micro-tears which provide
easy entry for bacteria/viruses.
Sexual Networks
Disease can spread quickly through a group of people, or network, even if only a few individuals
are infected at first. Not knowing your partner’s status, having multiple sex partners and not
using condoms increases the risk. Timing also matters. The risk of STI spread is higher if you or
your partner has multiple partners at the same time. This overlap pattern is called
“concurrency.” (“Serial monogamy” is a pattern of sticking with only one partner for a certain
time, breaking up, and then starting with a new partner.)
Even a small change in concurrency makes a big difference. Statistical modeling of group risk
shows that if 55% of the people in a group of 1,000 have multiple concurrent partners (the
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concurrency rate) and the rest only have one partner, then roughly 2% of the group is
connected through their sexual partnerships and is vulnerable. When the concurrency rate
moves to 63%, only an 8% rise, the vulnerable population jumps up to 41%. Even more
alarming, a further 2% rise in concurrency to 65% creates a vulnerable population of 64%.6 So
having concurrent partnerships – or your friends’ having concurrent partnerships - can increase
this risk on campus.
Getting Tested
Approximately one in five (20%) people living with HIV disease do not know that they have it.
Evidence suggests that these 20% are responsible for nearly 50% of all new infections each
year, and that a significant number of new infections could be avoided if these individuals were
aware of their status.7
The only way to know if one is infected with HIV is to be tested via a blood or oral fluid test.
Information on HIV and STD testing, plus a search engine for locating testing sites, can be found
on CDC’s National HIV and STD Testing Resources web site (http://hivtest.cdc.gov/).
According to the Centers for Disease Control, the largest share of new HIV infections are among
men who have sex with men (MSM).8 However, 36% of infections occur heterosexually, as
shown in this graph (Figure 3) of new HIV infections among Blacks in 2009.
Figure 3: New HIV infections among African Americans in the US, 2009
6
Morris M, Epstein H, Wawer M. (2010) Timing is everything: International variations in historical sexual
partnership concurrency and HIV prevalence. PLoS One. 5 (11):e14092.
7
Hall HI, Holtgrave DR, and Maulsby C (2012). HIV transmission rates from persons living with HIV who are aware
and unaware of their infection. AIDS 26 26(7):893-6.
8
Source: CDC. Available at http://www.cdc.gov/nchhstp/newsroom/NBHAAD2012Graphics.html.
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Background Material for Section 5: Using Condoms
Male Condoms
One of the most effective ways to reduce risks for STIs and HIV is by using male condoms:
 Male condoms are a thin sheath designed to fit over the penis.
 To be effective, condoms must be used consistently and correctly.
 The O.P.R.A.H. memory device helps ensure that male condoms are used correctly.
 Besides protecting against STIs, condoms have the additional advantage of protecting
against unwanted pregnancy.
Some factors to consider when choosing condoms include material, lubrication, size and
texture. Most condoms are approved for reducing the risk of STI transmission and pregnancy.
Manufacturers test random samples from every batch of condoms to make sure they do not
leak or break easily. However, be aware that novelty and specialty condoms are not
recommended for STI prevention and pregnancy prevention. Check the label to be sure.
 Materials: There are 4 types of condom materials: latex, polyurethane, polyisoprene,
and natural skin. All protect against pregnancy. Remember that latex condoms can
only be used with water- or silicone-based lubricants. Oil, petroleum jelly (Vaseline),
or lotion can cause holes or weakness. Latex, polyurethane, and polyisoprene also
protect against STIs, but natural skin condoms DO NOT. Natural skin condoms have
pores large enough for some organisms to get through, so they are not
recommended. The most commonly available kind of male condom is made of latex,
which may irritate people with allergies to latex. Polyurethane or polyisoprene
condoms can be used instead.
 Lubrication: Condoms are available with and without lubrication. Lubrication makes
the condom easier and more comfortable to use, and helps prevent breakage.
Common lubricants are silicone- or water-based. As mentioned above, oil-based
lubricants, such as baby oil or Vaseline, can cause latex condoms to break, and must
not be used. Lubricants containing the spermicide Nonoxynol-9 (N-9) should not be
used by individuals at risk for HIV because it has been found to increase the risk of
transmission with frequent use. However, using a condom, with or without N-9, is
still much safer than having unprotected sex.9, 10
9
www.who.int/mediacentre/news/notes/release55/en/index.html (accessed April 5, 2013).
10
www.avert.org/condom.htm (accessed April 5, 2013).
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 Texture: When reading condom packaging, brands list descriptive terms, such as
"ultra-thin," "sensitive," "high sensation," or "extra strength." Some people prefer
thinner condoms that allow for more sensation. Others prefer thicker condoms.
(Studies have shown that "ultrathin" condoms are just as effective as regular
condoms.) Other choices include "ribbed" or "studded" condoms, which are designed
to increase pleasure. Texture is a matter of personal preference. No studies have
rated their relative effectiveness. All condoms that are intended for intercourse are
government-approved, which means that they meet certain standards of
effectiveness. Not everyone finds the ribbed style pleasurable or even comfortable.
 Novelty/Specialty: IMPORTANT! These condoms usually do not meet the FDA
standards for protection against pregnancy and STIs. Flavored condoms are mostly
used for oral sex. The flavors can help disguise the smell and taste of latex. They are
not recommended for vaginal or anal sex. Some are coated with lubricants that
contain sweeteners that can affect the vagina's acidity level. If they are used for
vaginal sex, the sweeteners can predispose the woman to yeast infections.
Advantages of male condoms include that they:
 Allow male involvement in prevention of pregnancy and sexually transmitted
infections;
 Can be relatively inexpensive compared to other forms of birth control;
 Have no side effects;
 Are easy to obtain and require no prescription;
 Require little preparation compared to other forms of birth control;
 May help a man stay erect longer and/or prevent premature ejaculation; and,
 Provide very effective pregnancy prevention and STI risk reduction when used in
conjunction with any other birth control method (except the female condom).
How to use a male condom: Before opening the condom package, first check the expiration
date along the edges of the package. If the date has passed, discard the condom. Do NOT use a
condom after its expiration date. Also, never use two condoms of any sort – two male, two
female, or one male and one female – at once, as the friction between them can cause the
condoms to break.
 OPEN: Open the condom carefully, so that your nails or teeth do not tear the
condom. Many condom packages have a “tear edge.” Look for the tear edge using
your fingers to push the condom away from the edge before carefully tearing open
the package. It is best not to use your teeth or nails.
 PINCH: Pinch about one-half inch of the tip of the condom with your fingers. This
leaves room at the tip (a small air pocket) for the ejaculate (semen/cum) to go when
orgasm occurs, and helps prevent the condom from breaking. Be careful not to use
your nails.
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 ROLL: As you hold the tip, place the condom on the head of the erect (hard) penis.
Roll the condom all the way to the base of the penis. Use your hand to smooth out
any air bubbles. Feel free to use water-based lubricant on the outside of the condom.
Note: if the penis is uncircumcised, pull back the foreskin before placing the condom
on the head of the penis and rolling it to its base.
 ACT: Use the condom during intercourse or other sexual activity. If the condom
breaks or comes off during sex (this may happen occasionally), STOP immediately and
remove the condom. Then put a new condom on the penis and continue.
 HOLD: After ejaculation and while the penis is still erect, hold onto the bottom of the
condom and gently withdraw from the sexual site. This helps prevent the condom
from being left inside, spilling semen and/or letting the condom fall off the penis
after withdrawal. Then dispose of the condom by tying it in a knot, wrapping in tissue
and putting in a safe container that is secured from pets and children. Do not flush
condoms down the toilet as they can clog plumbing.
Female Condoms
The female condom was developed during our lifetime. The second generation of female
condoms, which is made from a different material, was released in 2009. It is more effective at
both preventing STIs and pregnancy, and people generally like it better than the earlier version,
because it feels better. As is true of the male condom, it is important to check the expiration
date and open the package carefully.
Advantages of female condoms include that they:
 Are controlled by the woman;
 Have no side effects and no effect on hormones;
 Are easy to obtain and require no prescription;
 Can be used by people who are allergic to latex;
 Can be inserted up to 8 hours before sex;
 Stretch when warmed (inside the vagina);
 Can be used with oil-based as well as water-based lubricants;
 May enhance sexual sensation (the external ring may stimulate the clitoris during
vaginal intercourse); and,
 Stay in place whether or not a man maintains his erection.
How to use a female condom: Before opening the condom package, first check the expiration
date along the edges of the package. If the date has passed, discard the condom. Do NOT use a
condom after its expiration date. Again, never use two condoms of any sort – two male, two
female, or one male and one female – at once, as the friction between them can cause the
condoms to break.
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 OPEN: Open the condom carefully, so that your nails or teeth do not tear the
condom. Many condom packages have a “tear edge”. Look for the tear edge using
your fingers to push the condom away from the edge before carefully tearing open
the package. It is best not to use your teeth or nails.
 PINCH: Identify the outer ring at the open end and the inner ring at the closed end.
Pinch or squeeze the inner ring between thumb and index finger and insert it deep
into the vagina. The outer ring must stay outside the opening of the vagina.
 ARRANGE: Position the condom by placing a finger through the outer ring to make
sure there are no twists.
 LEAD: During intercourse, guide your partner’s penis in through the opening of the
outer ring.
 TWIST: When finished, grasp and twist the outer ring, then gently pull the condom
out of the vagina. Then dispose of the condom by tying it in a knot, wrapping in tissue
and putting in a safe container that is secured from pets and children. Do not flush
condoms down the toilet, as they can clog plumbing.
Condom Negotiation
It is not always easy to introduce the idea of using a condom, especially in “the heat of the
moment.” Planning ahead and practicing in relaxed, non-sexual settings such as this Event can
be very helpful. The following are some suggestions for condom negotiation:
 Learn as much as you can about HIV, HBV, HCV, and other STIs. That will make it
easier to talk about safer sex.
 Think in advance about the situations that make it difficult to have safer sex. These
may occur when you don’t have condoms or have used alcohol or drugs. Try to
decide what to do in these situations so you can both reduce the risk of contracting
STIs.
 Decide when you want to talk. The best time is not just before having sex or when
you are high.
 Decide in your own mind what you will and won’t do during sex.
 The following are some suggestions for approaching condom negotiation when you
are with your partner:
 Give your partner time to think about what you’re saying. Don’t rush.
 Pay attention to how your partner understands what you’re saying.
 Slow down if you need to.
 Talk about the times when it’s hard to have safer sex. These may be times when you
don’t have condoms or have used alcohol or drugs. Try to decide what to do at those
times so you can both reduce the risk of contracting STIs.
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 If your partner does not want to practice safer sex, ask yourself if this is the type of
person you really want to have sex with. When drugs and alcohol are used, be more
attentive to prevention behaviors such as using condoms.
 If your partner gets angry or threatens you when you raise the issue of condoms,
seek help from a violence prevention program.
The following are some common complaints about or challenges of male condoms and
suggestions for overcoming them.
 Condoms may dull physical sensation of sex. Using a few drops of lubricant inside the
condom (and on the outside, if condom is not lubricated) can increase sensation.
 Putting on a condom may make men feel frustrated or lose their erection. They can
avoid this by practicing using a condom during masturbation.
 They may break or tear during sex. This should be a very rare problem, if the condom
is put on correctly. Emergency contraception (“Plan B”) is available if pregnancy is a
concern.
 The condom may feel too tight or otherwise uncomfortable for one or both partners.
Experiment with different styles and sizes to find the condom that is most
comfortable for you and your partner.
The following are some common complaints about or challenges of female condoms and
suggestions for overcoming them.
 They are more expensive than the male condom (female condoms cost about $2,
while the cost of male condoms varies by brand). They are less expensive if
purchased in larger quantities.
 They can be noisy if not fully lubricated. Use a lubricant if you experience this
problem.
 It is not possible to hide that you are using a female condom. Plan what you will say
to your partner in advance.
 It may seem difficult to insert. Practice insertion when you are relaxed and
comfortable.
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Background Material for Section 6: Defining Healthy Relationships
In a healthy relationship, partners trust each other with personal information. They have fun
together. They feel comfortable with the level of physical intimacy. They resolve conflicts
together and apologize when needed. Partners should be open to talking about whatever
makes either of them uncomfortable. In addition, they:
 Respect each other’s values, property, bodies, space, and limits;
 Disagree without name-calling, putdowns, or threats;
 Ask what is important to their partners and about what they think and feel;
 Stop if either person says “no”;
 Communicate openly and truthfully;
 Discuss their problems;
 Acknowledge mistakes and work to change problem behaviors;
 Ask for what they want, i.e., don’t expect the other person to be a mind-reader; and,
 Work together, e.g., negotiate differences, and share costs fairly.
Extremely unhealthy relationships, which may involve physical and/or verbal abuse, are
relatively easy to spot. Some other things that an abusive partner might do include: 11
 Constantly put the other down;
 Act with extreme jealousy or insecurity;
 Show an explosive temper and mood swings;
 Make false accusations;
 Act extremely possessive; and,
 Tell the other what to do.
Less unhealthy relationships are more difficult to identify. Warning signs might include one
partner isolating the other from friends or family. One partner might insist that the other not
do anything without him (or her). Or he or she might call or text more than the partner prefers.
Popular Relationship Myths
 There is only one true love for each person.
 It’s best to wait until you find the perfect person before you get married.
 It’s best to perfect your relationship before getting married.
11
Adapted from the Love is Respect website: http://www.loveisrespect.org/is-this-abuse/is-this-abuse. Accessed
April 8, 2013.
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 If you really try, you can work out the differences in any relationship, no matter how
unhealthy it is.
 Love is the only thing you really need to make a relationship happy.
 Couples that live together before getting married are happier in the long run.
 People who are opposites complement each other.
 When you find the right partner you will just know it, and the choice will be easy.
Suggestions for Building Healthy Relationships12
 Increase your self-awareness about what you do in relationships. Figure out how you
really act and do with your partner, and then ask whether your actions fit with your
goals.
 Be honest with yourself, and then potential partners, about what you want.
 One of the challenging parts of a strong relationship is to be fully open with the other
person – both about your strengths and your weaknesses and fears. As you are
building your relationship, try gradually sharing those hidden parts with your partner.
 Read about communication from experts and then try to use it in small doses; seek
professional resources such as counselors if necessary.
 Talk with trusted male friends about how men react to you. Use this information to
consider how you present yourself.
 Make important decisions together. Don’t just “let things happen” or let one person
dominate the decision-making.
 Don’t blame all the relationship’s problems on the other person. Take responsibility
for your actions as well.
 Work to make each other feel safe expressing thoughts and feelings by accepting
your partner’s views as their right, not criticizing or contradicting them.
 Make time to have fun together.
 Be clear and honest with the other person about your commitment to them and to
your relationship. If you want to be exclusive, be clear that you won’t be involved
with anyone else; then keep that commitment. If you want to keep seeing other
people, be clear about that and honest about not being exclusive.
12
Based on the Hill Harper Interview series on healthy relationships (http://www.youtube.com/user/twoofusorg)
and on Markman HJ, Stanley SM, Blumberg SL (2010). Fighting for your Marriage: Positive Steps for Preventing
Divorce and Preserving a Lasting Love. San Francisco: Jossey-Bass.
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 Be supportive of your partner. This can include: listening, touch, doing things to help
(such as helping with errands), giving encouragement and small gifts. Giving advice is
not necessarily helpful, unless it is requested.
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Background Material for Section 7: Creating Healthy Relationships
Healthy Conflict Resolution
All couples have disagreements, and some points of disagreement may never be resolved.
However, couples can still maintain a healthy relationship by managing their disagreements
more effectively and safely. It is important to recognize that both partners have valid
viewpoints and that compromise is possible. Table 8, below, presents some strategies for
effective conflict resolution.
Table 9: Strategies for Conflict Resolution
Poor strategies for resolving conflict:
Bad timing – choosing an inappropriate time to
argue about an issue.
Choosing an impersonal means of
communication.
Blaming, name-calling, insulting, and/or assigning
bad intentions.
Bringing up many unrelated issues at once.
Expressing only anger, covering up other
emotions.
Making requests that are unclear, expecting the
other person to read your mind.
Making threats and refusing to compromise.
Escalating the situation.
Ending disagreements with violence or
withdrawal.
Alternative strategies:
Choose a time to talk when you are both free and
able to focus on the discussion.
Talk face-to-face, rather than using text or other
electronic modes of communication.
State the facts clearly. Use “I messages” and
specific examples.
Discuss one issue at a time.
Express all of your feelings. Use “I messages” (e.g.,
“I feel jealous …”, “I was hurt …”, “I was scared
...”).
Suggest a concrete alternative to the behavior
that is bothering you.
Describe the consequences of the desired action,
including positive ones.
Take a cooling off period, if necessary, to avoid
becoming too angry.
Take the initiative to change the direction of the
conversation. Acknowledge that it is not going in a
productive direction and directly negotiate a
change in tone and strategy with your partner.
“This isn’t heading in a good direction, how about
if we stop, take a breath, and start again?”
Adapted from McKay M, Davis M, and Fanning P (2009). Messages: The Communications Skills Book. Oakland: New Harbinger
Publications.
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Healthy Sisters: Event Curriculum
The Healthy Sisters Event Curriculum describes the activities that are to be conducted to
present and reinforce Healthy Sisters topics, including timing, materials, and facilitation ideas
specific to each section. Refer back to the educational content (above) as needed during the
activities.
Section 1: Setting the Stage (25 minutes)
Purpose of this section: To lay the groundwork for the Event and provide an opportunity for
the participants to become acquainted.
Activity 1.1: Pre-test and Introduction (15 minutes)
Purpose: To introduce the participants to the structure, procedures, and expectations of an
Healthy Sisters Event
Materials: Sign In Sheet, (easel pad wall sheets), (large envelope)
Handout: Event Agenda, Pre-test
NOTE: All Materials and Handouts that are printed NOT IN PARENTHESES can be found in the Event Materials document,
reachable through hyperlinks. Items that are in parentheses [“(“ and “)”] are locally derived, and should be provided by the
facilitators or Campus Champions.
1. Ask participants to sign in as they arrive.
2. Distribute the Event Agenda and Pre-test as the participants arrive; ask participants to
return the Pre-test to you when they have completed it.
 Emphasize that they should not worry about getting correct answers on the Pre-test.
 Discourage participants from discussing the Pre-test.
3. Collect the completed Pre-tests and store them in the large envelope.
4. Both facilitators should introduce yourselves. The following is an example of an
introduction. Your introduction should reflect you and your personality. It will be helpful
to tell the participants your background in health and relationships counseling.
“Hello everyone, my name is [NAME]. I am a facilitator for this Healthy Sisters:
Straight Talk for Sisters Event. I am happy to be here. We will have two facilitators for
Healthy Sisters, one who will be responsible for the healthy sexuality sections and one
who will work with you on healthy relationships. Both of us will be here for the whole
time and will be able to answer questions as we go through the Event.
“Healthy Sisters is focused on supporting you in developing or enhancing your
understanding and skills around healthy sexuality and healthy relationships. Both start
with you being focused on your control of your body, your sexuality, and the kinds of
relationships you want to develop and be in with men. In this Event, we will provide
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you with information and tools, and a safe environment in which to explore those
topics with other women.
“I am looking forward to sharing information about being sexually healthy. Being
sexually healthy means getting what you want and need from sexual interactions. It
means not being abused or otherwise ending up with unintended consequences.
These could include sexually transmitted diseases, like chlamydia or HIV. They could
include being drawn into a relationship that you are not ready for. Or they could
include an unplanned pregnancy.
“I want to congratulate each of you for deciding to learn more about being a
sexually healthy person. When I talk about sex, I’m not just talking about penises and
vaginas. I’m talking about a range of activities and expressions related to sexuality. It
involves our desires to be physically and emotionally intimate with another person.
Sex often -- though not always -- involves our genitals. While we won’t be going into
all the complexities in this Event, sexuality involves our sense of who we are: our selfrespect, self-esteem, our gender identity, our sexual orientation, our values, and our
need to be close to another person. Today we will take about how we can share and
enjoy our sexuality in ways that avoid harmful outcomes and promote healthier
relationships. Let’s start by discussing the goals of this Event.”
5. Review the following Event goals in your own words. You may want to write them on an
easel pad for ease of reference throughout the Event. The specific goals of an Healthy
Sisters Event are to:
 Promote healthy relationships and open, effective communication;
 Increase self-awareness of one’s risk of contracting a sexually transmitted infection;
 Encourage the adoption of attitudes and behaviors that promote sexual health; and,
 Reinforce a sense of agency and self-efficacy regarding sexual interactions.
6. Lay the groundwork for the Event by noting that sexual health means different things to
different people. Present the World Health Organization’s definition of sexual health:
“Sexual health is a state of physical, mental, spiritual, and social well-being in relation
to sexuality. It requires a positive and respectful approach to sexuality and sexual
relationships, as well as the possibility of having pleasurable and safe sexual
experiences, free of coercion, discrimination and violence.”
“In this Workshop, we are going to talk about how to put this definition into
practice, while having fun.”
7. Inform participants of the purpose of the parking lot (for keeping track of questions or
ideas that come up during a session for addressing at a different time in the Event).
Point out the question box, location of restrooms, etc.
8. Ask participants to turn off their cell phones. Due to the private nature of the Event,
participants MAY NOT use cell phones (voice, text, or camera) during the Event.
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9. Explain that this is designed to be a fun, informative, and confidential Event. Emphasize
the importance of maintaining the privacy of those attending the Event.
10. Review the Event Agenda, noting the breaks and the importance of returning on time.
Inform participants that they may take personal breaks to use the restroom or take care
of other personal business as needed.
11. Ask participants to share their expectations for the Event. Write down each participant’s
expectation on the easel pad. Post the expectations once each participant has had an
opportunity to speak and discuss what expectations should be met through the Event
and which, if any, will not be covered. For example:
“I’m glad to say that we will be able to meet almost everyone’s expectations today.
Unfortunately we will not be discussing where AIDS came from, but during one of the
breaks I will be happy to refer you to a resource where you can get that information.”
12. Ask participants whether they have any questions or concerns. If so, address them and
then proceed. Before moving on, make certain that the following points have been fully
covered and clarified:







The purpose of the Event;
Participant expectations for the Event;
Confidentiality;
Ground rules and norms;
The agenda, including timing and breaks;
Use of the Parking Lot and Question & Answer box;
Importance of not using any electronic devices during the Event; and,
 Miscellaneous logistics, i.e., bathroom location.
Activity 1.2: Fantasy Name Icebreaker (5 minutes)
Purpose: To let participants know that the Healthy Sisters Event will be casual and fun, and
to help participants get acquainted and settled
Materials: (name tags), (markers)
In this activity, participants will be asked to select a fantasy name of their choice by which they
will be known throughout the Event. Referring to participants by their fantasy names
encourages them to step “outside themselves” and let go of inhibitions that might prevent
them from discussing issues related to sexuality. Participants who do not already know each
other may also feel more comfortable participating during the Event.
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1. Pass out name tags and markers and ask participants to pick a cute and sexy name for
themselves. Encourage everyone to participate and write their new name in big letters
on the name tag. Each person will introduce themselves using the new name and ask
everyone to refer to her by the fantasy name for the rest of the Event. Model this
behavior by addressing people by their fantasy name as they put on their name tag.
2. After everyone has selected a fantasy name let them introduce themselves to the rest of
the group using that name. Welcome each person by her fantasy name by saying, for
example, “Welcome, Hot Momma!”
Activity 1.3: Sisters Code (Rules of Conduct) (5 minutes)
Materials: (easel pad wall sheets)
1. Put up a wall note at the front and write “Sisters Code” on top of it. Then, ask
participants to create their own rules.
2. No rule gets written up unless there’s a general consensus. If participants appear to
have difficulty suggesting rules, you may want to give the group examples of several
“agreements”:
“We will be respectful of each other’s opinions.”
“We will not talk over one another.”
“We will not record or report to others what any one person said in the Event.”
 One rule should specify that cell phones must not be used during the Workshop.
 One rule should mandate confidentiality and spell out what that means.
Confidentiality means not repeating what others have said during the Workshop
outside of the Workshop. Also, during discussions, think about maintaining
confidentiality of those not present; for example, avoid identifying past sexual
partners by name.
3. Once they make their essential social contract with the rules, post it in plain sight where
you can always refer back to it.
Throughout the Event, after completing a section, introduce the next section through a
“bridge,” and remind participants about the Question and Answer box. For example, after this
exercise you might say:
Bridge:
“So now that we’ve assumed our alter egos and loosened up a bit, let’s get ready to
discuss how people talk about sex and sexuality. Are there any questions before we
move on? Remember you can put questions in the box that we can discuss at the end
of the day.”
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Section 2: Talking about Sex and Sexuality (20 minutes)
Purpose of this section: To encourage participants to relax and become comfortable with
discussing sex and sexuality as a group.
Activity 2.1: Whatchamacallit? (20 minutes)
Purpose: To encourage the use of appropriate, neutral terms in place of slang terms often
used for various reproductive body parts
Materials: (easel pad wall sheets)
In this activity, participants will be asked to list slang terms for reproductive body parts. They
will then discuss the implications of the terms, emphasizing that terms with negative
connotations will not be used in this Event.
A word about shyness: This activity is usually met with laughter and sometimes shyness. The
effect of speaking sexual words out loud can be powerful. Asking women how they feel about
the words commonly used and about the medical terms gives them an opportunity to think
about the influence words, behaviors, values, and attitudes have upon their own feelings,
attitudes, and beliefs about sex and sexuality. If a participant appears to have difficulty with a
word, help her by speaking the word with confidence and volume. Do this in a way that does
not embarrass or shame. Acknowledge that many people have difficulty using these terms:
“Everyone has genitals, and often people refer to them in different ways.”
Two options in step 2 for initiating for this activity are provided. Select the one that you feel
more comfortable with.
1. Label three easel pad sheets with “vagina,” “penis,” and “sexual intercourse” and post
them around the room.
2. Ask participants to call out some commonly used names they may have heard for
genitals and sexual acts and write them on the appropriate sheet;
- OR Divide the participants into two or three groups and have them spend two minutes at
each sheet writing down all the terms they can think of.
Try not to let a pause in the Event go for too long, but do allow them time to process questions
after you ask them. Many of the young women have never been asked these questions in this
format. Try to mentally count three seconds after asking a question before continuing.
3. Once participants start running out of terms, ask them to call out names for other body
parts like elbow, stomach or ear.
4. Ask participants why they think there are so many terms for sexual body parts, but not
as many for non-sexual body parts.
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5. Many participants will not realize that these terms have negative connotations. Identify
the terms that have a negative connotation and cross them out on the easel pad to
emphasize that terms that degrade women or women’s bodies will not be used in the
Event.
6. Explain that sex is emotionally charged and often held in secret in our society, which is
one reason why so many slang terms have developed.
It is very important to foster discussion throughout the Event, and not just push on through to
the next section in order to get through the curriculum. We will provide discussion prompts
after some of the sections in order to help you foster discussion at any point during the section
where conversation lags.
Discussion Prompts for Whatchamacallit?


Ask women to discuss why we use sexual language to be disrespectful to one another.
Ask women how they can change their own use of sexual language as put downs or to
demean someone.
Bridge:
“Next we are going to discuss the facts about sexual health and sexually transmitted
infections, including HIV. Are there any questions before we move on? Remember
that you can put questions in the box that we can discuss at the end of the day.”
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Section 3: Sexual Health Facts (110 minutes)
[Link to Background Material for This Section]
Purpose of this section: To review the potential consequences of engaging in unprotected sex,
such as sexually transmitted infections, including HIV, or an unintended pregnancy.
Activity 3.1: The Facts about STIs (45 minutes)
Learning Objectives: Name the two most common STIs AND Name two STIs that cannot be
cured AND Explain that most STIs have no initial symptoms.
Materials: (easel pad wall sheets)
Handout: “Basic STI Facts for Women”, (local STI brochure)
1. Ask participants what the acronym STD, and more recently STI, stands for. Explain that a
person can have an infection and potentially be able to infect others without actually
having a disease, which is why the term “infection” has come into favor in recent years.
“STI” will be used in this workshop.
2. Ask participants to name as many STIs as possible. List each on the easel pad in the
order they are given.
3. Review the general information on STIs in the educational content section of this
manual, emphasizing the three types of organisms that cause STIs, symptoms for men
and women, and the additional important facts.
4. Distribute the “Basic STI Facts for Women” handout. Refer to the STI list that
participants generated and review for each the description in Table 5, Basic Facts about
STIs, reinforcing the following:
 The organism that causes it;
 How it is transmitted;
 The symptoms (be sure to note that many STIs will not have symptoms right away);
and,
 Whether and how it can be cured.
5. Remind participants of the following points once again:
 Most STIs produce no significant symptoms until the infection is advanced.
 DO NOT WAIT for symptoms to develop before getting checked.
 Chlamydia and HPV are the two most common STIs.
 The viral infections, i.e., HIV, HPV, HSV, Hepatitis B and C, cannot be cured, although
some symptoms can be treated.
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 Individuals who are sexually active should be tested regularly to protect themselves
and their partners.
6. Distribute local STI brochures to participants.
Key Points about STIs:









STIs may be caused by bacteria, parasites or viruses.
Many infected people do not feel or look sick.
Any sexual contact (not just vaginal intercourse) can pass an STI.
Douching before or after sex will not prevent or treat STIs.
Most bacterial STIs can be cured; most viral STIs can be treated but not cured.
Untreated STIs can cause infertility.
One sexual contact is all it takes to get an STI.
Having any STI increases your chances of getting HIV.
Get tested!
Activity 3.2: HIV/AIDS Discussion (15 minutes)
Learning Objectives: 1) Explain the difference between HIV and AIDS
2) List three factors that influence whether someone exposed to HIV becomes infected
3) Describe how to determine whether someone is infected with HIV
Handout: (local testing brochure)
1. Begin by asking participants to share what they know about HIV.
2. Define the acronyms “HIV” and “AIDS.” Most people will know these so quickly jot the
correct terms, ”human immunodeficiency virus” and “acquired immune deficiency
syndrome,” on the easel pad. Clarify the difference between HIV and AIDS.
3. Review the HIV/AIDS information on page 29. Be sure to encourage discussion among
participants and allow time for questions.
4. Distribute local testing brochures to participants.
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Key Points about HIV/AIDS:
 You cannot tell whether a person has HIV simply by looking at them.
 Whether you become infected and how long it takes to show symptoms depends on many
factors, including age, gender, and overall health.
 Symptoms may take weeks, months, or years to appear.
 You can get HIV the first time you have sexual contact with an affected person.
 Having an STI increases your risk of getting HIV.
 Many people who have HIV are not aware of it.
 Get tested!
Activity 3.3: STI Fact or Fiction (20 minutes)
Purpose: To examine beliefs about STIs and assess their validity
Materials: STI Fact or Fiction Materials
Handouts: ”Common Misconceptions About STIs and HIV/AIDS”
In this activity, participants will have an opportunity to discuss beliefs about sex and sexuality.
These may include things they do not believe, as well as information they have received but are
not sure about. Encourage respectful, non-judgmental discussion among the participants.
1. Post the two large “FACT” and “FICTION” cards on the walls in the room where everyone
can reach them.
2. Distribute the 12 “STI Fact or Fiction” cards.
3. Ask each participant who received a card to post it under the appropriate sign.
4. After the notes have been posted, distribute the “Common Misconceptions About STIs
and HIV/AIDS” handout, then read each note aloud and discuss.
5. Be sure that the correct information regarding the fictional statements (indicated in
bold below) is clear to all participants before moving on.
Answers to STI Fact or Fiction
 You can get an STI even if you only have one sexual partner. T
 While not all STIs have symptoms in the early stages, all STIs have symptoms eventually. F
 If a woman has had a Pap smear and was not told she had any STIs, then she can be sure she
is uninfected. F
 Condoms do not protect against all STIs. T
 HIV is only passed through anal sex. F
 You can’t get herpes if your partner has no visible sores/ is not having an outbreak. F
 Urinating or washing the genitals after sex will not keep you from getting an STI. T
 If your partner shows you a negative HIV test result, then he or she does not have HIV. F
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



You can get an STI the first time you have sex. T
Once you’ve had a particular STI, you can never get it again. F
People who are allergic to latex cannot use condoms. F
STIs are passed only by semen, so withdrawal before ejaculating will prevent a man from
passing an STI to his partner. F
Activity 3.4: HIV/STI Bingo (30 minutes)
Purpose: To review and reinforce the material learned in the previous discussion
Materials: HIV/STI Bingo Materials, (small prizes)
After providing the basic information in the discussion, have the group play a round of HIV/STI
Bingo to continue acquiring information in an engaging and fun manner.
1. Give each participant a game card and a handful of candy pieces (at least 15) to use as
markers.
2. Briefly explain the rules of Bingo in case anyone in the group is not familiar with them.
Point out that the center square is free, so it should be marked immediately.
3. Select a random starting point on the list of questions and read the question aloud to
the group. Encourage participants to discuss the question and decide on the answer.
4. Once the participants have agreed on the correct answer, those with the correct answer
on their cards should mark it with the candy game pieces.
5. Check off the question on the list so the answers can be checked when someone gets a
bingo.
6. Repeat the process until a participant covers a straight line (vertical, horizontal or
diagonal) on her card and calls out “BINGO.”
7. Check the participant’s answers against the list, and correct any incorrect answers. Give
a small prize to the winner of the round(s).
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Discussion Prompts for Sexual Health Facts


Ask women to discuss how understanding the risks of sexually transmitted diseases both
immediately and over time, may affect the way in which they think and act around casual
sexual encounters.
Ask how women can help one another to practice better physical and psychological sexual
safety.
Bridge:
“Next we are going to talk about how to assess the level of risk in our sexual
behaviors. Are there any questions before we move on? Remember that you can put
questions in the box that we can discuss at the end of the day.”
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Section 4: Understanding and Assessing Risk (60 minutes)
[Link to Background Material for This Section]
Purpose of this Session: To raise participants’ awareness of their personal level of risk of the
consequences of engaging in unprotected sex discussed in Section 3.
Activity 4.1: Sexual Networks (20 minutes)
Purpose: To introduce the concept of the sexual network and its impact on sexual health
Materials: “You and Your 4 Sexual Partners” Case Study, (easel pad wall sheets)
1. Using the easel pad, draw the “You and Your 4 Sexual Partners” Case Study and then
post it and present it.
2. Remind participants of the importance of communication in relationships and introduce
the concept of disease transmission through sexual networks. Note that testing will be
discussed further in a later activity.
Key Point about Sexual Networks:
 The fewer sexual partners you have, the lower your risk of sexually transmitted infections.
Activity 4.2: Risk Continuum (20 minutes)
Learning objective: List at least one behavior in each of the three risk levels, i.e., high risk,
low risk, no risk
Materials: Risk Continuum Materials, (sticky notes), (pens)
Handouts: ”The Risk Continuum”
1. Explain to participants:
“There are many things we can do to have sexual fun with a partner, and some are
safe and some are not so safe.”
2. Post the three Risk Continuum signs around the room.
3. Ask participants to write on two individual sticky notes an activity or behavior they think
is safe and one that they think is less safe.
 The activities can be something they enjoy doing. They can be something they have
heard that other people enjoy.
 Encourage them to think of some activities that they think would carry lower risk of
STI/HIV transmission and some that they think would carry higher risk.
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 Refer back to ground rules about being respectful and keeping information
confidential.
4. Ask participants to place their sticky notes on the wall in no particular order. Once all
the notes are on the wall, make sure that there are at least two activities from each
column in Table 9 (below) before moving on. If necessary, add Risk Continuum cards
(provided in the Event Materials) to ensure an adequate variety.
Key Points about the Risk Continuum:





Abstinence is the only 100% sure way to keep from getting HIV/STIs.
The only safe sex is solo sex (masturbation).
Some sexual activities are more risky than others.
Oral sex carries a lower risk of HIV transmission than anal intercourse.
Having another sexually transmitted infection can increase a person’s risk of getting HIV.
Table 10: Comparison of Risk Behaviors and Levels
High Risk
Low Risk
Mutual masturbation without a
Mutual masturbation with a
condom or latex barrier, with
condom or latex barrier, with
cuts on exposed skin
cuts on exposed skin
Sharing sex toys that have
Wet (or deep) kissing
contact with body fluids
Having vaginal or anal sex
Anal sex with a condom
without a condom
No Risk
Mutual masturbation with a
condom, with no cuts on
exposed skin
Taking a bath or shower
together
Sitting in a hot tub naked with
another person
Oral sex without a condom or
dental dam
Vaginal sex with a female
condom
Massage
Inserting your finger into your
partner’s anus
Licking honey off your partner’s
vagina without using a condom
or other barrier
Sharing toothbrushes or eating
utensils
Cuddling
Vaginal sex with a condom
Masturbation by oneself
Oral sex with a condom or other
barrier and no climax
Watching an adult movie with
your partner
Having unprotected sex
5. Ask participants where they think each activity should be placed according to risk, and
why.
6. As the group comes to an agreement on the risk levels for each activity, move the sticky
notes and/or cards to the appropriate location. If necessary, address any remaining
myths or misunderstandings.
7. Distribute the “The Risk Continuum” handouts.
8. Reinforce the key points about HIV and STI risk (see box).
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9. Reiterate that particular behaviors, not sexual identity per se, create risk of STI/HIV
transmission.
“For example, receiving oral sex from a woman carries the same risk as receiving oral
sex from a man. It’s the behavior that counts.”
10. Reiterate the three strategies for protecting yourself and your partner:
 Know your partner and her status.
 Protect yourself and your partner by choosing lower risk sexual activities.
 Get yourself tested regularly if you have engaged in medium- or high-risk activities.
“We need to be conscious of the risks we do take, make our choices intentionally, and
make a personal commitment to reduce our risk of contracting or transmitting an STI
as much as possible. How aware do you think men and women on campus are of
differences in risk?”
11. Ask participants how they (or women they know) have successfully convinced partners
to switch from higher risk to lower risk activities. Can they identify strategies for making
this easier? How can this be done without leading men to feel rejected?
Discussion Prompts for Understanding and Assessing Risk


Ask women to discuss how they can create and maintain control over what activities they
initiate or are drawn into with a partner.
Ask women how they can prepare themselves to discuss and promote safer sexual practices
in both casual and committed relationships.
Activity 4.3: Getting Tested (20 minutes)
Purpose: 1) To generate/increase awareness that sexually active people should be
periodically tested for HIV and other STIs, even if they have no symptoms. 2) To reinforce the
social norm that many of their peers get tested frequently and that it is a normal and socially
acceptable thing to do.
Materials: Get Yourself Tested video (included on USB drive)
Handout: (local testing information)
1. Ask participants about their experiences getting tested on or near their campus.
 Discuss the merits of getting tested as part of testing day activities on campus, or
getting tested based on personal behaviors.
 From their descriptions and responses, identify strategies for making the process
easier, being able to remember, overcoming potential stigma or embarrassment, etc.
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2. Ask participants about their experiences getting a partner to test with them or having
been asked by a partner whether they have been tested.
3. Use active listening to elicit strategies for making the process easier, being able to
remember, overcoming potential stigma or embarrassment, etc.
 Play the Get Yourself Tested (GYT) video13 about getting tested with your partner.
4. Give everyone a copy of the Local Testing Information handout.
5. Ask everyone who has one to use their smartphone, laptop or tablet to find a testing
center using one of these methods:
 Enter a zip code at: www.GYTNOW.org
 Text a zip code to: GYTNOW (498669)
 Enter a zip code at: http://www.plannedparenthood.org/. The Planned Parenthood
site also has a live chat for pregnancy and STI questions.
6. Ask participants to create a reminder in their phones or other system to remind them to
make a testing appointment. If the participants are friends outside of the workshop, ask
them to consider reminding each other about getting tested.
Bridge:
“Next we are going to discuss male and female condoms. Are there any questions
before we move on? Remember that you can put questions in the box that we can
discuss at the end of the day.”
13
Also available online at http://vimeo.com/12565188.
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Section 5: Using Condoms (75 minutes)
[Link to Background Material for This Section]
Purpose of this section: To describe the advantages of using condoms and understand their
effectiveness in reducing HIV transmission risk
Activity 5.1: Male Condom Demonstration: O.P.R.A.H. (10 minutes)
Learning Objective: List the five steps represented by the O.P.R.A.H. memory device
Materials: (male condoms), (penis model)
Inform participants about the O.P.R.A.H. memory device for remembering how to use a
condom correctly. As you speak, demonstrate each step using a condom on one of the penis
models.
 OPEN: Open the condom carefully.
 PINCH: Pinch about one-half inch of the tip of the condom with your fingers so that
you leave a small pocket at the tip.
 ROLL: As you continue to hold the tip, place the condom on the head of the erect
(hard) penis.
 ACT: Use the condom during intercourse or other sexual activity.
 HOLD: After ejaculation and while the penis is still erect, hold onto the bottom of the
condom and gently withdraw from the sexual site. Discard in a safe manner (out of
reach of pets or children). Do not flush down the toilet.
Key Points about Male Condoms:






Condoms are the only method of birth control that also protect against STIs.
Condoms have many advantages, including being inexpensive and easy to find.
Natural skin condoms do NOT protect against HIV.
Latex condoms cannot be used with oil-based lubricants.
Make sure to leave a small pocket at the tip when putting on a condom.
Remember O.P.R.A.H.
Activity 5.2: Male Condom Practice (10 minutes)
Purpose: To practice using condoms correctly
Materials: (male condoms), (penis models)
[plastic cucumbers or bananas may be substituted for penis models if necessary]
1. Distribute condoms and penis models to each participant.
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2. Ask participants to put the condoms on the models using the O.P.R.A.H. method just
demonstrated.
3. Observe whether participants experience any challenges and answer any questions.
4. After everyone has finished practicing, discuss any challenges.
5. Remind participants that the condom should be removed after intercourse and should
not be used more than once.
6. Ask participants whether they found the demonstration to be difficult or easy, and why.
Activity 5.3: Male Condom Race (10 minutes)
Purpose: To practice using condoms properly in a more stressful situation
Materials: (male condoms), (penis models)
In this activity, participants practice putting a condom on properly under more stressful
conditions. This activity is designed to simulate the extra factors, e.g., excitement, alcohol,
darkened rooms, that may be involved in a real sexual encounter.
1. Divide the participants into two equal groups standing parallel to each other.
2. Give each group one penis model and give each person one male condom. If possible,
dim the lights in the room.
3. Explain that the object of the game is for each team member to use the male condom
correctly every time as quickly as possible. The penis model cannot move to the next
person if the condom is not put on correctly. Remind participants about the O.P.R.A.H.
memory method.
4. Starting at the beginning of each line, one person holds the penis model while the next
person in line will put the condom on. A third person will spin the participant with the
condom twice (once in each direction while their eyes are closed) before she begins to
put the condom on.
5. Explain the purpose of dimming the lights and spinning the person putting on the
condom. Emphasize that these factors may make it more challenging to correctly use a
condom or to discuss safer sex options with a partner.
6. Once spinning stops the person with the condom will attempt to correctly put it on the
penis model being held by the second person. Once complete the person who was
holding the condom is spun around and follows the process of attempting to put the
condom on correctly.
7. Keep this pattern going like a relay race until the entire team correctly uses a condom
on the penis model.
8. The first team to correctly use each condom gets a prize, e.g., 10 additional condoms.
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9. Review the O.P.R.A.H. method again and ask participants whether they have any
questions or comments about the exercise.
Activity 5.4: Female Condom Demonstration: O.P.A.L.-T. (15 minutes)
Learning Objectives: 1) Describe the steps involved in using a female condom correctly
2) List three benefits of the female condom
Materials: (female condoms), (pelvic model)
Explain the use of the female condom as follows:
1. Hold the condom in your hand and demonstrate the flexibility of the inner ring of the
condom and how it can be bent for easier insertion. Women who have used a
diaphragm, NuvaRing or similar device will be familiar with the insertion method.
2. Explain how the extended portion of the condom is meant to lay outside of the body,
covering the outer lips of the vagina. Demonstrate this on the vagina model.
3. Use your fingers to demonstrate how the penis enters the vagina. Explain that both
partners must take care to ensure that the penis goes through the ring in the condom,
because there’s a risk that his penis could enter the vagina outside of the condom. A
male condom should NOT be used with a female condom.
4. Tell participants that the condom should be removed after intercourse and should not
be used more than once.
5. Pass a female condom around so that participants can touch it and become more
familiar with it.
6. Review the O.P.A.L.-T. memory device for remembering the steps in using a female
condom:
 OPEN: Carefully open the package so as not to rip the contents.
 PINCH: Pinch or squeeze the inner ring between thumb and index finger and insert it
deep into the vagina.
 ARRANGE: Position the condom by placing a finger through the outer ring to make
sure there are no twists.
 LEAD: During intercourse, guide your partner’s penis in through the outer ring
opening.
 TWIST: When finished, grasp and twist the outer ring, then gently pull the condom
out of the vagina. Discard in a safe manner (out of reach of pets or children). Do not
flush down the toilet.
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Key Points about Female Condoms:
 Condoms are the only form of birth control that also protect against STIs.
 Female condoms give you more control, can be inserted up to 8 hours before sex, and can
be used with lubricants.
 Remember O.P.A.L.-T.
Activity 5.5: Condom Negotiation for Safer Sex14 (30 minutes)
Purpose: To practice ways to negotiate condom use with a partner
Materials: Condom Negotiation Role Playing Scenarios
Handouts: Condom Information Cards
1. Ask the participants to identify some strategies for making condom use easier:
 Different ways to talk about it
 Strategies such as keeping condoms on hand
2. Ask participants to think about and list the pros and cons of condom use.
3. Divide the group into 3 or 4 teams and give each a role play scenario. Follow the
instructions on the cards.
4. Have the groups come together and ask one person from each team to read the
scenario aloud and briefly summarize the team’s advice.
5. Ask the group if they agree or disagree with the advice, and why.
6. After completing the role plays, review the main points of the condom negotiation
session:
 Success in negotiating safer sexual practices with your partner depends on mutual
trust, the strength of your intention to be safer, and your ability to persuade your
partner.
 You are more likely to persuade your partner to use latex protection if you show
respect for your partner’s concerns, know how to eroticize latex products, and have
accurate information about risks and risk reduction
 Safer sex negotiation discussions should begin when you are sober.
 Even if you are both HIV-positive, you should still use condoms.
7. Distribute condom information cards.
14
Adapted from: Yale University (2003). Negotiating Harm Reduction with Partners. Available at
http://info.med.yale.edu/psych/3s/HHRP+/HHRP+Cnslr_manual/HHRP+handouts/HHRP+grp4_handouts.pdf.
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Key Points for Successful Condom Negotiation:






Learn all you can about STIs and safer sex.
Think about what you want to do in advance.
Talk about it with your partner.
Take your time; don’t rush your partner.
Listen to your partner.
Realize that you do not have to do anything you do not want to do.
Discussion Prompts for Condom Promotion


Ask women to discuss how they can create a script for initiating a discussion about condom
use with a casual or a committed partner.
Ask women to discuss how they will prepare themselves to deal with a casual or committed
partner who is unwilling to use a condom.
Bridge for One Day Event:
“Next, we are going to talk about what it means to be in a healthy relationship, which
is ideally the basis for a healthy sexual relationship. Are there any questions before we
move on? Remember that you can put questions in the box that we can discuss at the
end of the day.”
Bridge for Two Day Event:
“We’re going to wrap up Healthy Sisters for today. Today was intended to give you
important information about sexual health that you can use in your life. As you go
home or out on a date tonight, please think about how you can begin to actively use
what we discussed today. Overnight if you think of questions about what we
discussed today, please jot them down and put them in the box and we will be sure to
try to discuss them.
“Tomorrow we are going to talk about developing and maintaining healthy sexual
and romantic relationships. Tonight when you are falling asleep, think about what
your ideal partner looks and acts like and why – and how you act in return. Tomorrow
will be an important day. Thank you for coming and see you in the morning.”
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Section 6: Defining Healthy Relationships (120 minutes)
[Link to Background Material for This Section]
Purpose of this section: To raise participants’ awareness of what constitutes a healthy
relationship.
Activity 6.1: Healthy Relationships Discussion (30 minutes)
Learning Objectives: 1) Describe the characteristics of a healthy relationship
2) Identify warning signs of an unhealthy relationship
3) Assess a personal relationship using the healthy relationship checklist
Handouts: “Healthy Relationship Checklist”
1. Ask participants to think about a current or previous romantic relationship they have
been in, or if they have never been in one, think about a relationship they know about.
2. Distribute the “Healthy Relationship Checklist” handout. Ask participants to review the
checklist against the relationship they have in mind and to answer the questions based
on their experience of that relationship.
3. Ask participants whether there are items on the list that they would like to have
explained, or that they want to discuss how to achieve. Other discussion questions
might include:
 How well does this checklist reflect what you want from a romantic relationship
now?
 Is there anything missing from this list that is important to good relationships?
4. If the conversation lags, try discussing the following three elements of healthy
relationships from the Healthy Relationship Checklist:
 How can we act with "mutual understanding and kindness"?
 How can we “ask for what you want and need in this relationship” and “feel close to
each other (not just physically) and willing to trust each other with personal stuff”?
 What does it mean to say each partner takes “responsibility for their own actions and
not blame other for their failures” and “admit when you are wrong and apologize to
each other when needed”?
Key Points about Healthy Relationships:




Mutual respect and open communication are key to a healthy relationship.
Both you and your partner need to be concerned about sexual health.
An intimate relationship is not always sexual, and vice versa.
Men and women may want and expect different things from a sexual relationship.
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Activity 6.2: Relationship Influences (30 minutes)
Purpose of this section: To reflect on the ways in which our relationships are influenced by
observations of couples around us
Handout: “Couples That Have Influenced Me”
In relationships, people tend to repeat patterns that they have observed in other couples,
consciously or unconsciously. In this activity, participants will have an opportunity to reflect on
what they have learned from influential couples in their lives.
1. Distribute the handout “Couples that Have Influenced Me.”
2. Instruct the participants to fill out the form by listing couples in their lives that have
most influenced their view of relationships in the first column, and listing the couples
positive and negative qualities and practices in the second and third columns.
3. Ask for volunteers to read their responses about one of the couples on their lists and
describe the ways in which it has influenced them.
4. Summarize the discussion by reviewing items in common on the lists. Ask for comments
or observations.
Discussion Prompts for Healthy Relationships and
Relationship Influences


Ask women to discuss how they can create relationship standards for themselves that
incorporate the best of what they have learned from couples who have influenced them.
Ask women to discuss how they will avoid repeating the worst that they have seen or
experienced in their own or other people’s relationships.
Activity 6.3: Choosey Lover (30 minutes)
Purpose: 1) To help participants identify what kind of partner they want. 2) To
present/reinforce the idea that it is beneficial to be highly selective about partners; choosing
the right partner can help them reach their goals.
Materials: (magazines and newsprint with pictures of young men), (pens), (scissors), (glue),
(tape), (index cards), (music and audio equipment)
Handouts: “Risky Traits in Potential Dates and Mates”
1. If the workshop includes more than five young women, divide them into small groups.
Ask them to discuss the kinds of men with whom they want to have relationships. Ask
them to think about what he would look like and how he would act. Allow them 5
minutes to discuss within their groups.
 A participant may say, “I don’t have a type, I just like what likes me.” An appropriate
response might be,
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“That’s all fine and good, but what if you had to or got to choose? What would you
want him to look like? If you had a magic wand, what would he look like? What would
he be like? How would he act?”
2. Ask the participants to think about what kind of partner they want. Ask them to reflect
on what kind of partner they are interested in having now, and what kind of partner
they think they want in the future (if they are not one in the same).
3. Distribute magazines and materials, and instruct the participants to create a collage that
represents their ideal partner.
4. After the women have finished creating their collages, have them list 5 items on the
index cards under each of the following categories:
 Ideals: qualities and characteristics of their ideal partner
 Deal Breakers: characteristics or issues that could lead to the termination of the
relationship
5. Ask the participants to share their ideal mates (picture and list) as well as their deal
breakers with the group and discuss.
 Remind the participants that it is important to think about the things that they want
out of their relationships. This includes not only their partners’ characteristics, but
also how their partners make them feel. Point out items in common on their lists. For
example, several of the responses may relate to intimacy.
 During this discussion have the women reflect on the realities of having a partner
that meets all of these criteria.
6. Ask the participants to create another list of 5 qualities/characteristics under the
following categories:
 Realistic: what they absolutely need from a partner
 Red Flags: issues that could potentially become deal breakers
7. Give each participant the “Risky Traits in Potential Dates and Mates” handout and let
them read it.
Key Points about Choosey Lover:
 Be aware of what qualities are important to you in a partner, but don’t expect to the find the
“perfect” person or relationship.
 To have better relationships, increase your self-awareness.
 Ask whether your actions fit with your goals.
 Be honest with potential partners about what you want.
 Become more comfortable with being vulnerable. If you want to know what a man is
thinking or what he wants, ask him.
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Discussion Prompt for Choosey Lover

Ask women to discuss how our choice of a partner reflects how we see ourselves as women.
Activity 6.4: Reality Checks for Unrealistic Expectations (30 minutes)
Purpose: To consider the implications of some common beliefs and misconceptions about
relationships
1. Tell that participants that now that they’ve discussed ideal and real partner selections
that they are going to delve into a conversation about ideal and real relationships. This
may be done as a large group, or by dividing the women up into small groups. Give each
small group one of the following topics to discuss and then share their thinking with the
larger group.
2. Explain to participants that you are going to read some statements about relationships
that reflect ideas they or others may have about relationships, and that they are to
discuss their reactions to them.
3. Read or assign the following statements in bold. Allow time after reading or assigning
each one for the participants to discuss what they think about them. Make sure that the
key point following each statement has been made by the participants (or you if
necessary) before moving on to the next statement.
“People who are opposites complement each other.”
Key point: People are often attracted to people who are different from them, but the
differences can often lead to conflict too. Being compatible and having things in
common can make relationships easier in the long run unless you really commit to
working out differences.
“There is only one true love for me.”
Key point: There are lots of men in the world, and not just one true love for anybody.
“True love” is something made up from the movies. There are probably many men on
this campus with whom you could have a great relationship. There’s no such thing as a
perfect relationship.
Follow up question: What is the danger or downside of thinking this way?
“I plan to wait until I find the perfect person before I get married.”
Key point: No one is perfect. People have to be careful not to set unrealistic standards
or they’ll never meet their goals (in this case, marriage).
“It’s best to perfect your relationship before getting married.”
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Key point: No relationship will ever be perfect, so don’t use this as an indicator of when
to get married.
“If you really try, you can work out the differences in any relationship.”
“Love is the only thing you really need to make a relationship happy.”
Key point: These are romantic ideals, but they are not realistic. There are some
relationships that will just never work, for any of a number of reasons. You may be in
love, but with someone who cannot ever commit to you. That will never work if you
want commitment.
“Couples that live together before getting married are happier in the long run.”
Key point: Studies suggest that this is not true.
“When I find the right partner I will just know it, and the choice will be easy?”
Key point: It is not necessarily an easy choice because you won’t necessarily “just know
it.”
Discussion Prompts for Choosey Lover and Unrealistic Expectations


Ask women to discuss when they were not choosey about their choices of lovers or
boyfriends and what it has meant for their happiness.
Ask women to discuss how they will decide going forward what is important to them in
making choices of lovers or boyfriends.
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Section 7: Creating Healthy Relationships (110 minutes)
[Link to Background Material for This Section]
Purpose of this section: To provide the participants with knowledge and tools for improving the
health of their relationships
Activity 7.1: Sex and Intimacy Discussion (30 minutes)
Purpose: To understand the distinction between a sexual relationship and an intimate
relationship
Materials: Hill Harper Excerpt, (easel pad wall sheets)
Handouts: “Types of Intimacy”
Although participants may have varying opinions on this question based on their experiences, it
is important to remind them that sexual intercourse does not necessarily equate to intimacy.
Intimacy is based on many more relationship factors than sex alone.
1. Ask the group to answer these two questions:
 How do you define intimacy?
 How do you define having sex?
2. Write their initial thoughts on the easel pad and post them.
3. Ask participants whether intimacy has to involve sexual intercourse? Why or why not?
What about the reverse?
4. Read the excerpt from Hill Harper’s book, which is written from the man’s perspective.
5. Give each participant the Types of Intimacy handout and walk them through the Types
of Intimacy, allowing time for them to think about who they’re intimate with in each
way.
6. Referring to the Hill Harper piece, ask the participants to discuss the following
questions:
 How well does his description of things match your experiences?
 If we want greater intimacy with men, how can we promote that?
7. Summarize the activity and ask people to think about the pros and cons of forming
intimate relationships before engaging in any sexual activity.
Discussion Prompts for Sex and Intimacy


Ask women to discuss what kinds of intimacy they currently experience in their lives and
how that intimacy contributes to their happiness.
Ask women to discuss what barriers they create to the development of intimacy and how
they can overcome those barriers.
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Activity 7.2: Improving Communication in Relationships (10 minutes)
Purpose: To encourage participants to think about ways to communicate more effectively in
relationships15
1. Ask participants:
“What do you think are the main communication problems that men and women have
in relationships?”
Record responses on a wall note.
2. Explain to participants that a group of psychologists have identified the following 4
major types of communication problems. Write them on a wall note as you review
them:
 Escalation: Allowing or encouraging minor disagreements to turn into big fights.
 Invalidation: Putting the other person down by, for example, name calling or
belittling.
 Negative interpretations: Thinking that the other person has a bad intent or a worse
intent than he or she actually does.
 Withdrawal and avoidance: Refusing to acknowledge or talk about important issues.
3. Ask for their reactions to this list. Are these behaviors familiar from their own
experiences with relationships or relationships they may have witnessed, such as their
parents’?
Activity 7.3: Active Listening (20 minutes)
Purpose: To practice the process of active listening
1. Explain that listening means paying full attention. Active listening is important because
it makes people feel valued and allows for clearer communication.
2. Present the three skills in active listening:
 Clarification: Ask questions to ensure you understand what is being said.
 Paraphrasing: Restate the key content of the message to make sure that you understood
correctly.
 Responding: Respond both to spoken messages, and to unspoken messages that you perceive
through tone, body language, facial expression, etc.
15
Adapted from Markman HJ, Stanley SM, Blumberg SL (2010). Fighting for your Marriage: Positive Steps for
Preventing Divorce and Preserving a Lasting Love. San Francisco: Jossey-Bass. This material is reproduced with
permission of John Wiley & Sons, Inc.
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3. Demonstrate each of these skills briefly for the group with your co-facilitator.
4. Ask the participants to split into pairs and take turns practicing each of the skills. Make
sure to allow enough time so that each gets a chance to be the speaker and the listener
for each skill. The speaker should select a subject that it is somewhat upsetting or
emotional for her. Explain the rules as follows:
“One person is the speaker, and the other is the listener. The speaker will talk about
something that is bothering her or worrying her. The listener’s job is to listen, ask
clarifying questions, paraphrase, and respond to what she is saying.”
Circulate and listen to what the pairs are saying. Give constructive feedback.
5. Bring the group back together and ask how they felt about this experience. Ask to what
extent it would be useful in talking with men.
6. Ask how this applies to digital communication such as texting, social media, and email.
What are the challenges related to this kind of communication?
Discussion Prompts for Improving Communication & Active Listening


Ask women to discuss the ways in which they block good communication and ways they can
work to be better communicators.
Ask women to discuss how they will use active listening tools to improve their
communication with other women and with men in their lives.
Activity 7.4: Healthy Conflict Resolution for Couples (20 minutes)
Purpose: Teach the 5 suggested steps couples can use for resolving conflict
Handouts: “Healthy Conflict Resolution for Couples”, Ways to Resolve Conflict cards
1. Open up the discussion by the common reasons that men and women have
disagreements, based on their experience. Start by asking:
“Are disagreements in relationships a problem?”
2. Reinforce that all couples have disagreements, but the way that those disagreements
are handled can make relationships more healthy or less healthy.
3. Distribute the “Conflict Resolution for Couples” handout and “Resolving Conflicts” cards.
Talk through the main points. Ask participants for their response to it.
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Steps for Resolving Conflict:





Take time to understand the other person’s perspective.
Clearly define the problem. Break into smaller pieces if necessary.
Brainstorm as many possible solutions as you can.
Agree on a solution that you are both willing to try.
Follow-up afterwards to discuss how well the solution is working.
Activity 7.5: Advice Columnist (30 minutes)
Learning Objectives: 1) Identify common relationship problems and how to address them. 2)
Recognize the importance of open communication.
Materials: Advice Columnist Questions, (paper), (pens)
Handouts: “Resources for Healthy Relationships”
1. Ask the participants to form up to three groups. Make sure each group has paper and
pens.
2. Give each group one of the scenarios from the Event Materials (same as below but
without the “key points” for discussion). Ask them to prepare a response as if they were
an advice columnist.
3. Give them about 10 minutes to prepare a response. Have each group present their
scenario and response to the group.
4. Discuss reactions to the scenarios and responses. Before moving on, make sure that the
key points provided below each question have been brought up either by the
participants or you.
Scenario 1. I just found out that the guy I've been seeing since last semester has a
girlfriend at home. He didn’t tell me. I found out from his roommate. How should I
handle this?
Key Points:
 She should find a private time to ask him directly what is going on. (Don’t handle this
over text!)
 It is possible that the roommate may not have correct information.
 It depends how serious her relationship is. Did they agree to be monogamous?
 If she has had unprotected sex with this guy, she should get tested.
Scenario 2. I'm in my first serious relationship, but it seems we are constantly fighting.
Is arguing necessarily a sign of a troubled relationship?
Key Points:
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 It depends what is meant by “fighting.” Physically hitting another person is never
acceptable.
 Verbal disagreements and arguments are part of every relationship. However, very
hurtful comments can be a form of abuse.
 It depends on why they are arguing. It could be a sign that they are not compatible,
or it could be that they need to work on their communication skills. It could be that
one or both of them has a temper, and they need to work on that.
 They need to “fight fair,” which means: (1) not engaging in name calling, (2) focusing
on communicating their own feelings rather than on blaming the other person, and
(3) considering taking a “time out” if either person gets really upset.
Scenario 3. My boyfriend’s idea of foreplay is touching and fondling. My idea of
foreplay is having a romantic conversation first - that's what turns me on. The problem
is that we can never do it my way. Why is it so hard for him to realize that I really can
get turned on with conversation?
Key Points:
 She should talk to him when they are relaxed and in private about what she likes to
do sexually and ask what will please him. She should be direct about what she wants
in a positive way without making him feel put down. (Example: “I get really turned on
when we just talk for a few minutes and really focus on each other,” not “You don’t
want to talk to me, you just want to have sex with me.”)
 She should start by saying how much she enjoys being with him.
 If he will not listen and understand the need to please her, this is a real problem,
because both partners should have their needs met.
 Men receive a lot of misinformation about what sex is supposed to be like. Sex in
movies and on TV is often depicted as very rushed. However, it is important for him
to listen and to respect her desires.
5. Summarize by pointing out that these two sections on healthy relationships covered a
large topic in a relatively short timeframe.
 Many websites and books are available on the subjects of communication, sexual
communication, sexual satisfaction and relationship improvement.
 Counseling resources are available online, and campus counselors can also
recommend resources for them.
6. Distribute the handout, “Resources for Healthy Relationships.” In closing, reinforce that:
“It can be difficult to see your own relationship clearly. If you think that you may be in
an unhealthy or abusive relationship, you should seek help from a counselor on
campus or another health professional.”
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Discussion Prompts for Healthy Conflict Resolution & Advice Columnist


Ask women to discuss the ways in which they can better manage conflict resolution both
with romantic partners and with friends and family.
Ask women to discuss how they can better gain good advice and different perspectives on
their sexual and romantic relationships.
Bridge:
“For our last activity, we are going to discuss how we can put what we have learned
here today to use in our lives. Are there any questions before we move on?
Remember that you can put questions in the box that we can discuss at the end of the
day.”
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Section 8: Putting It All Together (25 minutes)
Purpose of this section: To reinforce the points made throughout the Event and give
participants an opportunity to ask any lingering questions
Activity 8.1: Review Questions (5 minutes)
Purpose: To respond to any questions placed in the Question and Answer box during the
Event and make sure that the items on the Parking Lot have been addressed
1. Remove questions from the Question and Answer box and read them one at a time.
2. Give the participants an opportunity to answer the question. If necessary, provide a
response and reinforce with a few facts.
3. Continue until each question has been answered.
4. Review the Parking Lot and ask whether the items posted there have been dealt with
satisfactorily. If not, make a plan for handling them, e.g., finding information and
emailing it to the participant or the whole group after the Event.
5. Thank participants for using the Question and Answer box and the Parking Lot.
Activity 8.2: Planning for Action (10 minutes)
Purpose: To develop a plan for and a pledge to have healthier relationships
Materials: (brochures, flyers, or other materials with local resources for support for sexual
health/healthy relationships)
1. Ask participants to think of at least one behavior they can start doing, stop doing, or do
differently that will lead to healthier relationships.
2. Ask for volunteers to tell the group about the change they plan to make.
3. If appropriate (i.e., the participants are friends outside of the Event), ask participants to
discuss ways in which they might be able support each other to make their changes.
4. Provide information about any campus-based support groups or networks or other
resources available in the area.
5. Ask the women to pledge to support other women and men who are working to create
and sustain healthy relationships.
6. Remind the women of the resource list that was provided early on day 1.
Healthy Sisters Event Guide
Page 81
Rev 8/2013
Activity 8.3: Post-test and Closing (10 minutes)
Materials: (goodie bags)
Handout: Post-test, “Phenomenal Woman” by Maya Angelou
1. Ask for any last questions or thoughts.
2. Distribute the post-tests and feedback forms. Remind them:
 Not to write their name on the post-test; and,
 To work individually and do their best to answer honestly and correctly.
3. Allow time for participants to complete them thoroughly and then collect them and put
them in the envelope.
4. Tell the women that in three months there will be a gathering of the same group so that
you can talk about how you have used the information and connections from the Event.
5. Distribute or read Maya Angelou’s “Phenomenal Woman.”
6. Thank everyone for participating and remind them that they are beautiful women who
deserve to be happy and to have healthy, fulfilling relationships.
7. Distribute goodie bags.
Post-Event: Tying Up Loose Ends
Several tasks related to evaluation and reporting require attention shortly after the Event
concludes. The following list provides a reminder of these items.
 Organize the pre- and post-tests and evaluations.
 Return the room to the original set-up.
 Complete the Event Facilitator Report and Feedback Form.
 Debrief with your co-facilitator to address any issues that may have arisen and
discuss ways to improve future Events.
 Return all Event materials, the pre- and post-tests, the evaluations, and your
completed report and feedback form to the Campus Champion.
 Share any concerns or suggestions with the Campus Champion.
 Begin to plan for the follow-up session and other activities that you want to conduct
to reinforce the Healthy Sisters’ messages and support women’s decision making.
 Set a date three months from the time of the Event for the follow-up.
Page 82
Healthy Sisters Event Guide
Healthy Sisters: Event Materials
Print as needed before Events.
You may want to laminate most of the materials and cards to facilitate their use in more than
one Event.
Remember to collect materials after each Event for future use.
Event Preparation Worksheet
Materials Checklist
□ USB drive with A/V materials
□ (projector or large-screened
laptop), (music player)
□ (easel pad wall sheets)
□ (markers in various colors),
(glue), (tape), (paper), (pens),
(index cards), (sticky notes),
(scissors)
□ Sign in Sheet
□ Event Agenda*
□ Pre-test*
□ (2 large envelopes)
□ (name tags)*
□ “Basic STI Facts for Women”*
□ (local STI brochure)*
□ (local testing brochure)*
□ Sexual Fact or Fiction
Materials
□ “Common Misconceptions
About STIs and HIV/AIDS”*
□ STI Bingo Materials
□ (small prizes)
□ “You and Your 4 Sexual
Partners” Case Study
□ Risk Continuum Materials
□ “The Risk Continuum”*
□ (local testing information)*
□ (male and female condoms)
□ (dental dam)
□ (penis condom demonstration
models or substitutes)*
□ (female pelvic model)
□ Condom Negotiation Role
Playing Scenarios
□ Condom Information Cards*
□ “Healthy Relationship
Checklist”*
□ “Couples That Have
Influenced Me”*
□ (magazines/newsprint with
pictures of young men)
□ “Risky Traits in Potential Dates
and Mates”*
□ Hill Harper Excerpt
□ “Types of Intimacy”*
□ “Healthy Conflict Resolution
for Couples”*
□ Ways to Resolve Conflict
Cards*
□ Advice Columnist Questions
□ “Healthy Relationship
Resource List”*
□ (local resource information)*
□ (goodie bags)*
□ Post-test*
□ “Phenomenal Woman”, by
Maya Angelou*
□ Facilitator Report and
Feedback Form
* One for each participant
Event Preparation Timeline
Date of event: __________________________________________________________________
Preparation starting date (28 days before event): ______________________________________
Activity
Days
Before
Start
Reserve a space for the event
28
Begin promoting event
21
Prepare event materials as
needed
14
Gather materials
7
Make copies of handouts
7
Prepare easel pads
1
Check room set up (tables in a
“U” or conference set up)
1
Page 84
Target
Completion
Date
Done
Notes
Healthy Sisters Event Guide
Sample Flyer
HEALTHY SISTERS:
STRAIGHT TALK FOR
SISTERS
A Healthy Relationship
and Safer Sex Event
Sample Flyer
When:
[Date and Time]
Where:
[Location]
RSVP to:
[Name and Phone Number]
Activity 1.1: Sign In Sheet
Healthy Sisters: Straight
Talk for Sisters
PLEASE PRINT ALL INFORMATION. Your name and email address will ONLY be used to send you
a request to fill in an online follow-up survey, and will be deleted from our records upon
completion of the project.
NAME
1
2
3
4
5
6
7
8
9
10
11
12
Activity 1.1: Sign In Sheet
EMAIL
Activity 3.3: STI Fact or Fiction Materials
First, print out the two large cards on the next two pages. Then print out the small cards on the
third page, and cut them apart.
When you get to Activity 3.3 in the Event, post the two large “FACT” and “FICTION” cards on
the walls in the room where everyone can reach them. Then distribute the 12 “STI Fact or
Fiction” cards to participants.
Follow the directions in the Event Guide for Activity 3.3.
Sexual
Fact
Page 90
Healthy Sisters Event Guide
Sexual
Fiction
FACT OR FICTION?
You can get an STI even if you only have
one sexual partner.
FACT OR FICTION?
While not all STIs have symptoms in the
early stages, all STIs have noticeable
symptoms eventually.
FACT OR FICTION?
If a woman has had a Pap smear and was
not told she had any STIs, then she can be
sure she is uninfected.
FACT OR FICTION?
HIV is only passed through anal sex.
FACT OR FICTION?
FACT OR FICTION?
Condoms do not protect against all STIs.
FACT OR FICTION?
You can’t get herpes if your partner has no
visible sores/ is not having an outbreak.
FACT OR FICTION?
Urinating or washing the genitals after sex
will not keep you from getting an STI.
If your partner shows you a negative HIV
test result, then he or she does not have
HIV.
FACT OR FICTION?
FACT OR FICTION?
You can get an STI the first time you have
sex.
Once you’ve had a particular STI, you can
never get it again.
FACT OR FICTION?
People who are allergic to latex cannot use
condoms.
FACT OR FICTION?
STIs are passed only by semen, so
withdrawal before ejaculating will prevent
a man from passing an STI to his partner.
Activity 3.4: HIV/STI Bingo Materials
Assemble the parts for STI Bingo before the event begins by printing the following pages onto
card stock and cutting the question cards apart. Obtain a large bag of candy to use as game
pieces. Smarties or M&Ms work well.
Instructions:
1. Give each participant a game card and a handful of candy pieces (at least 15) to use as
markers.
2. Briefly explain the rules of Bingo in case anyone in the group is not familiar with them.
Point out that the center square is free, so it should be marked immediately.
3. Select a random starting point on the list of questions and read the question aloud to
the group. Encourage participants to discuss the question and decide on the answer.
4. Once the participants have agreed on the correct answer, those with the correct answer
on their cards should mark it with the candy game pieces.
5. Check off the question on the list so the answers can be checked when someone gets a
bingo.
6. Repeat the process until a participant covers a straight line (vertical, horizontal or
diagonal) on her card and calls out “BINGO.”
7. Check the participant’s answers against the list, and correct any incorrect answers. Give
a small prize to the winner of the round(s).
Asked?
Column
Question
Answer
FACTS
What will prevent hepatitis B?
A VACCINATION
SYMPTOMS
Pain in the lower a__________. (fill in the
blank, starts with “a”)
ABDOMEN
PREVENTION
Not having any kind of sexual intercourse.
ABSTINENCE
MYTHS
Who is at risk for getting an STD?
ANYONE WHO IS
SEXUALLY
ACTIVE
SYMPTOMS
B_________ when peeing. (fill in the
blank, starts with “b”)
BURNING
MYTHS
Most people with STDs are
a______________--they have no signs are
symptoms. (fill in the blank, starts with
an “a”)
ASYMPTOMATIC
PREVENTION
Talk to your partner about STDs b_______
having sex. (fill in the blank, starts with
“b”)
BEFORE
SYMPTOMS
Pus-filled b___________ in the genital
area. (fill in the blank, starts with “b”)
BLISTERS
FACTS
What is the most common way hepatitis is
spread?
BY BLOOD
Asked?
Page 98
Column
Question
Answer
FACTS
HPV is the virus that causes genital warts.
What other disease does HPV cause?
CERVICAL
CANCER
PREVENTION
What can you get before you are exposed
to HPV and Hepatitis B that will keep you
from getting those STDs?
A VACCINATION
FACTS
What is the most common reportable STD
in the U.S.?
CHLAMYDIA
PREVENTION
These can prevent STDs and unplanned
pregnancy when used correctly and
consistently every time you have any kind
of sex.
CONDOMS
SYMPTOMS
Unusual or heavy d_________ from the
vagina or penis. (fill in the blank, starts
with “d”)
DISCHARGE
MYTHS
D_________ does not protect women
from getting an STD and may actually
cause a vaginal infection. (fill in the blank,
starts with “d”)
DOUCHING
RISKS
True or false: You can only have one STD
at a time.
FALSE
MYTHS
True or false: Women who only have sex
with other women do not need to worry
about STD.
FALSE
SYMPTOMS
Swollen g________ in the groin. (fill in the
blank, starts with “g”)
GLANDS
Healthy Sisters Event Guide
Asked?
Column
Question
Answer
MYTHS
Condoms may not prevent STDs spread by
skin-to-skin contact, such as HPV and
h_________. (fill in the blank, starts with
“h”)
HERPES
RISKS
What virus can be passed to a baby
through mother’s breast milk?
HIV
FACTS
What is the most common unreported STD
in the U.S.?
HPV
PREVENTION
True or false: Most birth control methods
protect against STDs.
FALSE
SYMPTOMS
I___________ around the genitals or anus.
(fill in the blank, starts with “i”)
ITCHINESS
PREVENTION
This type of drug equipment should not be
shared with others.
I.V.
FACTS
What system is damaged by HIV?
IMMUNE
SYSTEM
SYMPTOMS
When someone is i__________ it means
they are not able to get pregnant. (fill in
the blank, starts with “I”)
INFERTILE
PREVENTION
Mutual m_____________ means only
having sex with one person who only has
sex with you. (fill in the blank, starts with
“m”)
MONOGAMY
Asked?
Page 100
Column
Question
Answer
MYTHS
Can HIV be spread by using the same toilet
as a person living with HIV/AIDS?
NO
RISKS
True or false: Getting high or drunk may
lower your ability to make smart choices
about safe sex.
TRUE
FACTS
What kind of lubricants should never be
used with latex condoms?
OIL-BASED
RISKS
Most STDs can be transmitted by vaginal,
anal, and o_____ sex. (fill in the blank,
starts with “o”)
ORAL
SYMPTOMS
P________ during sex. (fill in the blank,
starts with “p”)
PAIN
FACTS
What is the name of the test that women
get that tests for cervical cancer?
PAP SMEAR
RISKS
Having more than one p_________ will
increase your risk of getting an STD. (fill in
the blank, starts with “p”)
PARTNER
MYTHS
Some people think you won’t get an STD if
you do this after sex.
PEE
SYMPTOMS
PID stands for P________ I__________
D___________. (fill in the blanks, starts
with “p”, “i”, and “d”)
PELVIC
INFLAMMATORY
DISEASE
Healthy Sisters Event Guide
Asked?
Column
Question
Answer
FACTS
A woman with an untreated STD may have
problems getting p___________ later in
life. (fill in the blank, starts with “p”)
PREGNANT
RISKS
A p__________ woman can pass STDs to
her baby during pregnancy or birth. (fill in
the blank, starts with “p”)
PREGNANT
PREVENTION
True or false: A woman can still get
pregnant if she has sex during her period.
TRUE
FACTS
You can have an STD and not have any
s_____________. (fill in the blank, starts
with “s”)
SYMPTOMS
RISKS
HIV is found in these body fluids: blood,
vaginal secretions, breast milk, and
s_______. (fill in the blank, starts with
“s”)
SEMEN
PREVENTION
What is a non-sexual way to spread STDs
through blood?
SHARING
NEEDLES
RISKS
What kind of contact spreads infections
like genital herpes, HPV, and lice?
SKIN-TO-SKIN
SYMPTOMS
S__________ on the penis or vulva can be
a sign of syphilis or genital herpes. (fill in
the blank, starts with “s”)
SORES
RISKS
Anal sex can be a higher risk sexual
activity because the membranes are
fragile and can easily t______. (fill in the
blank, starts with a “t”)
TEAR
Asked?
Page 102
Column
Question
Answer
SYMPTOMS
Men may have pain or swelling in the
t___________. (fill in the blank, starts
with “t”)
TESTICLES
FACTS
True or false: African Americans have the
highest STD rates compared to all
racial/ethnic groups in the U.S.
TRUE
RISKS
If you are being yelled at, you may be in an
u___________ relationship. (fill in the
UNHEALTHY
blank, starts with “u”)
FACTS
STDs are mainly spread through
u_____________ oral, vaginal or anal sex.
(fill in the blank, starts with “u”)
UNPROTECTED
MYTHS
A v__________ can get still get an STD or
get pregnant, even if it is their first time to
have sex. (fill in the blank, starts with “v”)
VIRGIN
SYMPTOMS
Women may have bleeding between
p_________. (fill in the blank, starts with
“p”)
PERIODS
MYTHS
Some people believe if you w______ after
sex, you won’t get an STD. (fill in the
blank, starts with “w”)
WASH
Healthy Sisters Event Guide
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
TRUE
PAIN
FALSE
BY BLOOD
PERIODS
SKIN-TO-SKIN
BEFORE
NO
CHLAMYDIA
GLANDS
STD
FREE
IV
WASH
SORES
UNHEALTHY
A VACCINATION
ASYMPTOMATIC
BURNING
PREGNANT
TRUE
HERPES
CERVICAL
CANCER
A VACCINATION
SHARING
NEEDLES
PEE
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
UNPROTECTED
ABDOMEN
TRUE
FALSE
SYMPTOMS
TESTICLES
PARTNER
PREGNANT
BLISTERS
STD
FREE
BEFORE
VIRGIN
IMMUNE
SYSTEM
DISCHARGE
HIV
IV
FALSE
ORAL
ABSTINENCE
PEE
SHARING
NEEDLES
ANYONE WHO
IS SEXUALLY
ACTIVE
DOUCHING
PELVIC
PAP SMEAR
INFLAMMATORY
DISEASE
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
OIL-BASED
INFERTILE
TEAR
MONOGAMY
NO
HPV
ITCHINESS
SEMEN
CONDOMS
WASH
TRUE
PAIN
STD
FREE
A VACCINATION
ASYMPTOMATIC
BY BLOOD
PERIODS
FALSE
TRUE
HERPES
ANYONE WHO
CHLAMYDIA
GLANDS
SKIN-TO-SKIN
FALSE
IS SEXUALLY
ACTIVE
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
SORES
UNHEALTHY
A VACCINATION
BURNING
PREGNANT
BEFORE
VIRGIN
UNPROTECTED
ABDOMEN
STD
FREE
IV
FALSE
SYMPTOMS
TESTICLES
TRUE
A VACCINATION
PEE
PREGNANT
BLISTERS
PARTNER
TRUE
NO
CERVICAL
CANCER
SHARING
NEEDLES
DOUCHING
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
IMMUNE
SYSTEM
DISCHARGE
HIV
A VACCINATION
WASH
PAP SMEAR
PELVIC
INFLAMMATORY
DISEASE
SEMEN
ABSTINENCE
ASYMPTOMATIC
OIL-BASED
INFERTILE
STD
FREE
TRUE
HERPES
ANYONE WHO
HPV
ITCHINESS
ORAL
MONOGAMY
IS SEXUALLY
ACTIVE
TRUE
PAIN
TEAR
CONDOMS
DOUCHING
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
BY BLOOD
PERIODS
FALSE
FALSE
VIRGIN
CHLAMYDIA
GLANDS
SKIN-TO-SKIN
SORES
STD
FREE
BEFORE
PEE
A VACCINATION
BURNING
UNHEALTHY
IV
NO
UNPROTECTED
ABDOMEN
PREGNANT
ABSTINENCE
WASH
CERVICAL
CANCER
SHARING
NEEDLES
FALSE
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
UNPROTECTED
TESTICLES
TRUE
FALSE
ASYMPTOMATIC
BLISTERS
PARTNER
DISCHARGE
STD
FREE
BEFORE
IS SEXUALLY
ACTIVE
CERVICAL
CANCER
BY BLOOD
SHARING
NEEDLES
HERPES
ANYONE WHO
PELVIC
HPV
INFLAMMATORY
DISEASE
HIV
IV
DOUCHING
PAP SMEAR
INFERTILE
ORAL
ABSTINENCE
VIRGIN
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
PREGNANT
ITCHINESS
TEAR
MONOGAMY
FALSE
A VACCINATION
PAIN
SEMEN
CONDOMS
PEE
CHLAMYDIA
PERIODS
STD
FREE
FALSE
NO
TRUE
GLANDS
FALSE
BEFORE
WASH
OIL-BASED
SORES
SKIN-TO-SKIN
IV
ASYMPTOMATIC
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
IMMUNE
SYSTEM
BURNING
UNHEALTHY
FALSE
HERPES
SYMPTOMS
ABDOMEN
PREGNANT
UNPROTECTED
TESTICLES
CERVICAL
CANCER
BY BLOOD
SHARING
ANYONE WHO
NEEDLES
IS SEXUALLY
ACTIVE
STD
FREE
BEFORE
DOUCHING
BLISTERS
TRUE
IV
VIRGIN
DISCHARGE
PARTNER
ABSTINENCE
FALSE
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
HPV
PELVIC
INFLAMMATORY
DISEASE
HIV
TRUE
PEE
PAP SMEAR
INFERTILE
SEMEN
ABSTINENCE
NO
PREGNANT
ITCHINESS
STD
FREE
IV
WASH
A VACCINATION
PAIN
ORAL
MONOGAMY
ASYMPTOMATIC
CHLAMYDIA
PERIODS
TEAR
CONDOMS
HERPES
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
TRUE
GLANDS
FALSE
FALSE
OIL-BASED
SORES
SKIN-TO-SKIN
IMMUNE
SYSTEM
BURNING
STD
FREE
BEFORE
VIRGIN
SYMPTOMS
ABDOMEN
UNHEALTHY
IV
FALSE
UNPROTECTED
TESTICLES
PREGNANT
ABSTINENCE
PEE
SHARING
NEEDLES
ANYONE WHO
IS SEXUALLY
ACTIVE
DOUCHING
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
BLISTERS
TRUE
A VACCINATION
NO
BY BLOOD
DISCHARGE
PARTNER
ABSTINENCE
WASH
HPV
INFERTILE
STD
FREE
TRUE
ASYMPTOMATIC
PAP SMEAR
ITCHINESS
HIV
MONOGAMY
HERPES
CERVICAL
CANCER
ANYONE WHO
PREGNANT
PAIN
TEAR
CONDOMS
IS SEXUALLY
ACTIVE
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
A VACCINATION
PERIODS
ORAL
MONOGAMY
DOUCHING
CHLAMYDIA
BLISTERS
SEMEN
CONDOMS
VIRGIN
TRUE
DISCHARGE
STD
FREE
FALSE
FALSE
OIL-BASED
INFERTILE
FALSE
IV
PEE
IMMUNE
SYSTEM
ITCHINESS
SKIN-TO-SKIN
A VACCINATION
NO
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
SYMPTOMS
PAIN
UNHEALTHY
UNPROTECTED
PERIODS
PREGNANT
BEFORE
ASYMPTOMATIC
GLANDS
STD
FREE
IV
HERPES
CERVICAL
CANCER
SHARING
NEEDLES
WASH
ANYONE WHO
BY BLOOD
SORES
TRUE
A VACCINATION
IS SEXUALLY
ACTIVE
HPV
BURNING
PARTNER
TRUE
DOUCHING
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
PAP SMEAR
ABDOMEN
HIV
TRUE
VIRGIN
PREGNANT
TESTICLES
SEMEN
ABSTINENCE
FALSE
A VACCINATION
BLISTERS
STD
FREE
BEFORE
PEE
CHLAMYDIA
DISCHARGE
TEAR
MONOGAMY
NO
TRUE
PELVIC
INFLAMMATORY
DISEASE
ORAL
CONDOMS
WASH
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
TRUE
INFERTILE
FALSE
BY BLOOD
ITCHINESS
SKIN-TO-SKIN
BEFORE
CHLAMYDIA
PAIN
STD
FREE
IV
IS SEXUALLY
ACTIVE
PERIODS
UNHEALTHY
A VACCINATION
DOUCHING
GLANDS
PREGNANT
TRUE
VIRGIN
CERVICAL
CANCER
A VACCINATION
SHARING
NEEDLES
ASYMPTOMATIC
HERPES
ANYONE WHO
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
TRUE
DISCHARGE
TRUE
OIL-BASED
PELVIC
INFLAMMATORY
DISEASE
PARTNER
IV
PEE
IMMUNE
SYSTEM
INFERTILE
STD
FREE
FALSE
NO
SYMPTOMS
ITCHINESS
HIV
TRUE
WASH
UNPROTECTED
PAIN
ORAL
ABSTINENCE
ASYMPTOMATIC
SHARING
NEEDLES
FALSE
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
SYMPTOMS
TESTICLES
SEMEN
MONOGAMY
HERPES
UNPROTECTED
BLISTERS
TEAR
CONDOMS
IS SEXUALLY
ACTIVE
DISCHARGE
STD
FREE
BEFORE
DOUCHING
IV
VIRGIN
ANYONE WHO
CERVICAL
CANCER
PELVIC
BY BLOOD
INFLAMMATORY
DISEASE
FALSE
HPV
INFERTILE
SKIN-TO-SKIN
SHARING
NEEDLES
FALSE
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
IMMUNE
SYSTEM
BURNING
UNHEALTHY
SYMPTOMS
ABDOMEN
PREGNANT
IV
NO
UNPROTECTED
TESTICLES
STD
FREE
FALSE
WASH
BLISTERS
TRUE
TRUE
ASYMPTOMATIC
DISCHARGE
PARTNER
ABSTINENCE
HERPES
CERVICAL
CANCER
BY BLOOD
SHARING
NEEDLES
PEE
B
I
N
G
O
FACTS
SYMPTOMS
RISKS
PREVENTION
MYTHS
PREGNANT
DISCHARGE
HIV
BEFORE
A VACCINATION
PELVIC
INFLAMMATORY
DISEASE
TEAR
ABSTINENCE
CHLAMYDIA
INFERTILE
STD
FREE
TRUE
ITCHINESS
SEMEN
MONOGAMY
FALSE
OIL-BASED
PAIN
ORAL
CONDOMS
PEE
SHARING
NEEDLES
ANYONE WHO
IS SEXUALLY
ACTIVE
DOUCHING
VIRGIN
Activity 4.1: “You and Your 4 Sexual Partners” Case Study
#2 – Before coming to college, she
was sexually involved with a man
who used IV drugs and was in the
criminal justice system, but she is
embarrassed about this and
doesn’t share this information.
#1 – Says that she is a virgin
but has actually performed
oral sex without using a
condom.
{Example:
Man’s name}
#4 – Says that she
has only had one
partner before and
that they were
monogamous.
Actually, her partner
had a lot of other
partners that she
did not know about.
Red dot = infected partner
White dot = uninfected partner
#3 – Says that she enjoys sex and
has dated a lot of guys but always
uses protection.
Activity 4.2: Risk Continuum Materials
First, print out the three large cards on the next two pages. Then print out the 18 small cards on
the third and fourth pages, and cut them apart.
When you get to Activity 4.2 in the Event, post the three large cards on the walls in the room
where everyone can reach them.
Keep the cards so that you can use them to provide adequate variety.
Follow the directions in the Event Guide for Activity 4.2.
High
Risk
Low
Risk
No
Risk
Abstinence
Vaginal sex with a
condom
Anal sex with a
condom and
lubrication
Hugging
Massage
Giving oral sex
without a condom or
dental dam
Sharing sex toys
without cleaning or
use of new condom
Masturbation
Unshared sex toys
Anal sex without a
condom
Sexual stimulation of
Vaginal sex without a
another’s genitals
condom
using hands
Giving or receiving
oral sex w/ condom
or dental dam
Insertive anal sex
without a condom
Receiving oral sex
without a barrier
Receptive anal sex
without a condom
Sharing sex toys with
cleaning or use of
new condom
Tongue kissing
Activity 5.5: Condom Negotiation Role Playing Scenarios
Scenario #2:
Scenario #1:
You are single and have not had sex for a long
time.
You are at a party. You have just arrived. You
meet a guy who you find very sexually
attractive who comes on to you, and wants to
leave the party with you. He has been drinking.
You want to leave and have sex with him. What
do you do?
Your partner of one year has left you. You feel
extremely depressed and rejected.
On campus, you run into a guy that you had
hooked up with before the boyfriend that you
just broke up with. You had sex with him
without condoms before and never got an STI
or got pregnant.
He suggests going back to his apartment. What
do you do?
Role Play Instructions:
Role Play Instructions:
One person plays the female character. She
wants to have sex and use a condom. The other
person plays the male character who does not
want to use a condom.
One person plays the female character who
wants to use a condom. The other person plays
the male character who says they do not need
to use a condom because when they were
hooking up before they never used them and
everything was fine.
Scenario #3:
You have been in a serious relationship with a
guy for one month. You have not been sexually
intimate with each other. He has just ended a
committed relationship that lasted several
years, and he says that he has not had any
sexual partners since then. You got chlamydia
from another partner last year, but took the
antibiotics that you were prescribed at the
time. You want to talk to him about having sex
for the first time. What do you do?
Scenario #4:
You have been hooking up with a guy for
several months, but it is not serious. You use
condoms for vaginal sex, but have never used a
barrier for oral sex. After participating in the
Healthy Sisters workshop, you think that it
would be best to use barriers to oral sex too.
How can you bring this up with the guy?
Role Play Instructions:
Role Play Instructions:
One person plays the female character and the
other person plays the male character. Each can
decide what they think this character would say
and how they would say it.
One person plays the female character and
presents reasons for using condoms for oral
sex. The other person plays the male character
who is unsure how he feels about this idea.
Activity 7.1: Hill Harper Excerpt
Hill Harper on Sex and Intimacy16
“It seems to me that the basic things we want are pretty clear. A man wants
to find a woman who wants to be with him. A woman wants to find a man who
wants to be with her. … So far, so good – it all sounds pretty simple. So why does
it break down? Where does it break down?
“What sex is to men is often very different from what it is to women. The
evidence is everywhere, from the differences in our biology to the different ways
we use language. Studies show that women often suggest sex as shorthand for
closeness. ….
“When a man initiates sex, it’s not necessarily to feel closer to his partner.
… A man may initiate sex for no other reason than the enjoyment of the physical
experience that sex is, and this can come into conflict with the emotions that
women bring to the experience.
“When women expect sex to be the doorway into the relationship, it leaves
them at cross-purposes with men and can contribute to the communication
breakdown. Neither is saying what he or she means – not on purpose, but
because it hasn’t occurred to the person that his or her partner means something
else when he or she uses the same words.
“How can we expect things to get better if we are not willing to make our
truth known to the person we are having sexual relations with?
“I would hope for everyone to be wide open to the possibility of sex as a
powerful and expressive part of their relationship. In order for that to happen,
though, there has to be trust, fun, and ease – in other words, friendship. The only
way to arrive at these vital preconditions is through communication.”
16
Excerpted from: Harper H (2009). The Conversation: How Black Men and Women Can Build Loving, Trusting
Relationships. New York: Gotham Books, pp 121-23.
Activity 7.5: Advice Columnist Questions
Question 1:
I just found out that the
person I've been seeing
since last semester has a
girlfriend at home. He
didn’t tell me. I found out
from his roommate. How
should I handle this?
Question 3:
My boyfriend’s idea of
foreplay is touching and
fondling. My idea of
foreplay is having a romantic
conversation first - that's
what turns me on. The
problem is that we can
never do it my way. Why is
it so hard for him to realize
that I really can get turned
on with conversation?
Question 2:
I'm in my first serious
relationship, but it seems
we are constantly arguing.
Is arguing necessarily a sign
of a troubled relationship?
Healthy Sisters: Participant Handouts
Print one copy per participant before each event.
The handouts from activities 3.1, 3.3, 5.5 and 7.4 are meant to be printed double-sided. The
rest should be printed single-sided.
Although handouts can be printed in black-and-white, they are designed to be printed in color.
Note special printing instructions for card handouts.
Distribute when instructed in curriculum.
Healthy Sisters:
Straight Talk for Sisters
EVENT AGENDA
Section
Activity
Time
Section 1: Setting the Stage
Section 1: Setting the Stage
Section 1: Setting the Stage
Section 2: Talking about Sex and Sexuality
Section 3: Sexual Health Facts
Section 3: Sexual Health Facts
Section 3: Sexual Health Facts
Section 3: Sexual Health Facts
Section 4: Understanding and Assessing Risk
Section 4: Understanding and Assessing Risk
Section 4: Understanding and Assessing Risk
Section 5: Using Condoms
Section 5: Using Condoms
Section 5: Using Condoms
Section 5: Using Condoms
Section 5: Using Condoms
Section 6: Defining Healthy Relationships
Section 6: Defining Healthy Relationships
Section 6: Defining Healthy Relationships
Section 6: Defining Healthy Relationships
Section 7: Creating Healthy Relationships
Section 7: Creating Healthy Relationships
Section 7: Creating Healthy Relationships
Section 7: Creating Healthy Relationships
Section 7: Creating Healthy Relationships
Section 8: Putting It All Together
Section 8: Putting It All Together
Section 8: Putting It All Together
TOTAL TIME
Pre-test and Introduction
Fantasy Name Icebreaker
Sisters Code
Whatchamacallit?
The Facts about STIs
HIV/AIDS Discussion
Sexual Fact or Fiction
HIV/STI Bingo
Sexual Networks
Risk Continuum
Getting Tested
Male Condom: O.P.R.A.H.
Male Condom Practice
Male Condom Race
Female Condom: O.P.A.L.-T.
Condom Negotiation for Safer Sex
Healthy Relationships Discussion
Relationship Influences
Choosey Lover
Reality Checks
Sex and Intimacy Discussion
Improving Communication
Active Listening
Healthy Conflict Resolution
Advice Columnist
Review Questions
Planning for Action
Post-test and Closing
15
5
5
20
45
15
20
30
20
20
20
10
10
10
15
30
30
30
30
30
30
10
20
20
30
5
10
10
545
Activity 1.1: Event Agenda
Page 164
Healthy Sisters Event Guide
Activity 3.1: “Basic STI Facts for Women”
Basic STI Facts for Women
Name (Causal
Agent): Mode of
transmission
Gonorrhea (Bacteria):
Acquired by vaginal,
oral, or anal sex;
contaminated hands or
sex toys.
Syphilis (Bacteria):
Acquired by vaginal,
oral, or anal sex;
contaminated hands or
sex toys. In rarer
instances, close body
contact, saliva, blood.
Chlamydia (Bacteria):
Acquired by vaginal,
oral, or anal sex;
contaminated hands or
sex toys.
Genital Herpes
(Virus): Acquired by
vaginal, oral, or anal
sex; contaminated
hands or sex toys, plus
direct skin contact with
an ulcer.
Hepatitis B [Hep B]
(Virus): Acquired by
vaginal, oral, or anal
sex; contaminated
hands or sex toys, but
more easily by
exposure to blood or
(more rarely) saliva.
Human
Immunodeficiency
Virus [HIV] (Virus):
Acquired by vaginal,
Symptoms
So what?
Curable?
Testing
May have no
symptoms, or there
may be a yellow
discharge from the
penis, pain when
urinating, pain in the
testicle area or
prostate gland,
and/or fever.
Initially: painless
ulcers on the
genitals. Later: rash,
swollen glands and
hair loss. Can lead to
deterioration of
eyesight and/or
brain function.
Usually no
symptoms, but there
can be clear
discharge from the
penis with pain.
Can lead to
infertility.
Yes, with antibiotics,
but if damage has
occurred, it will not
be reversed.
Urine sample
(results in few days
to one week) or
penile swab (results
in few days to one
week).
Untreated, it can
lead to heart,
liver, joint and
central nervous
system disorders.
Yes, with antibiotics,
but if damage has
occurred, it will not
be reversed.
Blood test (results in
few days to one
week).
Can lead to
infertility.
Yes, with antibiotics,
but if damage has
occurred, it will not
be reversed.
Fever; blisters and
ulcers on genitals,
anal area or mouth;
varying degrees of
pain at areas of the
sores. Symptoms
initially last 1-2
weeks.
No symptoms, or
yellowed skin and
eyes, dark urine,
fatigue, nausea and
vomiting.
Goes into
remission after
an initial
outbreak and
then periodically
reoccurs.
No, but drugs can
suppress outbreaks
and help manage
pain.
Urine sample
(results in few days
to one week) or
penile swab (results
in few days to one
week).
Swab from active
sore (results in one
to two weeks).
In a small
number of cases,
never completely
heals, and may
develop into liver
disease and/ or
liver cancer.
No, but most cases
resolve in 3-6
months.
Note: A vaccine is
available.
Blood test (results
available in few days
to one week).
There may be flu-like
symptoms initially,
but often there are
no symptoms for
Destroys the
immune system
and progresses
into AIDS, during
No, but use of a
multi-drug regimen
can slow disease
progression and
Mouth swab (results
available in 20
minutes), blood test(results available in
Name (Causal
Agent): Mode of
transmission
Symptoms
So what?
Curable?
Testing
oral, or anal sex;
contaminated hands or
sex toys, but more
often by exposure to
blood particularly
when injecting drugs,
less often from sharing
razors or
toothbrushes.
several years after
infection.
which physical
wasting, cancer,
pneumonia, and
other lifethreatening
diseases occur.
manage symptoms.
Unpleasant sideeffects to drugs are
common.
one to two weeks),
or finger stick
(results available in
20 minutes).
Human Papilloma
Virus [HPV] (Virus):
Can cause cancer
of in the area
infected: vulva,
vagina, cervix,
penis, anus,
tongue, tonsils or
throat.
Can lead to
infertility.
Both genital warts
and HPV-related precancer or cancer can
be treated. Warts
often recur. Note: A
vaccine is available.
Warts are diagnosed
by appearance, oral
or anal lesions by
biopsy. For women,
Pap smears test for
HPV.
Yes, with antibiotics.
(Bacteria): Acquired by
vaginal, oral, or anal
sex; contaminated
hands or sex toys.
Usually no
symptoms;
sometimes genital
warts (flesh-colored
growths) or genital
or anal irritation or
bleeding.
Milky urethral
discharge, pain or
burning sensation
when urinating,
irritation of the
penis.
Penile swab (results
in few days to one
week).
Pubic Lice [Crabs]
and Scabies
Intense itching and
skin rashes.
Extreme skin
irritation, and
surface wounds
which could lead
to other skin
infections.
Yes, medicated
shampoos and
lotions kill the lice.
Diagnosis by
inspecting skin for
parasites, eggs, and
typical lesions.
Penile itching,
irritation, or
discharge; or
burning after
urination or
ejaculation.
Rarely, infertility.
Yes, with antibiotics.
Discharge can be
examined under
microscope.
Acquired by vaginal,
oral, or anal sex;
contaminated hands or
sex toys.
Non-gonococcal
Urethritis [NGU]
(Parasites): Through
skin-to-skin contact
and sharing personal
items (underwear,
towels, etc.)
Trichomoniasis
(Parasite): Acquired by
vaginal, oral, or anal
sex; contaminated
hands or sex toys.
Activity 3.1: “Basic STI Facts for Women”
Page 166
Healthy Sisters Event Guide
Activity 3.3: “Common Misconceptions About STIs and HIV/AIDS”
Common Misconceptions About
STIs and HIV/AIDS
Misconception
You can’t get an STI from oral sex.
You can’t get an STI from anal sex.
You can’t get an STI the first time you
have sex.
You can’t get an STI from sex in a pool
or hot tub.
A woman can’t get an STI / can’t pass
an STI if she is using birth control pills.
You can’t get an STI if you have sex
standing up.
You can’t get an STI if you urinate or
wash the genitals after sex.
You can’t get herpes if your partner
has no visible sores / is not having an
outbreak.
You can’t get an STI if you only have
one partner.
You can’t get an STI from a man who is
a virgin.
STIs are passed only by semen, so
withdrawal before ejaculating will
prevent a man from passing an STI to
his partner.
You will know it if you have an STI.
You can tell if your partner has an STI.
Only people who have sex with
multiple partners have STIs.
If your partner has been tested and is
negative that means you don’t have
an STI.
If you have a sports physical or a
regular check-up with your medical
provider and were not told that you
have an STI, then you’re clear.
Fact
All STIs can be passed by anal, oral, or vaginal sex.
All STIs can be passed by anal, oral, or vaginal sex.
If your first sex is with someone who is infected and you do
not use condoms, your risk for getting an STI is high.
Chlorine in the water does not protect you from the internal
spread of STIs, and it can break down condoms.
Birth control pills protect from pregnancy, but provide NO
PROTECTION from STIs.
Position does not matter: STIs can be spread anytime there is
sexual contact.
STIs can enter the body immediately, so urinating or washing
is not effective.
Herpes virus can be spread even when there are no visible
signs and the person isn’t experiencing symptoms of an
outbreak.
If your partner has or has previously had other partners, he
could have an STI and pass it to you.
If the man has NEVER had any kind of sexual contact including
vaginal, oral or anal sex, it is unlikely that you could get an STI
from him. However, some men count only vaginal sex when
they say they are a “virgin.”
This is inaccurate on two counts. First, there is a small amount
of pre-ejaculate that a man cannot control and may not be
aware of. This fluid can pass STIs. Second, some STIs like
herpes and syphilis can be passed by skin lesions (sores)
whether the man ejaculates or not.
Many STIs do not have symptoms, especially in the early
stages.
Many STIs do not have symptoms, especially in the early
stages.
If your partner has or has previously had other partners, he
could have an STI and pass it to you.
STIs are not always passed in a predictable way, and not every
STI has a 100% accurate test. So the only way to know your
own status is to get yourself tested.
Unless you requested STI testing, it is likely that you did NOT
get tested for any STIs.
Misconception
If you’ve had a pap smear and were
not told that you had any STIs, then
you do not have any STIs.
STIs can be cured with medicine, so
it’s no big deal to get an STI.
There are 100% accurate tests for
every STI.
If your partner shows you his negative
HIV test result, then he does not have
HIV.
If STI symptoms go away, the STI has
gone away or been cured.
Once you’ve had a particular STI, you
can never get it again.
You can get STIs from toilet seats.
You can get STIs from regular kissing.
HIV is only passed by anal sex.
Only gay men get HIV.
Condoms protect against all STIs.
Condoms break easily, so they are
ineffective in preventing STIs.
Two condoms are better than one for
preventing STIs.
Plastic wrap is as good as a condom
for preventing STIs.
A lot of men can’t use condoms due to
size issues or allergies to latex.
Fact
Unless you asked for STI testing it is likely that you did NOT get
tested for any STIs, except indirectly for HPV.
Some STIs are not curable at all. Even STIs that are curable
with antibiotics can cause permanent damage if the infections
are not treated in the early stages.
No test is 100% accurate. Some STIs, especially HIV, can take
weeks to months to show up on a test. Others like herpes or
oral cancer from HPV virus are hard to detect unless there are
symptoms.
While HIV usually shows up on tests within a couple of weeks,
it can take as long as 6 months. Having a negative test 3 weeks
ago may mean that he doesn’t have HIV, OR it may mean he
has it, but it hasn’t shown up on the test yet. Also, if your
partner had a risky contact after the HIV test, he could have
picked up HIV after the test.
Some STIs, especially herpes and syphilis, have stages where
they produce no symptoms, but they are still present and can
cause illness/symptoms in the future unless they are treated.
Except for hepatitis B, you can get the same STIs over and over
either because you do not build up immunity to the disease
(gonorrhea, chlamydia, syphilis, trichomoniasis) or because
there are many strains of the disease and there is still risk of
infection with a different strain (HIV, hepatitis C, HPV).
STI organisms do not live long on dry, cold, smooth surfaces. It
is extremely unlikely that you will get an STI from a toilet seat.
Unless a person has a herpes type 2 sore on the lips (which is
possible although most cold sores are from herpes type 1), it is
unlikely that you will get an STI from regular kissing.
Worldwide, more cases of HIV were spread through
heterosexual contact and vaginal sex than any other mode of
transmission.
Condoms do not protect against STIs that can be passed by
skin-to-skin contact: herpes, syphilis, genital warts, scabies and
pubic lice.
Condoms are tested for quality and seldom break if they are
used correctly and before they expire.
Two condoms are NOT BETTER. Using two condoms increases
friction levels and thus increases the risk of breakage.
Plastic wrap is more porous and can allow some types of
infections through.
Condoms are available to fit all sizes of penises, and men who
are allergic to latex can use polyurethane or polyisoprene
condoms.
Activity 3.3: Common Misconceptions About STIs and HIV/AIDS
Page 168
Healthy Sisters Event Guide
Activity 4.2: “The Risk Continuum”
The Risk Continuum
No Risk
Low
Risk
Low
Risk
Low
Risk
Low
Risk
Low
Risk
Low
Risk
Low
Risk
Medium
Risk
Medium
Risk
Examples
Abstinence, hugging, massage,
masturbation, fantasy, phone sex,
cybersex, dry kissing, unshared sex toys
Explanation
No bodily fluids are exchanged.
Sexual stimulation of another’s genitals
using hands as long as there are no cuts
or other skin breaks
Risk of bodily fluid exchange is very low
(though cuts on the hand would increase the
risk of infection entry).
Giving or receiving oral sex with a
condom or dental dam
Receiving oral sex without a condom or
dental dam
Sharing sex toys with cleaning or use of
new condom
Tongue kissing
Use of a barrier usually prohibits exchange of
bodily fluids.
Receiver is at lower risk than giver, partly
because saliva is not known to transmit HIV.
Cleaning or condom use limits fluid exchange.
There is some risk of exchange of bodily fluids
Insertive or receptive vaginal sex with a
condom
Insertive anal sex with a condom and
lubrication
Giving oral sex without a condom or
dental dam
Sharing sex toys without cleaning or use
of new condom
Medium Sexual stimulation of another’s genitals
using hands that have cuts or broken skin
Risk
Condom use limits fluid exchange if used
correctly and for the entire time.
Medium Receptive anal sex with a condom and
lubrication
Risk
High
Insertive anal sex without a condom
Risk
Insertive or receptive vaginal sex without
High
a condom
Risk
Cuts could allow bacteria/viruses to enter
the skin.
High
Risk
Receptive anal sex without a condom
Activity 4.2: The Risk Continuum
Condom use limits fluid exchange if used
correctly and for the entire time.
Giver is at higher risk than receiver.
Fluids/bacteria/viruses can be transferred.
Cuts could allow bacteria/viruses to enter the
skin.
Fluids/bacteria/viruses can be transferred.
Fluids/bacteria/viruses can be transferred.
Anal mucous membranes are especially
susceptible to micro-tears which provide easy
entry for bacteria/viruses.
Activity 5.5: Condom Information Cards
The cards on the next two pages are formatted for double-sided printing on business card stock
such as Avery 8371. If business card stock is not available, print double-sided on heavy paper
and cut apart for distribution during the event. Laminating the cards makes them more durable
for carrying in a wallet.
USING A MALE CONDOM
USING A MALE CONDOM
(Remember: OPRAH)
Open the package with fingers only. Check that the package is
intact and that the expiration date has not passed.
Pinch the top to allow room for semen.
Roll to the base of the penis.
Act: use the condom from start to finish.
Hold the condom and gently withdraw. Then
tie it in a knot and put it in a trash can.
Scan this with a smart phone QR reader
to see a video showing how to put on a male
condom.
(Remember: OPRAH)
Open the package with fingers only. Check that the package is
intact and that the expiration date has not passed.
Pinch the top to allow room for semen.
Roll to the base of the penis.
Act: use the condom from start to finish.
Hold the condom and gently withdraw. Then
tie it in a knot and put it in a trash can.
Scan this with a smart phone QR reader
to see a video showing how to put on a male
condom.
USING A MALE CONDOM
USING A MALE CONDOM
(Remember: OPRAH)
Open the package with fingers only. Check that the package is
intact and that the expiration date has not passed.
Pinch the top to allow room for semen.
Roll to the base of the penis.
Act: use the condom from start to finish.
Hold the condom and gently withdraw. Then
tie it in a knot and put it in a trash can.
Scan this with a smart phone QR reader
to see a video showing how to put on a male
condom.
(Remember: OPRAH)
Open the package with fingers only. Check that the package is
intact and that the expiration date has not passed.
Pinch the top to allow room for semen.
Roll to the base of the penis.
Act: use the condom from start to finish.
Hold the condom and gently withdraw. Then
tie it in a knot and put it in a trash can.
Scan this with a smart phone QR reader
to see a video showing how to put on a male
condom.
USING A MALE CONDOM
USING A MALE CONDOM
(Remember: OPRAH)
Open the package with fingers only. Check that the package is
intact and that the expiration date has not passed.
Pinch the top to allow room for semen.
Roll to the base of the penis.
Act: use the condom from start to finish.
Hold the condom and gently withdraw. Then
tie it in a knot and put it in a trash can.
Scan this with a smart phone QR reader
to see a video showing how to put on a male
condom.
(Remember: OPRAH)
Open the package with fingers only. Check that the package is
intact and that the expiration date has not passed.
Pinch the top to allow room for semen.
Roll to the base of the penis.
Act: use the condom from start to finish.
Hold the condom and gently withdraw. Then
tie it in a knot and put it in a trash can.
Scan this with a smart phone QR reader
to see a video showing how to put on a male
condom.
USING A MALE CONDOM
USING A MALE CONDOM
(Remember: OPRAH)
Open the package with fingers only. Check that the package is
intact and that the expiration date has not passed.
Pinch the top to allow room for semen.
Roll to the base of the penis.
Act: use the condom from start to finish.
Hold the condom and gently withdraw. Then
tie it in a knot and put it in a trash can.
Scan this with a smart phone QR reader
to see a video showing how to put on a male
condom.
(Remember: OPRAH)
Open the package with fingers only. Check that the package is
intact and that the expiration date has not passed.
Pinch the top to allow room for semen.
Roll to the base of the penis.
Act: use the condom from start to finish.
Hold the condom and gently withdraw. Then
tie it in a knot and put it in a trash can.
Scan this with a smart phone QR reader
to see a video showing how to put on a male
condom.
USING A MALE CONDOM
USING A MALE CONDOM
(Remember: OPRAH)
Open the package with fingers only. Check that the package is
intact and that the expiration date has not passed.
Pinch the top to allow room for semen.
Roll to the base of the penis.
Act: use the condom from start to finish.
Hold the condom and gently withdraw. Then
tie it in a knot and put it in a trash can.
Scan this with a smart phone QR reader
to see a video showing how to put on a male
condom.
(Remember: OPRAH)
Open the package with fingers only. Check that the package is
intact and that the expiration date has not passed.
Pinch the top to allow room for semen.
Roll to the base of the penis.
Act: use the condom from start to finish.
Hold the condom and gently withdraw. Then
tie it in a knot and put it in a trash can.
Scan this with a smart phone QR reader
to see a video showing how to put on a male
condom.
USING A FEMALE CONDOM
USING A FEMALE CONDOM
(Remember: OPAL-T)
Open the package with fingers only.
Pinch the inner ring between thumb and index finger and insert
it deep into the vagina.
Arrange: Place a finger through the outer ring to make sure
there are no twists.
Lead: Guide your partner’s penis in through
the outer ring.
Twist: When finished using, twist the outer
ring, then gently pull it out and discard it.
Scan this with a smart phone to see a
video showing how to put on a female
condom.
(Remember: OPAL-T)
Open the package with fingers only.
Pinch the inner ring between thumb and index finger and insert
it deep into the vagina.
Arrange: Place a finger through the outer ring to make sure
there are no twists.
Lead: Guide your partner’s penis in through
the outer ring.
Twist: When finished using, twist the outer
ring, then gently pull it out and discard it.
Scan this with a smart phone to see a
video showing how to put on a female
condom.
USING A FEMALE CONDOM
USING A FEMALE CONDOM
(Remember: OPAL-T)
Open the package with fingers only.
Pinch the inner ring between thumb and index finger and insert
it deep into the vagina.
Arrange: Place a finger through the outer ring to make sure
there are no twists.
Lead: Guide your partner’s penis in through
the outer ring.
Twist: When finished using, twist the outer
ring, then gently pull it out and discard it.
Scan this with a smart phone to see a
video showing how to put on a female
condom.
(Remember: OPAL-T)
Open the package with fingers only.
Pinch the inner ring between thumb and index finger and insert
it deep into the vagina.
Arrange: Place a finger through the outer ring to make sure
there are no twists.
Lead: Guide your partner’s penis in through
the outer ring.
Twist: When finished using, twist the outer
ring, then gently pull it out and discard it.
Scan this with a smart phone to see a
video showing how to put on a female
condom.
USING A FEMALE CONDOM
USING A FEMALE CONDOM
(Remember: OPAL-T)
Open the package with fingers only.
Pinch the inner ring between thumb and index finger and insert
it deep into the vagina.
Arrange: Place a finger through the outer ring to make sure
there are no twists.
Lead: Guide your partner’s penis in through
the outer ring.
Twist: When finished using, twist the outer
ring, then gently pull it out and discard it.
Scan this with a smart phone to see a
video showing how to put on a female
condom.
(Remember: OPAL-T)
Open the package with fingers only.
Pinch the inner ring between thumb and index finger and insert
it deep into the vagina.
Arrange: Place a finger through the outer ring to make sure
there are no twists.
Lead: Guide your partner’s penis in through
the outer ring.
Twist: When finished using, twist the outer
ring, then gently pull it out and discard it.
Scan this with a smart phone to see a
video showing how to put on a female
condom.
USING A FEMALE CONDOM
USING A FEMALE CONDOM
(Remember: OPAL-T)
Open the package with fingers only.
Pinch the inner ring between thumb and index finger and insert
it deep into the vagina.
Arrange: Place a finger through the outer ring to make sure
there are no twists.
Lead: Guide your partner’s penis in through
the outer ring.
Twist: When finished using, twist the outer
ring, then gently pull it out and discard it.
Scan this with a smart phone to see a
video showing how to put on a female
condom.
(Remember: OPAL-T)
Open the package with fingers only.
Pinch the inner ring between thumb and index finger and insert
it deep into the vagina.
Arrange: Place a finger through the outer ring to make sure
there are no twists.
Lead: Guide your partner’s penis in through
the outer ring.
Twist: When finished using, twist the outer
ring, then gently pull it out and discard it.
Scan this with a smart phone to see a
video showing how to put on a female
condom.
USING A FEMALE CONDOM
USING A FEMALE CONDOM
(Remember: OPAL-T)
Open the package with fingers only.
Pinch the inner ring between thumb and index finger and insert
it deep into the vagina.
Arrange: Place a finger through the outer ring to make sure
there are no twists.
Lead: Guide your partner’s penis in through
the outer ring.
Twist: When finished using, twist the outer
ring, then gently pull it out and discard it.
Scan this with a smart phone to see a
video showing how to put on a female
condom.
(Remember: OPAL-T)
Open the package with fingers only.
Pinch the inner ring between thumb and index finger and insert
it deep into the vagina.
Arrange: Place a finger through the outer ring to make sure
there are no twists.
Lead: Guide your partner’s penis in through
the outer ring.
Twist: When finished using, twist the outer
ring, then gently pull it out and discard it.
Scan this with a smart phone to see a
video showing how to put on a female
condom.
Page 174
Healthy Sisters Event Guide
Activity 6.1: “Healthy Relationship Checklist”
Healthy Relationship
Checklist
Can you speak about anything to your partner and receive mutual understanding and kindness?
YES
NO
SOMETIMES
Do you bring out the best qualities in each other?
YES
NO
SOMETIMES
Do you feel like you can honestly ask for what you want and need in this relationship?
YES
NO
SOMETIMES
Are you both comfortable with how physical the relationship is or isn’t?
YES
NO
SOMETIMES
Do you both feel close to each other (not just physically) and are willing to trust each other with
personal stuff?
YES
NO
SOMETIMES
Does your partner take responsibility for their own actions and not blame you for their failures?
YES
NO
SOMETIMES
Can the two of you admit when you are wrong and apologize to each other when needed?
YES
NO
SOMETIMES
Do you feel less like yourself when you have been with your partner, that is, you’ve been
pretending to be someone you’re not?
YES
Activity 6.1: Healthy Relationship Checklist
NO
SOMETIMES
Activity 6.2: “Couples that Have Influenced Me”
Couples that Have
Influenced Me
Instructions: Reflect on couples in your life that you think have most influenced your view of
what relationships are like. List those couples in the first column. Then reflect on the positive
and negative qualities and practices you observed in those couples, and list them in the second
and third columns.
How this relates to healthy relationships: In relationships, we tend to repeat patterns that we
have observed in other couples, either consciously or unconsciously.
Couples that have most
influenced my view of
what relationships are
like:
1.
Positive qualities or practices
that I learned from these
couples:
2.
3.
Activity 6.2: Couples that Have Influenced Me
Negative qualities or
practices that I learned from
these couples:
Activity 6.3: “Risky Traits in Potential Dates and Mates”
Risky Traits in Potential
Dates and Mates
Many times it is hard to recognize bad behavior in someone we’re close to or are interested in
in a romantic/sexual way. Bad behaviors, especially if there’s a pattern of them, that is, they
happen again and again, can be signs of underlying bad traits.
Look at the behaviors in the table below17 and try to think about whether someone you are
close to or someone you are interested in often exhibits them.
Behavior
Is critical to you about things you cannot change (your physical traits, personality,
or quirks)
Trait
Overcritical
Is physically violent toward others (family, friends, or strangers)
Violent
Flies into a rage when frustrated (very impatient or can't handle when things don't
go his or her way)
Angry
Stands you up for appointments without excusing him or herself
Inconsiderate
Shows little or no remorse when wrongs you or another
Inconsiderate
Makes everything about him or herself almost all of the time
Can't tolerate your honest opinion (you have to walk on rice paper)
Vain
Intolerant
Flirts with others in your presence
Disrespectful
Fails to respect your decision to say no
Disrespectful
Blames everyone but self (“never my fault”)
Victim
Is extremely needy and demands that you take care of those needs
Needy
Tries to take physical liberties with you regardless of your protests or concerns
Bully
Minimizes intentional rudeness and inconsideration with humor (often says “just
kidding”)
Mean
Steals your things or your money
Dishonest
Tries to isolate you from friends, family, and others
Controlling
Schedules your activities and routines without consulting you
Controlling
Overdoes the substances (alcohol, tobacco, pills, etc.)
Uncontrolled
Activity 6.3: Risky Traits in Potential Dates and Mate
17
Adapted from Ron J. Hammond, Chapter 8 Dating and Mate Selection IN: Sociology of the Family. Web available for free use.
http://freebooks.uvu.edu/SOC1200/index.php/ch08-dating-mate-selection.html
Types of Intimacy
Intimacy means openness and sharing, and sometime vulnerability. There is not just one way to
be intimate, and you can be intimate with many different people.
Below we’ve listed several different types of intimacy. 18 Read each one and think about
whether you have that kind of intimacy with anyone, who that might be, and then write in that
person’s initials.
This will get you to think about all the ways you can be intimate, and how
Type of Intimacy
Emotional Intimacy: You are able to share a wide range of both positive
and negative feelings without fear of judgment or rejection.
Physical Intimacy: The delight in being sensual, playful, and sensitive in
sexual intimacy that is joyful and fulfilling for both partners.
Intellectual Intimacy: Sharing ideas or talking about issues or even hotly
debating opinions and still respect each other’s beliefs and views.
Spiritual Intimacy: Discussing how spirituality works in our lives, in such
a way that we respect each other’s particular spiritual needs and beliefs.
Conflict Intimacy: The ability to work through our differences in a fair
way, and reach solutions that are broadly and mutually satisfactory,
recognizing that perfect solutions are not part of human life.
Work Intimacy: You are able to agree on ways to share the common
loads of tasks in maintaining your home, incomes, and pursuing other
mutually agreed goals.
Parenting Intimacy: If you have children, you have developed shared
ways of being supportive to each other while enabling our children to
grow and become separate individuals.
Crisis Intimacy: You are able to stand together in times of crisis, both
external and internal to our relationship and offer support and
understanding.
Play Intimacy: Having fun together, through recreation, relaxation or
humor.
Aesthetic Intimacy: Being delighted in beauty, music art, nature and a
whole range of aesthetic experiences and each of us is prepared to
support the other’s enjoyment of different aesthetic pleasures.
Activity 7.1: Types of Intimacy
18
Augsburger, D. (1988) Sustaining Love. Regal Publishing.
Who in Your Life
Activity 7.4: “Healthy Conflict Resolution for Couples”
Healthy Conflict
Resolution for Couples
Remember: all couples have disagreements, but the way that disagreements are handled can
make relationships healthier or less healthy.
Before you argue, try writing down:
 The problem as you see it.
 Why it is important (include your feelings).
 Some possible solutions.
How Couples Can Resolve Conflict:
START
Stop and take a breath. Be clear about what it is that you are arguing
about.
START
Choose the right time. Don’t have an argument when you can’t take the
time to see it through.
DISCUSS
If you are planning to win, then both of you will lose. Prepare to
understand the other person’s views and expect that you will both have
to compromise.
DISCUSS
Clearly state what is bothering you and be honest about it.
DISCUSS
Express your feelings about the issue. Own your own feelings – don’t
blame the other person for them. (“I feel jealous when you …”)
DISCUSS
Get out of your head and listen carefully. Don’t spend the time he is
talking preparing your next argument.
RESOLVE
Don’t just say what is wrong or upsetting, suggest alternatives.
RESOLVE
If you are too angry or upset to think and talk clearly, take a break. Agree
to a time to continue – it may be 1 hour or 1 day later, but come back to
the conversation.
If you reach a compromise, follow up later to discuss how well the
solution is working.
Activity 7.4: Healthy Conflict Resolution for Couples
Activity 7.4: Ways to Resolve Conflict Cards
The cards on the next two pages are formatted for double-sided printing on business card stock
such as Avery 8371. If business card stock is not available, print double-sided on heavy paper
and cut apart for distribution during the event. Laminating the cards makes them more durable
for carrying in a wallet.
Ways to Resolve Conflict:
Ways to Resolve Conflict:
Choose a time when you both are able to focus and are free of
distractions.
State the facts, without attributing blame.
Discuss one issue at a time.
Express all of your feelings, not just anger.
Suggest an alternative behavior or solution.
Taking a cooling off period, if necessary!
End with agreement, counterproposal or postponement. If you
postpone, schedule a time to talk again.
Choose a time when you both are able to focus and are free of
distractions.
State the facts, without attributing blame.
Discuss one issue at a time.
Express all of your feelings, not just anger.
Suggest an alternative behavior or solution.
Taking a cooling off period, if necessary!
End with agreement, counterproposal or postponement. If you
postpone, schedule a time to talk again.
Healthy Sisters
Healthy Sisters
Ways to Resolve Conflict:
Ways to Resolve Conflict:
Choose a time when you both are able to focus and are free of
distractions.
State the facts, without attributing blame.
Discuss one issue at a time.
Express all of your feelings, not just anger.
Suggest an alternative behavior or solution.
Taking a cooling off period, if necessary!
End with agreement, counterproposal or postponement. If you
postpone, schedule a time to talk again.
Choose a time when you both are able to focus and are free of
distractions.
State the facts, without attributing blame.
Discuss one issue at a time.
Express all of your feelings, not just anger.
Suggest an alternative behavior or solution.
Taking a cooling off period, if necessary!
End with agreement, counterproposal or postponement. If you
postpone, schedule a time to talk again.
Healthy Sisters
Healthy Sisters
Ways to Resolve Conflict:
Ways to Resolve Conflict:
Choose a time when you both are able to focus and are free of
distractions.
State the facts, without attributing blame.
Discuss one issue at a time.
Express all of your feelings, not just anger.
Suggest an alternative behavior or solution.
Taking a cooling off period, if necessary!
End with agreement, counterproposal or postponement. If you
postpone, schedule a time to talk again.
Choose a time when you both are able to focus and are free of
distractions.
State the facts, without attributing blame.
Discuss one issue at a time.
Express all of your feelings, not just anger.
Suggest an alternative behavior or solution.
Taking a cooling off period, if necessary!
End with agreement, counterproposal or postponement. If you
postpone, schedule a time to talk again.
Healthy Sisters
Healthy Sisters
Ways to Resolve Conflict:
Ways to Resolve Conflict:
Choose a time when you both are able to focus and are free of
distractions.
State the facts, without attributing blame.
Discuss one issue at a time.
Express all of your feelings, not just anger.
Suggest an alternative behavior or solution.
Taking a cooling off period, if necessary!
End with agreement, counterproposal or postponement. If you
postpone, schedule a time to talk again.
Choose a time when you both are able to focus and are free of
distractions.
State the facts, without attributing blame.
Discuss one issue at a time.
Express all of your feelings, not just anger.
Suggest an alternative behavior or solution.
Taking a cooling off period, if necessary!
End with agreement, counterproposal or postponement. If you
postpone, schedule a time to talk again.
Healthy Sisters
Healthy Sisters
Ways to Resolve Conflict:
Ways to Resolve Conflict:
Choose a time when you both are able to focus and are free of
distractions.
State the facts, without attributing blame.
Discuss one issue at a time.
Express all of your feelings, not just anger.
Suggest an alternative behavior or solution.
Taking a cooling off period, if necessary!
End with agreement, counterproposal or postponement. If you
postpone, schedule a time to talk again.
Choose a time when you both are able to focus and are free of
distractions.
State the facts, without attributing blame.
Discuss one issue at a time.
Express all of your feelings, not just anger.
Suggest an alternative behavior or solution.
Taking a cooling off period, if necessary!
End with agreement, counterproposal or postponement. If you
postpone, schedule a time to talk again.
Healthy Sisters
Healthy Sisters
How to Bring up a Difficult Subject:
How to Bring up a Difficult Subject:
I felt ________________ (emotion) when ______________ (cite specific
example). This is important to me because _______________________
(affirm commitment to the relationship.)
I felt ________________ (emotion) when ______________ (cite specific
example). This is important to me because _______________________
(affirm commitment to the relationship.)
Then:
Then:
Invite the other person to respond.
Seek to understand the other person’s views.
Invite the other person to respond.
Seek to understand the other person’s views.
Steps for Resolving Conflict:
Steps for Resolving Conflict:
1. Take time to understand the other person’s perspective.
2. Clearly define the problem. Divide a big problem into smaller pieces.
3. Brainstorm all possible solutions.
4. Agree on a solution that you are both willing to try.
5. Follow-up afterwards to discuss how well the solution is working.
1. Take time to understand the other person’s perspective.
2. Clearly define the problem. Divide a big problem into smaller pieces.
3. Brainstorm all possible solutions.
4. Agree on a solution that you are both willing to try.
5. Follow-up afterwards to discuss how well the solution is working.
How to Bring up a Difficult Subject:
How to Bring up a Difficult Subject:
I felt ________________ (emotion) when ______________ (cite specific
example). This is important to me because _______________________
(affirm commitment to the relationship.)
I felt ________________ (emotion) when ______________ (cite specific
example). This is important to me because _______________________
(affirm commitment to the relationship.)
Then:
Then:
Invite the other person to respond.
Seek to understand the other person’s views.
Invite the other person to respond.
Seek to understand the other person’s views.
Steps for Resolving Conflict:
Steps for Resolving Conflict:
1. Take time to understand the other person’s perspective.
2. Clearly define the problem. Divide a big problem into smaller pieces.
3. Brainstorm all possible solutions.
4. Agree on a solution that you are both willing to try.
5. Follow-up afterwards to discuss how well the solution is working.
1. Take time to understand the other person’s perspective.
2. Clearly define the problem. Divide a big problem into smaller pieces.
3. Brainstorm all possible solutions.
4. Agree on a solution that you are both willing to try.
5. Follow-up afterwards to discuss how well the solution is working.
How to Bring up a Difficult Subject:
How to Bring up a Difficult Subject:
I felt ________________ (emotion) when ______________ (cite specific
example). This is important to me because _______________________
(affirm commitment to the relationship.)
I felt ________________ (emotion) when ______________ (cite specific
example). This is important to me because _______________________
(affirm commitment to the relationship.)
Then:
Then:
Invite the other person to respond.
Seek to understand the other person’s views.
Invite the other person to respond.
Seek to understand the other person’s views.
Steps for Resolving Conflict:
Steps for Resolving Conflict:
1. Take time to understand the other person’s perspective.
2. Clearly define the problem. Divide a big problem into smaller pieces.
3. Brainstorm all possible solutions.
4. Agree on a solution that you are both willing to try.
5. Follow-up afterwards to discuss how well the solution is working.
1. Take time to understand the other person’s perspective.
2. Clearly define the problem. Divide a big problem into smaller pieces.
3. Brainstorm all possible solutions.
4. Agree on a solution that you are both willing to try.
5. Follow-up afterwards to discuss how well the solution is working.
How to Bring up a Difficult Subject:
How to Bring up a Difficult Subject:
I felt ________________ (emotion) when ______________ (cite specific
example). This is important to me because _______________________
(affirm commitment to the relationship.)
I felt ________________ (emotion) when ______________ (cite specific
example). This is important to me because _______________________
(affirm commitment to the relationship.)
Then:
Then:
Invite the other person to respond.
Seek to understand the other person’s views.
Invite the other person to respond.
Seek to understand the other person’s views.
Steps for Resolving Conflict:
Steps for Resolving Conflict:
1. Take time to understand the other person’s perspective.
2. Clearly define the problem. Divide a big problem into smaller pieces.
3. Brainstorm all possible solutions.
4. Agree on a solution that you are both willing to try.
5. Follow-up afterwards to discuss how well the solution is working.
1. Take time to understand the other person’s perspective.
2. Clearly define the problem. Divide a big problem into smaller pieces.
3. Brainstorm all possible solutions.
4. Agree on a solution that you are both willing to try.
5. Follow-up afterwards to discuss how well the solution is working.
How to Bring up a Difficult Subject:
How to Bring up a Difficult Subject:
I felt ________________ (emotion) when ______________ (cite specific
example). This is important to me because _______________________
(affirm commitment to the relationship.)
I felt ________________ (emotion) when ______________ (cite specific
example). This is important to me because _______________________
(affirm commitment to the relationship.)
Then:
Then:
Invite the other person to respond.
Seek to understand the other person’s views.
Invite the other person to respond.
Seek to understand the other person’s views.
Steps for Resolving Conflict:
Steps for Resolving Conflict:
1. Take time to understand the other person’s perspective.
2. Clearly define the problem. Divide a big problem into smaller pieces.
3. Brainstorm all possible solutions.
4. Agree on a solution that you are both willing to try.
5. Follow-up afterwards to discuss how well the solution is working.
1. Take time to understand the other person’s perspective.
2. Clearly define the problem. Divide a big problem into smaller pieces.
3. Brainstorm all possible solutions.
4. Agree on a solution that you are both willing to try.
5. Follow-up afterwards to discuss how well the solution is working.
Page 188
Healthy Sisters Event Guide
Activity 7.5: “Resources for Healthy Relationships”
Resources for Healthy
Relationships
HEALTHY SEXUALITY AND RELATIONSHIP WEBSITES
The Bacchus Network: www.bacchusnetwork.org/sexual-health.html, smartersex.org
Center for Young Women’s Health: http://www.youngwomenshealth.org/healthy_relat.html
Elevate (Black Women & HIV): www.elevateconversation.org
The Kinsey Institute: kinseyconfidential.org
Love is Respect: www.loveisrespect.org/
Planned Parenthood: www.plannedparenthood.org/health-topics/relationships-4321.htm
Scarleteen: www.scarleteen.com
US Department of Health and Human Services Office of Adolescent Health:
www.hhs.gov/ash/oah/adolescent-health-topics/healthy-relationships
SELECTED BOOKS ABOUT SEXUALITY AND RELATIONSHIPS
Barbach, L.G. (1982) For Each Other: Sharing Sexual Intimacy. New York: Doubleday Books.
Copage, E.V. (2001) Soul Mates: An Illustrated Guide to Black Love, Sex, and Romance. New
York: Plume.
Elmore, R. (1997) How to Love a Black Man. New York: Grand Central Publishing.
Harper, H. (2009) The Conversation: How Men and Women Can Build Loving, Trusting
Relationships. New York: Gotham.
Hendrix, H. (2002) Getting the Love You Want: A Guide for Couples. New York: Henry Holt & Co.
Johannides, P., Gross, D. (2000) The Guide to Getting It On! (The Universe's Coolest and Most
Informative Book About Sex). New York: Goofy Foot Press.
Komisaruk, B.R., Whipple, B., Nasserzadeh, S. and Beyer-Flores, C. (2009) The Orgasm Answer
Guide. Baltimore: The Johns Hopkins University Press.
McCloud, M.T. (2010) Living Well, Despite Catching Hell: The Black Woman's Guide to Health,
Sex and Happiness. New York: New Life Publishing.
McKay, M., Davis, M., Fanning, P. (2009) Messages: The Communications Skills Book. New York:
New Harbinger Publications.
Activity 7.5: Resources for Healthy Relationships
Activity 8.3: “Phenomenal Woman” by Maya Angelou
“Phenomenal Woman”
From: Angelou, Maya (1994). The Complete Collected Poems of Maya Angelou.
New York: Random House.
Pretty women wonder where my secret lies.
I'm not cute or built to suit a fashion
model's size
But when I start to tell them,
They think I'm telling lies.
I say,
It's in the reach of my arms
The span of my hips,
The stride of my step,
The curl of my lips.
I'm a woman
Phenomenally.
Phenomenal woman,
That's me.
I walk into a room
Just as cool as you please,
And to a man,
The fellows stand or
Fall down on their knees.
Then they swarm around me,
A hive of honey bees.
I say,
It's the fire in my eyes,
And the flash of my teeth,
The swing in my waist,
And the joy in my feet.
I'm a woman
Phenomenally.
Phenomenal woman,
That's me.
Activity 8.3: “Phenomenal Woman” by Maya Angelou
Men themselves have wondered
What they see in me.
They try so much
But they can't touch
My inner mystery.
When I try to show them
They say they still can't see.
I say,
It's in the arch of my back,
The sun of my smile,
The ride of my breasts,
The grace of my style.
I'm a woman
Phenomenally.
Phenomenal woman,
That's me.
Now you understand
Just why my head's not bowed.
I don't shout or jump about
Or have to talk real loud.
When you see me passing
It ought to make you proud.
I say,
It's in the click of my heels,
The bend of my hair,
The palm of my hand,
The need of my care,
'Cause I'm a woman
Phenomenally.
Phenomenal woman,
That's me.
Healthy Sisters: Evaluation and Feedback
Forms
Print one copy per participant before each event.
Remember to collect completed forms, place in a large envelope, and seal the envelope after
each of the pre-test and the post-test.
Healthy Sisters Event Pre-test
We ask that you do not write your name anywhere on this document because the information
you provide should be anonymous. We will use the code number you create below only to
match information to see how successful the training was, but only you will know this code
number. We will never try to identify you personally.
Write the last letter of your last name: ____
Write the day of the month that you were born: ____
Write the last letter of the name of the city where you were born: ____
NOW COMBINE TO CREATE YOUR ANONYMOUS CODE: _____________
(For example: Dana Cropper, born in Los Angeles on March 23 = R 23 S)
CLASS:
RACE/ETHNICITY (please select only one):
_____African American/Black
_____Freshman
_____African
_____Sophomore
_____Asian/Pacific Islander
_____Junior
_____Caribbean/West Indian
_____Senior
_____Caucasian/European American
_____Graduate
_____Hispanic/Latin American
_____Native American/Indigenous
_____Multi-ethnic
_____Other: _______________________
AGE: _________
Please indicate whether the following statements are “true” or “false”:
1. Most people who have HIV look sick.
2. You can’t get HIV from oral sex.
3. Some untreated STIs can cause infertility.
4. A person can get HIV from one sexual contact.
5. Condoms should be used with oil-based lubricants.
6. Having another STI can increase your risk of getting HIV.
7. STIs always have symptoms.
8. All STIs are curable.
9. You can get an STI in your rectum (butt) or throat.
10. Healthy relationships require open communication.
11. After being infected with HIV, some (but not all) people get flu-like
symptoms that soon go away.
12. Sexual intercourse shows that a relationship is at the highest level of
intimacy.
13. If you have unprotected sex with a person who is HIV positive, you will
TRUE
FALSE
Please indicate whether the following statements are “true” or “false”:
TRUE
FALSE
YES
NO
YES
NO
always become infected.
14. Using birth control pills, IUDs and or contraceptive implants can also
reduce the risk of getting a STI.
15. When agreeing to have sex, it is important that your partner be as
concerned about sexual health as you are.
16. Most STIs can easily be cured by a pill with little or no long-term
consequence.
17. Cleaning your vagina (“douching”) before and after sex will
significantly reduce your risk of getting an STI.
18. When using a male condom, it’s important to make sure that there is an
air pocket in the tip.
19. STIs can be spread by sharing sex toys.
20. Two advantages to using condoms are that, when used properly, they
protect against STIs as well as pregnancy.
21. Condoms made from latex, natural skins, and polyurethane are equally
effective at protecting against STIs.
22. The letters in the O.P.R.A.H. memory device stand for Open, Put on,
Ready, Act, Hold.
23. The steps for using the female condom are Open, Pinch, Arrange, Lead,
Twist.
24. Three benefits for women using the female condom are that the woman
has more control, that it can be used with any type of lubricant, and that
it can be inserted up to 8 hours before intercourse.
25. People who are in a sexual relationship spend the majority of their time
together and share everything.
26. Men and women engage in sexual intercourse for the same reasons.
27. The best time to resolve a disagreement is “in the heat of the moment.”
28. An intimate relationship is always sexual.
29. If I get in trouble because of some kind of sexual activity, I know of a local
resource where I can get help.
30. I intend to get tested for HIV and other STIs in the near future.
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Healthy Sisters Event Guide
Please select the response that is true for you TODAY:
(SKIP if you have never had vaginal or anal sex)
1. I use a protective barrier (e.g., condom) when I have
vaginal or anal sex.
2. Before having sexual intercourse, I talk with my
potential partner about consequences that could
occur and how to avoid those I don’t desire.
3. When going out with or inviting a potential sexual
partner to hang out at home, I keep a condom handy
in case we decide to have sex.
Always
Mostly
Sometimes
Never
Healthy Sisters Event Post-test and Feedback Form
We ask that you do not write your name anywhere on this document because the information
you provide should be anonymous. We will use the code number you create below only to
match information to see how successful the training was, but only you will know this code
number. We will never try to identify you personally.
Write the last letter of your last name: ____
Write the day of the month that you were born: ____
Write the last letter of the name of the city where you were born: ____
NOW COMBINE TO CREATE YOUR ANONYMOUS CODE: _____________
(For example: Dana Cropper, born in Los Angeles on March 23 = R 23 S)
CLASS:
RACE/ETHNICITY (please select only one):
_____African American/Black
_____Freshman
_____African
_____Sophomore
_____Asian/Pacific Islander
_____Junior
_____Caribbean/West Indian
_____Senior
_____Caucasian/European American
_____Graduate
_____Hispanic/Latin American
_____Native American/Indigenous
_____Multi-ethnic
_____Other: _______________________
AGE: _________
Please indicate whether the following statements are “true” or “false”:
1. Most people who have HIV look sick.
2. You can’t get HIV from oral sex.
3. Some untreated STIs can cause infertility.
4. A person can get HIV from one sexual contact.
5. Condoms should be used with oil-based lubricants.
6. Having another STI can increase your risk of getting HIV.
7. STIs always have symptoms.
8. All STIs are curable.
9. You can get an STI in your rectum (butt) or throat.
10. Healthy relationships require open communication.
11. After being infected with HIV, some (but not all) people get flu-like
symptoms that soon go away.
12. Sexual intercourse shows that a relationship is at the highest level of
intimacy.
13. If you have unprotected sex with a person who is HIV positive, you will
TRUE
FALSE
Please indicate whether the following statements are “true” or “false”:
TRUE
always become infected.
14. Using birth control pills, IUDs and or contraceptive implants can also
reduce the risk of getting a STI.
15. When agreeing to have sex, it is important that your partner be as
concerned about sexual health as you are.
16. Most STIs can easily be cured by a pill with little or no long-term
consequence.
17. Cleaning your vagina (“douching”) before and after sex will
significantly reduce your risk of getting an STI.
18. When using a male condom, it’s important to make sure that there is an
air pocket in the tip.
19. STIs can be spread by sharing sex toys.
20. Two advantages to using condoms are that, when used properly, they
protect against STIs as well as pregnancy.
21. Condoms made from latex, natural skins, and polyurethane are equally
effective at protecting against STIs.
22. The letters in the O.P.R.A.H. memory device stand for Open, Put on,
Ready, Act, Hold.
23. The steps for using the female condom are Open, Pinch, Arrange, Lead,
Twist.
24. Three benefits for women using the female condom are that the
woman has more control, that it can be used with any type of lubricant,
and that it can be inserted up to 8 hours before intercourse.
25. People who are in a sexual relationship spend the majority of their time
together and share everything.
26. Men and women engage in sexual intercourse for the same reasons.
27. The best time to resolve a disagreement is “in the heat of the moment.”
28. An intimate relationship is always sexual.
29. If I get in trouble because of some kind of sexual activity, I know of a
local resource where I can get help.
30. I intend to get tested for HIV and other STIs in the near future.
Page 200
FALSE
YES
NO
YES
NO
Healthy Sisters Event Guide
Please select the response that is true for you TODAY as a
result of participating in this event:
Strongly
Agree
Agree
Disagree
Strongly
Disagree
Strongly
Agree
Agree
Disagree
Strongly
Disagree
Agree
Disagree
Strongly
Disagree
1. I now have the tools and approaches that I need to
negotiate how I behave in my intimate relationships.
2. I am better able to communicate with my partner about
protecting ourselves from contracting HIV and other
STIs.
3. I plan on discussing healthy/safer practices with my
sexual partner(s).
4. I better understand the importance of practicing
healthy/safer love.
5. I better understand how to prevent the spread of HIV
and other sexually transmitted infections (STIs).
6. I better understand my risk of getting HIV and other
STIs.
7. I now intend to use condoms or dental dams every
time that I have sex.
8. I am better prepared to say “no” to a sexual partner if
they refuse to use condoms or dental dams.
(SKIP 9-12 if you have never had vaginal or anal sex)
9. When I am going to have sex, I feel more comfortable
about asking to use a condom.
10. I feel more comfortable providing a condom if my
partner does not provide one.
11. I feel more comfortable suggesting or recommending
specific sexual activities to a sexual partner.
12. I feel more comfortable declining or refusing to
engage in sex when I don’t want to have it.
We welcome feedback on the event and suggestions for
improvement:
1. I felt welcomed and encouraged to participate in the
event.
2. The information was presented clearly and in easily
understood terms.
3. The facilitator(s) answered my questions about
HIV/AIDS, STIs, and sexual health.
4. There was enough time to cover the information in
the amount of detail that I wanted/needed.
5. The topics that were covered were relevant to my
Strongly
Agree
We welcome feedback on the event and suggestions for
improvement:
Strongly
Agree
Agree
Disagree
Strongly
Disagree
understanding of the purpose of the event.
6. I enjoyed the activities.
7. I would change:
8. I would do more of (or less of):
Page 202
Healthy Sisters Event Guide
Healthy Sisters Event Facilitator Report and Feedback Form
Facilitator name: _______________________________________________________________
Phone: _____________________________ Email: _____________________________________
Date of Training: ______________________ Number of participants: ______________________
Location: ______________________________________________________________________
1. Did the training space accommodate the group?  Yes  No
If not, please give us some comments about why not:
2. Did you have enough resources for the presentation?  Yes  No
If not, please give us some comments about why not:
3. Did the training:
Begin on time (within 5 minutes)?  Yes  No
End on time (within 10 minutes)?  Yes  No
If not, please describe the circumstances:
4. How well were you able to stay on schedule in terms of time and the order of activities?
 Very Well
 Generally OK
 Had some difficulty
 Had a lot of difficulty
If you found it difficult, please describe the circumstances:
If some activities took longer than scheduled, please specify which activities and why:
5. During event closing/wrap-up, to what degree did most of the participants indicate their
hopes for the event were fulfilled?
 Mostly fulfilled  Generally fulfilled  Somewhat unfulfilled  Mostly unfulfilled
Please provide some comments about why you think they felt this way:
6. How satisfied overall were you (as a leader) with how the event went?
 Very Satisfied
 Satisfied
 Not Satisfied
 Very Unsatisfied
Please provide some comments about why you felt this way:
7. Do you have any additional comments about the event (add pages or continue on back
as needed)?
Page 204
Healthy Sisters Event Guide
Healthy Sisters Answer Key for Questions 1 – 28
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
Most people who have HIV look sick. ----------------------------------------------------------------------- FALSE
You can’t get HIV from oral sex. ------------------------------------------------------------------------------ FALSE
Some untreated STIs can cause infertility. ------------------------------------------------------------------ TRUE
A person can get HIV from one sexual contact. ----------------------------------------------------------- TRUE
Condoms should be used with oil-based lubricants. ---------------------------------------------------- FALSE
Having another STI can increase your risk of getting HIV. ---------------------------------------------- TRUE
STIs always have symptoms. ---------------------------------------------------------------------------------- FALSE
All STIs are curable. ---------------------------------------------------------------------------------------------- FALSE
You can get an STI in your rectum (butt) or throat. ------------------------------------------------------ TRUE
Healthy relationships require open communication. ---------------------------------------------------- TRUE
After being infected with HIV, some (but not all) people get flu-like symptoms that soon go away.
------------------------------------------------------------------------------------------------------------------------- TRUE
Sexual intercourse shows that a relationship is at the highest level of intimacy. ---------------- FALSE
If you have unprotected sex with a person who is HIV positive, you will always become infected.
------------------------------------------------------------------------------------------------------------------------ FALSE
Using birth control pills, IUDs and or contraceptive implants can also reduce the risk of getting a STI.
------------------------------------------------------------------------------------------------------------------------ FALSE
When agreeing to have sex, it is important that your partner be as concerned about sexual health as
you are. -------------------------------------------------------------------------------------------------------------- TRUE
Most STIs can easily be cured by a pill with little or no long-term consequence.----------------- TRUE
Cleaning your vagina (“douching”) before and after sex will significantly reduce your risk of getting
an STI. --------------------------------------------------------------------------------------------------------------- FALSE
When using a male condom, it’s important to make sure that there is an air pocket in the tip.TRUE
STIs can be spread by sharing sex toys.---------------------------------------------------------------------- TRUE
Two advantages to using condoms are that, when used properly, they protect against STIs as well as
pregnancy. ---------------------------------------------------------------------------------------------------------- TRUE
Condoms made from latex, natural skins, and polyurethane are equally effective at protecting
against STIs. ------------------------------------------------------------------------------------------------------- FALSE
The letters in the O.P.R.A.H. memory device stand for Open, Put on, Ready, Act, Hold. ------ FALSE
The steps for using the female condom are Open, Pinch, Arrange, Lead, Twist.------------------ TRUE
Three benefits for women using the female condom are that the woman has more control, that it
can be used with any type of lubricant, and that it can be inserted up to 8 hours before intercourse.
------------------------------------------------------------------------------------------------------------------------- TRUE
People who are in a sexual relationship spend the majority of their time together and share
everything. --------------------------------------------------------------------------------------------------------- FALSE
Men and women engage in sexual intercourse for the same reasons. ----------------------------- FALSE
The best time to resolve a disagreement is “in the heat of the moment.” ------------------------ FALSE
An intimate relationship is always sexual. ----------------------------------------------------------------- FALSE