Human Sexuality HIV Counselling Module Outline

Module Outline
Module Name:
Human Sexuality and HIV Counselling
Credit Value:
15 credits
Module Description
This module is designed to integrate human sexuality with HIV. Attention is paid to contemporary and
compelling South African literature. The three prescribed text books compliment this exciting course on
Sexuality and HIV. Wasserman’s book on sexuality unfolds dimensions of sexuality that are pertinent to
both adolescents and adults, and the book is written as though it were a practical guide for beginner
counsellors. Morrel, et al., take the reader through a research journey into South African Schools, and
from the classroom unpack gender and sexuality as it impacts on HIV. The classroom is the laboratory,
and the authors reach formidable conclusions as to how gender and gender roles influence attitudes,
perceptions, and behaviours. Finally Alta van Dyk’s seminal work on HIV, in all its facets, draws all the
threads of this course together. It is essential reading.
Module Content and Structure
This module is about how gender and sexuality are such an intrinsic part of who we are personally and in
our professional lives. Students learn about the diversity and complexity of gender-related concepts and
the importance of gender and sexuality in the context of HIV/AIDS. The impact of gender and sexuality
within the counselling interaction is explored throughout this module to enable students to understand
and appreciate the role of these issues within the context of a trainee counsellor. HIV and sexuality are
inextricably linked, as the route of HIV infection is primarily transmitted through sexual behaviours.
This module provides participants with a good grounding of the issues relating to HIV/AIDS, focusing on
the role of the counsellor in the South African setting, and the need for counsellors trained specifically in
dealing with HIV and sexuality. The module will equip students with the skills to keep up-to-date with the
most recent developments in the ever-changing HIV field and give them the confidence to deal with a
wide range of issues related to HIV and AIDS, with an emphasis on counselling, and crisis intervention.
Sexuality [its fundamental meaning], sexual identity development and sexual behaviours specifically with
regard to adolescent sexuality are woven into the sessions.
Key learning outcomes
On completion of this module students should be able to:
 Define and apply sexuality and sexual orientation to your practice skills.
 Apply the concepts and terminology of gender and sexuality in the context of HIV/AIDS, and be
sensitised to the language of sexuality.
 Analyse the impact of homophobia and hetero-sexism on persons with a gay, bi-sexual, lesbian, and
transgendered identity. Also be familiar with the concept and psycho-socio-dynamics of MSM and
WSW (men who have sex with men, and women who have sex with women. In this context,
students will recognise the differences in respect of sexual identity and sexual behaviours.
 Discuss the relationship between HIV/AIDS and sexuality and develop a repertoire of skills in
conducting pre and post screening counselling with persons requesting such tests.
 Explain adult sexuality in relationship to gender roles, sexual expression, fantasy, intimacy and
power.
 Know the basics HIV & AIDS, including TB, which is closely related to HIV in the South African
context.
 Understand how cultural, legal (stigma, role, tradition) and gender issues impact HIV/AIDS
counselling, and continue to fuel the pandemic.
 Engage with clients to complete a full psycho-sexual history.
 Be familiar with the range of sexual dysfunctions, including sexually transmitted infections.
 Counselling clients who wish to be screened for HIV and STI’s as well as the HIV+ client(s), and apply
crisis intervention to HIV concerns.
 Be familiar with” vulnerable/marginalised groups”, such as sex work, and the impact of
marginalisation/discrimination for HIV and health.
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 2
Module Structure
Session
Topic
Reading
Session 1
Introduction to Sexuality and
Definition of Terms
Popovic, M. (2006). Psychosexual diversity as the best representation of
human normality across cultures. Sexual and Relationship Therapy,
21(2), 171-186.
Session 2
Gender, Social Roles and Identity
McKenzie, S. (2010). Genders and sexualities in individuation: theoretical
and clinical explorations. Journal of Analytical Psychology, 55, 91110.
Morrell, R., Epstein, D., Unterhalter, E., Bhana, D., & Moletsane, R. (2009).
Towards Gender Equality: South African schools during the HIV
and AIDS epidemic. Pietermarizberg, South Africa: University of
KwaZulu-Natal Press.
Session 3
Sexual Orientation and Gender
Identity Development – from
Heterosexuality to Transgender
Lert, F., Sitta, R., Bouhnik, A-D., Dray-Spira, R., & Spire, B. (2010). HIVpositive men who have sex with men: biography, diversity in
lifestyles, common experience with living with HIV. AIDS Care,
22(1), 71-80.
Session 4
Psycho-sexual Assessment and
Counselling Strategies in Sexuality
Isaacs, G. & Miller, D. (1985). AIDS – its implications for South African
homosexuals and the mediating role of the medical practitioner.
SAMJ, 66, 327-330.
Session 5
Sexual Dysfunction and Sexually
Transmitted Infections Concerns
Dune, T.M. & Shuttleworth, R.P. (2009). It’s just supposed to happen: The
myth of sexual spontaneity and the sexually marginalized. Sex
Disability, 27, 97-108.
Session 6
Key Populations in Respect of
Sexuality – Sex work, , Men who have
sex with men, People who use drugs,
gender based violence and HIV in
South Africa
Desmond Tutu HIV Foundation. (2011). Key Populations, Key Responses. A
Gap Analysis for Key Populations and HIV in South Africa.
Pretoria: South African National AIDS Council.
Session 7
An Introduction to HIV and AIDS in
South Africa
Department of Health. (2011). Getting to Success: Improving HIV Prevention
Efforts in South Africa. South Africa HIV Epidemic, Response and
Policy Synthesis [Draft report No. 1]. South Africa: Department of
Health.
Van Dyk, A. (2008). HIV/AIDS Care & Counselling: A Multidisciplinary
Approach (4th ed., pp.3-91). South Africa: Pearson Education SA
Session 8
HIV Treatments
Van Dyk, A. (2008). HIV/AIDS Care & Counselling: A Multidisciplinary
Approach (4th ed., pp. 92-114). South Africa: Pearson Education SA.
Session 9
HIV Prevention and Education
Van Dyk, A. (2008). HIV/AIDS Care & Counselling: A Multidisciplinary
Approach (4th ed., pp.164 – 211). South Africa: Pearson Education
SA.
Session 10
Gender, Sexuality, and Cultural
Issues: Stigma and discrimination –
Implications for counselling
Hanass-Hancock, J. (2009). Interwieving Conceptionalisations of Gender and
Disability in the Context of Vulnerabiity to HIV/AIDS in
KwaZuluNatal, South Africa. Sex Disability, 27, 35-47.
Doi:10.1007/s11195-008-9105-9
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 3
Session
Topic
Reading
Session 11
Pre- and Post-test Screening:
Counselling considerations for
adherence/compliance
Van Dyk, A. (2008). HIV/AIDS Care & Counselling: A Multidisciplinary
Approach (4th ed., pp.251 – 264). South Africa: Pearson Education
SA.
Session 12
Crisis Intervention and HIV: A model
for intervention
Isaacs, G. (1993). Human sexuality and living with HIV infection. AIDS
Bulletin, 2(2), 15-16.
Van Dyk, A. (2008) HIV/AIDS Care & Counselling: A Multidisciplinary Approach
(4th ed., pp.265 – 297). South Africa: Pearson Education SA.
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 4
Assessment Requirements
Assessment
OUTLINE & REQUIREMENTS
%
45%
Case Study with hypothetical
assessment/counselling plan
Based on the Case Study provided and using
your theoretical insights, discuss how you
would go ahead and draw up a hypothetical
assessment/counselling plan to assist the
client in this case.
Due Date: Session 6
Word Count: 2000 words.
Assessment 2:
Answer one of the four essay questions
provided.
Assessment 1:
45%
Essay
Word Count: 2000 words.
Due Date: Session 11
Class Participation
Students are assessed throughout the
duration of the course on their:
10%
 preparation for class,
 participation in activities and
discussions,
 application of learning and;
 Attendance (prior notification of
absence is required).
Students are assessed according to all four
criteria and graded accordingly.
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 5
Assessment 1:
Case Study
Session due:
Session 6
Length:
2000 words (4/5 pages)
Marks:
45% of overall grade
Case Study:
Johan, aged 23 years, has been referred to you by a medical practitioner after he received an HIV positive
diagnosis.
In your first interview with him he reveals the following to you:
He comes from a religious background, and both of his parents are conservative and extremely religious.
His older brother is a Minister in the Dutch Reformed Church, and his younger brother is in Grade 12.
Johan is completing a Master’s Degree in Chemical Engineering. He is in the first rugby team and enjoys
sport. He also shares that he has also been dating a woman from University, and she is training to be a
nurse.
During this session, he discloses to you that he “thinks he is gay”, and you are the first person (outside his
family and friendship circle) that he has told. He “lied” to the doctor by saying that he was “drunk one
night and he and his friends picked up two female sex workers”. The doctor was not impressed and told
him his behaviour was irresponsible.
On further probing, Johan shared the following:
 As a child he had been sexually molested by an uncle, and has kept this as a secret.
 He had had same gendered sexual experiences as an adolescent, but brushed them off as an
adolescent phase; but still felt guilt around those experiences.
 As an undergraduate he tried to date women, but was not successful.
 He began to ‘surf the net’, and was fascinated with gay chat sites.
 He soon found gay venues, and travelled from Stellenbosch to Cape Town to seek out gay men.
 He feared being found out by both family and friends, especially his rugby mates, and his
current girlfriend [he has had one sexual encounter with her, but it was not satisfying for him, so
he avoids sexual intimacy with her].
 He had several clandestine sexual encounters with men but did not know how to approach his
family and peers for fear of their disapproval and possible rejection.
 More recently he met up with a 26 year old Doctor, and they started a relationship. He felt
somewhat comfortable BUT still needed this relationship to be kept secret. His friend was
becoming impatient, and threatened to leave. They had a huge row, some time ago, as his friend
(Piet) was insistent that they move in together, and when Piet said it was over, he became
depressed, anxious, and scared. One night, he got drunk, and went to a gay club, where he met
a very attractive man. They went home together, and for the first time he participated in using
crystal meth (Tik). He described it as an “awesome feeling”, with a highly charged sexual
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 6
sensation. He saw this man (Richard) again on three more occasions, where they used again,
and had sex. He also experienced penetrative sex for the first time, and enjoyed it, but he felt
confused as he was not an “effeminate man”.
 He has not seen this man again as Piet had come back into his life, and he feels he would like to
have an on-going relationship with him, but these recent circumstances have created serious
feelings of anxiety and guilt. . He did not share anything about these encounters with Piet, and
was burdened with the secret.
 Prior to going to the doctor, he felt ill, developed swollen glands, and had persistent diarrhoea,
and was losing weight. The rugby coach was concerned and recommended he sees a doctor.
 He gave consent for an HIV test, and the result was positive.
 He now has to work with this knowledge of his status, and his sexuality, his relationship with
Piet and his family/friends, etc.
Instructions:
Using your theoretical insights, discuss how you would go ahead and draw up a hypothetical
assessment/counselling plan to assist Johan (You are at liberty to plan this according to as many
sessions you believe you might need with him).
Your answer can include the following:
 A brief back ground history of salient developmental areas you think would be useful to explore.
 An overview of the stages of psycho-sexual development.
 Internalised homophobia/prejudice.
 Fantasy.
 Sexual identity and gender roles.
 Stigma and discrimination.
 The crisis of HIV.
 Counselling goals/intervention strategies.
 The coming-out process.
NB: At least 6 relevant references to current literature are to be included in your assignment in APA
reference style format.
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 7
Assessment 2:
Essay
Session due:
Session 11
Final paper length:
2000 words
Marks:
45%
Instructions:
Answer ONE of the following four essay questions
1. Write an essay on: “culture, gender identity and sexuality”, and how you, as a counsellor will
attempt to understand culture, gender identity, and sexuality with respect to Ayanda, the case
study described below.
Ayanda is a 26 year old black man who has been referred to you by a health clinic after he was tested HIV
positive. He lives in a township outside of Cape Town and is studying engineering at the Technikon. He
and his wife, Nomfundo, have a three year old daughter. Nomfundo is also recently fallen pregnant with
their second child. She works in a restaurant at night. They still live with their extended family who
comprise of Ayanda’s mother, who is a domestic worker, his two elder brothers, and his grandmother,
with whom he has a very close relationship, and who still practises as a traditional healer.
During your first interview, Ayanda discloses, that in order to supplement the family income, he has been
having sex with other men (male sex-workers). This has been a regular occurrence for the past four years.
Essay tips: Your answer could include:
 Psycho-sexual history
 Social considerations, including cultural perspectives
 biological sex, sexual orientation, and/or behaviour, gender identity
 Stigma
 Men who have sex with men (MSM) and vulnerabilities towards HIV
Once you have reached a collaborative assessment with Ayanda, how would you attempt to deal with his
HIV status and his sexual health, and what additional concerns might be difficult for him to negotiate in
this regard? List some of the intervention options you would like to explore with Ayanda.
OR
2. Using your theoretical knowledge, discuss the importance of working with human sexuality in the
context of HIV.
OR
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 8
3. Write an essay on Crisis Intervention and HIV; you may use extracts of a case study to assist you,
or an actual client if you have the means to interview a person who has been previously diagnosed
with HIV (in this instance you will be required to get formal consent, and use the ethical guidelines
provided by SACAP for a confidential interview).
OR
4. Using your theoretical knowledge, discuss the current themes and advances in HIV/AIDS
counselling in the Southern African Context.
NB: You are required to include at least 6 relevant references to current literature in your essay to be
provided in APA reference style format.
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 9
General requirements for essay writing
 Make absolutely you are certain of what is required of and that you have a good understanding of the
topic being addressed
 Have a clear, logical and well-argued presentation of ideas
 Write in a simple, clear and concise manner
 Punctuate appropriately and check spelling
 Engage academically and analytically with the themes and concepts of the essay in a coherent and
original manner
 Use theory and terminology appropriately
 Follow academic writing guidelines/structures – ensure you have an introduction, main body of
information and a conclusion
 Avoid plagiarism by referencing accurately, diligently and consistently. If it is someone else’s work it
should be acknowledged
 Include a Reference List
 If you have no other option but to hand write your assessment (although typed assessments are
preferable) you should ensure your work is neat and legible
 Stay within the recommended word allocation. Essays that are too short will not be able to adequately
meet the brief and essays that are too long are likely to include irrelevant information.
 Meet deadlines - Extensions are granted only in exceptional circumstances. Deadlines not met are
subject to penalties
 Discuss any queries with the relevant educator
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 10
Module Readings
Prescribed Textbooks:
Van Dyk, A. (2008). HIVAIDS Care & Counselling (4th ed.). South Africa: Pearson Education.
Wasserman, M. (2008). Dr. Eve’s Book - A guide for young people: rights; responsibilities; rewards. Cape
Town, South Africa: Human & Rousseau.
Morrell, R., Epstein, D., Unterhalter, E., Bhana, D., & Moletsane, R. (2009). Towards Gender Equality:
South African schools during the HIV and AIDS epidemic. Pietermarizberg, South Africa:
University of KwaZulu-Natal Press.
Prescribed and Recommended Readings:
Session 1:
Introduction to Sexuality and Definition of Terms
Prescribed Reading
Wasserman, M. (2008). Dr. Eve’s Book - A guide for young people: rights; responsibilities; rewards.
(pp.103 -205). Cape Town, South Africa: Human & Rousseau.
Popovic, M. (2006). Psychosexual diversity as the best representation of human normality across
cultures. Sexual and Relationship Therapy, 21(2), 171-186.
Session 2:
Gender, Social Roles and Identity
Prescribed Reading
Morrell, R., Epstein, D., Unterhalter, E., Bhana, D., & Moletsane, R. (2009). Towards Gender Equality:
South African schools during the HIV and AIDS epidemic. Pietermarizberg, South Africa:
University of KwaZulu-Natal Press.
McKenzie, S. (2010). Genders and sexualities in individuation: theoretical and clinical explorations.
Journal of Analytical Psychology, 55, 91-110.
Recommended Reading
Connell, R. (2012). Transsexual Women and Feminist Thought: Toward New Understanding & New
Politics. Sex: A Thematic issue, 37(4), 857 – 881.
Session 3:
Transgender
Sexual Orientation and Gender Identity Development – from Heterosexuality to
Prescribed Reading
Lert, F., Sitta, R., Bouhnik, A-D., Dray-Spira, R. & Spire, B. (2010). HIV-positive men who have sex with
men: biography, diversity in lifestyles, common experience with living with HIV. AIDS Care,
22(1), 71-80.
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 11
Session 4:
Psycho-sexual Assessment and Counselling Strategies in Sexuality
Prescribed Reading
Isaacs, G. & Miller, D. (1985). AIDS – its implications for South African homosexuals and the mediating
role of the medical practitioner. SAMJ, 66, 327-330.
Session 5:
Sexual Dysfunction and Sexually Transmitted Infections Concerns
Prescribed Reading
Dune, T.M. & Shuttleworth, R.P. (2009). “It’s just supposed to happen”: The myth of sexual spontaneity
and the sexually marginalized. Sex Disability, 27, 97-108.
Session 6:
Key Populations in Respect of Sexuality – Sex work, Men who have sex with men,
People who use drugs, gender based violence and HIV in South Africa
Prescribed Reading
Desmond Tutu HIV Foundation. (2011). Key Populations, Key Responses. A Gap Analysis for Key
Populations and HIV in South Africa. [Report]. Pretoria: South African National AIDS Council.
Session 7:
An Introduction to HIV and AIDS in South Africa
Prescribed Reading
Department of Health. (2011). Getting to Success: Improving HIV Prevention Efforts in South Africa.
South Africa HIV Epidemic, Response and Policy Synthesis: Draft report (No. 1). South Africa:
Department of Health.
Van Dyk, A. (2008). HIV/AIDS Care & Counselling: A Multidisciplinary Approach (2nd ed., pp. 3-91). South
Africa: Pearson Education SA.
Session 8:
HIV Treatments
Prescribed Reading
Van Dyk, A. (2008). HIV/AIDS Care & Counselling: A Multidisciplinary Approach (2nd ed., pp. 92–14).
South Africa: Pearson Education SA.
Session 9:
HIV Prevention and Education
Prescribed Reading
Van Dyk, A. (2008). HIV/AIDS Care & Counselling: A Multidisciplinary Approach (2nd ed., pp. 164–211).
South Africa: Pearson Education SA.
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 12
Recommended Reading
Bangkok Tenofovir Study: PreP for HIV prevention among people who inject drugs. (2013). Centre for
Disease Control: National Centre for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.
Retrieved from http://www.cdc.gov/nchhstp/newsroom/docs/PrEP-IDU-factsheet-508.pdf
Session 10:
Gender, Sexuality, and Cultural Issues: Stigma and discrimination – Implications for
Counselling
Prescribed Reading
Hanass-Hancock, J. (2009). Interweaving Conceptualizations of Gender and Disability in the Context of
Vulnerability to HIV/AIDS in KwaZulu-Natal, South Africa. Sex Disability, 27, 35-47.
doi:10.1007/s11195-008-9105-9
Session 11:
Pre- and Post-test Screening: Counselling considerations for adherence/compliance
Prescribed Reading
Van Dyk, A. (2008). HIV/AIDS Care & Counselling (4th ed., pp. 251-264). South Africa: Pearson Education.
Session 12:
Crisis Intervention and HIV: A model for intervention
Prescribed Reading
Isaacs, G. (1993). Human sexuality and living with HIV infection. AIDS Bulletin, 2(2), 15-16.
Van Dyk, A. (2008). HIV/AIDS Care & Counselling: A Multidisciplinary Approach (4th ed., pp. 265-297).
South Africa: Pearson Education.
Recommended Books:
Aggleton, P., et al. (1991). AIDS Responses, Interventions and Care. London: The Falmer Press.
Cameron, E. (2005). Witness to AIDS. Cape Town: Tafelberg Publishers.
Chaitow, L. (n.d.). HIV & AIDS the Natural Way. Element Books.
Epprecht, M. (2008). Heterosexual Africa? The History of an Idea from the Age of Exploration to the Age
of AIDS. South Africa: The University of Kwazulu-Natal Press.
From Top to Bottom. (2010). A sex –positive approach for men who have sex with men: A manual for
healthcare providers. Anova Health Institute.
Gevisser, M., & Cameron, E. (Eds.). (1994). Defiant Desire: gay and lesbian lives in South Africa.
Johannesburg: Raven Press.
Gonsioreck, J.C. (Ed.). (1982). Homosexuality and Psychotherapy. New York: The Haworth Press.
Greathead, E., Devenish, C., & Funnell, G. (Eds.). (1998). Responsible Teenage Sexuality: A manual for
teachers, youth leaders and health professionals (2nd ed.). Pretoria, South Africa: van Schaik
Publishers.
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 13
Isaacs, G., & McKendrick, B. (1992). Male Homosexuality in South Africa: Identity Formation, Culture and
Crisis. Cape Town. Oxford University Press
Kaiser, J.D. Healing HIV: How to Rebuild your Immune System. California: Health First Press.
Kinsey, A.C., et al. (1948). Sexual Behaviour in the Human Female. New York: Pocket Books.
Kinsey, A.C., et al. (1948). Sexual Behaviour in the Human Male. Philadelphia: W.B. Saunders.
Kinsey, Alfred C. et al. (1948/1998). Sexual Behaviour in the Human Male. Philadelphia: W.B.Saunders;
Bloomington, IN: Indiana U. Press.
Orr, N., & Patient, D. (n.d.). The Healer Inside You. South Africa: Juta.
Walker, L., Reid, G., & Cornell, M. (n.d.). Waiting to Happen: HIV/AIDS in South Africa. South Africa: Juta.
Walker, L., Reid, G., & Cornell, M. Waiting to Happen: HIV/AIDS in South Africa. South Africa: Juta.
Worden, J.W. (1982). Grief Counselling and Grief Therapy. Routledge Publishing
Worden. J.W., (1982). Grief Counselling and Grief Therapy. Routledge Publishing
Recommended Journal Articles:
Balbin E.G., Ironson, G.H., & Solomon, G.F. (1999). Stress and Coping: The Psychoneuroimmunology of
HIV/AIDS. MD Bailliere's Clinical Endocrinology and Metabolism, 13(4).
Connell, R. (2012). Transsexual Women and Feminist Thought: Toward New Understanding & New
Politics. Sex: A Thematic issue, 37(4), 857 – 881.
Crisis Intervention Techniques, Retrieved from:
http://www.thecounselingteam.com/interactive/articles/Crisis%20Intervention%20Techniques.
pdf
Hanass-Hancock, J. (2009). Interweaving Conceptualizations of Gender and Disability in the Context of
Vulnerability to HIV/AIDS in KwaZulu-Natal, South Africa. Sex Disability, 27, 35-47.
doi:10.1007/s11195-008-9105-9
Leiphart, M. (1997). Psychoneuroimmunology: A Basis for HIV Treatment Jeffrey. Focus, 12(3).
Peltzer, K. & Pengpid, S. (2006). Sexuality of 16- to 17-year-old South Africans in Context of HIV/AIDS.
Social Behaviour and Personality, 34(3), 239-255.
Rohleder, P. (2010). They don’t know how to defend themselves: Talk about disability and HIV risk in
South Africa. Disability and Rehabilitation, 32(10), 855-863.
South African College of Applied Psychology
Human Sexuality and HIV Counselling
Module Outline
Page 14

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