Knowledge, skills and attitudes are all important for establishing a supportive relationship and providing effective treatment to a person living with HIV/AIDS.

Knowledge means an understanding of information and ideas. It is important for HIV/AIDS-related treatment because it allows caregivers to understand what is going on, to reassure the person seeking help, and to suggest the most appropriate plans. It is important that knowledge is kept up to date, so that it can be the basis for providing the best possible treatment.

Having skills means knowing how to do something. The skills may relate to technical work (such as how to prescribe medicines) or 'people' work (such as how to support a person living with HIV/AIDS in communicating their treatment needs). Some of the most essential skills for providing effective treatment include:

• listening
• planning
• taking action.

Attitudes refer to how individuals view issues and other people. Appropriate attitudes are vital for people involved in HIV/AIDS-related treatment work. For example, if a person is open and genuine, rather than condemning or pitying people living with HIV/AIDS, it will encourage people to come forward for help, take care of themselves and avoid feeling overwhelmed. It is also important for people involved in treatment work to be respectful and accepting of socially marginalized people such as sex workers, prisoners, men who have sex with men, and injecting drug users.

Some examples of the knowledge, skills and attitudes needed for effective HIV/AIDS-related treatment work are set out below.

Participatory group activity

Aim

To identify the knowledge, skills and attitudes needed by an 'ideal' treatment provider.

Instructions

1. Explain the aim of the activity.

2. Present participants with the definitions of knowledge, skills and attitudes (see above). Provide them with an example of what each one means in practice in relation to HIV/AIDS-related treatment work.

3. On a large piece of flipchart paper, draw three interlinking circles and label them 'knowledge', 'skills' and 'attitudes'. Draw an ideal treatment provider in the centre where the circles overlap.

4. Ask participants to write the knowledge, skills and attitudes of an ideal treatment provider on small pieces of paper and to stick them in the appropriate circle on the flipchart.

5. Review what everybody has placed in the three circles. Encourage the participants to ask each other questions and to make comments.

6. Facilitate a discussion about what has been learned from the activity, based upon questions such as:

• Did participants determine the relative importance of knowledge, skills and attitudes?
• Which knowledge, skills and attitudes are preferable and which are necessary?
• How does the ideal treatment provider compare with reality?
• What practical steps can NGOs/CBOs take to close the gap?

Facilitators' notes

• Remind participants that no one is perfect and that the ideal treatment provider is simply something to aim for! Help them to focus on practical ways to make their own work as near to ideal as possible, while taking into account their context and resources.

• Encourage participants to see that a balance of knowledge, skills and attitudes is necessary for treatment work to be effective. For example, a doctor might have immense knowledge, but, without good communication skills and a positive attitude, her/his work will not be successful.

Example

At a skills-building workshop, NGO/CBO participants brainstormed about what knowledge, skills and attitudes are required to carry out effective HIV/AIDS-related treatment. They then presented them in the form of a diagram with an ideal treatment provider at the centre.

Afterwards, the facilitator led a group discussion about what had been learned from the activity. For example, participants agreed that the negative attitudes of doctors often arise because they lack skills and resources, and that they need moral and practical support from others to improve their provision of treatment.

Reference: Adapted from a workshop on access to HIV-related treatment, India HIV/AIDS Alliance and the International HIV/AIDS Alliance, India, February 2001.