Final Program and Oral Abstracts [International Conference on AIDS (8th: 1992: Amsterdam, Netherlands)]

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TUESDAY, 21 JULY 1992

TuD 0516 A PROGRAM OF ASSISTANCE IN ETHICS
AND LEGAL AFFAIRS - APPEAL OF PROTECTION IN VENEZUELA, *Carrasco
Edgar, Lawyer, OPL-SIDA/MSAS (Office for Prevention and Control of
AIDS, Venezuelan Ministry of Health
Issue/Problem: HIV/AIDS pandemic i not only a problem of public health, affectinR
our community, but also a problem of humanity with ample social, cultural, economic,
political and legal dimensions and consequences. Discrimination and rejection of
people with HIV/AIDS and the so-called risk-groups, affect seriously the constitutional individual and social rights and all kind of rights in general, hindering,
hence, effective prevention of the pandemic.
Description of Project: Violation of Human Rights in case of HIV/AIDS has motivated
Venezuelan's OPL-SIDA (Office for Prevention and Control of AIDS of the Ministry of
Health) to create a Consulting Office for Ethic and Legal Affairs, which forms part
of the National AIDS Program. This office renders assistance to individuals and institutions in matters of HIV/AIDS. This includes: labour problems, family and minor
problems, social security, judicial and penitentiary problems. For better accomplishment, participation of governmental and non-governmental organizations, related to
AIDS and Human Rights, has been solicitated.
Results: A judicial - constitutional Appeal of Protection, legally sentenced, to defend the benefit of Individual Rights of workers/employees HIV=+, has claimed and
reestablished the rights referred to: violation of choice of work, confidentiality
of medical reports and laboratory results, consent to perform antibody tests, elimination of those tests as condition of pre- and durinR employment, social and
health security, information.
Conclusions: The experience has led to a thorough investigation of legal problems
and supports education program by means of conferences and publications.
Carrasco, Edgar, OPL-SIDA/MSAS, Edif. Sur, Centro Sim6n Solivar,
Piso 2, Oficina OPL-SIDA, Caracas, Venezuela
Tel. 41 47 32 - Fax 42 83 33
TuD 0518 DISCRIMINATION AND SEROPOSITIVE WOMEN IN MEXICO.
Marquez, Araceli and Licea, Gloria. GIS-SIDA, AC.
Mexico, D.F.
PROBLEM:
Seropositive womon in Mexico should faco a doublo discrimination,
first as HIV seropositive an d socond as women; bosidos thoy are
confronting many problems of social, clinical, medical and psychological nature.
DESCRIPTION OF PROJECT:
Through in-depth interviews to HIV women atteuiding GIS-SIDA our
work team is documenting discrimination against women in Mexico.
On the other side we spend some time on mini-workshops regarding
seropositive women and AIDS issues.
RESULTS: After a year of documenting cases we have produced some
papers, documents and files. Have attended radio programs and have
given interviews to mass media. The most important result, with
the support of GIS-SIDA, is the recovery of our self-esteem as
women living with HIV or AIDS.
LESSONS LEARNED:
As women and seropositive individuals we have learned that if we
do not fight for our civil and human rights discrimination will
continue for a long time.
Marquez, Araceli. GIS-SIDA, AC; Queretaro 219-H,
Col. Roma, 06700 Mexico, D.F. Tel. [phone],
FAX [phone].
TuD 0520 DISCRIMINATION IN AIDS-RELATED SERVICES EXPERIENCED BY U.S.
BLACK GAY AND BISEXUAL MEN. Bellinger Jr.. George*; Mays, V.M.**;
Cochran, S.D.** *Black C.A.R.E., LA, CA & Minority Task Force on
AIDS, NY, NY, USA **Univ of California, Los Angeles, CA, USA
Obiective: When U.S. homosexually active Black men seek AIDS-related services, they
face the possibility of racial and/or sexual orientation discrimination. Although
an issue frequently raised by ethnic minority activists, little research has
documented the types and extent of this discrimination.
Methods: Questionnaires were completed by 844 homosexually active Black men (84%
self-identified as gay, 15% bisexual) recruited nationally. Included were questions
concerning experiences with discrimination in AIDS-related health care services,
education or information and the individual'sself-reported HIV infection status
(untested, tested-not infected, infected-asymptomatic, and HIV disease diagnosed).
Results: Men who were HIV infected, both asymptomatic and symptomatic, reported
significantly more frequent sexual orientation discrimination in receiving health
care in general than men who had never taken an HIV antibody test, f (3,816)=4.28, P
<.01. Of the tested men, HIV negative and symptomatic men, reported significantly
greater racial discrimination from White gay men in receiving AIDS services, F
(3,817)=4.08, p <.01. HIV negative and symptomatic men also indicated more
frequent sexual orientation discrimination from heterosexual Blacks when receiving
AIDS services, ~ (3,815)=4.58, p <.01.
Conclusion: For U.S. Black gay and bisexual men, entry into the AIDS-related
network in search of health care, education or resources, carries with it also
significant risk of experiencing discrimination, both from the heterosexual Black
community where being gay is highly stigmatized and from White gay men insensitive
to racial/ethnic and cultural issues. While it is important to increase services
available for Black gay and bisexual men, organizations must be staffed by providers
who are sensitive to their needs if we are to increase rates of utilization.

TuD 0517 DENIAL OF MEDICAL CARE OR INSURANCE COVERAGE FOR AIDS/HIV DISEASE:
AN ETHICAL ISSUE IN RIO DE JANEIRO
Ramos-Filho CF; Vieira W; Berbara V; Fahrat J; Lacerda McR; Melo,
LAV. Regional Council of Medicine of Rio de Janeiro (CREMERJ).
PROBLEM: in Rio de Janeiro, RIV-infected individuals are often denied
medical attention and/or health insurance coverage, once their condition is known,
ACTION: CREMERJ is an independent, statutory institution, to which all practising
physicians in the State must belong. Any health institution, or third-party paying
organization (including insurance companies) must register into CREMERJ, and have a
medical director, responsible to CREMERJ for the company's deed. CREMERJ's duty,
established by federal law, is to care for the observance of proper ethical and
technical standards of practice. Resolution passed by its body of councellors must be
obeyed by all doctors. Ethical transgressions, as instances of malpractice, are judged
by CREMERJ, and may bring about several penalties, including prohibition of practice,
and the closure of an institution. Following the observation of frequent violations of
HIV+ individuals right to medical care, Resolution 35 was passed in Feb-91. It was
sent to every physician in the State; CREMERJ organized meetings with NGOS, physicians
and health care institutions, explaining the Resolution's goal, and its resolve to
enforce it, asking NGOS to refer suspected cases of violation for investigation.
RESULTS: in 1991, 15 cases of supected violation of patients' rights were examined by
CREMERJ. In all instances where this was verified, negotiations with the offending
party restored the patient's rights. No further action was taken against offenders,
since it was felt that time should pass, for Resolution 35 to be widely known and
understood. However, after 1 year of its existence, legal action will be taken in all
cases of voluntary violation.
CONCLUSION, a firm stance by CREMERJ created a channel both for the denounciation and
correction of violation of rights of NIV-infected persons. However, only cases being
brought to CREMERJ's attention can be acted upon. Further public awareness of
Resolution 35, its aims and consequences is still very much necessary.
Celso Ferreira Ramos-Filho, Av. Brigadeiro Trompowski, s/nr - Ilha
do Fundao - Rio de Janeiro - RJ - Brasil. Tel.: [phone],
Fax: [phone]
TuD 0519 ANTI-DISCRIMINATION POLICIES IN THE US INCREASE USE OF HIV TESTING
Phillips Kathryn A, Center for AIDS Prevention Studies
University ofCTifornia, San Francisco
Objectives: This study analysed the association between 1988 state screening
policies and voluntary HIV testing utilization. Most states regulate screening, but
states vary widely in their policies. Previous studies have not controlled for
other factors related to utilization or have analyzed data not representative of the
US population.
Methods: This cross-sectional study used individual-level household survey data from
the 1988 AIDS Knowledge & Attitudes Survey (part of the U.S. National Health
Interview Survey), which was merged with state policy data. A logistic regression
model was used to assess the association between state policies and testing
utilization, controlling for risk status, sociodemographics, knowledge of AIDS, and
state AIDS cases.
Results: Of 30,000 individuals interviewed, 3% had been tested voluntarily and 4%
planned to be tested voluntarily. Individuals were significantly more likely to
seek testing (OR=1.4, 85% CI=l.l-l.8) if they lived in states with antidiscrimination lass restricting insurer and employer screening; that promoted
voluntary, anonymous screening; and that were early adopters of high numbers of AIDS
policies protective of individual rights. Individuals were not less likely to seek
testing (OR=1l.l, 95% CI=.8-1.4) in states with name reporting requirements. Antidiscrimination policies increased testing among those who perceived themselves to
be at low-risk (OR=2.5, 95% CI=1.5-4.1), but had no effect on those who perceived
themselves to be at high-risk (OR=.8, 95% CI=.7-1.6) or who were self-reported
members of risk groups (OR=1.0, 95% CI=.4-1.4)
Conclusions: Anti-discrimination policies increase testing utilization for some
individuals.
Phillips Kathryn A, PhD, Center for AIDS Prevention Studies,
UCSF, 74 New Montgomery #600, San Francisco, CA USA 94105
Phone: [phone] Fax: [phone]
NOTES

Bellinger, George Jr., BLACK C.A.R.E., ISSR, University of
California,Ios Angeles, 405 Hilgard Avenue, 1283 Franz Hall, L.A.,
CA 90024-1563; Tel:[phone], Fax: [phone]

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