Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Track D: Social Science: Research, Policy & Action
Mo.D. 1780
RISK CONCEPTS AND SEXUAL PROTECTION IN THE IMAGERY AND CUSTOMS
Sikos. Graciela. Hospital Pirovano, Buenos Aires, Argentina
Issue: There is a lack of effective methods designed to modify sexual risk (in terms of HIV
transmission) behavior
Project: The research - funded by WHO and with the assistance of MNl:aTonal AIDS Office -
aimed at studying how men and women conceive risk and protection related to situations
involving sexual intercourse, how they actually protect or expose themselves to the contagion of STD/HIV, and the facilities/difficulties they have to modify risky behivior through a
5-week group program with participatory methodologies and aimed at making explicit sexual discourses, fantasies and practices.
The study covered 170 urban, middle-class individuals, aged 17 -60. Four s amples were
designed: I youngsters; II adults belonging to the health team; III nd IV adults general population.The groups I, 11 and III belonged to the experimental group. Group IV was meant as a
control group aned attended an informative meeting with traditional conference/debate
methodology. Both the experimental and the control groups had pre-activity and post-activity surveys 'n order to evaluate changes in risky behavior:
Results: It was found that, at the time of the first meeting, I 6% of the population studied
were in peril of STD/HIV infection.The experimental group diminished the risk cases in
50% and worsened 3%, whereas within the control group the worsening figures doubled
the advancement ones.
Furthermore, we noticed that the program improved the information on ways HIV is transmitted; also stimulated discussion of sexual issues and prevention of STD/AIDS, and
increased female autonomy concerning decision making in situations of sexual exchange.
There seems to be association between gender and risk behavior (men being more frequently at risk than women) and between marital status and risk behaviour (separated men
and women being the group more frequently at risk). Among women an interesting association was found between discourses, fantasies and practices.
Lesson learned: The methodology employed permits the evaluation of the sociocultural
contexts while it is operating. It also promotes, at the same time, modifications of risky sexual behaviors. By means of the program applied it is possible to accelerate the introduction
of new meanings related to the risk and protection of STD/HIV infection, both in the
groups accepted cultural patterns and in the subjective structures, consequently reducing
the level of risky behavior:
G. Sikos, Esmeralda 1394, 6~o "A". Capital (1007). Argentina Tel/Fax. 327-04 I 0
Mo.D.1781
REVIEW OF DAY SERVICES FOR PEOPLE WITH HIV/AIDS IN THE SYDNEY
METROPOLITAN AREA
Malcolm A*, Goulburn, Lesley**. *Health Consultant,Sydney Australia:r"HIV/AIDS
Consultant AAA Consultancy Sydney Australia
Issues: Day care programs have become an integral part of the provision of care for
PLWH/As. In Sydney a range of funded and voluntary services have been established to
meet the needs of PLWH/As. Community concern about the extent to which these services were meeting the needs of PLWH/As resulted in an assessment to determine the
needs for day services and the appropriate model of service delivery for a day program in
the Sydney metropolitan area.
Project:The range of existing services were investigated along ith an assessment of the
particular needs of PLWH/As. Methods used included surveys, focrs groups and individual
interviews to determine the particular needs of PLWH/As.
Results:The review found that a day program existed but that these services were relatively
under-utilised by PLWH/As for reasons including, lack of information, difficulty of-access and
a limited range of activities available. Furthermoe, the programs did not always reflect the
diversity of the PLWH/As.The review also found that current day programs operated independently and were Ifragmented arnd duplicative.There were no mechanisms i place to
coordinate these services, and a climate of distrust and competitiveness existed.The primary need that people had was for a program that was flexible, that provided ar range of different activities and services and to which they felt an ownership. Many PLWH/As wanted
greater control over their programs and a greater degree of input into the management
and design of such programs.There was also a need to reach more isolated and difficult
groups of PLWH/As who lived away flom many of these services.
Lessons Learned: Although there appears to be well established services they may not
necessarily address the needs of PLWH/As. Mechanisms for co-ordination and the development of alliances between services may be a better option for the delivery of more effective services within the community.
L. Goulburn 9I Moncur St Woollahra Sydney Australia 2.010 Ph: (6 l) (2) 327 8 I 28
Fax: [phone] Email:lesleymgmsn.com
Mo.D. 1782
LOCAL AIDS CONTROL PROGRAM
Fernandes.C.L.0, Pererra, M.TC.*, Rocha, F: 0, Sole PIH, M1.A.* -. Associagho Brasileira
Interdisciplinar de AIDS- - Secretariat of Public Health of Rio do jr rerro-0
Issue: The lack of information red access to diagnosis, treatmert and pieventise means
increases the vulnerability to HIV/AIDS among slum residents.
Project: The Local AIDS Control Program was cr-eased to offer assistrme antI preventive
means in slums. It has been started as a pilot project in 2 slums in Rio de Janeiro City. It has
3 components: Public Health Centers, which are close to the sirres, assuire assistance; education - volunteers residents are trained by the project team to.give informtatron and distribute condoms to their neighbors, evaluation - reports on condoms consumption, qualitative studies and ar KAB survey in the two target communities an cin 2 othiei; selected as
contr-ol.
Results: KAB survey was done before the education work had st-uled. he sample size
was I1200. No significant difference were found between taiget rid control,communities,
in terms of sorio demographic features and condom rise, as well us the questions related
with knowledge and perreptions.Two years ahter" the survey vat Ceheated in the target

community and the two control ones, with the same total sample size. In the communities knowledge has increased, with no important differences.The average of correct
answers related to perception raised about 2% in the 2 control cornmrrorities, but 6,5% in

Mo.D.1780 - Mo.D.1785
the target one.The rate of regular condom use showed significant differences, increasing
15% in the target slum.
Lessons learned: Our Project reinforces a different kind of intervention, where self empowerment and community participation associated with assurance of assistance services and
means of prevention can awake more credibility on education action and behavior changes.
We believe that programs like this one can be more self sustainable.
Fernandes, J.C.L.,Rua Serafim Valandro 23/204 Botafogo- R.J. - Brasil Telephone: [phone]
2771 Fax: [phone]
Mo.D.1783
AU SAUNA. ON S'ADAPTE:AN EVALUATION OF INTERVENTIONS IN MONTREAL
SAUNAS
Ken Morrison. Joanne Otis*, Rene Berneche*, Rene Lavoie**, Claude Cyr**. * Universite du
Quebec 3 Montreal, **Sero-Zero
Objective: To assess the impact of the programme Au sauna.. on s'embolle, a two-year-old
prevention programme by Sero-Zero, designed to create a supportive environment for
safer sex in Montreal saunas.
Methods: This descriptive evaluative study utilised a mixed method that included both a
quantitative approach, a purposive sampling of 400 sauna clients over a two-week period,
and a qualitative approach, an opportunistic sampling which included focus groups of sauna
employees and interviews with sauna managers of 4 saunas.This study was undertaken with
close collaboration between academic researchers, community researchers, community educators, and commercial establishments.
Results: Clients were predominantly French (77%), from Montreal (7 1%). 1 7% described
themselves as bisexual; I 8% as being seropositive. Of the 31% who had been penetrated in
the past 3 months, 18% said they had sometimes, rarely or never used a condom. 84% of
the clients surveyed recognised the vocation of Sero-Zero. 64% had already heard of the
progranme.Those men who had heard of the campaign perceived a greater ability to practice safer sex (p<O.02). 75% had already taken pamphlets from the display cases. 74%
thought educational interventions in saunas were desirable; 70% thought they were well
thought--out; 73% thought they were useful and 45% thought them effective.There was a
direct link between these perceptions and the fact of carrying a condom in their towel
pocket (p<0.05). 79% thought themselves more informed about HIV transmission than 2
years ago. 64% thought that it was easier to negotiate safer sex than it was 2 years ago.
97% of clients and 100% of employees and managers thought that it was a good thing that
saunas participate in the fight against AIDS.
Discussion: Prevention education can be undertaken when clarity and collaboration are
integral parts of the process. Au souna.. on s'embnolle has been well-received and seems to
have have been effective in meeting its objectives. It is strongly recommended that such a
campaign rimprove their ongoing process evaluation and planning by formalising the informal
and by closely collaborating with academic researchers to learn about evaluation.
Ken Mornrison, D2103-1600 Beach,Vancouver, BC, Canada.V6G IY8 Tel.: [phone] I
Fax: 688-I 875 Email: [email protected]
Mo.D.1784
EVALUATION OF THE AIDS COMMUNITY ACTION PROGRAM:WHAT ARE THE
QUESTIONS? WHERE AND HOW DO YOU GET THE ANSWERS?
Auger Catherine*, Boyer, M**, Clarke, M**, Stinson, J**, Howlett, M**, Cerrd, M**, Oram,
J*. AIDS Community Action Program; ** Health Canada
Issue: The AIDS Community Action Program (ACAP) is a national initiative which supports
the community action component of the National AIDS Strategy by providing funding to
community-based organizations. One of the goals under Phase II of Canada's National AIDS
Strategy is to evaluate all programs and projects on an ongoing basis. ACAP developed
methodology and information gathering tools to collect data for the evaluation.
Project: The areas of focus for ACAP in Phase II were determined in partnership with communities through a national consultation.The outcome of this process guided the formulation of the program's funding guidelines, which will be presented. As ACAP is to be evaluated under the Strategy, an evaluation framework was developed which identified questions
to specify what indicators could be used to assess its performance and achievements, and
to define what information would be needed to do so.
Results: The indicators developed for evaluation of the program, data gathering methods
and tools will be presented (such as questionnaires).
Lessons Learned: The implementation and management of ACAP demonstrates that it is
possible for the government to conceive, implement and evaluate a nationally funded initiative in collaboration and partnership with key stakeholders fiom the community.
C. Auger, I I Holland Avenue, Tower A, 2nd floor Ottawa, Ontario, K I A I B4 Canada
Telephone 6 13-941I-21I51I Fax; 6 13-941I-2399
Mo.D. 1785
HIV+ PEERS AS TREATMENT INFORMATION COUNSELLORS:TRAINING PROGRAM
AND SERVICE DELIVERY
MlcClure, Craig M.0, Naumovich W, Robinson B. - -Community AIDS Treatnuent
Information Exrhange,Toronto, ON, Canada
Issue; Persons lising with HIV/AIDS prefer to obtain their treatment information fr-om their
peers for the following reasons clarity, plain language, trust and empathy. Comprehensive
raining his sot been availablo to PLWHIV/AIDS in treatetent information and/or peer
counselling skills.
Project: A two-year national conimunity-based project wit undertaken to develop a trainrug pi-cgrars that would enable PLWHIV/AIDS to deliver- treatment information-focused
peer counselling. txtensive consultations were untdertaken with communities of
PL:NHIVAI[)S ncr-ott Canada. An 80-hour trauining program, oncompassing person-centrod
(Rogern) counselling theory/skills and conventional and complomentary treatment infermation waus designed arid piloted in thurce cities Calgary, Halifax and Ton-onto. Process and
impact qsuestnaines and interviews were conducted with participants and facilitators.

Results: 40 PLWHIV/AIDS participated in the pilots. Based on the results of the evaluation,
a comprehensive training manual and organizational resource was written and distributed
to AIDS service organizations across Canada A volunteer-based peer treatment information
counselling service was established at Community AIDS Treatment Information Exchange

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