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

Tuesday, July 9, 1996

Tu.D.255 -Tu.D.356

Tu.D.255
DIRECT COSTS OF MEDICAL CARE RENDERED TO HIV/AIDS SEROPOSITIVE
ADULT PATIENTS IN FOUR PUBLIC HOSPITALS IN SANTIAGO, CHILE.
Trujillo Franklin,Toro L, Henriquez A., Jara C., Child R., Ortiz E. Comisi6n Nacional del
SIDA, Ministerio de Salud de Chile
Objective: The objective of this research is to establish direct costs involved in both outpalient care and hospitalization of adult HIV seropositive patients during the different stages
of evolution of the illness.
Methods: From August 1994 to February 1995 information pertaining to outpatient care
and hospitalization of 415 HIV seropositive patients was gathered. Based on the 1987
CDC, patients were classified in two groups. AIDS and NON AIDS.This latter included
groups I, I, III1 and category C2 of subgroup C (group IV).
Results: The sample group under research represents approximately I 6% of seropositive
HIV population in Chile, 36% of which corresponded to AIDS cases.

Total average direct costs of medical care are as follows
Stage of evolution Cost per day
AIDS US$ 12
NON AIDS US$ 5

Cost per year
US$ 4,196
US$ 1,723

Conclusions: (a) It may be concluded that the direct costs of medical care rendered to an
AIDS patient in Chile are in line with the costs reported for other developing countries. (b)
The cost of medical care rendered to an AIDS patient is substantially higher than the cost
of a NON AIDS patient, fSom which it may be derived a financial interest in slowing down
the progress of the infection (human and financial considerations). (c) The impact of cost
factors on the total cost, in descending order, is: specific drugs (antiretroviral drugs to treat
opportunistic infections): 75% in AIDS and 65% in NON AIDS cases; medical tests and procedures: 17% in AIDS and 22% in NON AIDS cases; medical check ups: 7.5% in AIDS and
8.8% in NON AIDS cases.
Franklin Trujillo, Mac Iver 54 I, Santiago ChileTelephone (56-2) 639400I ext. 673.
Fax [phone]
Tu.D.350
PROGRAMME OF ACTION AND PROMOTION OF AIDS RELATED HUMAN RIGHTS
IN VENEZUELA
Koch, Renate. Edgar Carrasco, ACCSI - Acci6n Ciudadana Contra El SIDA, CaracasNenezuela
Objectives: Action and promotion of AIDS related human rights in Venezuela.
Method: Direct legal assistance to persons affected by AIDS: counselling private and public
sectors; educational activities specifically targeted to lawyers, attorneys, judges, procurators,
health workers, educational institutes, and the public in general, and provide them with
instruments and guidelines designed to preserve human rights of people living with
SIIV/AIDS. Promotion of national network which includes governmental and non-governmental organizations/institutes who work on AIDS and/or human rights.
Results: A project which will provide us with the necessary financial support to reinforce
our infl-astructure, improve our services and enlarge the national network has been introduced in the European Community.The Ministerial Resolution SG439, which regulates antibody-tests to human rights' respecting conditions, has been designed in cooperation with
the Ministry of Health and is being promoted throughout the country.The network has
been established and includes 7 States of the Republic, which will be interconnected by email. Pronotion of networking activities in 5 further States is underway. Participation on
governwent initiative to revise antagonic health legislation AIDS has been included in all
hua in rights programmes. An investigation on prisons has been started, and women and
immigration issues are treated specificallyThe Declaration of the Paris Summit has been
promoted and its contents recognized by the President of the Republic. An increasing number of persons living with HIV/AIDS or their families request our legal assistance services.
We constantly participate on mass communication events.
Lessons learned: Though we consider to have been successful in promoting human rights
of people living with HIV/AIDS, there is still very few information on AIDS in our country,
and consequently human rights violation is taking place in the whole of the range of our
society, thus forcing as to intensify our educational and promotion activities. In order to
resch the variety of our societal structure, we have to motivate people to participate on
volunteering work, which is much lower in our country than in other parts of the world.
Renate Koch, Av. Rs to intensify our educational and promotion activities. In order to reach
the viiiety ol our societal structure, we havlnsert file 9630.RTF here
Tu.D.352
WOMEN'S HUMAN RIGHTS AND VULNERABILITY TO HIV: FINDINGS FROM THE
WOMEN AND AIDS RESEARCH PROGRAM
Whelan, Dsniel I, Rao Gupta G, Weiss E. International Center for Research on Women,
Washington, DC, USA
Issue: The complex relationship between women's human rights and their vulnerability to
HIV infection must be examined in order to develop policies and programs that can more
effectively address the rising incidence of infection among women worldwide.
Project: Data collected f-om seventeen research studies are examined to explore this relationship.This analysis demonstrates how a lack of promotion and protection of women's
I r iri hlts creates the conditions of vulnerability to HIV, and how HIV infection among
women impedes the full realization of their human rights.
Results: Women throughout the world experience significant barriers that impede their
ability to protect themselves flom HIV infection, including (but not limited to): lack of econonic irsdeperudence, information, legal recognition, mobility, and skills necessary for prevention; the unequal power imbalance inherent in gender relations: and the absence of femalecontroiled prevention methods. Insofar- as these barriers represent significant failures to proniote arid protect wornen's hurnan rights, women's vulnerability to HIV infection becomes a
human rights concern. ohe traditional public health focus on modifying risk behavior, however: is unable to effectively address vulnerability.This inability has lead to a paralysis in the
design of effective HIV prevention programs that can reduce incidence among women by
taking the context of vulnerability into account.

Lessons Learned: An integrated health and human rights framework that can address both
HIV risk and vulnerability is critical for designing initiatives and policies that can decreased
women's vulnerability to HIV
Daniel J.Whelan, ICRW, 1717 Massachusetts Ave., N.W, Suite 302,Washington, DC 20036,
Phone: [phone] Fax: [phone] email: [email protected]
Tu.D.353
WOMEN'S PREVENTION,A DILEMA IN DEVELOPING COUNTRIES.
Bianco, Mabel, Re, Maria Ines, Pagani, Laura. Fundacion para Estudio e Investigacion de la
Mujer. Argentina.
Issue: In developing countries women's vulnerability increases due poverty lack of governmertal prevention/action campaigns and higher sexual subordination of women.
Project: Small groups workshops to aware poor women in Argentina were organized since
1 992.The activities were developed with the participation of women.Those awared organized activities to arise other women. Poor women are unable to talk with their partners
on sexual and reproductive matters. Couples did not use condoms, women could not ask
their use. We worked different approaches to empower women and ensure the practice of
safer sex.
Results: It was possible to empower poor womnen.The majority of them after the training
could negotiate sexual relations with their partners.Those unable to negotiate considered
their difficulties in small groups with other women, to allow all of them to learn from their
experience. Different strategies were applied and were evaluated by the project team and
women. Special attention to cultural and religious values were considered.
Lessons learned: Poor women empowerment required a face to face work in small groups
including their partners if possible.Women empowered are well prepared to educate their
daughters and sons for equity among men and women in sexual relations.Taboos on sexuality and religious influences are stronger in poor women, need special strategies.
Mabel Beatriz Bianco Parana 135 3ro." 13". (10 17) Buenos Aires. Argentina.
Tel/Fax (54 I) 476 2763
Tu.D.354
SOUTH AFRICA'S RESPONSE TO PREVENTING HIV/AIDS AND OTHER STDS IN
WOMEN: INTRODUCING FEMALE CONTROLLED METHODS IN THE PUBLIC SECTOR
Abdool Karim, O., Mantell, JE5+, Scheepers F. *HIV/AIDS & STD Directorate,
Department of Health, Pretoria, Republic of South Africa; +HIV Center for Clinical &
Behavioural Studies, Columbia University, NY
Issue: The male condom has provided women with limited protection from HIV/AIDS and
other STDs since only a minority of men use condoms consistently. Unprotected sex is a
major factor in fuelling the HIV epidemic among women.
Project:The prevention of heterosexual HIV transmission in women through the introduction of female controlled methods is one of the HIV/AIDS & STD Directorate's key policy
issues.The commitment to this strategy was shaped by a 2-year consultative process
through the National AIDS Convention of South Africa that led to the National AIDS Plan.
This strategy is designed to increase women's acress to various methods ---mutual
monogamy the female condom, diaphragm with a microbicide, and a msicrobicide only A
training program for health care providers was developed and conducted. A mass media
cam:aign to promote awareness of barrier methods, including messages directed toward
men, will support this initiative.
Results: The HIV/AIDS & STD Directorate formulated a multiphase plan. In the first phase,
a feasibility/situation analysis was conducted with more than 400 key informants (health
care administrators, clinicians, and users).These interviews, along with clinics visits, helped to
shape and contextualise training program content. Meetings were held with provincial and
district authorities regarding how best to implement the program within the context of the
country's changing health care infrastructure.This assessment also served to crystallise and
propel the advocacy process for female controlled methods. A meeting with key rote players involved in women's reproductive health and barrier methods of HIV was convened to
obtain their input into the training program, clinic operational plan, and evaluation/monitoring.This meeting helped build the Department of Health's partnership with the private sector and other non-governmental organisations. In the second phase, a "train the trainers"
approach was used to train 180 health care providers, primarily nurses (20 in each of the 9
provinces).The third phase consisted of implementing a female controlled counselling protocol and evaluation and monitoring in the targeted clinics.
Lessons Learned: Scarce resources and sustainability will be optimised when HIV/AIDS/STDs
are integrated within a broader framework that includes family planning and primary care.The
South African government's leading role in AIDS prevention through its introduction of female
controlled methods into clinics will be a prototype for other countries.
Quarraisha Abdool Karim, Director, HIV/AIDS STD Directorate, Dept of Health, Private Bag
X828 Pretoria 000 1, Republic of South Africa
Tu.D.356
EDUCATION PROGRAM INVITING WOMEN TO USE THEIR RIGHTS FOR THE
PRESERVATION OF SEXUAL RELATIONSHIPS AGAINST HIV INFECTION:THE
HUMAN RIGHTS PROGRAM.
Musuamba Ndala*, Mlutowbo T*. Network rOn Ethics, Law And His In Zaire,
KinshasaZaire
Issue: Culture and tradition don't allow mrrimed or- unmarried women to talk about sexuality with their husbands or partners. So, they can't decide on the use of condoms to avoid
HIV infection.
Project: A program to reduce HIV/AIDS infection risks by sexual way among married and
unmarried women was initiated in education, sensibilization and prevention by "the
Network on Ethics, Law and HIV in Zani-e".The program began in November 1994 with: I.Mlarred and unmarried women interviews. It consisted to know their point of view on
wearing condoms by their- husbands when they asdopt a high irisk behaviour or when they
as-u HIV+. As for the single wowun, when they have occasional inter-course with doubtful
persons. About I1000 women were interviewed during 5 months. 2.faiving I S talks and
debates for 7 months to University and College students, women of non-governmental
organization (NCO) and other- social organizations. 3.TIV Rad broadcast.

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