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

Tu.D.2928 - Tu.D.2932

Tuesday July 9, 1996

research on the activities of nongovernmental or community-based ASOs in Japan
Methods: A questionnaire asking ASOs to provide information on their activities in detail
was sent out to 80 AS(ts in January 1995. Fifty-six answers were obtained, consolidated
and analyzed. The data were aiso published as a resource booklet 'NGO Information
Network" fcr thIe u se of people oing with HIV/AIDS, medical nstitutions, government
oiei and t'he general pubil is well as for the networking of ASOs.
Results: T he most popular activity offered by nearly 90% ASOs is educational. More than
two thirds offer counsehling and nforiimation service over telephone by trained volunteers.
Abouit 40% provide the care for PWA/H at their home or in the hospital. According to
tei cstiVts ASs)is, may be classified into three groups: all round (35%), education and hot
line (20%), education (35%) and other type of ASOs (10%).
Conclusions: Three major tasks were pointed out by this research: I.To establish an ASO
for PWH/A by themselves. Except haemophiliacs, PWH/A have no organization of their
own though they play an important roll in each ASO. 2.To establish more ASOs outside of
Tokyo. Almost two thirds of ASOs have their seats in Tokyo and its neighboring prefectures.
3.To offer variety of services to foreign nationals especially Asians.Though 1/4 of PWH/A
are non Japanese, only few ASOs offer services in their own languages.
SlaruiL, F, rulty of Letters, Keio Univ, Mi ta 2- 5M5,Minato- kuTokyo, 108 Japan Tel.:+81 -3 -a53-451 F I <.:+81 3-3798 /480 e ai: tarsuis flet.mita.keio.ac.lp
Tu.D.2928
DEVELOPING ATRAINING PROGRAM IN FEMALE CONTROLLED METHODS OF
HIV PREVENTION FOR SOUTH AFRICAN HEALTH CARE PROVIDERS
astell,.E.' +-, Ab dooi Kisrr in Q Scheepes E. +HIV Center for Clinical & Behavioural
Studies, Colusba Unier sitk/ NY; HIV/AIDS & STD Directorate, Department of Health,
Pretoria, Republic of South Africa
Issue: One of the eoaernment's key HIV/AIDS puevention strategies in South Africa is the
iroductit on of female controled methods (i.e., the female condom, diaphragm and microbtides) in clinics provid opfamily plann pservices. A training program had to be designed
to increase health dire proiders' skills as well as promote positive attitudes about women's
control over the choice of a ange of options to prevent HIV/AIDS and other STDs.
Project: Individual and group interviews were conducted and tape recorded with more
than 400 key role players/informants (health care administrators, clinicians, researchers and
end users).Throuoh this process, potential client, provider and structural barriers were identified with regard to implementing a woman-centred counselling protocol that enhances
women's seision making powei: In the development of a training program for health care
workers, inte view information was used to generate stories and role plays grounded in the
ives of clients and the realities of clinic service delivery. A three-day interactive "train the
trainer" workshop took place in all nine provinces in South Africa, resulting in the training of
80 health cire providers in female controlled methods.
Results: Infaormition highlighted the potential client, provide, and structural barriers that
mi7ht impede r plementat ion of this strategy. Client barriers included reluctance to talk
about sex and i elattionships, non clandestine nature of the method, preference for dry sex
practices, and fears about nsertive methods. Provider barriers were: negative attitudes
about methods acceptability a provider knows best" attitude, and concern about meeting
the demandt. Structural barriers included time and workload pressures, staff shortages, and
perceptions of inaidequate financial conmpenrsation. Workshop modules focused on skillbuilding and role modelling exercises related to providers values clarification, gender sensitivity comfort in talking about sex with clients, assessing chlient's level of HIV/STD risk, reproductive counseng of HIV infected womene. effective communication with clients, and motiwiting behavioural change in rients.
Lessons Learned: In the present day South Africa, intensive and appropriate training of
hea lth care workers n various settings showed that they had favourable attitudes and
sstrong rtetrns to plementing female i'controlled methods in clinics.
Joari E. PMartell, tHIV AIDS Directorate Dept & Health, Private Bag X828 Pretoria 0001,
R opubl iof South Africa.Tel: [phone] Fax [phone]
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A CONTINUUM OF CONFIDENTIALITY LINKING THE CONTINUUM OF CARE
AND PREVENTION OF HIV/AIDS
I is pblIar D., R ader A D. The Salvation Army, International Headquarters, London, UK
Issue: There is a need to acelerte communilty based care and prevention of HIV transmiso it, but a key rat e limiting element is the diversity of understanding of confidentiality
betwee contr e, cultures, and per sons. Consequently the interlnkage between care and
p eventlon has sbeen inaIdequately understood. Confidentiality has been predominately
defined n terms of one- to one relationship rather than shared and community confidentialit rhich is observed more often in functioning communities in developing countries.
Project: For s ix years, observations regarding the continuum of confidentiality have been
noted in 30 countries where HIV/AIDS responses byThe Salvation Army have emerged
facilitated through an international programme facilitation team.
Results: It many cultures, a spectrum of confidentiality has been noted as follows: (I) Onetoone co fidentiality therapist to client, client to friend; (2) Family confidentality - involinp a cir Ie of intimate others in which there is trust, belonging, loyalty, commitment; (3)
Shared confidentiality referrine to the diffusion of information from inside the private'
experience of a person or a small group, to the wider community; (4) Community confdentalt' focused on issues rather than persons, thought there can be r, nverbal
acknowldmenser of persons. It should be noted that professional conkidentialty also
nlude a es of knowenp within professional staff.
Lessons learned: Confidentiality is defined by relationship and agreed accountability not by
secrecy and prvacy The spectrum includes personal confidentiality regarding one to one
and famil intoimacy to iue centred conkidentiality with respect to community responsibility
asd iton. Community confidentiality can be developed and utilised as an environment for
lhaitge in norms and ttitudes and behaviours. It interlinks with the continuum of care and
harge, and is indiis ibte from these processes if effective acceleration of care and prevenIoan is to be achieved. Policy will incorporate the 'community voice' more effectisely when a
wider confidentiality is acknowledged
Dr Is C mpbeThe Salation As ry toteri tional He adq arterss 101 Queen Victoria
Srell, indonEirk4P'IEPV K -P1et /11 236 5222 Pax:0171 236 4153

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EFFECTIVE COMMUNITY DEVELOPMENT FOR HIV PREVENTION AND SEXUAL
HEALTH PROMOTION: POW!
Gillies, Pamela A, Jases, ' t, Slack,R5, Johnson, 5"*, Macdonald, M1" "University of
Nottingham. UK: 'Prest ste Outreach Workers Project, POW!, Nottingham
Issue: Local women car is errand sustain a community based project which seeks to prevent sexually transmitled dise i ses, promote health and provide referral for a wide range of
social welfare, educational and legal problems.
Project: Launched si 1990 as a research project based on Fre re's theory of oppression and
educational development, prostitute volunteers working in partnership with University colleagues were trained to assess local womens health needs. Using these data they designed a
community outreach project distributing condoms, with advice and referral to relevant services, and 'organised' to generate funding for premises providing a safe space for women for
respite and counselling. Self and objective evaluation techniques were implemented from
the inception of the project and were perceived by the women as crucial to their credibility
and sustainability in terms of funding as was the creation of a Management Committee with
financial accountability
Results: In 1 993-94, 2 full time outreach workers with 5 local volunteers made 1,300 contacts with women, 297 of these being first time contacts with prostitute women and 44
with other women from the area who were in need of help. 26% of cases were referred
for drug related problems. Linked data were not available in 93 94 for all repeat contacts,
but 74% of first time contacts reported general health beha viour changes between initial
and second contact with POW!; 6% reported changes in drug use, 6% intieased condom
use with clients and I% with private partners. In addition, 8 women enrolled for literacy
classes at POW and 2 oined access college courses.These findings were influential in the
worsen winning a grant from the UK Lottery Charities Commission to ensure cont inuation
of their operation until 1999.
Lessons Learned: A community development approach alied to institutonal flexibility in
patterns of working, shared control, and careful evaluation, can make a significant contribution to health promotion among women who may or may not identify with prostitution but
who share common difficulties arising from social disadvantage.
Dr Pamela Gillies, Dept. Public Health Medicine & Epidemiology University of Nottingham,
Nottingham NG7 2UH, U.K. Tel: 01 44 1I 15 9709302,
Fax: 01 I 44 I 15 970316
Tu.D.293 I
IMPROVING QUANTITY AND QUALITY OF MINORITY AIDS SERVICE
ORGANIZATIONS
Carter Patricia,* Coleman, J." Phillips," Bland, W."*" " National Organization of Black
County Officials, *Nationa l Minority AIDS Council, "*National isk Force on AIDS
Issue: With the advent of the 2 Ist century AIDS service organizations (ASO's) have
unprecedented challenges and demands to meet the growing needs of their chients and
changing demographics of the pandemic.The ability to garner support and build capacity
and strength are key determinants to ensure successful program implementation.
Project: Drawing on the experience of four national regional minority organizations
(NRMO's) in the United States funded by the Centers for Disease Control and Prevention,
this presentation will explore the provision of capacity building and technical assistance to
minority ASO's throughout the US and Puerto Rico. An analysis of the NRMO initiative
demonstrates them to be effective in improving the quantity and quality of services delivered to minority populations.
Results: The NRMO's provided technical assistance, training, and consultation to over 200
ASO's in 1994/1995.The group of four NRMO's has for-med informal nkages to explore
cross fertilization of techniques to better serve agencies in need of structured interventions
to build capacityThe initiative has developed model programs with potential rephlcation
worldwide.
Lessons learned: Technical assistance programs which offer consultation and training can be
extremely successful and contributable to effective AIDS programming.The overarching goal
is to ensure that ASO's are equipped financially and structurally to face and overcome dayto-day challenges, while improving the quality of HIV pri event on programs. As the AIDS
pandemic proliferates, the maximum output of ASO's is indispksable and, thereby significant in the lives of PLWHA's, their families and caregivers, as well as the AIDS movement
Patricia Cartes 1931 13th Street NW Washington, DC 20009. c/o J. Coleman
Tu.D.2932
PROJECT AREA-SPECIFIC TECHNICAL ASSISTANCE FOR HIV PREVENTION
COMMUNITY PLANNING
Cleveland, anet C.,* Hoffman, Coralee,*"5 Willingham, Mary. '-Centers for Disease Control
and Prevention, Atlanta, GA; **Academy for Educational DevelopmentWashington, D.C.
Issue: Since 1994, technical assistance has been provided to the 65 state, territorial, and
local health departments that receive HIV prevention funds, and their community planning
groups, to implement HIV prevention community planning. During the past yea the
Centers for Disease Control and Prevention (CDC) established a decentralized technical
assistance network to better meet the technical assistance needs of project areas and community planning groups.
Project: CDC contracted with the Academy for Educational Development (AED) in I995
to provide support In coordinating and developing a decentralized technical assistance net
work.The obtectives for the decentralized network are to strengthen the HIV prevention
community planning process; increase local capacity to plan sound HIV preventon programs; assist community planning groups in determining their own technical assistance needs
and identify the appropriate resources in addressing those needs: increase information sharing and skills-building experiences among the community planning groups; and provide a
wide array of technical resources to assist community planning groups in accomplishing vari
ous tasks associated with implementing a sound HIV prevention community planning
process.
Results: A national registry of local and regional experts from academic institutions, AIDS
service organizations, and community-based organizations has been established. Health
departnents and them community planning groups may access these experts for technical
assistance en a variety of areas, including process managment. eeeds assessmetl setting

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