Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

992 Abstracts 44283-44287

12th World AIDS Conference

Results: The NGO sector identified nine areas of Australian best practice in
international programming: Intiative in developing professional networks;critical
anaysis of the vulnerability and risk of HIV infection; nurturing leadership development in the Asia/Pacific region; facilitating best practice in community assistance
in prevention and care; fostering partnerships between the government and nongovernment sectors overseas; providing leadership in supporting "marginalised
populations"; facilitating national strategic planning; strengthening health sector
skills; and developing capacity in research, monitoring and analysis. The sector
also identified three areas which constrain the implementation of best practice:
contextual issues, lack of strategic approach and sufficient political will. The
document decribes lessons learned in overcoming some of these contraints from
domestic and international experiences.
Australia can strengthen its international response by - expanding and/or remodelling effective approaches; improving existing systems by which the government
and NGO sectors share lessons learned and develop a coordinated response;
broadening the scope of HIV programming to engage the private sector and
development banks and; improving the information sharing and expansion of
expertise.
44283 The process of policy making for HIV/AIDS prevention for
youth in the European Union
Stephan Crener, J.M. Reinders, V. Verneer. DRS, Woerden, Netherlands
Issue: Collecting and comparing the policies of HIV/AIDS prevention for youth in
the European countries.
Project: In every country, participating in this study, a well-informed national contact person of an established HIV/AIDS prevention organisation, is asked to fill in a
structured questionnaire about the (demographic, epidemiology, legislation, infrastructure, education and sexual behaviour) facts. A semi-structured questionnaire
asked for more information about the process of policy making: who is involved,
who is targeted, on what is it based, what facilitates and what are the constraints.
Results: The process of policy making for HIV/AIDS prevention for youth does
not involve youth directly. In many countries policies are top down made, however
more and more countries have delegated the policy making to non-governmental
institutes. The decentralisation has many different forms. Epidemiological situations have not always taken into account, e.g. the growing number of HIV
infections among young heterosexual girls.
Lesson learned: Decentralisation of policy making is a mean to involve field
organisations and can offer the chance to meet better the needs of their target
groups. Although youth participation is effectively realized in peer education, no
examples are found of youth participation in the policy making process.
44284 1Attaining immediate countrywide coverage of sex
workers: Need for partnership
Maurice Bloem, Nazrul Islam, R. Sushena. Shakti-Project, Care - Bangladesh,
H#60, Road - 7A, Dhanmondi, Dhaka, Bangladesh
Issue: Bangladesh is still considered to be a low prevalence country for HIV with
less than 0.1% in the general population and less than 1% among the people
living in high risk generating situations though the STD rates are significantly
higher in the later group.
Project: It has already been proven from global and regional experience that
small project may be successful within a limited group but they fail to prevent the
virus from invading into the general population in a country. Also that the road to
restrict the epidemic can be implementing behavior change intervention among
different subpopulations country wide, thus attempting to reach all the high risk
behavior group within the "window of opportunity" for 2-3 years. But it is not
feasible for one agency to reach all these groups. So government started working
with different organizations in the areas like HIV/AIDS programming, technical
support, advocacy, networking, research and training and exposure visits.
Results: 1. Developed a standardized intervention guidelines for targeted
intervention 2. Collaborate with NGOs currently implementing or interested to
implement behavioral intervention among sex workers. 3. A national consensus
developed for implementation of country wide targeted intervention which in a
nationwide plan for intervention involving lot of stakeholders like GOB, NGOs,
Private sector, people with high risk behaviors.
Lessons Learned: Involvement of all stakeholders is necessary and possible. High level commitment and endorsement in combination with grass root
response seems to be the way to success. This should be used in other types of
interventions also and only then Bangladesh can be the success story in Asia.
44285 1 The involvement of people living with HIV and AIDS
(PLHAs) in training, policy and programme development
Mick Matthews. Working Group Involvement of PLHAs, UK Ngo AIDS
Consortium, London, UK
Issue: The principle of the involvement of PLHAs has been widely endorsed but

the process through which may be achieved remains under-developed
Project: The involvement of PLHAs is a mantra that has been with us almost
as long as the epidemic. How can the desired outcome of integrated involvement
of PLHAs in planning, development and facilitation of HIV/AIDS strategies within
an HIV/AIDS aware environment be achieved? A set of Guidelines is being developed through the UK NGO AIDS Consortium from work undertaken initially
with Plan International. This will build on existing work on best practice and

include extensive contributions from PLHAs globally. The process of developing
the Guidelines and key principles for PLHA involvement will be presented.
Results: A living document describing processes for the effective involvement
of PLHAs, articulating the value of the social capital represented by PLHAs and
describing how this can inform and strengthen Training, Policy and Programme
Development.
Lessons Learned: Intellectual and emotional engagement and the need to
understand PLHA perceptions of HIV are crucial elements in developing relevant
HIV programming which is sustainable and responsive to a changing epidemic.
44286 1 Forum of Bangladeshi overseas migrant workers:
A grass-root response to HIV/AIDS
Sakiul Millat Morshed, Monirul Alam Mollah. Director Program, 8/15 Block-A
Lalmatia, Dhaka-1207, Bangladesh
Issues: Bangladesh exports a large number of skilled and semi-skilled manpower
(more than 4 million legal and illegal). Miseries and deprivation are quite common
among all these workers, like they are subject to indiscriminate HIV testing that
violate their human rights to confidentiality, informed consent and counseling.
Unfortunately, they are not aware of their rights and also not organized to protest
against any violation of human rights and harassment. Moreover 60% identified
HIV positive persons in Bangladesh are migrant workers or their spouse, so they
need to be organized to develop a supportive environment.
Project: SHISUK one of the leading NGOs working on HIV/AIDS and migrant
issues in Bangladesh tried to facilitate and trigger a process in which migrant
workers themselves establish a forum. The forum works (a) to be a credible
partner of Bangladeshi migrant workers for mobilizing the community to develop
a tolerant environment towards people with AIDS; (b) to influence policy makers
and other stakeholders; (c)for easy access (peer education, peer outreach) to information and implementation of a successful pre & post departure program; and
(c) pooling information from migrant workers (as a potent source to consolidate
issues related to migration) for using them in establishing their rights.
Result: The forum established within four months (from September 1997), a
core group of more than 300 migrant workers in eight administrative areas and this
number is expected to increase rapidly. Further, it received positive responses
from different segments of society and partners. In each administrative area,
monthly meetings are held regularly. Linkages have been made with regional
AIDS and migrant related organizations like CARAM-Asia.
Lesson learned: A mobile and distinct group like migrants can be united and
mobilized in a short period of time. Participation of migrant workers themselves
and the information accumulated during their meetings are crucial in efforts
advocating for their rights. Even illegal migrant workers were can be reached.
However, networking and collaboration within Bangladesh alone is not sufficient
to reach towards all goals of the forum, regional and international networking is
equally important.
44287 1 Adolescents living with HIV and the child welfare system:
The need for advocacy
Gary Harper1, S.G. Hosek1, R. Domanico2, P.L. Gault4, F.E. Lumpkins3.
1Psychology Dept., De Paul U., 2219 N. Kenmore Chicago; 2Cook County
Hospital, Chicago; 3Neon Street Programs, Chicago, IL; 4Independent Attorney,
Washington, DC, USA
Issue: Increasing numbers of adolescents who are homeless, runaway, survivors
of sexual/physical abuse, and/or "system kids" are contracting HIV and require
advocacy for their special needs.
Project: The state dependency system in the United States is witnessing an
increase in the number of adolescents who are living with HIV in their child welfare
agencies. Many of these agencies are unprepared to address the special needs
of this vulnerable population. In an attempt to fill this void, a group home was
developed to house and provide medical/psychological services to HIV-infected
adolescents who are wards of the state. In addition to a structured residential environment, the group home provides individual and group psychotherapy,
skills-building groups, community living groups, psychosocial case management,
educational counseling, and a mentoring/tutoring program. Medical services are
provided at local health care facilities.
Results: The struggles of opening and maintaining this group home have
brought attention to the myriad of special advocacy needs of adolescents living
with HIV. Previously unaddressed clinical issues have included inadequate knowledge regarding the course of HIV disease, fears of unwanted disclosure of HIV
status and anxiety regarding self-disclosure. Additional clinical concerns arose in
the areas of medication compliance and substance use. Unique issues related to
confidentiality were also a major concern for adolescents and administration within
the welfare system, group home, neighborhood, and school. Obstacles to meeting
the advocacy needs of these adolescents have been the child welfare staff's lack of
accurate information regarding the course of HIV disease and undue leniency due
to beliefs that the adolescents are "dying." This has resulted in a lack of attention
to such critical issues as substance use, sexual activity, structure, and discipline.

Lessons Learned: Adolescents living with HIV who are involved in the child
welfare system have limited legal rights to privacy regarding disclosure of their
serostatus and the immediate course of their lives. Thus, there is a need for
advocacy efforts to be developed and implemented to assist these young people. Recommendations include advocacy through youth empowerment, policy
development, legal and political representation, and developmentally appropriate
education and research.