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

996 Abstracts 44304-44308

12th World AIDS Conference

erosexually active adult men. Particular research gaps include issues of intervention format, number of sessions feasible or even desirable, behavior change
maintenance, and dissemination/technology transfer.
44304 Evaluation of a unique model of respite care: Victoria
AIDS Respite Care Society (VARCS)
Elizabeth Lindsey1, Kelli Stajduhar2, M. Scanlan2, G. Murphy2, L. McGuinness2.
1School of Nursing, University of Victoria, Box 1700 Victoria, BC; 2 Victoria AIDS
Respite Care Society, Victoria BC, Canada
Issue: VARCS has been heralded as a unique model of respite care. People living
with HIV/AIDS have access to respite care in the homes of trained volunteers.
Because of the uniqueness and apparent success of this model, Health Canada
funded an evaluation project to fully assess the efficacy of this model of care.
Design: Qualitative evaluation methods using a participatory action research
(PAR) approach.
Method: In keeping with PAR, the HIV/AIDS community were actively involved
in the evaluation process. Four evaluation components were identified; the history
of the organization, the community development model utilized, a description of
the program, and the impact and outcome of respite care on PLWHIV/AIDS, their
caregivers and health and social service agency personnel. Qualitative evaluation methods including open ended interviews, participant observation, survey
questionnaire development and utilization, focus group meetings, and content
analysis of print materials and records were undertaken by the researchers and
community participants.
Results: Overall, VARCS model of respite care was found to be highly effective. Eight themes emerged from the data to support this finding. These themes
include: providing appropriate care, accessing information, acknowledging sexuality, confronting stigmatization and AIDS phobia, addressing financial concerns,
creating a caring community, and providing support and client autonomy.
Conclusion/Lessons Learned: Providing respite care for PLWHIV/AIDS and
their caregivers in the homes of trained volunteers is a highly effective and unique
model of care. Based on the results of this evaluation, other communities are
encouraged to consider adopting this valuable and viable care option.
44305 A world-wide-web site for disseminating information
about evaluating innovative HIV/AIDS programs
G.J. Huba1, C.T. Kuo2, L.A. Melchior2, C.A. Elavia2, T.L. Tharasri2,
A.K. Kawata2, A.T. Panter3, J.G. Gelfand2. 15811A Uplander Way Culver City,
CA 90230; 2The Measurement Group, Culver City, CA; 3Univ of North Carolina
at Chapel Hill Chapel Hill, NC, USA
Issues: A key element in designing and implementing service delivery programs
for HIV/AIDS is the evaluation of those programs. Disseminating information
about evaluating innovative HIV services using the Internet is an excellent way to
rapidly reach a large audience.
Project: A world-wide-web site at www.tmg-web.com provides a forum for
disseminating evaluation methods, tools, and results from several groups of
innovative HIV/AIDS service delivery programs. The web site, developed and
maintained by The Measurement Group, provides information about the evaluations of 40 US HIV/AIDS service demonstration projects. The site features
program evaluation resources specifically designed for use in HIV/AIDS programs. A diversity of materials - for evaluating direct services as well as training
programs focused on HIV/AIDS - are provided, including data collection instruments and instructions for their use. Measures are provided in a range of formats,
such as standardized tests, self-administered surveys and questionnaires, structured interviews, guidelines for qualitative data collection, and other methods.
Both quantitative and qualitative evaluation approaches are represented.
Results: Users from 283 major universities, 69 governmental agencies, and 70
countries have accessed the site in its first year. More than 800 large computer
systems (domains) have accessed the site each month and the rate at which
new users access the site continues to grow. In the first year, there were 251,636
hits (requests for information) to the site. The web site has attracted the attention
of many users throughout the world in its goal of disseminating new information
about innovative models of HIV services to a wide audience.
Lessons Learned: The Internet appears to be an effective means for sharing
information pertinent to the evaluation of innovative HIV/AIDS services. Data
collection instruments can be developed and widely disseminated in this forum.
44306 Assessment of HIV counseling and testing services
(CTS) for women in US Government funded programs
Marilyn Falik1, D. Cairns2, M. Barini-Garcia2, S. Bryant3. 12730 University Blvd
W Suite 612 Wheaton Maryland 20902; 2BPHC, HRSA, U.S. DHHS Bethesda
MD; 3MDS Associates Wheaton MD, USA
Objectives: To examine the extent to which programs delivering primary care
to indigent client offer HIV CTS to women of childbearing age. Collectively, they

serve about 2.5 million of these women per year; approximately 10% are pregnant.
The study documents the percentage offering female clients CTS, and describes
its delivery.
Methods: A stratified, proportional probability sample of primary care programs (universe - 783 programs) was surveyed. The written instrument was
based on current literature and reviewed by an expert group, including program
representatives, HIV+ women, and HIV care clinicians.

Results: Response rate was 68%. Majority of respondents (91%) offer CTS,
either directly or by referral. Over half (52%) provide CTS on-site. Over 80%
use informed consent forms; very few use forms customized to address womens'/perinatal issues. Nearly all deliver test results in-person through scheduled
counseling sessions, and over 60% have physicians, mid-levels and nurses provide these services. Almost 92% offer CTS with each pregnancy. Less optimal is
that all pregnant clients do not receive the full continuum; 89% received pre-test
counseling, 75% testing, and 58% post-test counseling.
Conclusion: The majority of US government funded primary care programs
are offering HIV CTS to women of childbearing age. However, many women may
not be receiving the full continuum of HIV CTS.
44307 Program evaluation forum for state and local health
department HIV prevention providers
Kathleen Stark1, S.E. Dietz1, R. Hoffman2, S. Rogers2. 1Centers for Disease
Control, 1600 Clifton Road, Atlanta, GA; 2Academy for Educational
Development, Washington, DC, USA
Issue: As competition for resources increases, stakeholders expect proof of HIV
prevention program effectiveness. Yet many in this field face complex issues in
trying to appropriately conduct program evaluation. As a result, technical assistance in HIV prevention program evaluation is increasingly required. The provision
of program evaluation technical assistance is challenging with circumstances that
often do not yield easy answers.
Project: In response to this need, a CDC sponsored HIV Prevention Leadership
Forum on program evaluation was held on January 8-10, 1997 entitled Critical
Issues in HIV Prevention Evaluation: A Forum for Peer Exchange. A diverse
group of 32 persons from state and city health departments met with national
leaders in program evaluation to discuss issues specific to their needs. Instead
of a predetermined workshop training format, the program was planned by the
participants on the issues most directly affecting them. In a collaborative process
over several months before the forum, the participants worked with the sponsors
to develop each part of the agenda. The three main issues addressed at the
forum were (1) strategic planning for HIV prevention evaluation, (2) engaging and
empowering the community and program staff in evaluation, and (3) conducting
evaluation with limited resources. At the forum, participants spent 2 1/2 days with
their peers and national experts to develop approaches to their most important
program evaluation challenges. Follow-up activities included a network that can
be used for future technical assistance needs and a monograph that includes
evaluation resources that conveyed both the richness of the Forum's substance
and its spirit of peer collaboration.
Results: Participant evaluations, immediately following and 6 months after the
forum, showed a high degree of satisfaction with the process and the results.
The group problem-solving approach allowed each participant to address the
complexity of program evaluation issues more productively.
Lessons Learned: The HIV Prevention Leadership Forum proved to be an
effective mechanism for delivering technical assistance in complex program evaluation issues in HIV prevention.
243* / 443081 Border-crossing HIV/AIDS prevention in different
European states - A comparison
Michael F. Krauss1, E. Steffan2, Dr. W. Heckmann2. 1SPI Stresemann Str. 30
D-10963 Berlin; 2SPI Research gGmbH Berlin, Germany
Issue: In many regions within Europe, prostitution and drug scenes are developing in areas close to national borders. Extreme differences in income as
well as divergent legal systems have both played their part in encouraging this
development. Considered in the light of HIV and STD prevention criteria, there
is reason to believe that people are displaying high-risk behavioural patterns in
these areas.
Project: SPI Forschung gGmbH Berlin implements, supports and evaluates a
network of streetwork projects focusing on HIV/AIDS/STD prevention in border
regions in Europe. The so called UMBRELLA NETWORK is supported by the
Commission of the European Communities, the Federal Ministry of Health of the
Federal Republic of Germany, the German Laender of Bavaria, Saxony, Brandenburg and Mecklenburg-Pomerania as well as the following EU countries: Finland,
Italy, Spain, Portugal, and the following co-operation countries: Estonia, Poland,
the Czech Republic and Slovania. During the next few years other countries
will also be joining the scheme (Greece, Austria, Switzerland, Great Britain and
Ireland). The binational project teams have the task of contacting the prostitution
and drug scenes in the regions where they exist by means of outreach social
work. This work aims to provide information to those concerned as well as to
develop and disseminate prevention material and establish psycho-social and
medical/venereological consultation services and facilities.
Results: The scenes concerned show a high degree of acceptance of border-crossing prevention. Furthermore, it is also important that considerable improvements are made in the state of information provided to both prostitutes and
i.v. drug-misusers on HIV/AIDS and STDs and on health behaviour by supplying

prevention material and counselling in the respective mother tongues of the target
groups. Evidently, in all project areas, the number of medical check-ups made on
members of these scenes has risen in connection with outreach social work.
Lessons Learned: HIV/AIDS/STDs prevention programmes in border crossing prostitution and drug scenes are potentially successful within many European
regions if they are specifically adressed to meet the specific needs and understanding of the scenes concerned.