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

12th World AIDS Conference

Abstracts 60027-60033 1007

are nine young females who previously worked as commercial sex workers in big
cities in other province infected by HIV. In July 1996, one of them was getting
pregnant. Due to low understanding of the villagers on HIV/AIDS, her neighbours
prohibited her to give birth in her village. She was forced to give birth in Jakarta,
the capital city of Indonesia. Since October 1996, we carried out a Village Post
in that village, it is about 100 km from Jakarta. Village Post serves as center of
HIV/AIDS information dissemination to the villagers, especially young female.
Results: The villagers apparently begin to accept the presence of young female
and her baby with HIV+. They helped them such as by accompanying them to
have themselves checked up at general hospital in Jakarta. They, even, came to
the celebration of her baby's first birthday. About 20 young females in that village
are actively being AIDS volunteer in the Village Post. They were also joined life
skill training so as to being self-supported and remaining living in their village.
Lesson Learned: Misunderstanding of the villagers, especially the young
female, on HIV/AIDS can be remedied if they are well-trained and well-prepared.
60027 Private sector integration in AIDS prevention in Siaya
Joshua Otieno Adede. PO Box 971 Siaya, Kenya
Issue: Private Sector Organizations need increased HIV/AIDS education in order
to respond to the challenges posed by the Pandemic.
Twenty (20) Private Sector Organizations (PSO's) were identified in Siaya
Township for a pilot workplace AIDS education. Information was gathered from
each organization regarding how the workers and managements of the PSO's
perceive AIDS. Worksite visits were organized and discussions followed by showing of videos on AIDS and distribution of posters and booklets. Follow up visits to
the 20 PSO's were made frequently between August - October 1997.
Results: About fifteen organizations responded by allowing their staff two
hours a week for AIDS education. Some workers volunteered to be peer AIDS
educators. Some PSO's (10) support the project by donating finance (cash) and
items.
Lessons Learned: Aggressive Participation of the Private Sector in HIV/AIDS
prevention requires management support. Sensitization of the executives of the
PSO's and the impact of HIV/AIDS is a prerequisite in soliciting PSO's integration
to AIDS campaign.
1 60028 Female condom acceptability in a group of volunteers
(men and women)
Mridula Sainath. PO Box 2435, Government Building, Suva, Fiji Islands, Fiji
Objective: To assess the acceptability of female condoms in a group of volunteers, mean and women, in Fiji
Introduction: Female condom is not available in Fiji, as yet, either in Private or
in Government sector. This small study, with 60 donated 'Reality' braud condoms
will give some insight into the acceptability of female condoms locally.
Method: A group of 10 sexually active couples have volunteered to participate
in the study. A pre and post participation questionnaire will be given to assess the
acceptability of female condoms.
Results: will be shared at the meeting.
Lessons Learned: Because of lack of funding, the Results of This first female
condom study in Fiji will be used to further seek funding for Research and Advocacy for introducing female condom as an available option for harm reduction
behaviour.
S60029 Training senior health care workers in the care and
management of people with HIV/AIDS in resource limited
settings: An innovative approach
Catherine Mary O'Keeffe1, R. Sims2. 11 Nelson Mews Southend on Sea, Essex
SS11 AL; 2Mildmay International, Southend on Sea, UK
Issues: In order to care effectively for people with HIV/AIDS, health workers
require access to appropriate training. In resource limited settings it is essential that training has a multiplier effect which reaches all cadres of the health
system. Mildmay International has developed an innovative approach to training
senior health care professionals that creates successful cascading educational
programmes. This has proved to be an effective capacity building strategy.
Project: Since 1991 Mildmay has developed training programmes on the Care
and Management of people with AIDS in Kenya, Uganda and Tanzania. Two
week residential courses were offered that covered an holistic approach to care
at hospital and community level. Experiential and participatory teaching methods
were applied. The programme content included: epidemiology and transmission
of HIV/AIDS, infection control, palliative care, counselling, teaching methodology
and training local facilitators. A unique feature was the completion of a project
proposal by participants which focused on training other health care workers on
these issues. For those who successfully implemented their project a second
Facilitators' Course is offered, which further develops the teaching and course
management skills of the participants.

Results: 190 Senior health care professionals have completed the Mildmay
courses. They have subsequently trained over 7000 individuals and groups. Examples will be given. In many instances innovative care and educational projects
have been initiated.
Lessons Learned: Motivating and developing existing training skills in senior
health care professionals can produce outstanding results. If participants are to

be able to implement their own training programmes it is essential that they have
the support of their managers and access to small scale funds.
S60030 Increasing incidence of genital ulcer disease in Durban,
South Africa
Nigel O'Farrell12, A. Robinson3. 144 Crookham Rd, London SW6 4EQ; 2Tudor
Wing, Hillingdon Hospital, Middlesex, England, 3City Health Department,
Durban, South Africa
Objective: To report on trends in the numbers of new cases of genital ulcer
disease (GUD) amongst attenders at an STD clinic in Durban following the
recognition of HIV infection in this population.
Methods: Review of the Annual Reports of the Medical Officer of Health for
Durban from 1988-1996 in which the numbers of STD cases and diagnoses are
recorded for patients attending the main STD clinic in Durban.
Results: GUD cases have increased steadily since 1988, the year when HIV
was first reported at the clinic. The following numbers of cases of GUD were
reported annually amongst new patients- 5431 in 1988, 9563 in 1989, 12089
in 1990, 14039 in 1991, 15349 in 1992, 17175 in 1993, 16771 in 1994, 16707
in 1995 and 19314 in 1996. The numbers of actual new attenders at the clinic
(recorded from 1990 on) only increased from 35846 in 1990 to 41432 in 1996. Although GUD cases are managed syndromically, the most likely clinical diagnosis
is also recorded. The numbers of cases of genital herpes and donovanosis have
continued to rise quite significantly. In 1996, 6840 new cases of genital herpes
and 2743 cases of donovanosis were reported. A survey in mid-1996 showed
that 43% of male attenders and 57% of female attenders were HIV positive.
Conclusions: Although syndromic management of GUD has been in operation
at this clinic since at least 1987, the incidence of GUD has continued to increase
since HIV became endemic locally. Syndromic management appears to be insufficient to manage effectively the large numbers of cases of GUD, particularly
genital herpes and donovanosis. Promotion of health education and counselling
is and will be crucial in preventing the spread of HIV in these STD attenders,
many of whom are HIV positive.
S60031 | Care of widows in the northern region of Malawi by
Patricia C. Amadi community nurse for St. John's
Hospital in Malawi
Patricia C. Amadi. St John's Hospital, PO. CBox 18 Mzuzu, Malawi
Issue: Social injustice on widows is leading to their physical, social, psychological
and spiritual and emotional suffering. After the death of their husbands 95% of
the widows have their properties snatched, left uncared for, discriminated. Such
social injustice is influenced by cultural beliefs and practices which puts ownership
of family property into the hands of the husband and his relatives.
Goal: To socially and economically empower widows for their survival
Objectives:To provide physical, psychological and spiritual needs. To create
change of cultural beliefs and practices.
Project: Managed by ST. Johns hospital widows receive counselling, pastoral
care, domestic materials and assistance. To educate and motivate the widows to
form support groups, discuss possible substitutional beliefs and practices.
Results: Widows are coping with social-economic problems. Laws of protection
of widows and children are pursued.
Lessons Learned: Social injustice can be changed with good strategies.
60032 1Empowerment an effective strategy to the prevention of
HIV infection and the development of AIDS among
women in Malawi
Esther J. Munthali. Living Stonia AIDS Control Programme, PO. Box 279,
ekwendeni, Malawi
Objectives: To break the barrier for women access and control over economy.
To improve the living standards of women. To teach women of their rights and the
truth about their health as to dispel the false traditional concepts.
Methods: 18 youths and women clbs established through which sexual and
health issue and women rights are taught and discussed related to traditional
beliefs and practices. Skills training in homecraft, handcraft, management of small
business enterprises are given to girls and women supported by financial and
professionals experties assistance. Establishment of a local bank where only
woman's signature of authority can effect withdrawals and use of money.
Results: Women are becoming part of decision making in the household and
community dynamics. Family planning methods are taught and distributed by
women in community and effected by women at a household level. Girls and
young women are able to negotiate or say NO to sex.
Conclusion: Social and economical empowerment an effective prevention
strategy for HIV/AIDS infection in women in Malawi.

60033 1Meta-analysis and thematic cartography of trends in
incidence of HIV in India and the States
Abhaya Indrayan. Div Biostat & & Med Info/Univ Coll Med, Sci/Dilshad
Garden/Delhi, India
Background: Exact incidence of HIV and its trend at the national and the State
level in India is still obscure. Large number of small scale surveillance studies