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

12th World AIDS Conference

Abstracts 60104-60108 1019

aged 14-20 years are made to work all day, washing, cooking, cleaning, doing
child-care and other tasks, usually only in return for food, lodging and a small
salary. All these contribute to subjecting them to sexual abuse by employers,
adults within the household or neighbours. After the findings of a cross-sectional
case control study on risk factors of HIV/STDs among housegirls, a preventive
IEC/BCC intervention is carried out to create awareness and empowerment to
reduce further spread of HIV/STDs infection. House to house visits and contacts
followed by HIV/STDs educational video shows to households is being done.
These shows are accompanied by distribution of HLMs-posters, leaflets, newsletters and condoms. Peer educators start from what the group knows building up
and summarizing with questions, answers and discussions. In twelve months
a target group of 2500 people have been reached. Quick Assessment of the
intervention revealed that 98% have indicated learning more effectively about
HIV/STDs transmission. 75% indicated desire to change behaviour towards a
positive attitude. 50% acknowledged empowerment to negotiate safer sex with
their regular boyfriends, partner notification, counselling and voluntary screening.
An increased number of people dropping in for condoms (60%), HLMs (80%),
request for video shows (75%) is an evident indicator of positive outcome of the
intervention. 6% are now regular clients while 0.16% (4 housegirls) have tested
HIV+ as a result of earlier indicated reasons. One male adult of a household from
0.16% above tested HIV+. However, 20% (17% women/3% male) employers
are registering the concept of openness and transparency, employer-housegirls
relationship for easy and positive interraction necessary for preventive measures
to reduce the spread of HIV/STDs infection.
Evaluation indicates that: HIV/STDs IEC is easily welcomed and more understood by visual aids complimenting to hearing and reading especially to illiterate
or semi-illiterate such as housegirls. Shyness and stigma is also minimized. A
continued intervention is planned.
S601n04 An attributional analysis of Saudi male students'
reactions toward a friend with AIDS
Abdallah M. Badahdah. 2904 Ross Rd. Ames, Iowa, USA
Objectives: to study the reactions of saudi male students toward people with
AIDS using Weiner's theory of attribution.
Design: This study uses a between-subjects experimental design. The sample
was 299.
Background: Most of the studies on AIDS/HIV from social perspectives have
been conducted in Western countries. A small number of studies, however, have
been conducted in developing countires. For example, Review of the AIDS literature reveals the absence of studies on people's reactions toward AIDS patients
(PWA) in Saudi Arabia.
Methods: Structural equation modeling was used to test several hypotheses.
Results: It was found that respondents who assigned more responsibility to
the AIDS patient for his illness, resported more negative than positive affects.
Also, the more positive affects expressed by the respondents' the more willing
they were to help the AIDS patient. No path was found from assignment of
responsibility to willingness to help. Moreover, no path was found from negative
affects to willingness to help. Religious respondents reported less positive affects
toward the AIDS patient. Students with more knowledge about HIV resported
more willingness to help than respondents with less knowledge. No paths were
found from fear of AIDS to willingness to help and expression of negative affects.
Conclusion: Knowledge about HIV transmission is very important in reducing
negative attitudes toward people living with AIDS. Religious people in Saudi
Arabia still hold negative affects toward people with AIDS. More informational
programs directed toward religious people and the general public are important
and useful.

160106 HIV vulnerability of Filipina house maids in Malaysia
Aegile Fernandez1, Irene I.F. Fernandez1, Ali A.R. Remmelts2, Ivan
I.W. Wolfers3, Sharuna S.V. Verghis1. 1Tenaganita, 1 Ith Floor, Wisma Yakin,
Jalan Masjid India, Kuala Lumpur, Malaysia; 2 Vrije Universiteit, Amsterdam, The
Netherlands; 3Vrije Universiteit, Amsterdam, Holland
Objectives: To determine the factors of mobility and environmental conditions
which increases the vulnerability of Filipinas in Malaysia. To identify the knowledge, attitudes, beliefs and practices of Filipinas with regards to HIV/AIDS.
Design: Participatory research involving the target community focusing on
the health, knowledge, attitudes and sexual behavior of Filipinas with regads
HIV/AIDS.
Methods: A KABP was administered by Filipina interviewers trained by the
NGO, Tenaganita. The research was also monitored by the NGO. 2 Focus Group
Discussions, informal interviews and observations along with secondary data
analysis complemented the survey.
Results: A high majority believed that sharing needles and sex with PWAs
causes AIDS, but very few knew that HIV caused AIDS. A very small number
thought that sex with multiple partners was risky behavior. Condom usage was
very poor. The research also dispelled notions that Filipinas were permissive and
doubled up as sex workers.
Areas of future research must focus on partners and spouses at home. There
is a need for more education interventions on STDS/HIV/AIDS. and condom
use. Vulnerable sub-populations of Filipinas who need support are entertainers,
workers in resorts and part-time sex workers. There is a need for developing pre
and post departure and arrival programs for Filipinas in Malaysia.
60107 Challenge of HIV/AIDS and STD rising trends in Eastern
Europe
A. Gromyko. WHO Regional Office for Europe, Copenhagen, Denmark
For the past 5-7 years some countries of Eastern Europe and particularly the
Newly Independent States are experiencing an extraordinary epidemic of sexually
transmitted infections particularly syphilis and gonorrhea. The incidence of HIV
infection has also raised dramatically high in the last two years in Belarus, Kazakhstan, Russian Federation and Ukraine. In practically all Newly Independent
States the incidence rates for syphilis raised up to the 200 per 100000 population
and in some areas even to the level of 700 per 100000 of population and above.
Deep social and economical changes, obsolete legislation and policies towards
STD case management and treatment regimes, low financial support and other
factors determine the epidemic. WHO in close collaboration with UNAIDS has
started to assist these countries in mobilizing the international assistance, in
promoting policy changes towards an appropriate STD case management, supporting establishment of "best practice sites", promoting syndromic approach to
STD care, introduction of harm reduction practices and training in safety of blood
transfusions to diminish the spread of HIV infection. Positive signs of its impact
has been noted during the 1997 in some countries in slowing down the upward
trends of syphilis and other sexually transmitted diseases.
Conclusion: Working with STD policy makers, introduction of integrated approach to HIV and STD prevention are some of the important mechanisms for
control of STD epidemic in Eastern Europe which were applied to these countries
and contributed to the positive results. The presentation will review the current
trends of HIV and STD in Eastern Europe and the mechanisms which bring the
change.
60108 Prevalence of HTLV-I/II infections in different populations
group in Tunisia
Faouzi B. Mongi Begaya1, M. Karouri1, A. Mrabet2, 0. Bahri3, S. Amine3,
A.R. Oueslati1, A. Bahloul1. 'Banque Du Sang Hopital Charles Nicolles
Boulevard Du 9 Av Ril 1006 Tunis; 2Neurologie Hopital Charles Nicolles Tunis;
3 Virologie Hopital Charles Nicolles Tunis, Tunisia
Objectives: The aim of the present study was to investigate the seroprevalence
of HTLV among Tunisian individuals at low and at high risk for retroviral infections.
Methods: A total of 600 Tunisian sera collected from 70 old patients with
hematological disorders, 500 blood donors, and 30 patients with neurologic deseases, were tested in duplicate for anti HTLV-I/II antibodies using a cambridge
biotech ELISA. Repeatably reactives samples were further tested by western blot
Cambridge biotech. The samples were then screened for HIV using an ELISA kit
(Murex HIV-1 + 2) and submitted to western blot Murex. The blood donors were
also tested for Hepatitis B (HBV), C (HCV) and syphilis using mandatory tests.
Results: All the groups tested were found HIV negative. Samples from patients suffering hematological disorders and neurologic deseases were negative
for anti-HTLV antibodies. Sera from 4 blood donors were repeatably reactive by
ELISA for anti-HTLV antibodies. However, only 3 of them, 1 HCV positive and 2
syphilis positive, were found seropositive for HTLV-I and HTLV-II. The last blood
donor also found syphilis positive showed indeterminate results by western blot.
Conclusion: (i) At present, data indicate the absence of HTLV infections among

patients with hematological disorders even in the group of patients suffering neurologic deseases. (ii) We demonstrate a significant prevalence of anti-HTLV
antibodies among bloods donors (0.6%), thus we suggest that it may increase
in the next years. The overall prevalence was (0.5%). (iii) To insure blood safety
new blood donations should be tested with additional screening tests. We project
to resort to HTLV nested PCR on the samples found positive or indeterminate
with western blot.

I60105

Privatization of health care services in Malaysia:
Implications with ergards HIV vulnerability of
marginalized groups

Sharuna Verghis, Irene I.F. Fernandez. Tenaganita, 11th Floor, Wisma Yakin,
Jalan Masjid India, 50100 Kuala Lumpur, Malaysia
Objectives: To examine the factors in the privatization of health care services
in Malaysia which will impact the HIV vulnerability of marginalized groups like
foreign migrant workers, sex workers and plantation workers.
Methods: Interviews with members of the target communities complemented
with case files of case handling with the same communities, as well as secondary
data analysis.
Results: According to the WHO and IMF Malaysia has one of the most well
distributed health care services in the world. The active privatization of health
care services will change this scenario. Accessibility and affordability to/of health
care will be reduced. The appropriateness of health care is likely to be severly
compromised owing to the peculiar situation of life and work of the target groups
which puts them at the periphery of society. Suggested evidence of socio-economic inequalities in health also points to the same. The structure and processes
of health care envisaged both strongly suggest thatHIV vulnerability of the above
communities will be aggravated.
The privatization of health care services needs to be evaluated within the
context of growth strategies of states Development policies and programs ignoring redistibutive aspects of growth will engender socio-economic polarization
of health and HIV vulnerability of societies. Experience suggests that a purely
market response is inadequte to meet the health needs of peop-le, more so of
marginalized communities.