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

12th World AIDS Conference

Abstracts 60137-60142 1025

60137 Positive cafe: An efficient alternative helping people with
AIDS to integrate and fight their problems
Emilio C. Soares, Ezio T. Santos-Filho, R.M. De Lima, A.V.S. Menezes,
R.S. Ramos, H.C. Guerreiro. Av. Rio Branco 135 G. 709, Grupo Pela Vidda/RJ,
Rio de Janeiro, RJ, Brazil
Problem: Seropositive people in their great majority do not count with a place
to talk about their personal problems, look for solutions and counting with discretion and secrecy, within a friendly and happy environment. Issues regarding
seropositiveness are in general surrounded by an atmosphere of sadness and
despair.
Project: To create this space, the Positive Cafe has been organized in 1994, as
a weekly meeting of three hours duration, structured as a project. Independently
of sex, color, religion, race, social level or sexual orientation, the people with AIDS
are encouraged to take part of this integration activity.
Results: In 1997, with the introduction of frequent parties, raffles, entertainment, theater, live music and balls, and specially the celebration of the member's
birthdays, there was a very significant increase in the average of participants of
this activity. From an average of 10 weekly participants, after the implementation
of the new "attractions" for the activity the average number increased to 50 weekly
participants. Because of the guaranteed recreation and snacks offered freely during the activity, there was a significant increase of lower income participants to
the Positive Cafe. The reason for the great success of this activity is directly
related to its coordination: we observed that the follow up of the participants made
by the coordination (private talks during the activity, phone calls to find out why
somebody discontinued coming etc.) revealed to be an enormous stimulator for
the weakened self-worth esteem of the people with AIDS, working as an important
tool for their recuperation.
Lessons Learned: The use of this space as an activity of integration and
empowerment, allowed the participants to take part more efficiently in the other
activities of the organization, as well as to deal more positively with their own
problems and look for the proper solutions to the problems resulting of their
seropositiveness.
60138 AIDS, sexually transmitted diseases and risk behaviours:
A comparative study of two rural Senegalese
communities
Laurent Paupy1, Emmanuel Legarde2, G. Pison3. Mecora Group; 1Laboratoire
Anthropologie Biologque Musee De L'Homme Place Du Troca Dero 75116 Paris;
21NSERM Lab Anthropologie Bologique Paris; 3 Museum Lab Anthropologie
Bologique Paris, France
Objectives: To identify the factors possibly involved in the differential spread of
HIV/STDs infections in rural Sub-Saharan Africa.
Design: Comparison of two identicaly designed cross-sectional surveys in two
rural populations of Senegal.
Methods: Surveys on risk behaviours and HIV infection, syphilis, Neisseria
gonorrhoeae and Chlamydia trachomatis urethritises have been conducted respectively in July 1997 and February 1997 among two rural populations located
in Central (Niakhar area) and South-East Senegal (Bandafassi area).
In each site, 500 men and 500 women have been asked to participate and
(1) answer a standardised structured questionnaire; (2) provide blood and urine
samples for HIV/STDs testing.
Results: These two populations are known to present different socio-demographic and cultural characteristics, different knowledge and attitudes towards
AIDS and presumably different STDs prevalences levels (Niakhar is a low
HIV/STD prevalences area and Bandafassi is a high HIV/STD prevalences area
according to a preliminary pilot study). This communication will shows comparative results aiming to infer the differences in infection levels from population
characteristics.
Conclusion: Will depend on results of the analysis to be performed in late April
1998.
60139 1 Voluntary HIV testing and model counselling centre -
A pilot project
Bitra George. 2492 Sector-D Pocket-II Vasant Kunj, New Delhi-110070, India
Issue: There was a felt need to establish a centre where free, voluntary HIV
testing coupled with adequate counselling, would be available for the general
population in the city of Delhi.
Project: Through a joint effort of 6 NGOs, National AIDS Control Organisation
(NACO), STD Department of Safdarjung Hospital and UNAIDS, a model counselling centre was set up in Safdarjung Hospital, New Delhi. The counsellors
were supplied by the NGOs on a daily basis to the model centre on all weekdays.
Patients were referred from STD clinic, other departments in the hospital or came
voluntarily for testing. All clients were given adequate pretest counselling in which
knowledge about HIV/AIDS, STDs and proper condom usage, was imparted.
Confidentiality was assured at all stages and HIV test was conducted only after

written, consent. Post test counselling was conducted after a period of one week in
which test results were given to the client in addition to risk reduction information.
HIV positive clients were provided psychological & emotional support along with
support services, medical referrals and aftercare. Display of I.E.C material, documentation, distribution of condoms, regular meeting between counsellors and
clinicians and advocacy of the rights of HIV positives, were the other activities of
the centre.

Result: 550 clients received counselling between 12/5/97 and 31/12/97. 450
clients gave their consent for the test out of which 425 HIV tests were conducted
and 40 tested positive. Patients who wanted voluntary HIV test numbered 125
(22%), rest being referrals. Clinic attenders were predominantly young, adult,
married males; mean age - 24.1 years belonging to lower socioeconomic class.
The most favoured route of transmission of HIV was through sexual contact
(31/40), followed by injecting dry use (4/40) and vertical transmission (4/40).
Voluntary HIV testing & counselling centre has set high standards in counselling,
support & after care services for HIV positives, discrimination of information to
general population and is a model for similar centres all over the country.
60140 Addressing barriers in HIV/AIDS awareness and
complementing government-led initiatives in drug
prevention
Enrico Caja. 3rd Floor Golden Court Bldg. Magsaysay, Baguio City Philippines
Issue: Limited access to HIV/AIDS information among the youth require raising
awareness and support among the said group and introducing harm reduction
among vulnerable population within the said group.
Project:Considering that the local government may still perceive AIDS as a
moral issue resulting to limited support being extended to HIV/AIDS Awareness
programs. Almost no budget has been allocated for such programs in the "Summer
Capital of the Philippines". However, Drug Abuse is often looked at as a "socially
accepted" problem which politicians and church groups strongly support. Thus,
AIDS awareness was integrated in drug abuse prevention programs as a strategy. The strategy first targeted individuals undergoing rehabilitation who where
also introduced to the Harm Reduction Model. Hard to access target institutions
such as church run schools and universities became open to the concept of the
"drug abuse prevention activity". Under Philippine laws, drug abuse prevention
should be integrated in the curricula. Students and even professionals reached
were provided access to information, counseling and reproductive health services
without getting in conflict with religious organizations and their supporters.
Results: The program provided a venue for the youth to access information
not only about drug abuse but HIV/AIDS as well. The said program has also
generated support from the said sector of our society 3 universities, 1 college and
5 secondary institutions in Baguio City, Philippines.
S60141 Validation of a quality of life scale developed for HIV
disease
Caitlin Pepperell1, A.M. Phillips2. 'Queens University 2-68 Earl St., Kingston,
Ontario; 2Wellesley Hospital, Toronto, Canada
Objectives: To establish the concurrent validitiy of a new quality of life scale for
HIV infected patients.
Methods: The new questionnaire, Kingston Quality of Life Scale (KQOL) was
administered to 36 consecutive patients at an inner city HIV clinic in Toronto,
along with a medical outcomes study, short form 20 (MOS-SF20). This scale has
been previously shown to distinguish between clinically different groups of HIV
Patients.
Results: Scores on all subscales of KQOL were significantly correlated with
those in the corresponding subscale of the MOS-SF20.
The KQOL was validated. It is easyto use and covers areas such as sexual
function, appetite, sleep disturbance and other symptoms felt to be of importance
to the HIV infected population.
[ 60142 Implementing sexual health promotion with rural sex
work communities in Rajasthan, India
Bhawanishanker Kusum1, A. Philpott2, C. Plewman2. 1Gram Bharati Samiti 120,
Puranaramgarh Road, Jaipur-302002, India; 2International Family Health,
London, UK
Objectives: To assess the impact of Contextual factors in relation to behaviour
change among the rural sex workers.
Design: Gram Bharti Samiti, an Indian rural development organisation has
been working with International Family Health, a British based development
NGO, to implement a holistic sexual health programme for tribal sex work communities in Rajasthan. An important aspect of the programme has been its
focus on contextual factors impacting on behaviour change, condom use, social
stigma and the improvement of quality of life. The need to move from traditional
individualistic health belief models of health promotion is often stressed in the
HIV/AIDS field, but the process of implementing a structural change model is
rarely discussed.
Method: The non-traditional health promotion strategies used have included
poverty reduction, provision of clean water, legal representation and beautician
training. Challenges faced include client violence against workers, Police and
Pimp harassment, workers being arrested and land rights disputes.
Results: The implementation of structural change interventions have taught

both organisations of the importance of staff selection and support, sex work communities support of workers, the need to gain community credibility (and the time
that takes) and that changing power dynamics meets resistance at unexpected
levels and impacts on community dynamics both internally and externally.
Conclusion: Health promotion needs both structural and interpersonal interventions, however the instigation of structural change is rarely discussed. This
programme has learnt from facing the challenges of implementing both within