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

1098 Abstracts 60531-60536

12th World AIDS Conference

infant and for prescription of zidovudine (ZDV) according to ACTG 076 in order
to reduce mother-to-child transmission of HIV-1. A 15 months follow-up after
delivery is scheduled.
Results Expected: 1/ Knowledge of characteristics of pregnant women referred
to this hospital. 2/ Ability of the team to set up. 3/ Evaluation of mother-to-child
transmission rate.
Conclusion: Prevention efforts are critical in Russia. Few data are available
on people infected with HIV. Starting a comprehensive staff for women with HIV
disease will allow to characterise patient population in order to elaborate appropriate strategies of prevention of HIV transmission and to prevent mother-to-child
transmission.
60531 Techniques to train recent Latin American immigrants
with low literacy levels as peer-educators in the
Washington, DC area
Jose Gutierrez12, P.A. Moses2, C. Crespo3, G. Torres2, S. Mora4, D. Lopez5,
A. Mendez6. 11631 "S" Street, NW #703, Washington, DC 20009; 2Casa of
Maryland, Takoma Park; 3American University, Washington DC; 4Montgomery
County Health Department, Silver Spring, MD; 5Health Consultants
International, Silver Spring, MD; 6Prince George's County Health Department,
Cheverly, MD, USA
Issue: Recent immigrants from Latin America in the United States are at high risk
of HIV infection due to multiple barriers such as: low education, lack of knowledge
of HIV/AIDS prevention, lack of programs targeting the latino community, low
income, familism, machismo, and poverty.
Project: With the participation of 20 peer-educators (18 women, 2 men) with
low levels of schooling, predominantly from Central America we conducted a
community education project supported by the Washington AIDS partnership
and the Maryland AIDS administration. Regular meetings took place at a local
community based organization every other Saturday. We incorporated different
techniques to motivated, train, and empower peer-educators to educate the community about HIV/AIDS. The different techniques consisted of composing poetry,
drawing, handicrafts, card design, posters, condom's displays, appearances on
local Spanish radio talk shows, and listening exercises.
Results: We increased awareness in the community about HIV transmission
and prevention through one on one contact, HIV/AIDS presentations, and community outreach. Peer-educators reached a total of 3,786 community members
through one on one contacts from March through December of 1997.
Conclusion: Training of peer-educators with low literacy should include a variety of techniques as tools to enhance understanding and motivation to reach the
community in effective education of HIV/AIDS prevention activities.
S60532 Support to HIV-positive people given by HIV-positive
people
Asa Johansson. Gotlandsgatan/"72 11638 Stockholm, Sweden
Issue: Considering that Sweden is an ablong country with fare distance between
cities, HIV-positive persons easily get isolated. The initiators of the project knew
the importance of breaking this isolation.
Project: Therefore in 1995 The National Association for HIV-positive People
(RFHP) decided that one should devide Sweden into seven different areas, each
with one representative from the RFHP. The seven representatives main task are
to man a telephone to wich HIV-positive people can turn to get support. The other
task is to keep in touch with the hospitals within the representatives region, with
the purpose of supplying the staff, working with infectious diseases, information
about the program and the RFHP.
Results: The project has turned out well. Many HIV-infected people have been
in contact with the representatives and they can tell about the importance of
support from and contact with other HIV-infected. RFHP has succeeded to establish a project wich is able to meet the demands of all HIV-positives in Sweden,
irrespective of where they live.
Lessons Learned: Irrespective of where they live, HIV-positive people need to
get a chance to anonymously come in contact with people in the same situation.
60533 Provider versus community input
Rashad Burgess. Howard Brown Health Center/Stop AIDS, Chicago, IL,
USA
Howard Brown Health Center/Stop AIDS program located in the African-American
community has solicited a unique response from the community. It is apparent
that many service providers in the south side of Chicago, which are indigenous
to the community, are not very responsive to a non-African-American organization providing services in the African-American community. However, when we
surveyed the population we served and other individuals served by other AfricanAmerican agencies an overwhelming majority of the individuals welcomed our
efforts to expand and provide more services in their community. Currently we

provide the community with street outreach and risk reduction groups targeted
at African-American Men who have sex with Men and women who are at high
risk for infection because of high risk sex partners. Also, we have added an HIV
testing and counseling program, which solicited the negative response among
providers and positive response among the community (target population). All
of the programs are gaining momentum and preliminary data suggest that the
programs will be greatly successful.

Community Interest and Provider Interest do not always coincide. Also, because of racial politics, it is imperative that non-African-American agencies are
sensitive to community issues. Finally, when making decisions about service
delivery, dialog among providers is as equally important as community input.
S60534 A ten-year work the first results of a work - Santos, Brazil
Ricardo Hayden1, Regina Lacerda2, N.S. Gravato3. 1Prac2 2Rui Barbosa 23 4
Andar Santos/SP; 3Programa Municipal DST/AIDS Santos SP Brazil
Issue: During 8 years, Santos has presented the highest AIDS cases incidence;
and nowadays after 10 years of work, it is observed a tedency to stabilize the
epidemiologic standard.
Project: since 1989, a structured program focusing assistance, research and
prevention area, besides a strict epidemiologic control, has been developed. The
specialized assistance with multiprofessional ambulatory, day-hospital, therapeutic home assistance, lab, drugstore with universal antiretroviral distributor, lead
patients to present a better life quality and to live longer bearing the virus, a
wide prevention program is being continously developed with contamination risk
aiming sistematically social and programable levels.
Results: The main acquired result is expressed through epidemiologic data,
which show a decreasing incidence curve tending to stabilization and a prevalence
increasing curve, showing the results of an effective evaluation allow to evidence
acquisition results of safe behavior the number of preservatives distributed in the
city is gradually increasing.
Lessons Learned: Through analysing assistance and prevention activities, it
is noted that with politic willingness, structured program, team capability the AIDS
epidemy can be struggled, decreasing the population vulnerability to the virus.
| 60535 | Visual analogue scale (VAS) to assess the difficulty to
highly active antiretroviral treatments (HAART)
adherence
Albert Tuldra1, R.B.S. Bayes2, M.F.L. Ferrer1, L.M.A. Miguel2, A.A.P. Arno3,
B.C.S. Clotet3. 1Germans Trias I Pujol Hospital, Badalona; 2Autonomous
University of Barcelona, Bellatera; 3lrsi Caixa retivirology Laboratory, Badalona,
Spain
Introduction: The VAS scales are commonly used in clinical trials to assess
quality of life and pain. The research to know the causes of non-adherence to
antiretroviral therapy needs the use of fast and easy instruments such as VAS.
Objective: To know if the subjective degree of effort to adhere to HAART
changes depending on the time of administration or the drugs taken in the treatment. In case that significant differences were found, to determine the most
relevant causes.
Design: Longitudinal, controlled study.
Methods: With the reference of the Perceived Adjustment to Chronic Illness
Scale, designed by HVrny (Lancet, 1996), we have made an easy and simple
test, consisting only on a VAS scale and an open question. In a pilot study, we
have tested this instrument to 81 patients in several stages of the HIV infection,
with different periods of time after starting the HAART.
Results: Correlations between the effort degree and the pass of time have not
been found (r = -0.05). The protease inhibitor seems to be a determinant of effort:
people taking Ritonavir have more difficulties than people taking Saquinavir (p =
0.04) or indinavir (p = 0.019). The most common reasons for having difficulties in
the treatment are adverse events and the complexity of the therapeutic regimen.
Conclusion: The pass of time seems not to be a specially rellevant factor
difficulty to adhere to HAART. The types of drugs have some particularities
that implies more difficulties to adhere, but a more specific qualitative study to
determine specifically them should be necessary.
160536 Researchers as well as researched: PLWH/A involvement
in evaluation studies
Angela Aidala1, Leslie Sadler2, P. Messeri1, J. Moonhoward1, D. Jessop3,
K. Nelson3. 'Columbia School of Public Health, 600 West 168 Street; 2Seq
PLWH/HIV Advisory Group; 3Medical & Health Research, New York, NY United
States
Issues: There is an urgent need for community based evaluation research that
attempts to assess services available, or not available, to persons living with
HIV/AIDS. However, there are difficulties conducting good research among HIV
positive individuals, many of whom have a well-founded suspicion of outsiders,
and/or transient living arrangements, and/or a willingness to cooperate with research constrained by more pressing concerns of daily survival. Problems for
researchers include low response rates and nonresponse bias and lack of reliable
survey results. On the other hand, the PLWA community is ill-served by research
that is not representative.
Project: The Community Health Advisory & Information Network (CHAIN) is
a longitudinal examination of New York City's health and social service system

from the perspective of individuals living with HIV/AIDS. From its inception, the
project has had the active support and involvement of a number of PWA advisory
groups. Persons living with HIV/AIDS were included among project staff.
Results: This collaboration was invaluable for the success of the research. A
representative sample of over 700 individuals were randomly selected from the
rolls of service providers and through street outreach efforts to include individuals
outside of the service system. Recruitment efforts were highly successful with