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

166 Abstracts 13396-13401

12th World AIDS Conference

using one methode at the time of the study with a higher rate use in urban than
rural area (29.2% in Lome VS 8.8% in Adeta); P < 0.001.
Conclusion: There is an urgent need to intensify information, Education and
Communication towards sex education in TOGO especially in rural area in order
to protect adolescent from STD's (sexually transmited diseases) in particular
AIDS and unwanted pregnancies.
S13396 1 HIV positive women intervention in times of bereavement
Dona Abiniku Aseru1, Helen Candiru2, Jane Candiu2. 1Arua Regional Hospital
PO. Box 3 Arua; 2Network of Women Living with HIV/AIDS, Arua, Uganda
Issue: Many AIDS widows fall victims of family quarrels and are deprived of
assets leaving them with no hope to begin a life of widowhood.
Project: Family quarrels have often ensued in communities in Arua District in
times of death and bereavement leaving widows hopeless. An intervention was
carried out by the Network of Women living with HIV/AIDS (NACWOLA) Arua
Branch to unite them to solve problems affecting them in widowhood. This project
was aimed at addressing the fact that just as the beginning of life is planned
for, the end of life must be planned as well so that people die with dignity. To
this effect a network of HIV positive women have been going home visiting their
peers to educate and guide them in will making, to prepare them for death and
bereavement and encourage them to improve their economic status.
Result: The presence of their peers during bereavement is always a consolation to families who lose their loved ones to AIDS. Between 1996 and 1997, of
the 74 families visited 24 families have written wills. Many clients die with dignity.
Lesson Learned: The co-operation of HIV positive women in times of bereavement gives hope to AIDS widows and their families to cope with situation and
more community support gives a brighter future.
S133971 Using care cum available - Support program and
information dissemination for hemophilics living with HIV
in India
Indira Venkataraman1'2, V. Khanna3, R.V. Raman4. 1B-40 D.D.A. Flats Saket
New Delhi 110017; 23.4Hemophilia Society, (Delhi) New Delhi, India
Issues: General awareness about hemophilia is very low in India, and so are the
acceptance levels of people living with HIV. So those with hemophilia, and both
hemophilia and HIV suffer from inadequate care and discrimination.
Project: Awareness about HIV among hemophiliacs and appropriate interventions for those that are already affected by it, is increasingly becoming a critical
area due to its additional health dimensions. Because a large part of the community is confidential about their HIV status, they do not easily come forward to seek
counseling, information about prevention or the available care. The antiquated
wrong view that they are a 'high risk' group also prevents access to health to
those not with HIV. To this effect, a support group cum information gathering
and dissemination process was encouraged within the Hemophilia Federation
that would facilitate sharing experiences about these two debilitating conditions.
The effort was to gradually start accessing information and databases on HIV
issues and on HIV related complications special to such a group. Awareness
raising sessions were conducted one to one specially for hemophiliacs in many
far off areas and their caregivers, at home and in health centers. Capacity building sessions are held for certain hematologists, primary health care providers,
HIV positive hemophiliacs, & their families. More information has reduced risk
of infection in a country where the blood product supply is still not entirely safe.
HIV positive hemophiliacs are also provided with available subsidized Factor 8,
needed as infusions to control hemophilia, in view of frequent and potentially
crippling hemorrhages related to lowering of immunity due to HIV.
Results: This has been viewed as a pioneering effort in the community of
hemophiliacs in India. A lot of hemophiliacs living with HIV have benefited. Subsidized Factor 8 availability, whenever possible, has also increased their confidence
as this medicine is imported into India at otherwise unaffordable costs. Many HIV
positive Hemophiliacs have also emerged as leaders in the community.
Lessons learned: In order that HIV Positive Hemophiliacs are able to lead
relatively trauma free lives, such support mechanisms that provide life giving
information, provide subsidized medicines (whenever available) and create a
space for free interaction - is absolutely crucial, along with respect for their need
for confidentiality.
13398 Addressing extended life issues among older adults
affected by HIV
Nathan Linsk', M. Nazon6, T. Witten2, L. Baker9, J.P. Fowler7, B. Rydwells8,
K. Nokes3, V. Delgado4, J. Weinberg5. 1 University Illinois, Chicago MATEC
JACSW NAHOF 808 S Wood St, Chicago, IL; 2University Michigan Ann Arbor,
MI; 3Hunter College, New York, NY; 4Broward Mental Health, Miami, FL;
5University California, San Francisco, CA; Nat'l Assoc HIV Over Fifty - 6New
York, NY, 7Kansas, MO, 8Chicago, IL, USA; 9Age Concern, London, UK

Issue: Older adults, often a forgotten HIV-affected population, are an increasingly important prevention and service target globally. In the United States, the
proportion of AIDS cases over age 50 have consistently been 10-15% for over
a decade. Older adults always been a hard-to-reach population due to ageism
and negative attitudes about sexuality in later life. More recently, prophylactic and
combination therapies have shown promise for extending lives into later middle
age and old age. However, except for apparent shorter survival, little is known

about HIV management or how to foster treatment adherence among later life
people living with HIV.
Project: HIV over Fifty Task Forces have evolved in England and in several
states in the United States, which are now under the umbrella of a National Association on HIV Over Fifty (NAHOF). These projects combine research, educational
programs and consumer involvement to increase the knowledge of professionals
and persons living with HIV about the disease in the older years.
Results: NAHOF members have conducted research elucidating the particular
needs of older adults for tailored prevention messages and service environments
that recognize the difficulties of HIV affected adults fitting into programs established to service other health issues or populations. HIV over Fifty Task Forces
are now active in New York, Massachusetts, New Jersey, Florida and Illinois and
related work is ongoing in California, Washington, DC, Phoenix, AZ and Kansas
City, MO. NAHOF has established a membership base of 80 formal members
and about 300 participants in an information network. Two national meetings
have occurred in the United States, as well as a variety of regional meetings and
educational presentations in the United States and United Kingdom.
Lessons Learned: A major issue for older adults is separating the effects of
"normal aging" from the unique experiences of growing older with HIV. Older
adults may incorrectly feel they are not at risk or that their needs are marginalized
from the overall HIV or aging service or educational target groups. Specific efforts include education of service providers about HIV-related needs in the older
population, including how to tailor treatments and adherence motivation for older
individuals.
S13399 Adolescents and HIV/AIDS in Benin City, Nigeria (January
1994 to April 1997)
Elsie Offor, Grace O. Ogbeide, Evelyn Unuigbe. Dept. of Medical Microbiology
Faculty of Medicine University of Benin, PMB1154 Benin City, Nigeria
Objectives: To determine the prevalence of HIV/AIDS among adolescents in
Benin City. A recent study showed that 15% of adolescents here were sexually
active, some even from age 13 to 15 years. Also 10% had been treated for
sexually transmitted diseases (STD).
Methods: We studied adolescents (13-19 years) - and young adults (20-25
years) patients at the University of Benin Teaching Hospital (UBTH). Young Adults
were included since most of them must have been infected during adolescence.
From January 1994 to April 1997, serum samples from 46 adolescents and 109
young adults were tested by ELISA or rapid test kits. Repeatedly reactive sera
were confirmed positive by Western blot.
Results: Point prevalence for adolescents were 0% (0/6), 7.1% (1/14), 20%
(2/10) and 6.3% (1/16) and for young adults -26.7% (4/15), 14.3% (4/28), 26.7%
(8/30) and 33.3% (12/36) respectively. Cumulative prevalence were 8.6% and
25.7% for adolescents and young adults respectively. In the study period 1
adolescent and 2 young adults died of AIDS.
Conclusion: These data indicate an already existing and an increasing trend
of HIV/AIDS among adolescents in Benin City. Implementation of an intensive
targeted public health STD/AIDS prevention programme is urgently necessary,
especially in schools.
S134001 Determination of the surviving period of patients with
AIDS, diagnosticated in 1993, in Costa Rica
Juanita Alvarez, G. Herrera. Calle 10 - Avenida 34, Contigou Plaza Deportes,
Cristo Rey, San Jose, Costa Rica
Objective: To determine the period of survival among people with AIDS diagnosis
in 1993.
Methodology: The analysis of the record of 125 patients reported in the year of
1993 and the variables such as: clinical diagnosis of death, level of CD4, therapy
received, date of death and others.
Results: In the analysis of 104 patient's records, the period of surviving was:
in 18 patients -1 to 29 days (14.4%); 17 patients -1 to 3 months (13.6%); 12
patients 8 to 11 months (9.6%); 14 patients -1 to less than 2 years (11.2%);
only 4 patients: 3 to less than 4 years (3.2%); 27 patients with no information
about death report. Only 6 patients had received antiretroviral therapy from this
population. Sixty-two were homosexuals and bisexuals (50%), 23 heterosexuals
(18.4%), 99 patients were male (79.2%), 5 female (4%). The age average among
patients were 20-39 years old: 63 patients (50.4%).
Conclusions: Most of the patients were diagnosticated with AIDS in an advanced stage of the disease, which conditioned them to have a very short life.
It is important to promote free, confidencial testing with adequated counseling in
order to detect persons with early infections.
I 13401 Who is "the community" in community collaboration?

Kathleen MacQueen1, L. Blanchard2, E. McLellan3, G. Millett4, D. Metzger5,
S. Kegeles6, R. Strauss7. 'CDC 1600 Clifton Road, Atlanta; 2Lehigh Valley
Hospital, Allentown, PA; 3TRW, Inc. Atlanta, GA; 4University of Alabama,
Birmingham, AL; 5University of Pennyslvania, Philadelphia, PA; 6Center for AIDS
Prevention Studies, Sqn Francisco, CA; 7University of North Carolina, NC, USA
Issue: Community collaboration is increasingly recognized as critical to the success of HIV/AIDS prevention and treatment research and programs in the US
Effective collaboration requires an understanding of how different populations
define their communities and what they perceive as their strengths.