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

12th World AIDS Conference

Abstracts 13443-13447 175

13443 1 Business responds to AIDS: Integrating research into
practice
Cynthia M. Jorgensen1, A. Hammock1, V. lannscchione2. 1 Centers for Disease
Control and Prevention (CDC), 1600 Clifton Road, Mailstop K-52, Atlanta, GA
30333; 2Research Triangle Institute, RTP Research Triangle Park, NC, USA
Objective: To describe how research results from a national probability survey
of US business policies and practices regarding HIV/AIDS have been used to
further the Business Responds to AIDS program of the US Centers for Disease
Control and Prevention.
Methods: During summer 1995, the Responds to AIDS Program conducted
the first national probability survey of US businesses (n = 2252), stratified by size
and industry type. Businesses were randomly selected from a national list of more
than 470,000 US businesses with 50 or more employees and surveyed on using
a computer-assisted telephone interview. The response rate among eligible businesses was 79%, yielding 95% Cls ranging from +/-4% to +/-8%. Businesses
were asked about health benefits, workplace disability policies, manager training
on these policies, employee and family education and charitable efforts related to
HIV.
Results: Logistic regression modeling techniques were used to analyze the
data, and predictive models were produced on three key outcome variables - HIV
policies, education, and philanthropy. Of businesses with 50 or more employees,
28% reported an antidiscrimination policy for people with HIV (range 18%-80%
by size), and almost all train their managers in these policies. Smaller businesses
that reported ever having an employee with HIV were two to three times more
likely to have an HIV policy than were businesses that were unaware of an HIV+
employee. Businesses that are self-insured are six times more likely to have a
policy. Having an HIV+ employee and potential exposure to blood at the worksite
was associated with five to six times higher rates of HIV education. Results such
as these were used to better market the program, further materials development,
and adjust program direction.
Conclusions: Using research to guide programmatic efforts can be very useful
in identifying key factors that influence policies and practices at the worksite. Program changes resulting from this research include the dissemination of results
to other business leaders to publicize the business community, development of
documents in areas of need (e.g., employee and family education), and further
targeting of program efforts toward the segments of the business community
identified by the survey as needing additional support.
13444 Early intervention demonstration projects (EIDPs) in the
US: Linking HIV care and prevention services at the local
level
Joan Holloway, J.F. O'Neill, A. Powell, M. Gomez. US Health Resource &
Services Admin. (HRSA) 5600 Fishers Ln. 7A03 Rockville, MD 20857, USA
Background: To gain experience in managing the incorporation of early intervention (El) services into publicly-funded HIV programs at the local level and identify
primary care organizational strategies for linking new El services with existing
counseling and testing programs.
Design: From 1991-95, the Health Services and Resources Administration
(HRSA)/Centers for Disease Control and Prevention (CDC) funded local health
departments (LHDs) to establish EIDPs, among the first HIV early intervention
service programs developed in the US Projects were evaluated using a case
study design based on interviews with key staff members and review of project
documents.
Methods: LHDs carried out four major activities: 1.) design a network of publicly-supported counseling and testing sites; 2.) El diagnostic and clinical services;
3.) case management to coordinate other needs; and 4.) HIV prevention services.
Five service objectives were used in evaluation: 1.) outreach and recruitment;
2.) case finding and identification of clients; 3.) development of referral linkages;
4.) prevention programs; and 5.) primary medical care programs. LHD strategies
differed in the scope of services provided, number and type of network agencies,
allocation of funds between services and networking activities, and the creation
of specialized HIV clinics or use of exiting primary care services.
Results: LHDs developed four major program types: contracting to a major
medical care provider; enhancement of existing programs; emphasis on referral
and tracking; and use of existing system of care. Implementation timelines were
longer than anticipated. Challenges included: oversight; forging linkages; and
gaining agency staff support.
Conclusion: Implementation experiences from these EIDPs provide valuable
insights on the design of future El programs. In the development of El services, program design should address: 1.) developing trust between patient and
providers and between network providers; 2.) tracking HIV-infected persons from
counseling sites to care providers; and 3.) strong linkages to drug treatment
programs, mental health services and inpatient care.
13445 Assessing the needs for preventive actions against
STD/HIV/AIDS among Filipino seafarers

Agnes Tecson1, F.V. Ricon2, A.R. Busque1. 'Occupational Safety & Health
Center North Avenue Cornner Science Rd. Diliman; 2University of the
Philippines-Manila, Manila, Philippines
Issue: The working and social environment of Filipino seafarers make them
vulnerable to psycho-social problems, diseases and injuries, prominent of which
is increased risk of exposure to STD/HIV/AIDS infections due to commercial sex.

Project: Focused Group Discussions (FGDs), key informant interviews and
structured personal interviews were utilized to determine knowledge, attitudes, behavior and practices of the seafarers and their families A total of 58 representatives
from manning agencies, non-government and government organizations, seafarers and their wives participated in the FGDs; 10 key informants from the maritime
industry and 314 seafarers were interviewed using structured questionnaires.
Results: Majority of seafarers were in their most productive age (average
age, 35); 73.8%, college graduates. On respondents' awareness on HIV/AIDS,
95.88% have heard about the disease but many harbored misconceptions. Asked
on the sources of information, 65.29% of respondents cited print materials while
1.60% said information came from their families. Pre-departure orientation seminars were also mentioned but discussions on health aspects were very minimal.
With regards to attitudes and behavior, 49.04% engaged in sexual activities with
partners other than their wives due to drunkenness or peer pressure. In terms
of practices, 72.0% of respondents informed about STD/HIV/AIDS changed their
sexual lifestyles by abstaining from sex, maintaining a regular partner or using
protective devices such as condom.
Lessons Learned: Workplace initiatives to raise the level of knowledge and
awareness of workers, specifically seafarers need to be undertaken/expanded.
Existing programs, i.e. the Pre Departure Orientations required revisions to include
discussions on occupational safety and health particularly the risk and repercussions of STD/HIV/AIDS. Development/dissemination of information materials will
provide relevant information and lessen misconceptions.
13446 Private sector involvement in sustainable and innovative
prevention programs in the workplace
Annelise Hirschmann de Salazar1, M.J. Solis2, B.S. Zelada2, L. Chavez2,
F. Cano2. 11 Ave 11-19 Zonal 2Do Nivel Guatemala City; 2AGPCS-Fundacion
Fernando Iturbide Guatemala, Guatemala
Issue: The socioeconomic impact study for Guatemala shows that private enterprise will be affected severely by decreased productivity, increased costs in
training and health care costs, and loss of human life due to the AIDS pandemic.
Private enterprise involvement in innovative and effective program that targets
men and women in the workplace are neccesary in order to lessen the impact.
Project: Given the impact that AIDS is having on men and women of productive age, a comprehensive, innovative and participatory 22 hour workshop was
developed to implement in private companies all over Guatemala city. Employees
have the opportunity to receive the workshop and of becoming peer educators
for other employees and their families.
Results: The implementation of AIDS prevention programs in private enterprise
has been challenging but successful. During 1997, 12 companies have trained
their employees about AIDS through the comprehensive workshop program. 50%
of these, have established continuing peer education within the companies. 86%
of general managers apporached are intereted in having a permament AIDS
prevention programs implemented. More than 90% of all participants increased
their knowledge and modified attitudes about AIDS and condom use.
Prevention programs directed at people in the workplace are elective if the
employer is supportive of the program and believes that his company will be better off in the future through these innovative AIDS education training programs.
These programs are funded by the companies themselves permiting the project
to be sustainable.
S13447 Developing a multi-sectoral approach to STD/AIDS
prevention in the workplace for truckers
Perfecto Uysingco1, J.U. Del Gallego2. Tridev, Room 206, Del Mundo Bldg.,
2121 Taft Ave., Malate Manila; 2Tridev Specialists Foundation Inc., Manila,
Philippines
Issue: Truckers belong to an occupational group considered at high risk to
STD/AIDS. Since truckers are a very mobile and transient group by virtue of
their occupation, STD/AIDS interventions for this group require a multi-sectoral
approach right at the workplace or truck depots where truckers are based.
Project: The project aims to mobilize multi-sectoral participation and support
among trucking companies, private sector and government in establishing and
sustaining STD/AIDS prevention for truckers in the workplace. The project is
considered the first in the Philippines to provide interventions to truckers in their
workplace. The two-year project (August 1996-July 1998) has four major components: Networking and linkaging; Outreach and peer education; Monitoring and
evaluation; and Capability building.
Results: As of December 1997, the project has established partnerships with
10 trucking companies and trained 10 company coordinators from among managers, supervisors/dispatchers, and 24 peer educators from among drivers and
helpers. The partner companies provide space and time for employees to attend
project activities in the truck depots. The project has also established a referral
system for STD management with 11 city health centers, 3 social hygiene or STD
clinics and 2 nongovernment organizations (NGOs) in 2 cities where the partner
companies are based. It has trained 95 government and NGO personnel in STD

syndromic management from the referral health centers and clinics. Through its
outreach and peer education activities, the project has reached 1,207 truckers
with STD/AIDS prevention and risk reduction information. It has provided voluntary HIV/SY testing for 97 truckers. The project has conducted a baseline survey
and a mid-project monitoring survey.
Lessons learned: Multi-sectoral collaboration and support is an effective
approach in establishing and sustaining company-based STD/AIDS prevention