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

12th World AIDS Conference

Abstracts 13486-13490 183

clinic, in the Abidjan area, serving the medical and psychosocial needs of predominantly indigent PWAs and their families. Strategies have included creation
of a self-support group at the clinic and the development of an ongoing collaborative (internal and external) peer-driven prevention program. In South Africa, the
program consists of the development of community-empowered support groups
linked to Primary Health Care centers. These groups in turn provide multi-faceted
prevention programs by using community resources.
Results: The program in the C6te d'lvoire has, in the past 7 years, provided
care to almost 2000 PWAs. The development of the support group (with an active
membership of over 150) has further promoted solidarity and behavior change
among its members. Members also form part of ongoing school and prison AIDS
prevention campaigns, which have produced significant increases in knowledge
on AIDS and condom use. In South Africa, the program has developed 12 support
groups and 4 satellite support programs. These groups combined, educated over
150,000 people last year and held over 1200 counseling sessions.
Lessons Learned: AIDS programs, that combine care and prevention, substantially increase credibility and solidarity, and help reduce fear and discrimination.
It has been shown to be an effective strategy in addressing, the care needs of
PWAs and reducing further spread of the HIV epidemic.
13486 Home care programme for HIV infected women in Kenya
Christine A. Kowi, R.G. Lenya, P.A. Aduwa. Tapwak, PO. Box 30583, Nairobi,
Kenya
Objectives: Within the project of the HIV+ women care programme we implemented and partially assessed a home care programme so as to support people
infected with the disease.
Method: 50 women were enrolled and 25 agreed to commit themselves to the
home care programme. Visits were carried out by TAPWAK counsellors and a
consultant from medicine sanfrontier who distributed first aid drugs and food. We
organised weekly meetings for group training and counselling outside homes.
Each month, each woman is given an individual target to meet. These are reviewed every next meeting. Data are supplied on health status, nutrition and
social interest issues.
Results: All women favourbly answered to these visits and we recorded only
one death. Most HIV+ cases changed for the best through drugs and visitors
support. Difficulties were due to finance trouble and despair The women talked
of specific issues and were encouraged to live positively.
Conclusion: The pilot programme's partial results showed that homecare visits are comforting and improve infected women's quality of life thus, taking into
account this aspect is important to support PWAs.
13487 1 Evaluation of STD services acceptability in the general
population in Kinshasa, Congo
Bazola Malele, Nzila, Kivuvu, Tuliza. Project Sida BP 8502 Kinshasa,
Democratic Rep Congo
Objectives: * To evaluate STD services acceptability. * To compare the attendance (new cases: NC) between an STD Specialized Center (SSC) and other
primary health care centres (PHCC).
Methods: one SSC and 9 other PHCC provided STD services, after personnel
training, drugs and materials suppling. Large information on STD/HIV around
those centers was given by a theatrical company.
Results:

positive patients. Reasons given and observed for noncompliance with UP were
lack of time, non availability of personal protective equipment, barrier precautions
interfering in the skill, lack of a role model, habit, forgetfulness and lack of personal
esteem.
Lessons learned: Measures for improving compliance like constant supply
and easy availability of personal protective equipment, behavior modification
methodologies need to be incorporated into education programme. Incentives for
innovations, involvement of HCW in decision making, role modeling, penalty for
noncompliance are some of the techniques currently being considered.
13489 Participatory workshop - Effective tool for changing
attitudes towards HIV. Experiences of the UNDP/HIV and
Development Programme Warsaw, Poland
Kasia Malinowska-Sempruch1, J. Kazana1, G. Budka2. 1United Nations
Development Programme UNDP, UN Centre, PO Box 1, Warsaw 12; 2Social
AIDS Committee, Warsaw, Poland
Issue: Lack of systemmatic training in HIV/AIDS for various professional groups
results in a great and urgent need for innovative education.
Project: One of the most urgent needs emerging during implementation of
the first National Programme on AIDS in Poland (1993-1995) was a need of
a systemmatic training in the field of HIV AIDS for various professional gruops.
UNDP's HIV and Development Programme since it's creation in Warsaw in February 1995 has been receiving numerous requests for training both from the health
care sector, as well as from the social assistance institutions, eucational settings
and NGOs. Untill now we have trained some 7,000 individuals (nurses, doctors,
psychologists, priests, community leaders, prison administration, etc.) From the
evaluation forms that follow, some 95% of workshop participants state that before
our training they were never provided with information on HIV/AIDS other than that
from the media. For many of them participatory raining was the first experience
of this kind. As a person living with HIV is on each training team, this was also
the first time they conciously meet an HIV positive individual. One of our major
partners in this work was a local NGO, the Social AIDS Committee. Based on
the training methodology of the HIV and Development Programme headquarters
in New York, we have set up together a training programme on psychosocial
aspects of HIV and AIDS.
Results: The workshop of the HIV and Development Programme has been a
remarkable success throughout the country. It proved that the new methodology
of participatory training is very effective. After each training session an evaluation
form has been distributed to participants. A total number of some 5000 questionnaire's returned to us constitute the basis for our conclusions on effectiveness
of workshops on HIV. It also helped us to establish which working methods are
most successful. The extent of interest in our workshops currently exceeds our
training capacity, therefore a team of UNDP/HIV educators have been certified to
serve the needs of their local communities.
Participatory training is the most effective way to change peoples negative
attitudes towards HIV and AIDS. Workshop in which each participant has a
chance to present his/her views on the subject stimulates an internal dialogue
within particular community on many other sensitive issues (medical ethics, sex
education). Meeting the HIV infected person, along with an broadened knowledge
on HIV/AIDS, is the most valuable experience of participation in such workshop.
S13490 HIV/AIDS transmission in district health structures:
Impact of preventive strategy with health workers in
Cameroon
Etienne Kemou1, Justin Todem2, Tokam Martin Fetue3, Jean-Marie Talom3,
Leopold Zekeng4, Mamoudou S. Diallo6, Lazare Kaptue5. 1PO. Box 13162
(NGOs-SADE-Cameroon and SidAlerte), Yaounde; 2General Hospital-Younde,
Yaounde; 3SidAlerte, Yaounde; 4CHU, Yaounde; 5FMSB, Yaounde, Cameroon;
6PNUD-PNLS, Cotonou, Benin
Objective: To evaluate risk practices for HIV/AIDS transmission in limited resources health structures during care and assess the impact of a preventive
strategy in Cameroon.
Methodology: A two year program was develop from 1995 to 1997 in many
district hospital in Cameroon. The strategy consisted of: a baseline study follow
by the observation of practices during care. Analysis of data collected with all
staff member help to develop an adapted work plan for the hospital. Monitoring
and frequent evaluation and adjustment of that plan lead to the following results.
Results: 12 district health structures were involved. Data analysed shows
many high risk practices during care: 66.3% of health workers can't identify nosocomial infections within their service. 71.5% don't washed their hands before and
after care. 81% of health workers have been injured by used material (needles,
blades, etc.). The main risk practice is needles protection, etc. While 91% of
respondents recognised that body fluids projection is risky for HIV or hepatitis
transmission, only 24.9% take necessary precautions to protect themselves i.e.
wear of glasses, overall and mask, etc. The lack of information, training and staff
mobilisation are the major factors for these practices and attitudes. There is no

appropriate procedure for waist collection and care procedure in many services.
Results of the pilot program establish in each hospital lead to: mobilisation of
12 hospital staff through hygiene committee; establishment of waist collection
procedure in 12 hospital. The hygiene committee members are now training other
workers, controlling care quality and hygiene within the hospital. Two of them
have developed a strategy for cost recovery to ensure perennity and viability the
program. Access to educational and training documents is effective in most of the

Year
# STD NC managed by the SSC
# STD NC managed by the 9 PHCC

1996
7163
2896

1997 Total
9238 16401
4516 7163

Conclusions: The quality and accessibility of STD services play a major role
in the attraction of persons with STD or at high risk of STD. Because of incresead
information on STD/HIV, people attend the STD centres without self-consciousness.
S13488 Prevention of HIV transmission in a teaching hospital in
India
Geeta Mehta. Dept of Microbiology, Lady Hardinge Medical College, C-132
Defence Colony, New Delhi 110024, India
Issue: In India, the prevalence of HIV in the general population is increasing
rapidly and thus increasing the risk of transmission of HIV in the hospital environment.. Advocacy and compliance with the Universal Precautions (UP) is therefore
of prime importance.
Project: Education and awareness about the risk of transmission of HIV and
UP was made a part of medical teaching and imparted to all levels of health care
workers (HCW) during the infection control programme intensified during the past
2 years. As a part of the programme, a survey based on questionnaire and direct
observation was undertaken at intervals to estimate awareness, attitudes and
compliance with UP and other infection control methods.
Result: Analysis of surveys before, during and after 2 years of intensified
teaching showed a significant overall increase in the level of awareness among
all categories of HCW about the risk of transmission of HIV in the workplace. However, compliance with UP was inadequate and showed little consistent change,
adequate preventive measures continued to be mostly limited to the care HIV