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

188 Abstracts 13511-13515

12th World AIDS Conference

Lessons Learned: National AIDS Plans are not commonly known to union
leaders and teachers. Such plans could be improved with increased multi-sectoral/disciplinary input. The experience and credibility of union leaders can help
communities in efforts to determine the most appropriate ways to educate students about HIV prevention. Workshop instruments are useful in setting clear and
concrete objectives for HIV-related training and education. Trainers of teachers
must be careful in addressing sensitive differences.
13511 Level of risk continuum as a tool in HIV/AIDS prevention
education
Lalitha Sankaran, S. Sankaran. Desh 3 De Monte Colony Alwarpet, Chennai
600018, India
Issue: To use Level of Risk Continuum as a strategy to enable adolescents
understand sexual risk behavior.
Project: Adolescents need complete information on HIV/AIDS within an open,
and sensitive vision of human sexuality. However interventions aimed at adolescents have largely been moralistic and rigid laying down patterns of sexual
behavior in terms of "DOs" and "DON'Ts". Recognising this, DESH designed after
extensive field testing a loosely structured package for youth on issues related to
sex and sexuality.
A simple and watertight classification does not provide adolescents with full and
complete information on the degrees of 'risk' and 'no risk' attached to particular
sexual behavior. A Level of Risk Continuum is called for if information is to ever
translate into safe behavior and practice. In this Continuum, sexual behavior may
be broadly classified on a scale from High risk to Low risk and No risk. DESH's
intervention in some educational institutions led to an increase in understanding
of the Level of Risk Continuum among adolescents.

Level of risk continuum
High risk: Sex with Low risk: Sex with
multiple partners proper & regular condom use
Pre Post Pre Post
85% 100% 31% 77%
64% 76% 46% 79%

No risk: Sex with
married & faithful partners
Pre Post
47% 63%
89% 90%

Schools
Colleaes

Result: Through this tool young adults grew to understand "why" and "how"
sexual behavior was broadly classified as high, low and no risk. DESH is now a
strong advocate of the Level of Risk Continuum in initiating a thinking process
among adolescents which would lead to adoption or strengthening of healthy
practices and lifestyles.
13512 The role of student-educator interaction in school-based
HIV prevention programs
Dana Rudelic-Fernancez1, France Lert2, D. Jayle1, A. Ugidos1. 1192 Rue
Lecourbe, 75015 Paris, Crips, Ile-De-France; 21NSERM, Paris, France
Issues: What is the specificity of preventive interaction? Is there a "fundamental
rule" which organizes a preventive situation and which supports its reproducibility?
The answer to these questions requires an investigation of various parameters
and variants of the preventive situation.
Project: The research aimed at grasping the interaction underscoring HIV
prevention in school-context. Since 1992, GRIPS lie -de-France has coordinated
a school-based HIV prevention program which involved, in 1995/96 only, 60
000 students in the Paris region. We adopted a qualitative approach centered
on the student-educator interaction. The study included in situ observation of
17 interventions, semi-directive interviews and focus-groups with students and
HIV-prevention educators. Over 200 students were interviewed in general and
professional education schools.
Results: The perception and impact of these interventions was shown to be
directly linked to the school setting itself. When the prevention interaction does
not differentiate itself from the scholarly, pedagogic situation, it is described as
anonymous and interchangeable. The prevention agent is perceived as a teacher,
as someone whose main role is to exercise authority and transmit knowledge.
Five out of seventeen sessions were assessed in this way. In twelve other cases,
educators managed to instigate a more personalized, individual type of interaction
with students. The highest-rated sessions were those in which a two-fold relation
to school context was established: simultaneously inviting students' participation
at the collective, school-centered level (i.e. involving them through pre-existing
groups), they also called on their individual experience and personal history.
Instigation of such interaction often implied use of specific animation techniques.
Lessons learned: Preventive interventions in schools have a paradoxical
status: closely intertwined into the institutional context, they are simultaneously
detached from it. HIV prevention in schools implies a specific form of social
interaction, which relates both to students' school-life and to their out-of-school
existence. More research is needed on school as prevention setting and on forms
of social interaction it engages.
13513 Changes in HIV related knowledge, attitude and risk
behaviors among high school students in Chaing-mai,
Thailand
Nigoon Jitthai. Sch. of Int'l Health, The Univ. of Tokyo, Japan
Objective: To determine the changes in HIV related knowledge, attitude and risk

behaviors (KAP) among high school students in Chaing-mai, one of the areas
with the highest prevalence of HIV infection in Thailand.
Methods: In February 1992, an HIV related KAP survey of high school students
in two Chaing-mai high schools, one urban and the other rural, was conducted.
All of the grade 2 students (average age of 17 yrs) in each school were asked to
fill out a questionnaire during their home room or other class after the teacher had
left the class. The completed questionnaires were sealed and directly returned to
the researcher in order to promote trust and confidentiality between students and
researcher. A survey utilizing the same research instrument and methodology is
currently being conducted and will be completed in January 1998.
Results: All of the 344 students who received questionnaires completed them
(100% response rate). The results showed that most had exposed themselves
to information about drugs, sex and AIDS through several forms of intervention
resulting in a high level of HIV related knowledge, particularly knowledge about
modes of transmission and prevention of HIV infection. However, two-thirds of
the students involved in sexual activity had exposed themselves to the possibility
of HIV infection due to a failure to use a condom. A comparison of the results
of the 1992 and 1998 surveys, as well as the factors influencing changes in the
students' KAP, will be discussed.
Conclusion: The 1992 survey results suggest that besides providing basic
knowledge about HIV/AIDS, AIDS education programs should place more stress
on improving students' communication, relationship and decision-making skills.
S13514 Long distance training of elementary and first grade
school teachers: Sexuality, STD/Alds and drug use
prevention
Inocencia Negrao, M.C. Pimenta, C.E. Santos-Dos. Brazilian AIDS Program
Espl. Ministerios BI. G Brasilia DF, Brazil
Issue: Children are curious and have a natural way do express their sexuality. On the other hand, on a day to day basis, they receive inappropriate and
misunderstanding information, that can influence their attitudes and values.
Project: Searching do teach pre-school, elementary and first grade teachers
how do promote children's health through sexual education and prevention of
infectious diseases, STD, AIDS and drug abuse, the Brazilian National Program
on STD/AIDS and the Long Distance Teachers Coordination of the Ministry of
Education developed a long distance training project.
The project comprises 13 didactic interactive TV programs: 1 on work methodology and presentation; 2 on sexuality; 2 on communication; 2 on family, school
and interrelationships; 2 on STD and AIDS; 2 on drug abuse prevention and 2 on
planning and evaluation.
Through a national Educational Television Network the training was broadcast
to 2,000 remote stations and 50,000 classroom with a TV set spread throughout
the country, where teachers received, during 13 days, one hour TV interactive
instructions completed by two hours/day face to face workshops with teacher
training supervisors. Two specialists were in the central TV Station answering
questions alive or by telephone, fax and Internet.
Results: (1) In 1997, one thousand teachers specialists in long distance teachers' training and 80 thousand pre-school, elementary and first grade teachers
were trained to work with 2 million children aged 4 to 12 years. (11) 2.201.200
million support materials were produced and distributed to 50.000 schools.
Lessons learned: It became a challenge to promote healthy behaviours, attitudes and values aiming to influence a generation. Teachers welcomed the
initiative since they felt unprepared before to deal with issues of sexuality, AIDS
and drug use in the classroom setting in a positive manner.
13515 A KAP survey among youth in school in Nyanza
Province, Kenya
Ivan Hermans1, G. Nyanjom1, M. Ondiege2, R. Poulussen3. 1BADC/NASCOP
PO. Box 30461, Nairobi; 2MOH, Nyanza, Kisumu; 3 VVOB/MOH Nyanza,
Kisumu, Kenya
Purpose: To collect KAP data in order to develop messages and materials for an
STI prevention campaign JISIMAMIE (Stand up for yourself) in Nyanza Province.
Method: 1) Train HCW in operational research 2) Develop tools for KAP survey
3) Conduct 19 FGDs among all target groups and a quantitative survey among
youth in school in all districts 4) Analyse results for use in message and material
development.
Results: Youth being the primary target group, some results for youth in school:
Quantitative: Primary (n = 1483) (1) 58% had heard of HIV (2) Self-perceived
risk was 40.9% for boys and 32.8% for girls (3) 22.6% of girls and 52% of boys
stated they ever had sex (4) Of these 26% ever used condoms (5) mean age
of sexual debut was 12. Secondary (n = 794) (1) 93% had heard of HIV (2)
self-perceived risk was 50.9% for boys and 44.5% for girls (3) 36% of girls and
73% of boys stated they ever had sex (4) of these 52% ever used condoms (5)
mean age of sexual debut was 11.2 (6) same sex practices were reported by 5.2%
of boys and 6.2% of girls In all youth: All had heard about AIDS; boys initiated
sex (primary: 69.2%) but also girls (33.7%) 6.7% of sexually active girls had more

than 5 sex partners. Meaning of safer sex poorly understood (9.9% for boys
and 11% for girls). Qualitative: In 11 FGDs: Attitude towards people with AIDS
was non-discriminative and caring. Self-reported sexual activity was high. Sex is
defined as insertive vaginal sex. Condom use is low as many misconceptions
persist. Girls mainly consider sex as a service to the boy while boys do it for
pleasure and relieve. Basic knowledge on sexuality and safer sex is low. Sexual
debut is considered normal at age 12.