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

12th World AIDS Conference

Abstracts 14291-14296 241

14291 Etno-psychological project of HIV/AIDS prevention in
Peruvian communities organisations
Oscar Ortiz1, Aristides Vara Horna2, A.I. Aldazabal2, W.U. Alata3,
I.C. Hernandez2, M.A. Lozada4, C.I. Rocceti2, M.H. Cother2. 11r. Los Grafitos
721, Lima 36; 2lnadisar, Lima; 3Unsaac, Cusco; 4UNFV, Lima, Peru
Issues: Vulnerable populations to HIV/AIDS. Limited acces of rural populations
to HIV/AIDS prevention programes.
Project: A model programe was designed, wich one was used in three peruvian
communities: Chincheros, Punchauca, Chavin de Jauja. The programe is estructured metodologycally in: a) The narrative investigation, used for the recolection
of information about the population necessities and the preparation of educative
instruments and the registration. b) Etnopsichologycal techniques, that allows the
preparation of theoretic process in the population, the community participation,
and the organisation of preventive events against HIV/AIDS. c) Administration
of etnocontingencies, allows the sistematically modification of the community
behaviour. D) Community evaluation, were evaluated the changing of community
behaviours through temporal series interventions (TSI) and the checking of the
changing behaviour registers (CBR).
Results: In the 3 communities were the active participation of the ethnics
liders: politicians, religious, educators, families organisations and merchants. The
metodology of evaluation TSI and CBR offered sistematically information about
all the process of behaviour changies. The knowledges attitudes and preventive
practices were increased significantly. Were developed productive economical activities, and were consolidated support net based on the community organisations,
generating disfavourable context to HIV/AIDS propagation.
Lesson Learned: The organizated participation of the community, the especifyng of the objetive comunities, the preparation of registers appropriated to the
evaluation, the administration of appropriated behaviour modification techniques
and the flexibility in the redising of that interventions, allows the development
preventive skills in the community, taking to the reduce of vulnerability and risk
factors to HIV/AIDS.
14292 1 Social and sexual behaviour intervention against
STD/AIDS among Colombian women
Carolina Garcia Vargas, H. Ardila, J. Stanton. Liga Colombiana de Sida, Avenida
32 NP 14-46, Bogota, Colonbiana
Issue: STD/AIDS combined with Sexual-Reproductive Health Programs are not
available for women, especially for low-income women in Bogota. HIV-AIDS
prevalence shows a rapid increase among this population. AIDS risk behaviours,
gender, male power role and social and economic dependence to male partner
represent very common aspects among this targeted group.
Project: To design an educational stratregy in HIV AIDS, sex and reproductive health for colombian women from low economic level. To validate an HIV
reproductive health and sexuality educational package in order to be distribute to
institutes that provide services for these populations. The intervention design and
communicational material was based on the sexual, gender, reproductive and
HIV topics discussed in the focus group sessions with the participation of 100
women. Intervention strategies were based on Sex Behaviour Change Models
(Health Belief Model from, Information-Motivation-Behavioral Skills Model) and
Constructivist Models (social aspects related to gender, type of partner, social
dependence)
Results: Face to face meetings with similar characteristics to Focus Group
Sessions and short and participatory workshops were suggested by the women.
Male participation in Educational Interventions were recommended. Sexuality,
family planning, safer sex, female condoms, risk perception and negotiation with
men about condoms were some of the topics of the participatory wokshop.
Complementary, assertiveness, own sexual control, and differentiation between
love/trust from AIDS prevention were developed through Emotional and Cognitive
Strategies. Peer activities which contribute to community awareness have been
also programmed. Posters were also designed in order to reinforce this program.
Lessons Learned: Voluntarily work among women in order to spread consciousness about AIDS prevention and safe sex in the community seem important
to strenghthen. But combined with family planning, sexuality, empowerment and
gender issues.
14293 Integration of AIDS prevention and management into the
primary health care system
Pantyp Ramasoota. 25/5 Phuttamonthon 4 Rd Salaya, Nakornpathom,
Thailand
Issue: Community participation in the prevention of HIV infection and care for
PWAs can be enhanced through the strengthening of the PHC system.
Project: Given the rapid increase in the prevalence of HIV/AIDS in Rayong
Province, an intervention using community participation in prevention and care of
HIV/AIDS through PHC activities was developed. Two districts, with ten villages
in each, were chosen as experiment and control sites. Village Health Volunteers

(VHVs) in 20 villages were trained by Health center staff through participatory
training to increase their awareness and sensitivity to the problem. The VHVs
abilities in situational analysis, management of community resources, mobilization of people participation, counseling, and training were also strengthened.
The strategies include Participatory Rural Appraisal technique (PRA), Community
Counseling Clinic, Community Relief funds, Community Condom Corner, Youth
Volunteers Club, and the Village Understand AIDS programme.

Results: The villagers in experimental sites were very responsive to the programme. Their knowledge, attitude and sexual behaviors of the villagers were
much improved and were better than that of the control district. PWAs in the
villages were accepted and received good cares by families and communities.
Lesson Learned: HIV/AIDS is not dreadful subject if the people were made
understanding and familiar with the problem.
114294 A transdisciplinary approach to AIDS prevention
programs
Luiza B.N. Alonso. R. Capote Valente 104 apt 21, Sao Paulo, SP 05409-000,
Brazil
Objectives: To discuss the evaluation of AIDS prevention programs regarding
their process, results and impact, and a new proposal for their development.
Design:Qualitative study, focus group.
Methods: Five years of following up of ten AIDS Prevention Programs, including planning, implementation and evaluation of programs for women, adolescents
and heterosexual men in the cities of S. Paulo and Rio de Janeiro. Focus groups
with the purpose to know AIDS educators's experience and expectations.
Results: After fear, explored in many national campaigns that resulted in
lower adherence to preventive behaviors, programs based on awareness and
responsibilities had been developed over the 10 years, with substancial positive
success. However, the question about how do we know a program works well
has not yet well answered. Besides, educators are looking for programs beyond
a mechanistic concept of health and disease. It is imperative to work with the
fundamental laws of life and the enhancement of a social, ecological, planetary
and spiritual conscience.
Conclusions: AIDS prevention programs are the result of social dynamics.
social perception and theorethical framework. An approach that integrates culture, religion, science and art, informatics, politics, education and all members of
society seems to be the third step on AIDS prevention programs.
S142951 Casual sex and condom use: An impact evaluation study
in Bogota, Colombia
Ricardo Garcia-Bernal', J.A. Castro2, J.M. Caamano2, W.I. Klaskala'. 11400
N. W 10th Avenue, 10th floor (D21) University of Miami School of Medicine,
Miami, Florida, USA; 2Ministry of Health of Colombia, Bogota, Colombia
Objective: To evaluate the impact of national condom-marketing campaign on
sex practices among heterosexual individuals using motel facilities for casual
sexual encounters.
Methods: In 1996, a total of 214 motels frequently used for casual sex were
randomly selected and included in the study. A total of 850 motels' rooms were
equally assigned to either intervention or control group. Those rooms belonging
to the intervention group were equipped with graphically appealing pamphlets
promoting condom use and a pack of free condoms. Motel guests who used the
study rooms, at the time of their check-out, were approached by medical students
and asked to answer six questions related to condom use. Proportion comparisons and chi square tests were used to measure significance of differences
between cases and controls. In addition, a total of 1500 short, self-administered
risk-behavior questionnaires were distributed among motel guests, excluding
participants of the case-control study.
Results: Majority of subjects (98%), predominantly men (76%), provided verbal responses. One out of three participants from both groups (34% cases, 32%
controls) admitted using condoms while staying at the motel; no statisitically
significant differences were revealed (p > 0.05). The main reported reason for not
using condoms was the fact of having stable sex partner (25%). In the risk-behavior questionnaire, a total of 1,043 responses were received giving a compliance
rate of 69.5%. Majority of respondents (87%) knew that condom protects against
STD/HIV but only 34% of them actually used condoms during their stay at the
motel. Of those, 28% claimed using condom consistently. Half of the respondents
indicated that condom decreases sexual pleasure.
Conclusions: Availability of free condoms and provision of related educational
material, did not increase frequency of condom use. Despite of having good
understanding of protecting role of condoms against STD/HIV, heterosexual individuals involved in casual sex endeavors, continue engaging in risky sex practices
and neglecting condom use. An innovative approach for improvement of existing
condom promotion campaign is needed.
14296 Reflections on first round of HIV/AIDS behavioral sentinel
surveillance in two sites in the Philippines
Perfecto Uysingco. Tidev, Room 206, Del Mundo Bldg., 2121 Taft Ave., Malate
Manila, Philippines
Issue: Behavioral sentinel surveillance (BSS) is critical in providing information
for action on the trends and prevalence of behaviors related to HIV transmission
among selected population groups considered at-risk to HIV/AIDS.

Project: The Philippines conducted its first BSS in 10 surveillance sites (primary cities) in 1997. The project conducted the BSS in 2 sites, and analyzed
and evaluated the survey design, methodologies and tools and the process of
its implementation in the 2 sites. In particular, the project assessed the selection
of sentinel groups, key variables, survey questionnaires, organization of survey
teams, conduct of data collection, and relevance of BSS data to STD/AIDS
prevention programs.