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

410 Abstracts 23342-23347

12th World AIDS Conference

I 23342 Sexual health outreach amongst the Hijra (transvestite)
community of Peshawar, Pakistan
Tufail Mohammad1, Andy Bowerman2. 1Regional Institute, Peshawar; 20ra,
Peshawar, Pakistan
Issue: In all research and support there is little work aimed at this vulnerable
group. They have an historical presence in the North West Frontier of Pakistan and
are famous for their dancing and their freedom of sexual expression, behavioural
features restricted for the majority of the population.
Project: ORA and Physicians Forum for Family Planning are conducting an
outreach program into 2 groups of Hijras. The project is targeting basic health
needs and counseling of the sex workers. It includes within it STD management,
safer sex education and peer support to enable treatment as well as to facilitate
safe sex practices and basic health education advice and support. By focusing on
the immediate felt needs of the hijras, the community workers are finding a point
of entry into an other wise closed community. They are working on empowerment
of the clients to enable them to adopt safer behaviour. Initially they are trying to
gain a better understanding of the sexual identities and roles of the group. This is
happening through focus group discussion and with a weekly drop in clinic.
Results: Strategies for providing information and prevention materials (such
as condoms, lubricants) have been well received. So far more than 30 different
Hijras have received information and/or have requested a health screening. Of
these 7 have received treatment for a specific STD. More requests for referrals
are coming each week.
Lessons Learned: Rapport with community leaders and focal persons is essential to gain acceptance into vulnerable groups. The ability to work non-judgementally and without preconceived prescriptions has led to genuine relationship
building.
2242*/23343 Mobile AIDS booths (MABs) - A novel intervention
for migrating labour and their families
Surya Rao Kutikuppala, K.S.N. Raju, R.D. Pilli, K. Prakash Babu. Child
Foundation of India, Visakhapatnam, India
Issue: Migrating labour vulnerable to HIV/AIDS due to their life style in the cities
of India require innovative and suitable intervention strategies and appropriate
AIDS health awareness.
Project: Owing to rapid urbanisation and industrialisation many young men
and women from villages have been migrating to the cities for their livelihood. In
our study we found that 80% of the men who have been coming to cities getting
attractive wages and as there is lot of money in their hands while away from the
families for a long period they are going to commercial sex workers in the cities
and also having sex with co workers. After working for a period of 3-6 months go
to their native place for festivals like Dasara, Diwali or Sankranti where have sex
with their wives and infecting them. Having seen the fast hike in the number of
migrating labour infected with HIV/AIDS in and around Visakhapatnam city during
the past couple of years intervention strategies have been developed. The project
has on its staff the peer educators, professionally qualified medical practitioners,
counselors and social workers. Strategies include person to person information
at their workspot and habitation, counselling on HIV/AIDS, Health Education and
Sex Education combined with supply of condoms, group counselling and families
counselling through MABs.
Results: Mobile AIDS booths have been very well received by the migrating
labour. Within four months the number of customers increased from 18 to 340
going beyond our expected response by over 100%. Many migrating labour have
stopped going to prostitutes and developed a positive approach of using condoms
all the time when they happen to go for sexual intercourse.
Lessons Learned: Seventy (70%) migrating labour are illiterate as such initially
they have not accepted our approach with MABs but slowly due to techniques
adopted by us suitable to their attitude, cultural background, working pattern,
the results are very encouraging. The MAB programmes are potentially successful when they are addressed particularly to meet the specific needs and
undertstanding of the migrating labour and their families.
23344 | Impact of HIV/AIDS enlightenment on acceptability of
male condom use among female commercial sex workers
(CSWs) in Borno State, Nigeria
Tekena Obu Harry1,2, M.T. Wakili, L.A. Bello1. 1State Specialist Hospital,
Maiduguri; 2University of Maiduguri Teaching Hospital, PMB 1414 Maiduguri,
Borno State, Nigeria
Objective: To find out to what extent, if any, HIV/AIDS enlightenment would
influence the acceptability of male condom use among female CSWs in Borno
State, Nigeria.
Methods: 125 CSWs were enrolled in Maiduguri, and 125 others in Bama and
Banki, all in Borno State. Personal data were obtained from all 250 participants
through a questionnaire administered individually. The questionnaire also sought
for information about knowledge of STDs and AIDS. The Bama and Banki (en
lightenment) group were during one visit shown two video films on HIV/AIDS,
and given a lecture on the same subject. The CSWs were subsequently given
100 pieces of male condoms each, with the Maiduguri (comparison) group simply
advised to get their clients to use the Condoms. Much later, the CSWs were
visited again, to find out from each how many of the condoms had been used.
Results: With respect to age distribution, duration of prostitution, levels of
formal education, and knowledge of STDs and AIDS, the two groups were very

similar. However, among the enlightenment group condom use averaged 61.9%,
while among the comparison group it averaged 30.2%.
Conclusion: Enlightenment greatly increased acceptability of condom use.
With more enlightenment sessions, we expect the acceptability of condom use to
approach 100%. This will greatly help in the prevention of HIV spread from CSWs
among whom seroprevalence was 60.6% in 1996 in the same area.
233451 Practice of universal precautions in health care workers
in Thailand, 1987-1997
Ratree Sirisreetreerux1, Wiwat Rojnapithayakorn2, Wiput Phoolcharoen3. 1AIDS
Division Department of Communicable Disease Control Ministry of Public
Health; 2Senior Experts Dept. of Communicable Control; 3Director of AIDS
Division Nontaburi 11000, Thailand
Objective: To review the measures for preventing HIV transmission in health
care setting in order to identify management problem and develop guideline for
strengthening the universal precaution practice.
Methods: Data were collected from 2 main sources: 1. routine reports on universal precautions activities of all hospitals and 2. surveys and research reports
relating to exposures of health care workers to blood body fluid of patients before
and after universal precautions and cost of protective equipment and supplies.
Results: During 1987-1997, Ministry of Public Health had developed guidelines for prevention of universal transmission among health care workers. The
guidelines were distributed to health care facilities throughout the country. Training
of HCWs were conducted accordingly. It was found that the exposure rate before
and after the practice of universal precautions was 69.1 and 72.7 respectively.
A survey conducted in 1993 revealed the HCWs were mostly at moderate level
of universal precautions knowledge but not strictly practiced. There was over -
utilization of gloves and gowns making the cost rate on protective barriers before
and after universal precaution practice of 1:2.5. These finding indicated that the
real practice of universal precautions was at lower standard when compared to
those recommended in the guidelines.
Lessons Learned: The level of knowledge, experiences, beliefs and attitude
varied among health care workers. The routine training and seminars were not
successful in changing such behaviors. It is recommended that universal precaution practice be strengthened by participatory learning or interactive training
strategies.
23346 Harm prevention for infectious occupational accidents in
the health care group
Ignacio Maglio. Seccion Riesgo Medico Legal Hospital Muhiz, Parana 426, Piso
14", Oficina "1". (1071), Buenos Aires, Argentina
Objectives: Based on the study of legal, clinical and bioethical dilemmas which
aroused from different occupational accidents in an infectious diseases hospital,
a proposal of institutional harm prevention programme for occupational accidents
in VIH/AIDS was developed.
Project: The impact of HIV seroconversion in health-care workers after accidental exposure to HIV, locally and internationally, was studied. The social
constructions as regards risk by fear of contagion were determined together
with an evaluation of the health-care worker's risk of acquiring the infection.
Information about the determination of the risk of transmission from health-care
workers to patients was compiled. Based on the observation done, a programme
of harm prevention was designed as well as models of informed consent to report
accidents and cases of VIH infection in health care workers.
Results: Based on the implementation of the programme we obtained: a better
acceptance of the fulfillment of preventive and biosecurity measures, calmness
in the care group about the post-exposure covering, fall down of occupational
accident rates, clearness in the different levels of responsibility and consolidation of and adequate legal framework to prevent harm from discrimination
to the health-care workers HIV infected by implementing informed consents
which reasonably protect the interests of the institution, patients and health-care
group.
Lesson Learned: A harm prevention programme on occupational accidents
from an anthropological, legal and bioethical perspective allowed an integral
comprehension of the problem which gradually improved the acceptance of the
measures and the occupational conditions.
S527* / 23347 Heterosexual and perinatal transmission of HIV-1:
Associations with bacterial vaginosis (BV)
Taha Taha1, N. Kumwenda2, G. Liomba3, J. Chiphangwi3, D. Hoover2,
G. Dallabetta4, P. Miotti5. 1615 North Wolfe Street Suite #E6011 Baltimore,
Maryland; 2Johns Hopkins University Baltimore MD; 4AIDSCAFP FHI Arlington
VA; 5NIAID, NIH, Bethesda MD, USA; 3College of Medicine, University of Malawi
Blantyre, Malawi, Africa
Objectives: To determine the association of bacterial vaginosis (BV) with preva
lent and incident HIV infection and to examine the influence of BV on mother to
child transmission (MCT) of HIV.
Methods: Two large cross-sectional studies were conducted in 1990 and 1993
on pregnant women in Blantyre, Malawi. After appropriate counseling and obtaining informed consent, pregnant women were screened for HIV and sexually
transmitted diseases. HIV uninfected women were followed antenatally and postnatally to study risk factors for HIV seroconversion. HIV infected women were also