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

456 Abstracts 23569-23574

12th World AIDS Conference

23569 Economical support to needy women and young girls: a
powerful strategy to struggle efficiently against HIV/AIDS
and STD
Ruben Mbaiasra. B.P 1442 Ndjamena, TCHAD
That successful experience scheduled in our communities should be shared in
the purpose to make people from the Third World trying that strategy which is
efficiently leading to a global well-being.
To prevent STD and AIDS in some communities in Chad, local organisations are
working with women and young girls who used to earn money from prostitution;
or who used to go from bars to bars and from cabarets to cabarets where they
can drink modern and local alcohol drinks to be at last in "love" with unknown
men.
Many young girls and women living that ways died from AIDS; their many
boy-friends and their children also.
Since they are dealing with income activities such as commercial, husbandry,
garden and other, some can now demand the absolute use of condom to their
partners; some has made an option to live with one man at a time; some decided
to live without making love till they get married.
Now, we notice that people are facing less and less sexual divagation and
alcohol abuse that means that STD and HIV AIDS transmission should be limited,
as far as women and young girls do no longer, accept men to make sex abuse
with them.
23570 Change of sex behaviour in CSWs in Red Ligh area,
Multan
Akhter Ali Rizvi. 99-C Shah Rukn-E-Alam Colony multan, Pakistan, Pakistan
Community sex workers vulnerable to HIV/AIDS due to High risk behaviour require
coordinated continuous & proper intervention Health Education and support.
Project: 8000 population of lower socioeconomic group was focused in Multan
(South Punjab Pakistan) due to higher vulnerability to HIV/AIDS. To achive the
target STD Clinic was established in the red light area. The project comprises
of, six old sex worker as peer educators, Two supervisors, one coordinator, one
trained lady health worker, one blood screening technician & a medical doctor,
(The project Manager) Stretegy includes, knowledge of STD's HIV/AIDS prevention and condom use, reproductive and general health, Raising self esteem and
social relationships of CSW'S and increasing litracy for alternative employment
support to CSW'S.
Results: Due to police pressures and Muslims social constrains the project was
not received very well in the first eight weeks but in the next three months 929 sex
workers got STD and antenatal medical examination 577 CSWs & residents of
the red light area were screened for HIV/AIDS most of the sex workers changed
their sex behaviour and 11500 condom were used. Out of 1257 doctor/LHV
clints consultations 677 STD patients were identified only 3 HIV+ve patients were
identfied.
Lessons Learned: HIV/AIDS epidemic can be controlled in the sex workers &
general population by establishing clinics educatinq sex workers & clints, screening the high risk areas & changing the sex behaviour by promoting condom
use.
23571 An innovative partnership: In search of better health in
the transport corridor
Shimul B. Ajmera1'2, R.D. Bhattacharya3, J.K. Upadhayay4. 1Gap, B/02,
Siddhachakra Apts., Ellisbridge, Ahmedabad-380 006; 2Programme officer
Ahmedabad; 3Director Ahmedabad; 4Senior field worker Ahmedabad, India
Objective: To increase the awareness on HIV/AIDS/STDs amongst Truckers, to
increase the attendance in STD clinics, increase condom use, decrease in STD
prevalence rate & HIV/AIDS."
Methodology: GAP conceptualized the Truckers Health Project as jointly working with Truck, petrol pump owners and their associations. This was initialized by
sensitizing owners and association members on "Economic Impact of HIV/AIDS
on the Transport Corridor". The immediate outcome of this meeting was involvement of different associations by forming a steering committee, recruiting the
delegates as members, launching an action plan & by establishing partnership
with the Transport company, petrol pump company owners and their associations;
3 Interception points were identified so that 70% of the incoming and outgoing
truck traffic of Gujarat to be contacted; Field Workers and secondary stake holders were trained; Training included condom promotion and demonstration, STD
syndromic approach and counselling to avail STD services.
Result: Involvement of the Transport company owners and their associations
led to: More time and better access; Counselling to motivate truckers to use
condoms and avail STD treatment; Easy distribution and demonstration on use
of condom; Interpersonal communication to bring Behavioural Change through
appropriate IEC material. Better impact of the intervention project; Cost effectiveness; Sowing the seeds of sustainability.
Conclusion: This innovative intervention which has proved to be more ap
proachable and effective is perhaps the best way to interact with the primary and
secondary stake holders on National Highway. This work is supported by a grant
from "The Truckers Health Project".

23572 HIV/AIDS risk factors in a brothel setting: What about the
"lovers" of the sex workers?
Maurice Bloem1, M.Z. Uddin1, D. Mandal2, F.K. Chowdury1, J.V. Gomes1,
M.A. Quddus1. 1Shakti-Project, Care-Bangladesh, HS#60, RD#7A, Dhanmondi,
Dhaka-1209, Bangladesh; 2Bolton General Hospital Manchester, UK
Background: To identify STD/HIV risk behavior of babus (lovers of sex workers), to assess the STD/HIV situation among babus and to explore STD/HIV
intervention strategies for babus.
Methods: A pre-tested questionnaire was used to interview 233 babus in the
month of January 1998. Contact was made with the help of babu peer educators
of the project. Urine was examined for gonorrhea and chlamydia and blood for
HIV and hepatitis B. In-depth interviews and several PLA exercises were also
done among babus, shopkeepers, brothel owners and sex workers.
Results: There are two types of babus: residing in or around brothel (58.8%)
or occasional visitor (41.2%). Most of them are married (57.5), average age is
30 years. Majority of them are small business men (44.6%). Although 93 percent
labels the relationship between him and the sex worker as a love and/or husband
and wife relationship, sixteen percent of them had sex with other sex workers
in the brothel the last three months and the same percentage with sex workers
from outside. Twenty eight percent mentioned about having a sexual partner
outside the brothel (excluding wife or outside sex worker). More than half of them
(52.5%) knows about the role of condoms in STD prevention. The consistent
use of condom with all sexual partners is very low. Sixty nine percent had ever
suffered from an STD symptom, twenty four percent in the last year. More than
half practices self medication first and 86 percent is finally seeking treatment
from different sources. Eighty percent seeks treatment within a week. Almost
68 percent perceives himself as being at risk of getting HIV/AIDS. Most of the
information in relation to STDs and AIDS they received from the project staff and
its peer educators. They would like to have better treatment facilities for their
STDs.
Conclusion: Even if a brothel based intervention targeting sex workers and
their clients is able to achieve 100 percent consistent condom use, it is not a
guarantee for an HIV/AIDS free brothel, as long as the babus are not considering
safer sex behavior. The sexual network of the babus is yet another reason for a
quick need for nation wide HIV/AIDS intervention in high risk behavior generating
settings.
23573 Fishermen and HIV/AIDS vulnerability in southeast Asia
Shakti Paul. ARCM 7 Floor Prajadhipok Bldg. Chulalongkorn University Phyathai
Road Bangkok 10330, Thailand
Issue: Over a million fishermen in the mainland Southeast Asia (SEA) are exposed to the risk situations for HIV/AIDS infection that require effective intervention
programs to contain the spread of the disease.
Project: It provides a regional overview of fishermen situations in SEA including the migrants, review of their HIV vulnerability and gather information on
the existing HIV/AIDS intervention programs. It then develop a strategy for the
identification of information needs and gaps, data collection, hot-spots in the
region and model intervention programs at various levels.
Results: The fishing industry is one of the dominant force of economy in
SEA. In Thailand alone, there are 54,715 fishing boats. Thai fishing industry has
joint ventures in the neighboring Myanmar, Bangladesh, Cambodia, Indonesia,
Malaysia and Vietnam. Due to the hard work conditions, fishermen often engage
in heavy drinking and visiting brothels. Intravenous drugs and other substance
use is rather common. Many fishermen are reluctant to use condom with the sex
workers and usually do not care well for their illnesses including STDs. From a
limited HIV test data points a very high infection rate: 18.52% Thai positive in
Samut Sakon in 1996, Thailand, 10% and 5.4% Thai positive in Merauke, Indonesia in 1992-93 and 1994 respectively, 22.35% and 17.43% Burmese positive
in Ranong, Thailand in 1993 and 1994 respectively. A few available HIV/AIDS
prevention programs indicate difficulty in changing behavior of the fishermen.
Lessons learned: Transmission of HIV/AIDS among fishermen and their families is a serious problem in SEA. The present intervention programs are yet to
produce any significant reduction in the transmission of the disease. Careful review of the situation and subsequent development of model intervention program
is urgently needed.
S23574 | Seroprevalence of HIV, HTLV-1, HBV, HCV and syphilis
among female prisoners in Brazil
Angelica Miranda1, M.C. Viana2, P.R.M. Vargas2. 1Rualuiza Grinalda, 207 Villa
Velha Espirito Santo; 2Universidade Federal do Espirito Santo Vitoria, Brazil
Objectives: To determine the prevalence of HIV infection, HTLV-1 infection, hepatitis B and C and syphilis among incarcerated women in the Espirito Santo State
Penitenciary for Women, in Brazil.
Design: Cross-sectional study.
Methods: All women incarcerated from March to September 1997 were invited

to take part into the study. Demographic and criminal information were collected
and a blood specimen was taken.
Results: One-hundred-twenty-one women were assessed out of 122 selected
(response rate of 99%). Mean age was 30.2 years (SD 9.0) and mean education
was 4.8 years (SD 3.5), though more than half of the sample only completed 4
years of schooling. Regarding ethnicity, 47.9% were mulatto, 42.1% were white
and 9.9% were black. 37.2% were single and 38.8% were married. As far as