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

12th World AIDS Conference

Abstracts 23586-23590 459

services of medical practitioness in different zones were seeked also in the staff
are ex-sex workers that were cooperative enough to restore hope and courage
into our clients and of course four social workers were involved in given professional personal counselling. Initial strategy for attraction was the free distribution
of condom as encouragement and thus as time goes on introduction to medical
personal took place.
Results: The personal counselling programme has so far yielded positively
such that the pioneer clients of the project, made up of thirty sex workers, ten
immigrants and twelve refugees which is a tremedions increase with in a period
of eight months and of course there are plens to reach to other localities
lessons learned: Personal conselling has proved to be a very good method
of interventing HIV/AIDS for the special population if properly coordinated and
funded, though might be discouraging initially.
S23586 Comparative study of sexual practices (homosexuality)
and HIV/AIDS education in two major prisons in Nigeria
Regina Clement Akpan, D.E. Ofobrukwenta. Life Link Organisation 13
Commercial Rd. PO. Box 2659 Apapa Lagos, Nigeria
Objectives: To compare the rate of sexual practices (homosexuality) and level of
HIV/AIDS awareness in two major Prisons in Nigeria as well as creat awareness
of this subject matter.
Design: Survey Research
Methods: A 28 item questionnaire was administered to convicted prisoners
who have spent above Six Months in Prison. Two major prisons, One in the North
and One in the South of Nigeria were considered for the study. The selection of
the respondents was by random sample. The final number for analysis was 400
prisoners; 200 from each of the prisons. Structured interview and Focus Group
Discussions were also utilised to back up the quantitative technique.
Results: A total of 400 questionnaires were analysed. The mean age of the
prisoners was 29 years and there was a statistical significant difference between
the two prisons on the rate of their sexual urge P. <.01. 15% of the prisoners
in Kano were involved in homosexual practice, while 8% were involved at Kirikiri
Maximum Security Prison Kirikiri, 32.5% were aware of AIDS while at Kano 34.5%
were aware.
Conclusion: The utilisation of combined quantitative and qualitative techniques for this survey has proved very useful and more detailed HIV/AIDS/STDs
Education, Training and Counselling would be very useful for this target.
23587 Impact of religious beliefs on HIV/AIDS preventive
behavior in Rio de Janeiro, Brazil
Pirre George Bauer, Jucara Arabe, C.A.M. Sa, O.N. Santos, J.L.L. Hanan.
Hospital Universitario Gaffree E Guinle, R. Mariz E Barros, 775-20 ENF
10-20270-00Rio De Janeiro-RJ, Brazil
Issue: To present the increase of HIV infections and therapy refusal related to
religious beliefs.
Project: Physicians and social workers of the AIDS unit of a university hospital,
concerned by frequently mentioned, religion related HIV cases, analysed and
compared their reports to find out common denominators.
Results: The analysis of the reports revealed an increasing number of patients,
which due to their beliefs in the absolute power of their religion see no reason
to protect themselves or their partners from an HIV infection, provoking virus
transmissions even to their newborns. Some people with AIDS syndromes refuse
or stop (after their adherence to the religion) the whole treatment. They generally
mention: "God protects me." "He heals/will heal me." or "My body is closed. No
illness can touch me." All types of counselling given until now had no effect on
their behavior. While most of these patients are members of protestant christian
religions some are members of afro-brazilian religions.
Lessons learned: The presented cases of HIV infections are a matter of
concern and may in the future, if not controlable, fuel the HIV epidemic in Brazil
and in other points of the world where religious influences on their population are
remarkable. It will therefore be important to find ways to sensitize these persons
for the danger they are running and identify acceptable, adequate prevention
measures.
23588 Prevention of STD/HIV/AIDS transmission among
prisoners in the State of Sao Paulo, Brazil
Leonardo Guirao, Jr.1, J.G. Breda2, J.R. Marins3, R. Munhoz4. 1Health
Department of Sao Paulo State, Rua Visconde de Guaratiba 353 AP 22, Sao
Paulo, SP CEP 04125-040; 2Penitenciary Department of Sao Paulo, Sao Paulo,
SP; 3Sorocaba City AIDS Programme, Sorocoba, SP; 4Brazilian Health
Ministery, Brasilia, DF, Brasil
Issue: Prisoners are one of the most affected population for STD/HIV in the world.
In Brazil, due to a high level of injecting drug use, high risk sexual behaviours,
and overcrowded prisons within a chaotic prison system, that leads to constant

rebellions, the risk of HIV infection among this population is extremely high.
Project: It is know that there is a lot of resistance from managers and staff
members in general within the prison system to develop STD/HIV/AIDS related
prevention actions. Due to this resistence it was decided to establish a programme
for staff members of the penitenciary system. Jailers were trained to serve as peer
educators to prisoners. Four prison units in the state of Sao Paulo were selected.
The target population was the staff members, prisioners and their family. The

aims of the project were: to increase STD/HIV/AIDS related information, condom
availability and an integrated work with governamental organisations.
Results: 1- The project received a large acceptability from staff members and
prisoners; 2- Condoms have been effectively distributed within the four prison
units; 3- Expansion of 62% in the knowledge of the prisoners; 4- The same
methodology has been extended to other units in the state.
Lessons Learned: Despite the difficulties presented by the prison system to
develop HIV prevention strategies, it is possible to successfully carry out some
prevention actions. Involvement of various institutions linked to the penitentiary
system, recognition that prisoners need access to knowledge of HIV prevention
in order to become less vulnerable to the disease, will help in the establishment
of effective prevention programmes to the prison population.
S23589 A longitudinal study of the risk of HIV transmission in an
African prison
Oscaro Simooya1, N. Sanjobo1, P. Kunda1, C. Mutonga1, W. Melchior2.
SCopperbilt University Box 21692 Kitwe, Zambia, Zambia; 2Boehringer
Mannheim Nonnewald 2, D-82377, Penzberg, Germany
Objectives: Unprotected male to male sexual intercourse, sharing of razor blades,
tattooing and injecting drug use have been identified as risk factors for HIV transmission in African prisons (AIDS 1995). Beginning May 1997 we have followed
a cohort of inmates living at Kamfinsa prison in Zambia to determine the risk
of contracting HIV whilst in Prison. The prison does not provide condoms and
shaving appliances.
Methods: Before commencement of the project, a meeting was held with
prison staff and inmates at which the background to the study was explained.
The study is voluntary and open to inmates in prison for at least three months.
Participants undergo counselling and HIV testing at six monthly intervals. All
results are confidential and subjects are free to withdraw. It is anticipated that the
surveillance will take up to three years.
Results: A total of 78 inmates agreed to take part in the study. Eighteen (23%)
of these inmates were HIV seropositive at entry. At six months, 28 (36%) inmates
in the cohort were seen. All had lived continuously at the prison since entry. One
inmate, HIV negative at first visit, tested HIV positive at six months. This subject
reported that he had shared razor blades in the intervening period but had not
been tattooed or used drugs. He denied having had unprotected sex with another
inmate in the same period.
Conclusion: To our knowledge this is probably the first report of seroconversion in an African prison. The lack of specific measures for HIV control in African
prisons is a matter of great concern. There is an urgent need to bridge the gap
existing between public health measures readily available outside prison and
those offered inside.
S23590 Qualitative focus of the preservatives non usage causes
by Santos commercial sex workers
Cristiane Maria Tigre', N.S. Grauato2. 1R Almirante Cocrane 388 Santos Sao
Paulo; 2ASPPE Santos SP, Brazil
Issues: To deepen in a qualitative way, the emotional factors which increase
vulnerability of the CSW.
Project: During four years, using face to face intervention strategies, instructive
material distribution, counselling videos and group sessions over 52 prostitution
areas (pubs, nightclubs, hotels, escort girls agencies, streets etc.), it could be
noted through statements of CSW, that there are different ways of sexual intercourse with pimps, clients, husbands/boyfriends/companios. Through observation
of current statements of CSW intervention, factors which make the preservative
usage were noted, even when the same are avalilable.
Results: The CSW involvement with their clients occurs when they show
respect, love and caring during the sexual intercourse (the clients break the
professional barrier). So initially the client scapes from the professional contract,
only after will the CSW permit to get involved. In this single moment the risk is
increasedSuch data are compatible with the sexual via contamination, among
sexually active women to reach the behavior change among the CSW, we have
been applying technics as group dinamic, discussion group, individual and collective counselling at their working areas, approaching most of the times these
clients and supposed husbands, viewing to sensibilize both sides, about the real
STD contamination vulnerability with this behavior. Today CSW and their clients
participation in our meetings has significantly grown. They request informative
materials as well as preservatives, questioning and listening to orientation.
Lessons Learned: All this prevention strategy, cannot be taken apart from local
reality; to get a better approach and reach the target os STD/AIDS prevention
through respect and the acquired joint along with the CSWs, we feel that orientation is more significantly and efficient specially concerning the improvement of
sitf-love and health care.

23591 1 Infection vulnerability by HIV among commercial sex
workers in Santos - a soroprevalence study
Neide Gravato', R.M.V. Lacerda2, P.J. Chequer3, C. Landman4, E.A. Castilho5.
'Prac? Rui Barbosa No 23 40 Andar Santos Sao Paulo; 2Programa Municipal
DST/AIDS-ASPPE Santos SP; 3Ministerio Da Saude Brasilia; 4Fundacao
Oswaldo Cruz Rio de Janeiro RJ; 5Ministerio Da Saude, Brazil
Objectives: To evaluate the main behavior and determining risk conditions by