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

476 Abstracts 24178-24184

12th World AIDS Conference

Results: A wide range of materials were recovered from the litter bag. These
included used condoms as distributed by GMFA (n = 47) and torn GMFA condom
packs (77), other used condom brands (4) and other condom packs (45), GMFA
lubricant packs (57), other lubricant packs (6), large quantities of GMFA "green"
tissue paper, sundry items (including 6 used amyl nitrite bottles). These data complemented other sources to show: that sex was taking place at the PSE; GMFA
materials were being distributed and reaching the target group and were also
being taken away for later use and secondary distribution; identifiable contents
of the GMFA packs (condoms, water-based lubricant, tissues) were being used
in situ; men were not only "relying" on GMFA provision, but were bringing to the
PSE and using other brands of condoms and lubricants.
Researchers should be flexible and imaginative in collecting data. An opportunity to participate in a PSE litter collection resulted in a rich and unexpected
source of data. This offered unique insights into the activities and the behaviours
of the target population of gay men at PSEs. When used to complement more
formal survey and monitoring data conclusions could be drawn regarding service
delivery and future directions for health promotion at PSEs.
S529*/24178 Rapidly responding to HIV and AIDS - Can social
science inform community and international
interventions?
Chris Fitch, G.V. Stimson, T. Rhodes, A. Ball, G. Weiler, R. Sujata, A. Morue,
A. Perez-Gomez. 1 The Centre for Research on Drugs and Health Behavior, 200
Seagrave Road, London SW6 1RQ, London
Issues: Injecting drug use has played a critical role in the global diffusion of
HIV/AIDS. However, given the rapid spread of IDU (particularly in developing
countries), conventional social science has arguably been unable to inform interventions on both community and international levels.
Project: As part of the WHO Programme on Substance Abuse Drug Injecting
Project Phase II, the authors have developed Rapid Assessment and Response
(RAR) methodology and guide to facilitate data collection on HIV risk behaviour
among injecting drug users in 20 cities world-wide. The RAR guide: (1) allows community based and participative teams to undertake multi-method assessments in
brief periods; (2) use qualitative and quantitative data to inform sustainable local
interventions; (3) offer international agencies systematic multi-site assessments
to inform global public health policy and interventions. Arguably, prior to RAR
development, meeting all three objectives concurrently has proved difficult.
Results: The RAR guide has been evaluated in Colombia, Nigeria, and the
Ukraine. The guide was reported as: encouraging local teams to use new methods of conducting research outside of treatment settings (Nigeria); involving local
people and community stakeholders in research (Ukraine); and rapidly producing
clear overviews of the prevalence and nature of HIV/AIDS (Colombia).
Lessons Learned: The development of a RAR social science tool can inform interventions which met intervention objectives on both community and
international levels.
24179 Concepts, definitions and models for community-based
HIV prevention research in Canada
Dan Allman, T. Myers, R Cockerill. HIV Social, Behavioural and Epidemiological
Studies Unit, 12 Queens Park Crescent W Toronto, Ontario M5S 1A8, Canada
Issue: Canadian community-based HIV prevention research has traditionally
encompassed philosophies of health promotion, prevention and education, and
while we are able to trace the evolution of community involvement in Canadian
HIV prevention research across the history of the epidemic, very little has been
written about it, and few concepts or models have been defined.
Project: Over 425 published works from numerous disciplines were collected,
reviewed and analyzed, and a planning guide and decision-making model were
developed to assist community, research and funding stakeholders to plan, conduct and evaluate community-based HIV prevention initiatives.
Results: The handbook, entitled Concepts, Definitions and Models for Community-Based HIV Prevention Research in Canada, overviews the similarities and
differences between conventional and community-based research paradigms.
The handbook examines the history of AIDS and health promotion, traditions
of community involvement in AIDS research, and elements and issues of conducting community-based HIV prevention research including the organization
and structure of the research, the extent of stakeholder participation, research
environments, research methods and community relevance and representativeness.
Lessons Learned: No single model for community-based research is possible
or even desirable. The research needs of communities affected by HIV and AIDS
are just too varied. With this in mind, the project's handbook presents a flexible
planning guide and decision-making model which transforms the often theoretical literature into pragmatic and applied tools for community-based prevention
research.

24181 Estimating characteristics of hidden populations using of
network-based sampling
James Hughes, D.D. Heckathorn, R.S. Broadhead, H. Madray, Y. Van Hulst.
Dept. of Sociology, Univ of Connecticut, Storrs, CT USA
Issue: It is often important but difficult to estimate the characteristics of populations at risk of HIV, because they are hidden. Network sampling and the network

inventories are two inter-related methods for estimating the characteristics of
hidden populations.
Project: The Eastern Connecticut Health Outreach (ECHO) project has developed a method, Respondent Driven Sampling (RDS) and Peer-Driven Intervention
(PDI), of mobilizing drug injectors (IDUs) to recruit their peers to risk reduction interventions, and educate one another about risk. Operating out of a site in central
Connecticut, the RDS/PDI method has generated a sample of drug users which
stochastic models suggest should be representative of the actual IDU population.
In 1997 US Centers for Disease Control funded a project to gather data from the
community, and from the sample itself, to determine the representativeness of
the IDU population attracted by the RDS/PDI methods.
Results: Results will be presented comparing age, race, and gender in the
RDS/PDI population to: (a) the characteristics of the IDU population as estimated
by the injectors we interview; (b) the characteristics of injectors that injectors
we interview inject with, eliminating redundancies with a closed network method;
and (c) the characteristics of injectors as estimated from local police, emergency
room, and HIV testing records.
Lessons Learned: If RDS/PDI is a reliable method for accumulating a relatively
representative sample of hidden populations, it can be used to identify and correct
the biases in other risk reduction initiatives.
Supported by the Centers for Disease Control U62/CCU114816-10.
124182 1 AIDS, power and community mobilisation
Anthony Gariff. 38 Mardaleway, Loughborough Leicestershire LE11 3SS, UK
Issue: How can participative approaches by NGOs and CBOs empower seropositive persons to challenge their subordination and exclusion?
Project: A three-stage, progressively selective qualitative survey of 44 organisations in 23 countries in both North and South was followed by personal
interviews with a sample chosen on the basis of type, field, and experience. The
results are compared, analysed and contextualised.
Results: A report on the processes whereby PWAs acquire the skills to selforganise and gain greater control over decision-making and resource-allocation.
Parallels are drawn with other models of 'third generation' development strategy
used by NGOs and CBOs.
Lessons Learned: Preliminary conclusions indicate the significant potential
of strategic multi-level alliances for lobbying and advocacy. Effective community strategies acknowledge and engage the underlying factors which cause the
epidemic to impact most heavily on the poor and marginalised.
124183 1 Positively fit: Community organizing for HIV and
rehabilitation
David A. Swan1, W.G. Hiebert2. 148 Cambridge Street, Victoria, British
Columbia; 2 Victori HIV Centre: Participant/Researcher, Victoria, Canada
Issue: Positively Fit was a Health Canada sponsored, participatory action research (PAR) project. During the project many issues of power and control
emerged. These issues included the line between "insiders" and "outsiders" and
the concept of "participatory" as defined by various constituent groups. As formal
research has concluded, the desire to sustain the unique organizational model
that evolved, remains strong. How to fulfill this desire, i.e. how to ensure that
control, once grasped, stays with the participants, is the issue.
The Research Project: Positively Fit was conceived to examine the impact
of rehabilitation activities on the quality of life of PWAs. It facilitated linkages
between PWAs and did not create new services or programs. The project had 83
participants and was run by a steering committee of participant researchers with
a manager from an academic background. PWAs were encouraged to become
active in ways they themselves would define; these might include a short walk or
an intensive workout, changes to diet or learning yoga. Some chose to become
active in the social aspects of the project.
Results: As a participant-driven project, Positively Fit, allowed participants to
develop a sense of citizenship as opposed to clienthood in their dealings with
the local HIV centre. PWAs found great satisfaction in creating working relationships with other helping agencies where some staff chose to alter their roles
from directing health care to facilitating personal health choices. This citizenship
empowerment resulted in a struggle for the control of the program as a result of
the program as the research project concluded. This is still unresolved.
Lessons Learned: PAR is more than a methodology- it is a process with political implications. When participants are given control of research, they choose
areas of interest beyond the parameters defined by "outside" researchers. If PAR
projects are to be successful, AIDS Service Organizations must see themselves
in partnership with PWAs and not as professionals working with clients. When
clients become citizens, projects become more dynamic and lead to unexpected
results.
| 24184 | Assessing of knowledge, attitude and belief (KAB) on
AIDS: An Iranian survey

Mohammad Raoufi1, P. Kowsarian2, A. Nowroozi3. 121, Hafez Sherazi Alley,
Vali-E-Asr St., Tehran; 2Tehran University, Tehran; 3Academy of Mei Cal,
Sciences, Tehran, Iran
Objective: To assess the public awareness of and reaction to AIDS, deemed
essential for development of appropriate and relevant educational message,
materials and strategies for AIDS prevention and control.