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

494 Abstracts 24276-24281

12th World AIDS Conference

I24276 Evaluating a group empowerment model for HIV+ gay
Puerto Rican men
Blanca Ortiz-Torres1, F. Perez2, M. Mendez2, J. Calder6n2, R. Rosado2,
N. Maldonado2, 0. Perez2. 1PO Box 23174 GUSEP San Juan; 2Univ of Puerto
Rico, PO Box 23174 GUSEP, San Juan, Puerto Rico
Objectives: To determine the effectiveness of a group empowerment intervention
on strategies for social support-seeking, coping, changes in depressive mood,
initiation and maintenance of safer sex practices among HIV+ gay Puerto Rican
men.
Methods: A randomized trial with two conditions (control and treatment) with
follow-up at three time points. Participants in treatment condition attend a twelvesession intervention including areas such as: disclosure, homophobia, social
support, safer sex, coping with losses, physician-patient relationship, alternative
treatments, adherence to treatment, nutrition and social support.
Results: Preliminary findings show that: there is an increase in healthy food
consumption, a reduction in alcohol and cigarretes consumption and an increase
in exercising. There is an increase in the use of alternative treatments such
as acupuncture and massage. A significant number of our participants report
more participation in the decision-making process regarding their treatment. At
follow-up participants report a reduction in feelings of fear and sadness and in
negative self-evaluations. Many of our participants report feeling less close to
members of their social network and less satisfaction with them when compared
with baseline. They report, immediately after the intervention, that less people
is dependent on them, less people ask them to do things they don't want to do
or give them undesired help. Although participants as a group showed relatively
high rates of safer sex practices at baseline, at follow-up there is a change in the
repertoire of safer sex practices reported by them.
Conclusion: A group empowerment model for Puerto Rican gaay HIV+ men
seems to be an effective intervention strategy in reducing depressive moods and
increasing health-related practices.
242771 HIV/AIDS psychotherapy in an era of hopefulness, an
innovative counseling approach for entering the
millennium
Camilo Delgado. 19445 Fontainebleau Blvd., Miami, Florida, USA
Issues: Mainstream counseling approaches that are not tailored to the specific
needs of the HIV/AIDS community may be ineffectual and even harmful. Retraumatizing the client can negatively impact immune functioning, sustain emotional
distress, and impair life functioning.
This workshop presents an empirically substantiated counseling model that addresses the specific psychological and spiritual needs of the HIV/AIDS client while
supporting optimal immune functioning by providing professionals with applicable
guidelines that simultaneously enhance these three crucial aspects.
Projects: Theoretical bases for this workshop include the most recent findings
in Psycho-neuro-immunology, Psycho-neuro-endocrine Behavioral Medicine, and
Mind-Body Immunology. The workshop combines lecture, interactive portions, experiential exercises, and handouts.
Results: The workshop addresses counseling issues such as fatalism regarding HIV disease, degree and duration of stress, grief, social isolation, and
depression, awareness of and commitment to life purpose and meaningful goals,
and spiritual needs of the client. It integrates cutting edge research on the effects of counseling on stress, emotions, and infectious disease susceptibility and
disease progression.
Lessons Learned: Standard counseling approaches are inadequate and do
not meet the fast changing needs of the HIV/AIDS populations. Some findings
even suggest that certain established psychotherapeutic approaches may have a
negative impact on people with HIV/AIDS. This workshop presents a counseling
model that supports psychological, spiritual, and immune response.
24278 The journey back from drugs: One step at
a time
Elmer Bisarra. 4248 Wilson Avenue, #A, San Diego, CA, USA
Issue: Because it is so hard to break their addictions, staying "clean and sober"
is extremely difficult for injection drug users. As a result, they cannot take medications regularly, maintain a healthy lifestyle, stabilize their housing, or be productive
members of a non-drug using society.
Project: This is a case study of an HIV positive injecting drug user who, after
release from jail, has become a leading HIV/AIDS activist and community organizer in San Diego, California. The steps to this to this life change began with Mr. Bizarra
finding housing in a homeless shelter followed by entering a drug recovery center.
Next came involvement in regular drug use recovery meetings and enrollment
into college to study to become a drug abuse counselor. In addition, regular
involvement as an HIV/AIDS activist gave Mr. Bizarra a concrete purpose for
maintaining a drug-free life.
Results: It has been four years since Mr. Bisarra injected drugs, he is now the

Chairman of the Outreach Committee of the San Diego California HIV Consumer
Council. He is a certified drug/alcohol abuse counselor and an HIV street outreach
worker. In addition he is involved in the municipal court "Drug Court" program and
helps manage a clean and sober group home.
Lessons Learned: The experience of Mr. Bisarra and others like him on the
San Diego HIV Consumer Council have lead to the development of a new outreach program for injecting drug users which will incorporate efforts to combine

housing, counseling, education, and service as strategies to help HIV positive
injection drug users stay off of drugs and lead productive lives.
24279 | Overcoming depressed moods after an HIV+ diagnosis:
"Voices" from the epidemic
Victoria Alfonso1, Ishu F. Ishiyama2, Julio Montaner3. 11188 Matthews Avenue
Vancouver, British Columbia; 2 University of British Columbia Vancouver BC;
3Canadian HIV Trials Network Vancouver BC, Canada
Objectives: To analyse the facilitative processes involved in abating depressed
moods after an HIV+ diagnosis, and to identify the personal resources (resiliency)
that enable people to adjust after the diagnosis.
Design: Critical incident methodology
Methods: Twenty-two ninety-minute interviews were completed with eleven
patients from the Immunodeficiency Diseases Clinic at St. Paul's Hospital in
Vancouver. The inclusion criteria required that participants were not taking psychotropic medication and had no history of a psychiatric diagnosis. The CES-D
scale was employed as an indicator of depressed mood at two points in time
(at interview and at diagnosis). Critical events that facilitated dealing with depression and personal sources of resiliency that enabled endurance were elicited
during the first interview. An innovation to the methodology was introduced by
adding a phenomenological component via a second interview, allowing the coresearchers' "voice" to become instrumental in expanding descriptions of critical
incidents, cross-validating, and abscribing meaning to the emergent categories.
Results: 246 critical incidents were collected and classified into 13 facilitative
categories: (a) participation in activities, (b) establishing social connection, (c)
connection with self, (d) sharing the news, (e) commitment to life, (f) looking for
meaning, (g) helping others, (h) physical exercise, (i) gaining understanding of the
problem, (j) learning from a role model, (k) spiritual connection, (I) alcohol/drugs,
and (m) career/work. A strong thematic correspondence was found between the
13 emergent categories and the 19 self-reported sources of resiliency. All participants showed reductions on the CES-D scores. As a whole group, the difference
was statistically significant (F (1.10) + 25.25, p <.01).
Conclusion: From a clinical perspective resiliency emerged as a viable psychological construct that can be utilized to empower seropositive individuals to
become aware of an utilize those personal strengths and resources that can
facilitate the process of living with HIV, as well as prevent or minimize the risk of
future depressive episodes.
24280 Day care house for women living with HIV/AIDS
Rosario Ponce de Leon. Dr. Jose Terres 71 Col. Doctores Mexico, City 06720,
Mexico
Issue: Women is the group more vulnerable to the HIV infection due to psychological, biological, epidemiologic, economic and social factors. House keeping
women are among those, they got infected by sexual infection way and they
realized they are infected when their partners die. Sick, without work and money,
untrained, alone and discriminated they have to take care of their children.
Project: We started the work at the Day Care house for women living with
HIV/AIDS on April the first, 1996 where HIV/AIDS women can have medical,
psichological and emotional services. They sign in to the self support group for
women with HIV/AIDS and to the handcraft workshop at no cost. We offered
everything necessary in order for HIV/AIDS women can sell the products they
make to get some money to get food and medication for her and for their kids.
They can also get hot food for breakfast and lunch because sometimes they do
not have a penny for that.
Results: The population we attend come from the General Hospital of Mexico
and from the children's Hospital that are state hospitals for low class people. The
daycare house has bringing out satisfactory results such empowerment got by
the emotional support, higher selfesteem when they felt themselves as productive
women when they got some income to buy food for their children and overcoming
loneliness when they met more women in the same situation in the selfsupport
group.
Lessons Learned: Offering day care, food, medical attention, a friendly space
and the possibility of income give HIV+ women confidence because they feel they
are important. Their selfesteem have grown since they visited the office. They
give more time for thYemselves than before.
24281 | Continuous education and constructive actions inside of
the penitentiary
Georgina Gutierrez, B.A. Vazquez. Calle 19, Col. San Pedro de Los Pinos,
Deleg. Benito Juarez 03800, D.F, Mexico
Issue: To leave with HIV/AIDS and to be in jail.
Project: During the last year and increase of cases of HIV/AIDS was registered
among the people with lack of freedom in Santa Martha Acatitla Penitentiary which
is in Mexico City. So, we have the need to give follow up to medical care, social,

legal, work and human development programs to achieve a social readjustment,
with a change of attitude to themselves, their family and to the society, to have
an influence on their life quality and in their life project, trying to get the similar
results than the previous year.
Results: Since the change of authorities in the General Direction of Prison in
Mexico City, the program was stopped which was very successful because the
100% of prisoners who took the complete program hadn't got back to the jail.