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

12th World AIDS Conference

Abstracts 24282-24287 495

After the program was stopped the rate of prisoners who got back to the jail is
again the 50%. Currently my organization is working in order to get reforms to the
law. The objective is that the training programs are mandatory for the authorities.
Lessons Learned: Training programs have to be continuous and integral, because in the other way, self-destructive attitudes and to their environment appear
again.
24282 Psychological factors and adherence to combination
therapies: A pilot study
Tomas Campbell, P. Diaz, L.M.E. Osborne, N. O'Farrell, V. Moss, A. Kibble,
P. Bacon, S. Waldron. The Hillingdon Hospital Tudor Wing Pield Heath Road,
Uxbridge Middx, UK
Introduction: Inconsistent adherence to complex regimens of combination therapies can have potentially serious consequences for the patient and the larger
community e.g. drug resistance. Factors such as depression, anxiety, poor social relationships and negative attitudes toward medication and illness have
been associated with poorer adherence to complex combination therapies. This
study aimed to identify factors associated with better or worse adherence in an
out-patient group.
Method: 31 out-patients attending for treatment at a Sexual Health Centre in
a District General Hospital were studied (22 men, 9 women; of these 10 were
gay/bisexual men, 5 were ex IVDUs, and 10 were of African origin). A physician rated measurement of adherence was constructed and all patients received
an adherence score. Subjects also rated their own adherence. They completed
a structured interview and a questionnaire covering relationships, domestic arrangements, social support, alcohol and illegal drug use, levels of information
about, satisfaction with, and attitudes toward medication. The Hospital Anxiety
and Depression Scale and the Locus of Control Scale were also completed.
Results: Data were analyzed using a multiple regression analysis to determine
the factors which influence adherence positively or negatively. Physician rated
adherence and self ratings were compared.
Conclusions: We will discuss how factors which influence poorer adherence
can be minimized.
S24283 Italian guidelines for disclosure of diagnosis to HIV
infected child
Mariella Orsi1, Andrea Campana2, E. Ruea2, L. Galli2, G. Castelli-Gattinara2,
A. Mazza2, C. GAbiano2, M. Duse2, Vincezo Portelli2, L. Fundar62, D. Caselli2,
A. Guarino2, A. Tomasini2, P. Verona2, A. Plebani2. Via Massicini Is Fiesole
(Firenze); Clinica Pediatrica, Brescia, Italy
Issue: the process of communication is an essential tool involving parents, carers
and child in an on-going dialogue and if must recognise the changing and evolving
needs and autonomy of the child and other family members over time
Project: due to the increasing number of seropositive teen- agers and children
affected by AIDS, last July Essere Bambino a children's NGO involved in supporting children and families affected by HIV held a multi-disciplinary consensus
meeting in Italy to draw up communicating to children their HIV status. Health
and social staff of 15 paediatrics volunteers agreed on guildelines, summarised
in 10 operative points. On these points each centre must plan a local written
program and elaborate a proper methodology for evaluation of the efficacy of
communication. This evaluation will be the base of a multicenter research aimed
to scientifically improved definition of guidelines.
Conclusions: a better strategy of consuelling can improve both the family life
and the social relationships of HIV infected children. Furthermore we try to introduce a scientific methodology in the definition and the evaluation of the guidelines
for diagnosis disclosure.
24284 Peer support among HIV positive women an experience
from the national community of women living with
HIV/AIDS
Jacqueline Nabwire. c/o Beatrice Uere Nacwola PO. Box 4485 Kampala,
Uganda
Issue: Empowerment of HIV Positive women through peer support - An Experience from the National Community of women living with HIV/AIDS (NACWOLA)
in Uganda
Project: Due to the profound Isolation, stigma, poverty discrimination and lack
Of information among women living with HIV/AIDS, Women living with HIV/AIDS
in Uganda started a support Group namely y NACWOLA. The Group is by and
for Women living with HIV/AIDS. The Aim of the group is to share problems,
experiences, counseling and offer support to each other on positive living. The
strategies used are Information, Education and Communication (IEC) through
dramma, publications, sharing of testimonies (Advocacy) and income generating
activities like Rabbit - keeping, Heifer and Tailoring.
Results: Increased openness self esteem among HIVpositive women. Greater

involvement of the Community of HIV positive women in sensitization and advocacy. Cohesiveness which has enhanced several support among HIV positive
women and because of the above, we have succeeded in sensitizing communities hence reducing discrimination. Reduction of dependency syndrome through
income generating projects.
Lesson Learned: Psychosocial, emotional and economic empowerment is the
key factor in peer support among HIV positive women.

S24285 Whole person experience and recognition of different
ways of knowing: validating the inner wisdom of HIV+
persons
Bobbie Boland1 2, John Baker2, Philip Lundrigan2. 1270 Indian Meal Line Torbay
Newfoundland; 2NFLD Lab. AIDS Committee, St. Johns, NF, Canada
Issues: HIV/AIDS is often a fragmenting experience and it is important for one's
sense of self to feel acknowledged in our experience of HIV/AIDS. Communicating
our experience when we do not have the words or confidence to express ourselves is daunting. This research explores the kind of environment that enlivens
storytelling, that recognizes the whole person, the body, the mind and the spirit.
Project: This research project builds on previous work that explored whole
person experience and different ways of knowing, including the use of colour,
music, meditation, drawing and discussion. The process recognized the right of
the individual to speak or remain silent thereby giving the individual control of
their own process.
Results: Participants felt the holistic environment was necessary, had a positive
impact and allowed them to be comfortable enough to deal with major life issues..
It was important that they had control over the environment, their speaking and
being silent, their active or passive participation. Each participant had a favourite
doorway of exploration and avenues of communication such as symbolic objects
or gestures. The environment encouraged participants to become more inwardly
attentive. Control over process was extremely important in developing trust and
security.
Lessons learned: A comforting and welcoming physical space encourages
and supports creating a inner space to be reflective and to share with others.
The value of creating a space and process that is receptive to the different ways
people know and learn was affirmed. A holistic environment allows the wisdom
of the individual, their life system knowing to be the guide rather than an outside
force. For participants control of the process and acknowledgement of their expertise are key factors. Participants valued to opportunity to explore from a base
other than cognition and acknowledged they sometimes found deeper wisdom or
direction.
S24286 Ensuring adherence: A patient-team model
Barbara Wood1, G. Ilaria2. 129 Merwin St., Trumbull, Connecticut 06610; 2New
York Hospital Cornell Medical Center, New York NY, USA
Issues: Patient adherence with prescriptive care is a patient care and public
health issue. The HIV/AIDS patient must cope with complicated prescriptive care
over an unknown period of time. Without enhanced adherence assessment and
supportive interventions the HIV/AIDS patient is likely to become nonadherent to
his prescriptive care.
Project: Social Work Assessment was expanded to include adherence needs
and adherence deficit behaviors. Assessment was focused on key areas of adherence such as: environmental supports, financial supports, access to care,
beliefs and attitudes concerning care, social supports, physical or psychological
disabilities that inhibit self care, and learning style. Patients adherence needs and
adherence treatment needs were created in multi-disciplinary rounds. Linkage to
the community was tailored for each patient based on the adherence assessment
and team plan. Follow up and maintenance was also an individualized plan.
Results: Patients became more involved in their care through collaborative
problem solving interventions. Barriers to adherence were assessed in a timely
manner. Adherence behaviors became ego-syntonic and adherence skills were
enhanced.
Lessons Learned: Adherence can be improved with thorough assessment
and patient-team adherence interventions.
S24287 The development of students as HIV/AIDS educators
reaching out to their peers in school, members of their
family, relatives, friends and neighbors
Ruben E. Angeles. 8000 Bolton St Davao City, Philippines
Objectives: To dvelop students as an effective HIV/AIDS educators reaching
out to their peers in school, their family & relatives, friends and neighbors within
their area of influence.
Design: We strongly believe that a young student properly motivated & guided
as to the basic information on HIV/AIDS development-mode of transmital, and
consequences when one gets sick of the incurable disease could effectively share
education gained to people within their sphere of influence.
If only one will reach out to two members of their family who in turn will reach out
to two of their relatives and two of their friends and lastly two of their neighbors,
forty students (which is the is the size of one classroom in the Phil.) will be able
to spread information about the incurable disease to 320 students. Multiply these
by 100 and you would have reach out to 1,600 people.
Methods: Students are taught to join in discussing HIV/AIDS when presented
in their classroom.
The first agenda to be discussed is for them to think of a word or two that

will describe best AIDS when flashed before their eyes from newspaper report,
radio & television. Surprisingly they contributed these words: incurable, avoidable,
STD-sexually transmitted disease, irreversable effect, miserable, mysterious, selfinflicted, dangerous, drug related, blood transfusion, and a problematic disease.
A twenty minute 'workshop' among them will bring out the best in them as
to the Why-When-Who and How the HIV/AIDS becomes a community problem.
Proposals from them are entertained as to how they could be man and women