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

12th World AIDS Conference

Abstracts 24336-24340 505

Kerala being the densest state in India with the heterogeneous spread out of
all the so called labelled groups, can lead to unpredictable psychosocial and
economic disaster. A radical and warfooting intervention to tackle this issue has
become an emergency.
Out of the 40 women clients with anxiety and other neurotic features reported
at my counselling centre, 28 women, after an in-depth probing revealed that their
primary cause for anxiety and depression was concerning about their spouses
working abroad (Gulf countries) and in Mumbai. Information about HIV/AIDS from
news papers, radio, T.V. and other awareness campaign has given them ample
information to cause anxiety and depression. All the 28 women with anxiety and
depression, with varied degrees, showed concern and fear about their spouses
being in high risk group.
Result: These 28 women showed deep concern about their spouses of getting
infected with HIV/AIDS. They were apprehensive and manifested with a high degree of helplessness, insecurity feeling, cognitive dissonance, hysterical reaction
social inhibition and guilt and frigidity. Some also knew how to protect themselves
but were helpless in communicating a better safe sexual practice. Some even
developed emotional and sexual apathy towards their husbands. Many showed
sexual difficulties.
Lessons Learned: Appropriate and immediate intervention programmes required at the community level for the spouses and the near relatives of the labelled
groups. Individual and group counselling is an essentiality for the spouses and
other family members of the labelled group. A community based approach suggested to tackle the AIDS panic among the spouses and relatives of the labelled
groups
243361 Seropositive's women and AIDS sufferers: What future?
Adele Oli, Rose Dossou, Koua Desire Ndah. 106 B.P 1021 CIDEX 1 Abidjan 06;
2 Club Des Amis Abidjan, Cbte D Ivoire
Issue: Today, nobody could not to know the pain that VIH/AIDES spilled and
continue to spill through the world. Governments, ONG, association.... Have
spent all their energy in order to fight against that scourge but nothing. In fact,
some estimations showed that women's proportion became alarmed at this pain.
That be explain by the vulnerability of women. That the reason why it is necessary
for us to think about women's situation. In fact, how do ADS suffers live daily? Do
they really integrated in social level?
Project: Identify the social and economic problems of woman who is AIDS
sufferer and seropositive. Improve life condition of woman who is AIDS sufferer
and seropositive by creation of generator's activities.
Methods: Studies have been organised in my association when we paid visit
to the AIDS sufferer at home To 1994 for 1996. How do they live at home? How
did they announced the result of their state to their husband or partner? How did
the family reacted?
Resultats: During that period of search, 50 Seropositive's women and AIDS
sufferers had been taken a census of in 8 neighbourhood of Abidjan. 20 women
had received 75 thousands as loan to sell fishes at the market for instance. 5
women have been driven out by their husband because they didn't accept their
sate of serology. 10 women was died. 6 women didn't inform their husband or
partners about their state for fear that being drive out. 5 Seropositive's women
had informed their partners. Only 4 women received their friend's visit and pieces
of advices.
Lessons Learned: Generally speaking, women who received loans and women
who informed their partners hasn't problems; on the contrary, they started in the
fight against AIDS. Today, they make testimonies without hide their face. But
those who hide their state of serology have their state of life with is degraded.
i 24337 National AIDS hotline (non-charged) and the role of
telephone counseling in AIDS epidemic in Thailand
Narin Karinchai', Ornanong Intarajit', Anong Panatung2, Anothai Charoensap3.
Center Chiang Mai, Chiang Mai; 3 The House of Tomorrow Chiang Mai, Chiang
Mai, Thailand
Issue: The overwhelm AIDS patients being unable to access to medical care and
consultation in the hospital throughout the country.
Project: Free telephone AIDS lines throughout Thailand where people of all
level can reach AIDS information/education and sex education to protect themselves. Pre-test counseling, premarital counseling, and post-test counseling are
provided on the phone and by walking-in Hotline Center Foundation. Outreach
programs are also provided according to clients' requests. Most of medical consultations are explained an the phone while family therapy for preparing to die are
arranged through family members/relatives including hospital referrals throughout
the country. This services are provided by well-trained psychologist and health
psychologists.
Results: Saving some money from travelling to put the patients in hospitals
without better care but high cost of expenses. People/patients felt that they could
access to health care better than to consult the doctors who have no time for them.

Patients and their family members have gained understanding, encouragement
and morale. They have learned to appreciate life and death among families.
Lessons Learned: Counseling and psychotherapy through the telephone can
be done efficiently and effectively by well-trained psychologists and health psychologists.

24338 Changing behaviour of family members of PWAs through
home based care services in one Kenyan village
Anne Njoki Ngondo, A.M. Awuor, R.G. Lenya. Tapwak, PO. Box 30583, Nairobi,
Kenya
Issue: Participants in this workshop will gain competent methods of delivering
AIDS related home based care services necessary to effectively join with the client
and their family, access and modify the behaviours that compromise the physical
and psychological health of family members and finally to access interpersonal
dynamics that serve to either help or hinder the delivery of therapeutic services.
Project: Didactic instructions, culturally designed role plays, guided group
counselling process, audio visual aids and networking with community based
service providers dealing with the stigma of AIDS in the African community.
Lessons Learned: The approach enhanced self esteem, self efficassy, beliefs
and practices, cultural consciousness and orientation of the clients.
S24339 Barriers towards the implementation/utilization of HIV
counseling services
Joy Abraham1, C. Subrahmanian2. 13 Vail Ankanni Pr Asad P Lot#57 5B Mori
Road, Mahim, Mumbai; 2Counselling&Allied Services for AIDS, Mumbai, India
Issue: Counseling has not taken root as an established service delivery system
in India, as a result of which HIV counseling services are not only scare, but also
underutilized.
Project: CASA is an NGO providing counseling for HIV/AIDS since 1993. Comprehensive counseling services were offered to both, inpatients and outpatients
in the STD's department of a government hospital. Clients were predominantly
from lower socio-economic strata, and consequently, were people who had very
little access to information about HIV/AIDS, unaware of their rights and unable
to articulate service needs. Multiple contacts were required to achieve adequate
understanding of pertinent issues, and the challenge was to find way to encourage
people to utilize services and come back for regular follow-up.
Results: A total of 1635 counseling sessions were conducted with 1014 clients
in the period from January 1996-January 1997. Of the total sessions, 403 were
pre-test counseling sessions while 381 were initial sessions with people who had
tested positive from other centers but were unaware of their serostatus. Only
155 came in for post-test counseling either after first test or confirmatory test.
Follow-up sessions were more frequent with inpatients (587 sessions) than with
outpatients (108 sessions), although the number of outpatients far outnumbered
inpatients (631 vs. 383)
Lessons Learned: Services should match the needs of the target group to
maximize client participation and involvement. Counseling services should be
closely linked with other support services, particularly medical services. Cooperation and coordination between various professionals engaged in service delivery
enhance follow-up and client compliance.
24340 Inadequate pre- and post-test counselling for HIV in two
South African hospitals
Johannes Viljoen', M. Meijer', J. Claasens', C. Steenberg', T. Venter2,
G. Joubert3, E. Van der Ryst2. 'Dept. of Virology (G23), 2Dept. of Internal
Medicine (G73), 3Dept. of Statistics, PO Box 339, UOFS, Bloemfontein, South
Africa
Introduction: The extent and the worrying increase in the incidence of HIV in
South-Africa makes it one of the most challenging problems facing the medical
profession today. Full knowledge regarding the physical and psychological consequences of a positive HIV test result is essential before an HIV test can be
done.
Objectives: To determine whether pre- and post- HIV test counselling are done
as a routine part of the management of patients suspected of being HIV infected
in two hospitals in Bloemfontein, South Africa. A further goal was to determine
whether counselling was effective and whether behaviour modification occurred
as a result of counseling.
Methods: Personal face to face interviews with 65 HIV infected patients were
conducted by means of a questionnaire. The interviews were conducted in English
and where necessary an interpreter was used.
Results: Consent for HIV testing was obtained from 55 (85%) of the patients.
However, adequate counselling was done in only 31 (48%) of cases. The result
of the test was revealed to the patients in private in 55 (85%) cases. Regarding
behavioural modification, 30 (46%) of the patients claimed to be sexually nonactive post-counselling. Of the 35 (54%) patients who were sexually active, 21
(60%) claimed to have started using condoms post-counselling and 13 (37%)
said that the result and counselling had a diminishing effect on the number of
sexual partners involved.
Conclusion: These results show that informed consent is not always obtained
pre-testing, and that an alarming number of patients are not counselled. Pre- and
post-test counselling are, furthermore, done at sub-optimal levels and subsequent
behavioural changes following a positive test are not adequately inspired. Ways

to overcome these problems, such as more efficient training of personnel should
be found.