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

506 Abstracts 24341-24346

12th World AIDS Conference

24341 Pattern and characteristics of clients counselled for
HIV/AIDS between 1992-1995: Implications on future
counselling and training strategies
Elizabeth Matenga', E. Garura2, S. Ralepatha2, C. Nya Guyo2. 1No. 15
Rowland Square, Milton Park Harare, PO. Box 7225, Harare; 2AIDS Counselling
Trust Box 7225, Harare Harare, Zimbabwe
Objectives: (i) To review characteristics of clients referred for HIV/AIDS counselling.
Method: A retrospective study case records of clients seen by ACT between
1992-1995.
Study Factors: Demographic data, employment status, marital status, first
or second marriage, attitude towards involvement of partner in the counselling
process, and nature of referral.
Main Findings: In the main, men tended to be referred by doctors and employers, whilst women came by self-referral or through friends and relatives. More
men than women came for counselling. Index cases who were part of a second
marriage, did not communicate to their current spouse the reasons for break up
of their marriage or that they were widows. There were varied and very strange
reactions to the breaking of news of HIV status. Inspite of the gravity of the news,
only half a dozen cases of violent reactions by a spouse against the one who
brought the bad news was recorded. No cases of suicide or immediate break-up
of a marriage or relationship was documented. Younger clients below the age of
30 years were less likely to accept the advice not to try for another baby.
Conclusion: Findings are of great importance in planning and carrying out
future counselling training activities in this community.
24342 Personal experience in managing clinical problems in the
post test club
Peter Shisa Khaukha. AIDS Information Centre, PO. Box 1838, Mbale, Uganda
Project: I used to manage clinical problems before I trained as a Counsellor, the
kind of services that I and my fellow staffs used to deliver were very decayed, we
used not to think about patient's problems. Sometimes patients could end up by
crying before us, but this was not enough. The language that could be talked to
patients was very arrogant - there was no issue of user friendliness, once could
not listen to the patient's story - Most patients deserted us.
One time a client (patient) told me that one day you will fall sick and you
get this kind of treatment. Shortly AIC employed me. The remark to me by the
client kept on haunting me. When AIC trained me as Counsellor to manage the
clinical problems in Post Test Club, I acquired all the skills and started with work. I
from here discovered that the medical proffesion is totally decayed - by unethical
Health Workers who don't have basic Counselling skills.
Result: After the training, I do counselling & clinical problem management. Fry
clients I work on admire the way I deal with them, they keep on asking questions.
Being ethical and having a user friendly language will be beneficial to our
clients. Training as a Counsellor to all health workers is of greater benefit to both
clients and health providers.
24343 Impact of a computerized management information
system on counselling services at the AIDS Support
Organization, in Uganda
Nathan Tumwebaze, M.S. Monico. Taso PO Box 10443 Kampala, Uganda
Background: In January, 1997, The AIDS Support Organization (TASO) in
Uganda introduced a computerized management information system (MIS) which
includes records on all newly registered clients, all counselling sessions, and all
medical visits provided to these clients. Non-computerized data from previous
years only documented the number and location of counselling sessions while
the new MIS provides much more specific and detailed data.
Methods: We analyzed the frequency and types of counselling services provided in the first half of 1997 and presented these data to TASO counsellors at
a workshop in September, 1997. Overall in 1997, 15,332 clients received 31,677
recorded counselling services at 7 TASO centres in the eastern and southern
region of the country. To assess the impact of sharing the findings of the MIS with
counsellors, we have compared counselling services provided to active clients in
the 1st quarter with services in the 4th quarter.
Results: There were 6535 counselling sessions provided to 3863 clients in the
1st quarter, compared to 7968 sessions for 4484 clients in the 4th quarter; the
average increased slightly from 1.7 to 1.8 per client. The percentage of counselling sessions conducted in the home or community increased slightly from 9%
to 12%. The percentage of clients receiving 3 or more counselling sessions in
each quarter increased from 16% to 20%. When counsellors realized that 86%
of counselling sessions had been categorized as "on-going", they became more
specific in identifying the types of counselling they provide, and the percentage
of sessions categorized as "preventive" increased from 7% to 42%.
Conclusions: For an organization such as TASO which serves thousands
of clients at multiple sites, a computerized MIS is essential to identify services

needing improvement. After sharing MIS findings with counsellors in the field,
counselling in the home or community increased slightly, as did the frequency
and specificity of counselling services. This process of sharing of MIS findings
with counsellors can help them improve the care they provide to their clients.

I 24344 Awareness over sexual intercourses among the couples
of HIV infected partners
Djamboue Etienne Tapebi', Tanoh Amenan2, Kouame Affoue2, Koffi Kplohi2,
Tao Arsene2. 114 BP 2101, Abidjan 14; 2Lumiere Action, Abidjan, Ivory Coast
Issue: Besides psychological imbalance, one of the greatest problems faced by
people infected by HIV is mainly at sexual intercourses level.
Objective: Have HIV infected people live a normal and stable sexual life.
Strategy: Discuss sexual problems with 20 couples composed of partners
infected by HIV.
Results: In three months work we've realized that the majority of sexual
problems faced by HIV infected people are psychological ones.
Lesson Learned: A normal and balanced sexual life makes HIV infected
people happy.
1 24345 Why the participation of counsellors is important
Aminata M. Diaby, J.K. Kouame, F.K. Koffi, K.A.B. Kouadio, F.J. Fian. Lumiere
Action, 14 BP 2101 Abidjan 14, Cote D'lvoire
Example: PV HIV/AIDS of Lumiere Action in two hospital in counselling and
psychosocial support of peoples
Objectives: Help patients in these centers accept there status (P+) live a
positive life thanks to witnesses of advisers whom are also infected by the virus.
Strengthen partnership between communitary actors so to come once and for
all to an efficient response to HIV/AIDS and to ensure a socio psychological
education to patients known as carrying the HIV.
Methods: Training of people carrying HIV/AIDS and members of Lumiere
Action in counselling association. 4 permanent days of duty by week are spent
by the advisers in the inquiry offices of the hospital acting in counselling and
suggesting private calls. Visit to patients at hospital, counsellors give personal
hygiene assistance deliver speeches of good health. If possible share meats with
the HIV positives.
Results: In spite of numberous difficultes most often met to be in contact
with the patients. A dirrect action, a social and psychological support, a friendly
approach under the form of counsel proved to be more satisfactory and it had
even enterested the patients. The way of advising, the efficiency and the means
to close patients has consolidated the relations ship betwen the medical staff
working in the centers and the counsellors P+.
An experience to be developed and stretch all over the world in partnership
with the N.G.O'S and with sponsors with sufficient sum for the counsellors are
voluntaries for a materiel support to patients. The traumatism caused by the
HIV infection added to the strong paines that preceed it such as stigmatisation,
discrimination and refection are minimised thanks to the active and massive...
24346 1The impact of AIDS counseling in Africa: The experience
of Abidjan, C6te d'lvoire
Leman Isabelle Doumatey1, Regina Traore2, Dominique Kerowenan3
Philippe Eono4, Marc Aguirre5. '06 BP 1021 Cidex 1 Abidjan 06; 2Universite De
Cote Divoire Cercom, Abidjan; 3PNLS Abidjan; 4Cooperation Francaise, Abidjan;
5HOPE Worldwide Abidjan, Cote D'lvoire
Background: Increasing efforts, to promote responsible sexual behavior, and
to address the psycho-social needs, of growing numbers of PWAs in Abidjan,
have resulted in the active counseling of over 8000 PWAs. Despite these positive
efforts, the challenge of promoting and sustaining behavior change within this
population remains evident, with a significant number of pregnancies and STDs
still being reported. In addition, behavior change faces numerous social and
cultural barriers. The goal of this study was to assess the impact of counseling
and its limitations and to provide recommendations to local AIDS programs in
order to improve global counseling strategies.
Methods: A KAPB questionnaire was administered to a sample of 208 PWAs
attending 7 different AIDS care centers in Abidjan. One-to-one discussions were
also conducted for data collection. In-depth structured interviews were conducted
with 18 counselors at these centers.
Results: 50 (24%) of PWAs interviewed were illiterate. 16 (8%) had a secondary education. 196 (94%) knew that the AIDS virus is transmitted by sexual
intercourse. 41% use condoms during every sexual encounter, while 28% use
condoms occasionally. 56 (26%) have abstained since test disclosure. 105 (50%)
believe that they are more responsible sexually after receiving their HIV result. 24
(12%) believe that they may have contaminated their partner even after receiving
their result. 59 (28%) have partners that have not been tested. 50 (24%) are
active smokers and/or use alcohol frequently.
Conclusion: Despite the increasing availability of counseling services and high
levels of knowledge on AIDS its transmission among PWAs, serious limitations
still exist shown by relatively low levels of condom use, and high levels of ongoing
sexual relations and substance use and abuse. Low literacy and education levels
among PWAS, pose as barriers to effective prevention and should be appropriately addressed. Counseling programs must be evaluated periodically to assess

individual impact and should be client-tailored to ensure the effective promotion
of behavior change.