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

508 Abstracts 24353-24357

12th World AIDS Conference

raise self esteem and develop coping skills to manage the unique environmental,
interpersonal and intrapsychic stressors which place gay Latino youth at risk for
HIV; 3) facilitation by indigenous peers utilizing established protocols and 4) ongoing clinical and professional development supervision and training to empower
and raise competency skills for facilitators. In an attempt to continually improve
and modify the intervention, a process evaluation has been integrated into the
program.
Results: Preliminary results indicate a strong receptivity to this group based
intervention. Initial engagement and recruitment have been the most challenging
obstacle due to the clandestine nature of this population. Once engaged participants report extremely positive experiences within group and likewise, staff also
report extreme satisfaction with the guidance and support the program offers
specifically in the area of supervision.
Lessons Learned: Specialized group based HIV prevention interventions
which are tailored to the specific sociocultural needs of the population are urgently
needed. Such programs are viable when they are structured, comprehensive and
integrate theoretical information into the curriculum. Ongoing clinical supervision
and mentorship provide empowerment for staff and improves the group process
and facilitation.
24353 Networking among HIV positive women in Uganda:
A 5-years PWAs experience
Nabaggala ScouiaKasolo, N. Kiiza2, R. Nakijoba3. Theta Organization, PLDT
724 Mawanda Road, Kamokya, RO. Box 21175, Kampala; 2Nacwola, Kampala;
3Theta, Kampala, Uganda
Issues: In countries like Uganda, women are economically, socially, culturally,
disadvantaged and often have low education, they are therefore faced with a
big challenge in taking care of themselves and their families in this era of AIDS.
Initiation of networking among HIV positive women is a positive approach in
addressing some of these problems. NACWOLA *THETA is a branch of The
National Community of Women Living with HIV/AIDS in Uganda and are attached
to traditional healers' clinics.
Project: We hold seminars and workshops to sensitise women on various issues e.g. on our rights and health issues. We share experiences; identify problems
common to women and try to reduce/solve them in a supportive environment.
We reach out to the community through home visits, disseminate HIV/AIDS information through music, dance and drama and we encourage self help projects for
income generation.
Results: Various communities have been reached, most women have come
out and are fully involved in HIV/AIDS prevention and care activities. Self help
schemes have supported us thus reducing our dependency on male partners.
Through AIDS education, most of us have been able to make informed decisions
about our lives. Given proper information, we have the potential as individuals,
mothers, and caretakers to become agents of change for own well being and our
communities.
Lessons Learnt: Denying us basic information and resources gives us little
chance of taking proper care in prevention of illnesses affecting us.
24354 1 Psychological support for HIV positive persons and their
caregivers in a public-community based integrated model
Pietro Altini', G. Orofino2, R.M. di Frenna3, C. Revelli4, P. Ronco4. 'Arcobaleno
AIDS Via Melchior 9101A 8E; 2Amedeo di Savoia Hospital Turin; 3Laboratorio di
Psilologia Univ. Torino Turin; 4Arcobaleno-AIDS Psychologist Italy, Italy
Issue: Psychological distress in HIV infected people and in their friends, partners and relatives, constitutes a very important problem that needs specific and
appropriate intervention.
Project: "Arcobaleno - AIDS" Association (A.A.A.) since 1993 has tried to offer
psychological support for people with HIV related problems: patients, at any stage
of the disease, and caregivers. In the past two years the need to qualify this kind
of service has been felt. Consequently, a network has been created that involves
the Infectious Diseases Hospital in Turin, the Laboratory of Psychology of the
University of Turin and some A.A.A. volunteers. Anyone who is interested or
people who have resulted particularly psychologically distressed during Hospital
check-ups are invited to attend an initial assessment interview at the Association's offices. The person interested is then invited to participate in self-help
groups and/or to receive personalized psychological support. The latter consists
of weekly appointments during which attention is focused on the psychodynamic
exploration of patients' dreams. This approach appears to alleviate the situations
of technical impasse at times occurrent in traditional counselling technique.
Results: In the years 1996-1997 35 subjects have been assessed (30 HIV
pos. and 5 HIV neg.). Twenty have attended the self-help groups and 15 have
received individual support. We have been able to observe the following: 1) a
decrease in the defences such as negation; 2) consequent improved ability to
integrate with an improvement in compliance and in self-care; 3) an increase in
self-esteem.
Lessons Learned: Even when psychological support is not institutionalized,

the efforts and co-operation between the public health service and voluntary
associations can help in developing useful forms of intervention for those people
living with HIV.

24355 1 "Living with HIV" - Cognitive-behavioral group programs
enhance the process of adaptation to living with HIV
Julia Bock', L.C. Escobar', D. Riemer2, M. Hautzinger3. 1Johannes-Gutenburg
Universitat, Psychologisches Institut, Abt. Klinische Psycho., Staudinger Weg 9,
D-55099 Mainz; 2AIDS-Hilfe Frankfurt a.M.e. V Frankfurt a.M.; 3Eberhard-Karls
Universitat, TObingen, Germany
Issue: In a pilot study a psychological group program involving 8 persons with
HIV/AIDS, quality of life and coping with the infection are shown to be improved.
The process of adaptation of living with the infection can be improved especially through cognitive-behavioral group interventions and relaxation therapy.
Especially persons undergoing anti-retroviral therapy can profit from this.
Project: A group program of 18 sessions for people with HIV/AIDS was conducted over a period of four months by a psychologist of the self help organisation
AIDS-Hilfe Frankfurt e.V.. The group program included relaxation therapy, group
dynamical and cognitive-behavioural exercises, exercises for crisis management
and for the development of resources and leaves time for the free discussion of
current themes.
Originally 8 persons took part in the group. One person left the group because
of sickness and later died and another left for personal reasons. The age range
was from 30 to 46. Subjects had been tested HIV-seropositive from seven to
twelve years ago, except for one who had only recently turned HIV-positive. Two
patients had developed full blown AIDS, the others were in various stages of the
infection. The T4 counts varied between 0 and 650. Five participants had severe
psychological disorders like anxiety or depressive disorders. Many reported psycho-social problems in the context of relationships, medication, employment and
living with HIV/AIDS.
This pilot study is registered within the EUROVIHTA project, which is supported
EU-Commission, DG V/F/2.
Results: Due to the death of one participant and two severe cases of sickness,
the remaining participants were confronted heavily with death and sickness. Supplementarily the themes death, dying and medication were discussed in many
session, whereas other themes were left out. Improvements were found on the
following variables: coping, social support, quality of life, depression and anxiety,
adaptation to the infection of daily life.
Lessons Learned: Group programs support people with HIV/AIDS to adapt
their lifes to their infection and to increase ther quality of life. Structured and
theme centered programs, that are handled by the psychologist in a problem
solving oriented way are most effective. Patients untergoing anti-retroviral therapy or suffering from depression can profit especially rom cognitive-behavioural
exercises.
124356 Collaboration between consumers and providers in AIDS
pediatric and family programs
Damian Goldvarg', M. Garcia2. 1411 E. 11 St., Suite 201, Long Beach, CA
90813; 2Lapan, Los Angeles, CA, USA
Issues: Families with children infected with HIV/AIDS require innovative and
appropriate psychosocial interventions that include them in decision-making processes.
Project: Given the specific needs of families with children affected or infected
by HIV/AIDS several interventions using consumer's feedback were developed.
To enhance family participation, a family-centered approach was implemented by
involving: a family advisor (consumer); an advisory council; and focus groups to
assure that the psychosocial needs of the consumers were being met effectively.
Providers focused on empowering families and supporting family decision making
in the delivery of services. Consumers participated by advising staff, volunteering
their time in the delivery of services and in planning, developing and evaluating
family projects.
Results: Within three years, the number of families attending network meetings has increased from an average of eight to an average of twenty people
per session. The feedback from consumers has helped to develop new activities
and enhance the commitment to consumers not only toward their medical and
psychosocial well being but also to the well being of their communities.
Lessons Learned: Collaboration between consumers and providers is effective
when there is respect, information sharing, support, empowerment and flexibility
from both sides. When collaboration is effective consumers receive quality services that meet their needs and providers receive the information they need to
deliver the right services appropriately.
S24357 1 Health care workers' perceptions of changes in HIV
infection
Alice Tellier1, Patrick Stoessel1, L. Ridel2, D. Meunier'. 'c/o Association Didier
Seux 6 Rue De L'Abbe-Gregoire 75006 Paris; 2Laboratoire De Psychologie
Clinique, Universite Paris, France
Background: Many studies on burn out emphazise the personal and emotional
implications for health care workers (HCW) who care for HIV patients. Now,

therapeutic progress tends to trivialize the management of patients. We studied the consequences of this evolution on the attitudes, practices and personal
involvment of HCW.
Methods: We performed in-depth interviews with 20 HCW (nurses and nures'
aids) working in a non-governmental organization (NGO) and applying to join a
support group. The following data were collected: past professional experience,
motivations for HIV care, personal difficulties experienced within the caring re