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

12th World AIDS Conference

Abstracts 33282-33286 649

therapies. Our counsellors in collaboration with the two hospitals identified about
15 patients who had been put on the trial drug, mainly double or triple therapy.
The patients were then interviewed and later responded to a short questionnaire
that tried to solicit for any needs, actual or perceived in terms of counselling and
information on the therapy and general well being.
Results: Majority of the patients interviewed had acute psychosocial needs
related to their intense fear to seek care and support due to their positions in
society. They were also scared of stigmatization and lived very isolated lives leading to serious stress and anxiety most of the time. They had hardly any coping
mechanism and very little information even on the therapy they were receiving.
They rarely read or sought information for fear of being identified as HIV positive.
A few (4) had anxiety over their ability to continue financing the therapy up to the
required period, their property and loss of family support should their status be
revealed. Majority (11) were receiving the therapy without the knowledge of their
partners or family members.
Lessons Learned: Immediate efforts must be made to include psycho-social
support as a component of the clinical therapy being received by the patient.
The emerging psycho-social problems like stress, fear, anxiety does not auger
well for the effectiveness of the therapy and always leads to complacency and
patients dropping out of the treatment. Additional counselling time and resources
is required to address their specific needs.
S33282 1Same day HIV voluntary counselling and testing (VCT)
improves overall acceptability among prenatal women in
Zambia
Ganapati J. Bhat1 2, S. McKenna3, H. Terunuma4, Y. Ahmed5, N. Luo6,
S. Allen7, B. Hojer8. 1Dept. of Paediatrics & Child Health; U. TH. School of
Medicine, PO Box: 50110 Ridgeway, Lusaka; 2School of Medicine, University of
Zambia, Lusaka; 3Project San Francisco (PSF), Lusaka; 4Dept. of Virology,
University Teaching Hospital, Lusaka; 5School of Medicine and UTH, Lusaka;
6 Ministry of Health, Govt. of Zambia, Lusaka, Zambia; 7University of Alabama at
Birmingham Birmingham, USA; 8Karolinska Institute Stockholm, Sweden
Objectives: i) To evaluate the overall acceptability of HIV VCT, accompanied by
pre- and post-test counselling and same day testing by using rapid HIV assays
among women attending regular Prenatal Clinics (PNCs). ii) To determine factors
associated with requesting or declining for VCT.
Methods: Three clinics were chosen for the study. The Nurse-Midwives and
the Laboratory Technicians working at the PNCs were re-trained for the study
purpose. First 20-25 women arriving at the PNC participated in a group discussion led by a Nurse Counsellor. Following the discussion the interested women
were provided individual pre-test counselling. After an informed consent the blood
drawn for routine RPR testing was also tested for HIV using Capillus HIV-1/HIV
2 as a screening test. All positive results were then confirmed using Dipstick
HIV-1/HIV 2. The HIV result specific post-test counselling was offered after the
prenatal check-up.
Results: The results by each Clinic were as follows:

Awareness that AIDS not curable rose from 19.5% to 56%. The number reporting
extra-marital sex dropped from 18.4% to 12% only. However, the use of condom
after counselling was not statistically different.
Conclusion: There was improvement in both knowledge and attitudes as a
result of counselling. Yet it failed to show up in the crucial area of use of condom.
A two months gap between the pre and post reassessment was not adequate to
assess the behavioural change.
S33284 Peer support for young people living with HIV/AIDS in
three Nairobi slums, in Kenya
Michael Angaga, L. Owiti1. PO. Box 30218, Nairobi; t University of Nairobi, PO.
Box 30197, Nairobi, Kenya
Issue: Young people living with HIV/AIDS prefer to obtain information on HIV/AIDS
and counselling from their peers for the following reasons: clarity, language, trust
and empathy. Comprehensive training in peer counselling to infected youths has
not been available.
Project: A one year community based project was undertaken to develop a
training program that would enable youths living with HIV/AIDS deliver information on AIDS through peer counselling. Extensive consultations were undertaken
with communities of youths living with HIV/AIDS in three slums in Nairobi. A
two weeks training program encompassing peer helping skills was designed and
piloted in three slums; Dandora, Gomongo and Baba Dogo. Process and impact
questionnaires and interviews were conducted with participants and facilitators.
Results: 60 youths living with HIV participated in the pilots. Based on the
results of the evaluation a manual on peer helping skills was developed and
widely used by many community groups working with the youth on HIV/AIDS, in
the slums.
Lessons Learned: Through capacity building for the youth on information
giving, we were able to develop information service delivery model that is user
friendly to youths living with HIV and their peers. This has helped in enhancing
behavior change among the youths in the slums.
33285 | Survey of the effects of providing individuals with risky
behaviours with a negative HIV test result
Monica Zermiani1, Giovanni Serpelloni2, M.A. Mazzi3, U. Galvan4. 1 Via
Germania 20 37136 Verona; 2Head of Unit-Sezione Screening HIV Verona;
3 Researcher-Sezione Screening HIV Verona; 4Psychiatry-Sezione Screening
HIV Verona, Italia
Issues: One of the preventive measures suggested in order to contain the spread
of HIV is the creation of services for the screening and counseling of subjects at
risk for the infection of HIV.
Project: The basic hypothesis of the study is that the notification to some subjects of a negative HIV test result could induce a "reassuring effect" for the avoided
infection and a feeling of invulnerability. The objectives of the research can be
briefly summarized: 1) to investigate the effects of the notification of a negative HIV
test result to subjects at high and low risk of infection; 2) to monitor the repeated
risky behaviours in both the two groups of subjects in relationship with the notification of the negative test result and with counseling; 3) to point out the presence
of any "reassuring effect" or feeling of invulnerability induced by the notification
of the negative HIV test result with a consequent maintenance of risky behaviors.
Results: In this phase of the study the quetionnaires were submitted to 255
subjects belonging to the different groups at risk who had applied to the HIV
Screening Centre. Of these 255 subjects 152 were males and 103 females. 185
were heterosexuals, 27 homosexuals or bisexuals, 3 drug users, 6 ex drug users
and the other subjects were considered as "something else". The results of the
questionnaires submitted to the sample group during precounseling were the
following: informative level: mean 19.4 (scale 0-25 sd 2.8); risk perception: mean
27.5 (scale 0-48, s.d 4.7); attitude: mean 5.8 (scale 0-96, sd 2.7); risk aptitude:
mean 29.1 (scale 0-13, sd 9.1). All those subjects who resulted HIV negative
were submitted with the questionnaires on the informative level and on the risk
perception. The difference between pre and post counseling informative level was
significant (p.0.01). The results of post-counseling questionnaires were the following: informative level: mean 22 (sd 2.4), risk perception: mean 27.5 (sd 4.7). After
receiving a negative test result risk perception decreased in 51% of the subjects.
The suddivision of the subjects in high and low risk was possible on the basis of
more information: group at risk, use of condom and partner's HIV prevalence.
Lessons Learned: Even if we are still waiting the follow-up data we can
already assume that by providing a negative HIV test result we can produce a
"reassuring" effect by reducing risk perception and encouraging risky behaviours.
Risk perception should, therefore, be especially considered during post- test
counseling so as to plan interventions aimed at modyfying partially or totally risky
behaviours.
S33286 Counseling in the screening test for HIV infection
Domenico Zanaboni, L. Scudeller, V. Broletti, G. Mussati, L. Rizzi. Infect Dis

Dept-Policlinico San Matteo Via Taramelli 5 Pavia, Italy
Issues: To evaluate changing patterns of counseling request and effectiveness
in preventing sexually-transmitted HIV infection
Project: From 11/95 to 10/97 all individuals asking for an HIV screening test
were interviewed by a MD using a structured approach. Clinical and virological
meaning of ELISA, Western blot and PCR tests were thoroughly discussed along

Name of the Clinic
Attended Group Talk
Requested VCT
Overall Acceptability, %
HIV Prevalence (%)

U.TH.
320
229
72
68 (30%)

Chilenje
287
238
83
60 (25%)

Chipata
271
245
90
64 (27%)

Total
878
712
81
192 (27%)

Conclusions: Overall acceptability for HIV VCT was high (81%) among women
attending Prenatal Clinics in Lusaka. However, acceptance was low in women with
higher educational and socio-economic status. The use of two rapid diagnostic
tests was userfriendly, convenient and cost effective.
33283 Impact of counselling on HIV risk awareness and
practices amongst sexually transmitted diseases
subjects
Vijay L. Grover1, A. Indrayan2, S.C. Sharma3, A.T. Kannan2. 1150 Doctors
Apartments, 4 Vasundhara ENC Ave, Delhi-110096,; 2U.C.M.S. & GTB Hospital
Delhi 11095,; Ex-U.C.M.S. & GTB Hospital, Delhi 110095, India
Issues: Population vulnerable to HIV/AIDS through high risk behaviour in STD
clinic require appropriate counselling in the absence of vaccine and cure for AIDS.
Design: Intervention study on awareness
Methods: About five hundred confirmed cases of STD from a skin and venereal diseases were enrolled after the assurance of anonymity and confidentiality.
Information pertaining to respondents background, sexual behaviour as well as
their knowledge and attitudes towards AIDS were recorded. Each subject was
then counselled and given full and correct information regarding transmission
of AIDS, its signs and symptoms and the mode of its spread. They were also
educated about the consequences. Counselling was one to one and multiphasic,
by a group of qualified professionals in the field of skin and venereal diseases,
epidemiology, anthropology and psychology. After two months these subjects
were interviewed again and the impact of counselling assessed.
Results: Nearly 81% of the subjects were in the age group of 15 to 34 years.
More than 2/5th (42.9%) subjects were unmarried among males but only 10.9%
among females (p < 0.005). A total of 60% reported to have heard about AIDS
before the counselling which increased to 97.1% after counselling (p < 0.0001) in
both the sexes. The knowledge about methods of protection, avoiding free sex,
and not sharing I.V. drugs improved significantly after counselling (p < 0.0001).