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

12th World AIDS Conference

Abstracts 33314-33320 655

cerned. Is it religion in the form of moralising issues or placing value judgements?
This type of approach may be conceived as confrontational. Tension can there
by be added to the reality world of the counsellee(s). In my experience of work in
relation to religion as a viable care concept, the ability of the counselling process
to introduce the Word of God into the understanding of the affected & significant
others prove productive. The absorption of the-word and its mastery helps in the
total reality of those concerned. At any given time the Counselling Process must
be dynamic enough to meet the various religious facets of man.
Supplementary diet can boost the immune system like wise understanding of
the Word of God can nourish successfully an immune system that is spiritually
under nourished.
33314 Community counselling interventions in a rural area
Richard Julius Musiitwa. PO. Box 1679 Masaka, Uganda
Issue: Limited social services in rural areas make rural population vulnerable to
HIV/AIDS/STDs and require interventions to utilise the available resources in the
community.
Project: Given the increase in the spread of HIV/AIDS and other sexually transmitted diseases n rural areas, as intervention was made in Nakalembe Parish
of Masaka District, Uganda to focus on prevention counselling of HIV/AIDS and
other STDs. Nakalembe AIDS Community Programme combines resources of
medical staff, TASO Community Trainers, Community Counselling Aides and the
entire community members from the parish. The strategy includes counselling,
education on HIV/AIDS, provision of condoms and treatment of STDs.
Results: The programme was very well received by the community. Community
Counselling Aides were selected, trained and attached to the health unit to offer
counselling. The total number of sessions effectively from September 1997 rose
from 0 to 205 to date. A total of 1602 number of condoms have been requested
and given out which shows a safer sex method of prevention adopted. 29 cases
have been referred to the health unit for treatment of STDs.
Lessons Learned: Counselling in the community can be successful if it is
properly understood by the community to meet the desired need.
33315 Psychosocial care as a challenge in promoting
counselling services - Uganda experience
Claudia Somoka, E. Madraa, B.A. Byangire-Amanyire, P. Waibale.
STD/ACP-Ministry of Health P.O. Box 8, Entebbe, Uganda
Issue: Promoting the importance of psychosocial care for PLWHIV/AIDS within
our local traditional care system is not an easy issue to handle while counselling.
Project: Counselling in society is a delicate issue to handle in HIV infection and
disease, given the varrying cultural practices in Uganda. It is yet another major
component within the social and psychosocial care for PWA and their families.
The fact that shared confidentiality takes precedence in the community, rampant
widow inheritance, polygamy and circumcision for both women and men, societal
care still pose a challenge to HIV/AIDS counsellors.
Result: ACP-MOH as a lead sector in promoting strategies for AIDS care in the
country, has intervened in observed situation through providing different cardres
of counsellors at different levels of health units down to the community level to
clarify on the need of addressing harmful cultural aspects while counselling.
Lessons Learned: The experience gained so far, indicate that behaviour and
cultural barriers in counselling can be penetrated through the very people of that
culture. All they need is to be explored to the right skills which can then be
translated into the local practices through counselling in view of HIV/AIDS care.
3316 Building from the past to create a future for counseling
services in health care delivery system: Uganda
experience
Mary Byangire Amanyire, E. Madraa, C. Somoka. STD-ACP-Ministry of Health,
P.O. Box 8 Entebbe, Uganda
Introduction: Building from the past experience within the health are delivery
system has greatly strengthened the counseling services within the Ministry of
Health, STD/ACP. A training package for counseling services at different levels
has been entreched within the health care delivery system
Project: With increasing need for counseling services to complement care and
support for PLWHIV infection and disease, the existing traditional levels of health
delivery have had a hierarchy of trained counselors to augment Clinical, Nursing,
Social and Home care services from hospitals to the community. A series of
training guidelines and resource books have been developed. Trainers for each
District put in place and capacity building for planning purposes including support
supervision boosted. Councelors have been trained for hospitals using a sixteen
weeks' training package, Counselor Assistants for Peripheral Health Units use
a six weeks training package while Counseling aides for the community have a
training package of two weeks. Building from the past experience in traditional
systems of care has guided the establishment of comprehensive package for

continuum of counseling services.
Counseling services are in place at every level of care from Community to hospital with an in-built package for referral. A decentralised system of counseling
services has been established in every District, Home care services have been
rejuvenated with a back up of trained operational level health-workers.

33317 Usage of preservatives in rural zones as a mean to stop
HIV/AIDS in western C6te d'lvoire
Kouakou Robert Yao, D.S. Dougrou, Y.K.M. Yao-N'Da, S.A.M. Seya, V.N. Vako,
B.M. Basque. Cote d'lvoire Red Cross, 01 B.P. 1244 Abidjan, Cote d'lvoire
Objective: To sensitise men in order to increase the use of preservatives in the
rural area of Western C6te d'lvoire actually hosting Liberian refugees.
Method: The activity has been conducted in two villages in rural zone of
Western C6te d'lvoire. This area has been hosting about 400,000 refugees from
Liberia for the past 8 years. In the same area, the C6te d'lvoire Red Cross has
started a community based health care programme for Liberians and Ivorians
in 108 villages. In March 1997, an assessment concerning the knowledge of
AIDS, the use of preservatives and reasons for not using it in general has been
conducted in two large villages.
We noticed that in the village of Salleu and Trokoulimpleu, 91% and 86%
respectively of men (- 15 y. old) do not use any type of preservatives simply by
ignorance of the disease but also because there are no means to find preservatives. Since, we have established hearing and information centres regarding
AIDS. Preservatives are now available in the centres at low price.
Main Result: After 6 months of activity (since October 97), only 18% of men
in Salleu and 22% in Trokoulimpleu are not yet using preservatives for various
reasons.
What we have Learnt: the community based approach, specially in rural zones,
allow to better sensitise the population on HIV/AIDS prevention.
S33318 Counselling people living with HIV/AIDS
Rose E. Bwibo, V. Kamanya, P. Lugeleka. Jijengei Women Centre for Sexual
Health Mwanza, Tanzania
Jijengei Women's Centre for Sexual health is located in Mwanza, the second
largest city in Tanzania.
Jijengei's programmes address the root causes of social inequality for women
while acting as a demonstration site for clinical services, counselling, capacity
building, community awareness and training to improve the circumstances of
women's lives in Mwanza.
In counselling, women and their partners are helped to make responsible
decisions about their sexual and reproductive health. Counsellors experience
challenges in this undertaking, especially in HIV counselling.
This posters looks at some of the challenges counsellors face in HIV counselling
and possible solutions based on their experiences at the centre.
There is need to understand the cultural values and attitudes when providing
counselling.
33319 Training of health workers in pre and post test
counselling for HIV tests
Marina Nikitina. Bulatnikovskaya Ulitsa 4-1-28, Moscow, Russia
Issue: Lack of pre and post test counselling and informed consent for HIV tests
in medical establishments in Russia leads to human rights violations and is not
conducive to behaviour change.
Project: To make accessible pre and post counselling for patients taking a
test for HIV. To equip health workers of medical establishments with the skills to
conduct pre and post test counselling and to increase awareness about their own
rights and obligations and the rights of their patients. Research was conducted in
Moscow and in 3 regions in Russia to ascertain whether health workers conduct
pre and post test counselling and if not the reasons for this. Based on the results
of this research, a training model was developed to equip health workers with
the necessary skills to conduct counselling. 45 health workers from 15 regions
were trained, 3 workers from each region. A competition was then set up and
the team who developed the most effective project for training health workers in
their regions were awarded grants to implement trainings in their regions. Ten
subsequent trainings were implemented training 300 health workers. Supporting
materials were produced and distributed to AIDS centres, regional and local public
health committees, STD clinics and clinics working with drug users.
Results: Health workers were trained in counselling skills and conducted counselling amongst 60000 patients. 3000 information packages on counselling were
produced and distributed throughout Russia. Results of the project was made
available on AIDS infoshare's Russian language web page.
Lessons Learned: Results of the research showed that in 80% of the cases,
counselling was not conducted before or after testing since health workers were
unaware that this was obligatory according to Russian law since there is no mechanism to ensure that laws are upheld. Health workers also did not understand the
need for counselling, nor possessed the necessary skills to conduct counselling.
S33320 A belief model of sexual behavior of HIV-1 seropositive
Brazilian women

Elucir Gir1 2, M.M.F. Zago2, G. Duarte2, T.M. Moryia2. 1Avenida Bandeirantes
3900, 14040-902, Ribeirao Preto-SP; 2University of Sao Paulo-Nursing School,
Ribeirao Preto-SPF Brazil
Objectives: To identify the factors that determine the safe/unsafe sexual behavior of HIV-1 seropositive Brazilian women and intervene on them. To construct a
belief model concerning sexual behavior of them.
Design: Qualitative study.