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

12th World AIDS Conference

Abstracts 33327-33332 657

33327 AIDS prevention carried out by HIV(+) women
Celia Wainstein1, Elisabeth Rodriguez Rios2, J.M. Macias Jose3, V.F. Fridman
Vanesa2. 1Honorio Pueyrredon 364 8 "A" Buenos Aires; 2Programa
Sioa-Hospital Muniz, Buenos Aires; 3Sala 16 Hospital Muniz, Buenos Aires,
Argentina
Objective: This project has been deigned as a pilot study to explore the availability in HIV+ patients to work in social communication, (as social workers) to
educate people.
To teach risk behaviour, transmission of HIV, and how to prevent it.
Project: to qualify HIV+ patients to be able to help people to learn how to
prevent HIV infection, to gave instruction to provide people with knowledge in epidemiology, biosecurity, addictions, sexual transmission, discrimination and legal
matters.
Twice a week they received instruction in teaching methods and how to communicate the prevention rules, and knowledge within the range of theirs information.
Results: 76 HIV+ patients were trained.
During that period, 4 patients died. During 1997, 37 HIV+ women were performing social services, and been periodically evaluated
Lessons Learned: HIV+ patients can determine the knowledge about AIDS of
the people of Buenos Aires, and to educate them to prevent AIDS.
Education programmes for prevention and control were conducted by HIV+
women, identifying sites of high HIV risk.
33328 Problematic of a screening center in Burkina Faso: The
case of the center "Faire face"
Madina Traore, Francois Petitjean. APRODEC, BP 1855 Bobo 02,
Bobo-Dioulasso, Burkina Faso
Problematic: In Bobo-Dioulasso, second biggest town in Burkina Faso with some
400 000 inhabitants, HIV seroprevalence among adults is estimated to 12%. A
screening center was created on 2 nd April 1996 and placed under the supervision of a local association: APRODEC. The so called Centre "Faire face" is the
only one existing in Burkina faso. After seven month of operating there was not
great attendance. People prefered not to know, for they ignore the asymptomatic
phase.
Method: After a difficult start, the APRODEC quickly seated two commissions
to promote HIV screening. Conferences and debates have been organised on
HIV in various school and university centers on the town as well as among
associations and industrial companies. The support given by the medical centers
is also analysed.
Results: After the above-mentioned activities, we observed a neat increase in
the attendance rate of the center.
From April 96 to january 97 the average attendance was 14 people per month;
from january 97 to december this number passed to 27 per month.
Perspectives: The creation of an after-testing club and a permanence office
for the association of people living with HIV and the creation of an information
center.
33329 Applying a train-the-trainer approach to preparing
HIV/AIDS/STD front line counsellors: Opportunities and
challenges
Pauline Russell-Brown1, C. Francis2, H.U. Wagner1, C. O'Neill. 'Carribean
Epidemiology Centre (CAREC)/GTZ, 16-18 Jamaica Boulevard, Federation
Park, Port of Spain; 2CRF Associates, Port of Spain, Trinidad
Issue: Development of counselling services is one practical means to prevent
and control the spread of transmissible diseases including AIDS. Countries like
Guyana which have severe resource limitations must find approaches that will
efficiently support counselling development. This paper discusses the case of
Guyana and its experience with a counsellor training intervention.
Project: The National AIDS Programme in Guyana with the support of
CAREC and GTZ implemented a train-the-trainer programme to prepare front
line STD/HIV/AIDS counsellors. Acknowledging that training by itself can only
change skills, knowledge, and superficial attitudes and beliefs, the model being
tested combines training and technical preparation with social and professional
support, and supervised internships that bring counsellors into direct contact with
PHIVs/PWAs during their training.
Results: Three trainers and seven counsellors graduated from the programme
during the first phase. An operational plan developed jointly by graduates and
programme managers required graduates to work as counsellors initially in 3
of 10 health regions. Expansion of the programme to other regions would be
phased. Results of objective assessments indicate that the training objectives
were achieved. Post-training counselling and counsellor training activities detailed
in the plan were less successfully implemented.
Lessons Learned: Success of counsellor training programmes depends as
much on the quality of the training as on the follow-up support invested in individual graduates and in programme management. In the absence of strong

organizational structures, programme success is dependent on the level of social
support provided by peers and mentors.

S33330 HIV testing and counseling at a primary care health
center in a poor neighborhood of Rosario, Argentina
Damiah Adolfo Lavarello', G. Sanchez2, M. Adan2, J. Scandurra2,
A. Maltaneres2, A. Alonso2. 1 Whelwrignt AV 1421 6th 4th Rosario; 2Programa
Municipal De Sida (Promusida), Rosario, Argentina
Las Flores Health Center is an ambulatory care dependency of the Primary Care
Department of Rosario's city Health Secretary, sited in a periferic neighborhood
with one of the highest rates of prevalence of HIV infection. During 1996, an
incressing spontaneus request for HIV tests was detected, and no previously
organized circulation for this demand existed. As an answer, we constituted an
interdisciplinary team (clinicians, psychologists, social workers, nurses, gynaecologists) wich offered a multifacetic service called " Consultoria en VIH/SIDA",
available monday to friday from 8 am to 6 pm. The objectives were: to improve and
to promote the access to anonimous, confidential, voluntary and free HIV Testing
and Counselling, to offer information and support to people in this instance, and
to collect data for community work strategies. The first step was a reciprocal
capacitation and the obtention of a common speech reflecting receptivity, no-discrimination, commitment and open information. A special registration form and an
informed consent sheet to be signed were created. We obtained authorization for
non-medical signatures. Preparation time was two months. The service started
working on January 1997, and during that year, 97 tests were performed, of wich
7 (7.2%) were positive. The service had several consequences of value such as
a first time vinculation with a group of travestis, the evidence of a widely spread
use of drugs with no opportunities for rehabilitation, the opening of a space for
the participation of young volunteers of the neighborhood, and finally and over all,
the community developed a strong feeling that "their" health center was deeply
commited to the problem.
HIV Testing and Counselling services of low demand at Primary Care Health
Centers are possible and necessary, and can be organized on the basis of the
existing personal, offering a wide schedule of time of predisposed health care
workers. The early detection of HIV infections will improve prevention and treatments. Nurses demonstrate the highest advantages for this work. A teaching and
learning process takes place continuosly.
33331 Health intervention for cantineras (Barmaids)
Hunter Hammill', A. Mora2. 14126 Southwest Freeway Suite 1717, Houston,
Texas; 2Amigos Volunteers In Education & Svcs. (AVES), Inc, Houston, TX, USA
Issue: Newly immigrated Hispanic women, working as "cantineras", require
intensive HIV/STD prevention education and gynecological health care and empowerment.
Project: Houston has seen an increase of Hispanic immigrant women who
turn to "cantinas" for employment as barmaids paid to dance and drink with
patrons and also engage in commercial sex. These activities put them at high
risk for HIV/STDs. Due to the women's lack of knowledge on health care, and
limited language and culture-sensitive medical services, AVES designed for them,
an HIV/STD prevention program that provided education on the prevention of
HIV/STDs, and gynecological exams. This project used a Board Certified OB/GYN
who provided comprehensive exams on-site at "cantinas", and distributed contraceptives. Bilingual educators provided culture-sensitive, risk reduction education
and access to additional health care services.
Results: To date, 43 "cantineras" have received medical care and HIV/STD testing and treatment in a non-threatening, familiar setting. 5 cases of trichomonas,
6 cases of chlamydia, 4 cases of syphilis, one abnormal pap, one HIV positive
patient, and one pregnant patient were identified. 47% did not use contraceptives, 12% had a history of substance abuse, and 67% consumed alcohol in large
quantities. The women were taught gynecological health. Follow-up return rate
was 98%.
Lessons Learned: Providing on-site, comprehensive health care and prevention education to disenfranchised women can significantly improve their overall
health and reduce their risk for HIV/STDs. Utilizing culture and language competent staff increases participation and encourages involvement in own health care
and compliance with medical treatment.
184*/33332 Promoting condom use among female sex workers
in natural settings in Yunnan, China
Zunyou Wu1, J.P. Zhang2, Y.S. Wang3, M.H. Jia2, Y.H. Kang4, Y.J. Duan5,
L.L. Dong6. Chinese Academy of Preventive Medicine, 27 Nanwei Road Beijing
100050; 2 Yunnan Anti-Epidemic Station Kunming; 3 Yunnan AIDS Control Office
Kunming; 4 Chengjiang Anti-Epidemic Station Chengjiang; 5Ruili Anti-Epidemic
Station Ruili; 6Longchuan Anti-Epidemic Station Longchuan, China
Background: Commercial sex activities are prevalent while intervention programs
were only based on detention centers which produce no effects on modifying sexual behaviors.
Objectives: To evaluate the feasibility of implementing a prevention program
among female sex workers in natural settings in Yunnan to increase their knowl
edge of STD/AIDS and their condom use rate.
Methods: 30 establishments in Chengjiang, 34 in Ruili and 23 in Longchuan
were selected for the intervention study. The study went through five phases:
1) qualitative study; 2) baseline survey of female prostitutes on knowledge of
STD/AIDS and condom use rate; 3) development of specific educational materials based on the qualitative study and the baseline survey; 4) implementation of
comprehensive intervention activities including discussion, women's talk, video