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

700 Abstracts 33562-33566

12th World AIDS Conference

challenged their existing prejudices, improved their communication and decisionmaking skills, and gained a deeper sense of responsibility.
Conclusions: These documented outcomes suggest that intensive investment
in life-and decision-making skills, in the context of HIV/AIDS prevention, can have
significant and durable impact leading to integrated risk-reduction, sustained
behaviour change, and proactive advocacy for social change.
33562 Difficult-to-reach population groups in Switzerland:
The mediator approach. What can we learn?
Stefan M. Seydel1, P. Coda2, D. Kock3, M. Laubli-Loud3, J.I. Osterwalder4,
D. Zeegers Paget3, J. Niggli5. 'Intervention GMBH, Freiestrasse,
AMRISWIL/TG; 2lnst. F Social Prevention Med. (ISPM), Basle; 3Federal Office
of Public Health (FOPH), Berne; 4Cantonal Hospital, St. Gallen; 5Foundation
"Aid for Drug Addict", St. Gallen, Switzerland
Issue: The MEDIA Project, financed by the Swiss Federal Office of Public Health
(SFOPH), was set up in 1994 for a 3 year period. During the pilot phase, (1994-97)
30 mediators (6 female, 24 male) were recruited for work with peers in 3 different
types of context (1) prison setting; (2) ex-drug users and (3) drug users of Italian
origin. Over 500 discussions were conducted with their peers during the 26 month
pilot phase. A prevention gift box, supplied by private sponsors, was used to
initiate the discussion.
Project: Modifications to the project were made in light of the pilot phase
evaluation findings. The programme was then launched at a national level and
over the past year, has been implemented in a range of settings. These include
a larger number of the original trial context types (different sites) as well as new
contexts such as a women-specific methadone programme, and the PROVE
(medically prescribed heroin programme) for heavily dependent heroin users.
The principal changes made to the project for the main study include improved
initial and ongoing training for the mediators, and modifications to the prevention
gift box. The selection of mediators is more towards personal motivation and
acceptance by the peer-group as a safer sex promotor. The selection, basis and
ongoing training of mediators are ensured by local experts, who receive a training
module from the national coordinator. Furthermore, they are continuously trained
and counseled. The gift box was continued as a door-opener, but changed in
size. One major problem with the project is to find sponsors for the gift box.
The project has shown that the mediator approach not only helps to reach
difficult-to-reach population groups, but also helps to increase levels of motivation
and self-esteem in the mediators themselves.
S33563 The case of involving female educators in STD/HIV/AIDS
education programme for truckdrivers in Malawi
P.P Singogo. EC AIDS Education Project, PO Box 31404, Lilongwe 3, Malawi
Background: The EC AIDS project is under the umbrella of Ministry of Health
National AIDS Control Programme introduced these interventions in 1995 as an
extension of trucking company based initiatives which experienced some constraints that included 40% drop out rate of driver peer educators after a year,
inadequate managerial support and poor attendance by drivers as they are often
out on the road.
Objective: To promote risk reducing behaviour and maintain low risk behaviour
among truckdrivers using face to face or small groups discussions approach.
Current Activities: In collaboration with the district mult-sectoral advisory
body, the Project enrolled three female educators in each of the three major
border districts in the country. The educators were trained in STD/AIDS information, Condom use, social and communication skills. They are supervised by the
project/district staff and supported by the border officials. Their activities include
distibuting condoms and IEC materials, holding meetings and discussions using
participatory methods. Messages focus on STD/HIV transmission, prevention,
reduction in sexual partners and consistent condom use.
Lessons Learnt: The programme is reaching an increase of about 80% more
drivers than in company based interventions. The programme is quite innovative
as the female educators are readily accepted by drivers whose co-operation adds
impetus. An increased risk awareness characterised by self-reported reduction in
sexual partners and steady uptake of condoms as well as IEC materials. Drivers
are encouraged to purchase Socially. Marketed condoms. The programme gives
opportunity to foreign drivers who may not have been exposed to such interventions and refreshes those who have attended before. The companies have
been identified as convinient set up for curriculum delivery and institutionalisation of HIV/AIDS education programme as observed from less responsive peer
education activities accomplished in the companies.
Conclusion: Involving female educators in conducting informal STD/AIDS education for truckdrivers in border post and highway truck stops has proven feasible
in reaching even more truckdrivers including those who were otherwise missed
at company level. The approach has a spillover to surrounding communities.

33564 APTATICOS: Prevention of HIV/AIDS among children in
schools of the City of Sao Paulo
Teresinha Pinto1, C.D. Cavalari2, L. Guirao, Jr.2, R. Nicolosi2, V. Piassa Polizzi2.
1Al Ribeirao Preto 86 APTO 34, CEP 01331-000, Sao Paulo, SP; 2APTA, Sao
Paulo, SP, Brazil
Issue: The APTATICOS project was created due to the high number of seroposi
tive children needing to be integrated to schools and it was based on the principle
of preventing since their early ages.
Project: Group of twenty children, in the age of 10 and 11 years old, have
weekly meetings in their schools with two adult monitors from APTA (na AIDS
prevention NGO) who do not work in those schools. In those meetings they
discuss issues elected by children, such as: sex, HIV/AIDS, drugs, dating, family,
school, etc.
Results: Children are making a peer education with their parents and schoolmates, using the information assessed in meetings. The seropositivo children are
better adapted and integrated to their schools after the meetings began to occur.
Lessons Learned: Children have a lot of information, but have difficulties
to understand and systematize them. They are able to organize activities and
develop discussions at home and school.
S33565 Prevention of HIV/AIDS, drugs/alcohol abuse among
early adolescents of copper mining towns
Monique Racine1, H. Nakanyika2, L.D. Nzunda3. 18 Nationalist Way Pkland
Kitwe PO. Box 21476 Kitwe; 2Nursing Staff Kitwe; 3 Teaching Staff Kitwe, Zambia
Issue: Urban youth is a population more vulnerable to HIV/AIDS due to breakdown of traditional values. Innovative intervention is needed to strengthen peers
support.
Project: Given the rapid increase of orphans due to AIDS in the Copperbelt
Province, a multiple approach was developed to improve the quality of life among
early teens. Strategies include skills building programmes for primary school
teachers and community nurses together with youth aged 14 to 16 years in
view of reaching out youth of their respective communities. Activities as learning
experience include meetings with peers aged from 9 to 12 years, meetings with
orphans and their parents/guardians, classrooms quiz for grades 4 and 5 students
and radio programmes.
Results: The project has been well received by volunteer professionals, the
youth and their respective communities. A total of 178,106 youth aged 9 to 12
years have attended the 5 meetings guided by older teenagers and primary
schools teachers. Moreover, 20,512 orphans have been gathered for a longer
period since the project began in 1992. The latter who were not necessarily friends
became so through our CLUB 10 project, thus gaining peer support. Community
nurses are given the task to meet with parents and guardians to discuss AIDS,
family planning, substance abuse and other topics as requested.
Lessons Learned: Prevention of AIDS, drug/alcohol abuse in urban, Zambia
can be successful if nearby professionals, that is primary school teachers and
community nurses, are given adequate training to serve their communities. They
appear to be the only link between the traditional values and the scientific world
and are being respected by their communities.
S33566 Condom promotion success through Peer Educator:
An effective strategy in Faridpur brothels by Shapla
Mahila Samity
Shyamal Shyamal Prokash Adhikary1,2, Chanchala Mondal3, Miss Nila4,
Partha Sarathe Sarker5. 1 Rothkhola Goalchamat, PO Faridpur Dist Faridpur;
2Programme Director, Faridpur 7800; 3Coordinator, Faridpur 7800; 4Peer
Educator, Faridpur; 5 Project Officer, Faridpur, Bangladesh
Issues: Commercial sex workers at Faridpur Brothel have been implementing
STD/HIV/AIDS prevention intervention through promoting condom through Peer
Educator.
Description: Shapla Mahila Samity at the early of May 1997 did A condom use
studied at Faridpur brothels. It was seen that the customers/clients are not willing
use condom even if they loss the interest during penetration. A few CSWs were
practiced to use condom. STDs prevalence was 87% during the study. An office
was set up adjacent to the brothel and started a model of Peer Education at June
1997. 32 Peer Educator was formed the CSWs and the staff trained them up.
Bangladesh National AIDS Prevention and Control program, Ministry of Health
and Family Planning, Govt. of Bangladesh has been providing condom as per
need.
CSWs at Faridpur brothels have no or little knowledge about HIV/AIDS 91% of
CSWs are illiterate and due to their illiteracy, ignorance, compliance on HIV/AIDS
they were not practiced condom with the clients. Condom was seldom used by
the CSWs or learned clients.
After having training from Shapla Mahila Shamity the Peer Educators were
voluntarily distributed condom among the other CSWs at the brothel. Now the
Peer Educators are fully aware the danger signal of AIDS and they are aware
about their sexual life. CSWs now negotiates with the clients to use condom.
Results: Regular use of condoms increased from 3% in May 1997 to 13% in
December 1997. Reduction of STDs prevalence came down. It was seen that
the increasing awareness about STDs and motivation to use condom implies
many customers who were previously oppose to use condom are at present
using condom. Behavioral changes have come due to acquire knowledge about
STD/HIV and negotiation skill.

Lesson Learned: These strategies have served as a catalyst for treatment of
STDs and negotiation skill with the clients to use condom. The Peer pressure
might have an effective process to the intervention to promote condom using at
80% or above by the end of 2001.