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

12th World AIDS Conference

Abstracts 34102-34106 707

IFOP (a French institute specialized in surveys) was there in order to speak
directly to the passengers about the following questions:
(a) sexual behavior, including use of condoms and/or other prevention strategies;
(b) testing issues and access to counselling
(c) impact of AIDS among relatives and friends
(d) access to information concerning treatments and special needs in term of
prevention.
Results: in term of people reached through the several actions run during 20
crossings in summer 1997
(a) 721 people were involved in a video session (170 women vs 551 men)
(b) 127 people took part in small focus groups (69 men, 29 women, 29 in mixt
group)
(c) 468 individual interviews were carried out by the volunteers, from 5 to 45
minutes each (320 men vs 148 women)
(d) 5838 condoms were distributed, 7000 booklets were handed out and 379
questionaries were filled in.
The results of the survey make clearly understood the following conclusions:
(a) cultural and religious specificities are not barriers to efficient prevention among
these population;
(b) these population want to have specific programmes and specific prevention
campaigns in order to have better access to the general health French system;
(c) the impact of HIV is high in these communities and specific actions should be
designed on lessons learned.
264*/34102 Community based home care and women's
empowerment
Sonja Weinreich1, J. Mphanza2, M. Taraking2, H. Nagel2. C/0 Kara
Counselling, PO Box 37559, Lusaka; 2Chilenje Home Care, Lusaka, Zambia
Issue: In an area with high HIV seroprevalence, women provide care for a growing
number of chronically ill people at their homes.
Project: In a Catholic Parish in Lusaka, Zambia, a group of 110 female volunteer caregivers has been providing comprehensive care to chronically ill people
and their families since 1992. The activities comprise of nursing care, help in
domestic chores, spiritual care, counselling, distribution of food, fundraising, care
for orphans and survivors and medical care.
Results: In January 1997, 370 chronically ill people and 1,100 orphans were
registered with the project. The workload has increased over time due to the rising
number of chronically ill people in the community, due to the extension of care to
the patient's families and survivors, and to the growing acceptance of Home Care
within the community. The majority of the volunteer caregivers are widows, often
due to HIV/AIDS. Many of them look after sick people and orphans within their own
families. The average age of the caregivers is above 40 years. Through regular
meetings, workshops and retreats, they support each other psychologically and
spiritually. For the majority of the group members, the group is their first experience of managing their own group without male dominance. Efforts of recruiting
male members lead to the males trying to dominate the group structures.
Lessons Learned: To reduce the burden for women, strategies have to be
developed to achieve more gender equality in caring for the sick. However female
Home Care care groups have to be protected from being "taken over" by males.
How can Home Care groups sensitize women on gender issues and empower
women?
240*/ 34103 A critical assessment of HIV/AIDS prevention
interventions for people on the move in
sub-Saharan Africa
Thomas Painter. Centers for Disease Control & Prevention DHAP, Intl Activity,
MSE 50, Atlanta, GA, USA
Issue: The widespread occurrence of mobile livelihoods (including but not limited
to migrations) in Sub-Saharan Africa (a) contributes to the spread of HIV/AIDS
as people on the move engage in sexual networking in destination areas that
exposes them and their sexual partners in destinations and their families at home
to HIV infection and (b) creates challenges for HIV/AIDS prevention.
Objectives: Assess HIV/AIDS prevention interventions for people on the move
in Sub-Saharan Africa by (a) highlighting key issues in this kind of HIV/AIDS
prevention (b) review approaches used and reported results, and (c) discuss
implications for improving interventions.
Method: A review of intervention project reports and publications presenting
information on strategies, operational approaches and results of 16 country-based
and trans-border HIV/AIDS interventions in 12 Sub-Saharan African countries.
Results: Country-based interventions are more common than trans-border
interventions even though most initiatives aim to address target groups involved
in trans-border mobility and associated HIV risk taking; interventions provide
little evidence of successfully integrating relevant multidisciplinary perspectives
and findings from studies in the social and health sciences; interventions are
not establishing linkages with "community-based" social support structures that
frequently occur among people on the move, particularly in destination areas.

Conclusion: HIV/AIDS prevention interventions among people on the move
must (a) broaden their geographic scope, (b) increase levels of trans-border
coordination by different country-based HIV/AIDS prevention programs, (c) ensure internal capacity to assess and integrate relevant perspectives and findings
from studies in social and health sciences and (d) assess the potential benefits of developing linkages with social support organizations that occur among
communities of people on the move.

34104 Investigations of access to HIV-related treatments in Asia
through NGO collaborations
Melissa Muller1, T. Parwati1, G. Neilsen2. 1c/o YCUI Jalan Belimbing Cangy No.
4, Coordinator-Treaments Access Project, Denpasar, Bali; 2Project Consultant
Denpasar, Bali, Indonesia
Issue: There is stark inequality in access to HIV-related treatments for PLHAs.
Treatments for PLHAs throughout Asia are accessible to a small (usually wealthy)
minority, leaving the majority of PLHA without the most basic healthcare and
support.
Project: The project is reviewing and analysing existing strategies and activities
by which NGOs from 7 Asian countries (India, Indonesia, Malaysia, Philippines,
Singapore, Thailand and Vietnam) are facilitating and improving access to HIVrelated treatments. Organisations in each country are completing a comprehensive questionnaire which was designed with extensive deliberation. It is currently
being administered by 3 contact people in each of the countries through individual
and focus group discussions.
Results: Preliminary results indicate that NGOs play a vital role in improving
access to treatments through advocacy, activism, networking and participatory
approaches. The project report will be published in April, 1998. By mobilising
community networks we aim to develop creative recommendations to provide
an advocacy tool for action within national, regional and international negotiation
platforms. This review aims to further facilitate UNAIDS efforts and support in this
forum.
No conclusions can be drawn at this stage of the project. However, it is clear
that the challenge of access to treatments is much wider than just availability of
antiretroviral drugs.
34105 Territorializing AIDS prevention and declandestinizing
the epidemic through community organization practice
and participatory action-research
Rafael Garcia1, E.A. Moya2, Y. Scharbuy2, C. Castellanos2, R. Fadul2. 1Viariato
Fiallo 30, Ens, Julitta, Santo Domingo; 2 nstituto Sexualidad Humana/UASD,
SAnto Domingo, Dominican Republic
Issue: The HIV/AIDS epidemic in the Dominican Republic is a 'hidden evil' expected by most people to be faced by the Government or by someone else. HIV
affected households and community based organizations (CBOs) leaders long
for a more creative, continuous and committed AIDS prevention program at the
local level. New constructivist educational materials have been elaborated and
validated to promote an agglutinative health oriented social movement primarily
of the young population.
Project: The 'Strengthening Family and Community Response to AIDS' project
purports i) to territorialize preventive action in CBOs; ii) to create an adolescent
and young leadership skilled in participatory action-research and social mobilization; and iii) to declandestinize the epidemic with the active participation of
persons living with HIV and their families in CBOs preventive activities. The
series of seven group instruction modules 'To Learn is to Live' (24 full-color pages
each) introduces youths to basics on sexuality and AIDS, community organizing,
action-research and resource mobilization. The terminal objective is that trained
youths could elaborate and validate new modules according to their needs and
interests.
Results: Three local Consulting Councils composed by the leaders of 60
CBOs have been created in three high AIDS impact communities. Modules were
validated with religious leaders, persons living with HIV, community leaders and
activists, AIDS specialists, and adolescents and youths (aged 14-24). In 1997,
45 local 'Technical Supports' and 45 'Multipliers' of the modules from a pool of
472 CBOs were trained in this area. In January 1998, they started training groups
of 'Facilitators' who immediately started instructing small groups of young people
with the modules.
Lessons Learned: Adolescents and youths are overcoming apparent apathy,
learning to learn about sexuality and AIDS, discovering the advantages of community organization practice and action-research, and actualizing their leadership
potential through this CBOs empowering project. The involvement of many organizations previously passive in regards to AIDS has increased as a result of the
availability of highly attractive and culturally sensitive educational materials.
S34106 New York City's strategic plan for HIV/AIDS services
1998-2001
Matthew McClain1, David Klotz2, S. Lehrman3, A. Williams2, S. Simon2,
E. Chin-loy2, J. Pedraza4, A. Oliveria4. 1413 Schuyler Road, Silver Spring MD
20910; 2Mayor's Office AIDS Policy Coordination New York NY; 3Union College
Schenectady NY; 4HIV Health & Human Services Planning C New York NY,
USA
Issue: Given a vision that all people with HIV will have the best possible quality
of life and health outcomes, how can New York City plan for quality HIV/AIDS
services between 1998 and 2001 for the estimated 135,000 people with HIV

disease living there?
Project: The New York HIV Health and Human Services Planning Council (the
Council) devoted 10 months to the development of a strategic plan for HIV/AIDS
services for 1998-2001. The Council, mandated under Title I of the Federal
Ryan White CARE Act, selected an innovative, community-based, data-driven
methodology to address: Where are we now? Where are we going and how will
we get there? How do we monitor our progress? The audiences range from the