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

12th World AIDS Conference

Abstracts 34132-34136 713

the body/mind/spirit influence on the environment put individuals in touch with
deeper knowledge and different ways of knowing.
Methods: A naturalistic, qualitative study with the subjective experience of the
participants as focal point. Two data gathering techniques (a group gathering and
an individual interview) were used over a course of six months. Participants were
provided with the data analysis prior to a third gathering during which the interpretation of the data was affirmed by the participants. Participants were encouraged
to allow their story to unfold and be incorporated into the research.
Results: Using Constant comparative analysis, the findings show that storytelling has been a connecting experience. The holistic environment allowed
participants to remain in charge of their own process, encouraged them to be reflective and to share with others. Storytelling was helpful in grieving life losses and
reformulating one's life. The research was an empowering opportunity because it
acknowledged the participants' expertise and collaboration.
Conclusions: From a practise perspective this research begins to define what
worked for participants, i.e. what made the storytelling experience helpful. Form
a policy perspective, the research findings suggest ways to support and assist
marginalized groups. From a research perspective the findings also support a
rudimentary definition of a holistic grief model.
34132 Reintegration into a family network for people affected by
HIV/AIDS
Kalifa Soulama. SAS Bobo Bp1396 Bobo Dioulasso, Burkina Faso
Background: illustrate the key elements which facilitate the involvement of
extended families in the support of people affected by HIV/AIDS
Methods: case studies, life stories of persons followed up by the social service
of the SAS Centre (Social Action and Solidarity), an NGO working with and for
people affected by the HIV/AIDS.
Results: The extended family is traditionally involved in the support of sick
people, by financial help, drug payments, food gifts or care for the children of
the sick. But may People with AIDS (PWAs) are isolated and do not have any
support from their extended family. Some are even totally rejected or isolated
within the family (locked in a room apart...). The main reasons are said to be:
shame of being the relative of an AIDS patient, fear of being infected (through
daily contacts), financial difficulties, hopeless outcome. The SAS Centre has
implemented activities at several levels to improve the involvement of the family:
information sessions on HIV/AIDS (contamination, progress in the illness...) and
other illnesses (TB, child diseases....) and consciousness-raising for solidarity
with sick people (whatever illness) and their relatives; training of relatives in
daily care for sick people (nursing, feeding, basic needs...); sharing of serological
status with a relative identified by the PWA and with his/her consent; social and
economic support to the persons supporting or caring for the PWA and his/her
relatives (including foster families of orphans).
In addition to a general context of economic crisis which affects each family,
AIDS illness (stigma, characteristics of the disease) makes even more difficult
the involvement of families in giving support to people affected by HIV/AIDS.
Nonetheless, this involvement is essential for the future of people affected, including their psychological well-being. Consciousness-raising, training of relatives
in daily care of the sick, support to the caregivers (...) are key elements of better
family and community involvement.
34133 Legacy of the AIDS community demonstration projects:
Assessing the impact and sustainability of an HIV
prevention research project
Carolyn Guenther-Grey1, B. Krauss2, N. Corby3, A. Freeman4, G. Goldbaum5,
C. Rietmeijer1. 1Centers for Disease Control & Prevention, 1600 Clifton Rd., NE
Mailstop, Atlanta; 2National Development & Research Inst., New York, NY;
3Center for Behavioral Research & Serv., Long Beach, CA; 4AIDS Prevention
Project, Dallas, TX; 5Seattle-King County Health Dept., Seattle, WA, USA
Issue: In recent years, HIV prevention interventions in community settings have
been tested and found effective. Less attention, however, has been paid to the
long-term maintenance and effect of these intervention programs after the study
is concluded and the research funding ends.
Project: During 1991-1994, the AIDS Community Demonstration Projects
(ACDP) evaluated, and found evidence of the success of, an HIV prevention
intervention in five cities. In each city, populations at high risk of acquiring HIV
were recruited and trained to disseminate HIV prevention messages and materials (condoms, bleach kits, small-media materials) to their peers. In October 1997
(3 years after the ACDP ended), the lead investigator in each city completed a
brief questionnaire to assess the longevity of these projects.
Results: Interventions were sustained in 3 of 5 cities, though not necessarily
in their original form. Several factors were associated with whether (and in what
form) the interventions were continued in the study communities: (1) the ability
of program staff to obtain local funding (e.g., through HIV prevention community
planning groups); (2) local government support for (or lack of opposition to) the
continuation of the project; (3) acceptance and continued assistance with the

intervention from the target population; (4) maintenance of sufficient skilled staff
committed to sustaining the intervention; and (5) technical difficulty of intervention activities (e.g., developing small-media materials using behavioral science
concepts). Although not all the original interventions survived, the intervention
methods were adopted by other organizations, and the collaborative relationships between researchers and community members fostered new research and
programs.

Lessons Learned: Despite the conclusion of research funding, several of the
ACDP continued to operate 3 years beyond the research period. In order to
increase the likelihood that a successful intervention will continue after the study
has ended, researchers and program planners should take steps early to establish community participation and investment (both political support and funding)
in the intervention.
S34134 Taking control-PLWHAs and Australian AIDS
community-based organisations (CBOs)
Mark Edwards'2. 1RP. Box 177, Curtin, ACT2605; 2Monash University,
Canberra, ACT, Australia
Issue: The Australian response to HIV/AIDS, seen as a partnership between
government and the affected communities, has been internationally lauded as
exemplary because of its relative success in reducing the rate of new infections.
However, in relation to the care and treatment of those infected, it appears that
sections of the PLWHA community believe that a pattern of misrepresentation or
under-representation exists, and has existed, in Australia.
Project: This paper tests these perceptions by analysing the role of the AIDS
CBOs in the provision of care and support for PLWHAs. It is based on a series of
extensive interviews with representatives of all national and state/territory based
AIDS CBOs in Australia, politicians and health bureaucrats, as well as analyses of CBO publications, community newspapers and government publications
produced since the early 1980s.
Results: Two types of AIDS CBOs have developed in Australia. The first are
'mainstream' AIDS organisations which are handsomely funded by government
and play an integral role in policy development and implementation. The second
category are those organisations specifically established to cater to the needs of
positive people - these receive little government funding. PLWHA organisations
see the 'mainstream' AIDS CBOs as extensions of government bureaucracy and
accuse them of failing to represent the true needs of positive people. The paper
concludes that despite an increase in the size of the positive population, positive
people and their representative organisations, remain the poor cousins of the
Australian AIDS industry.
Lessons Learned: Within the Australian response to the HIV/AIDS epidemic
increased emphasis and funding needs to be provided for the overall care and
support of positive people to enable and empower them and their representative
organisations to cope better with the changing nature of the epidemic. This is
particularly important in relation to developments associated with current and
emerging medical treatments.
34135 The best practices for a community involvement in the
fight against AIDS: Illustration with a program in Burkina
Faso
Madina Tall, J. Ovedraogo, C. Traore. SAS Center Bp1396, Bobo Dioulasso,
Burkina Faso
Issues: The involvement of multidisciplinary actors in the fight against AIDS is
a key element of its success. These actors may be health or social workers,
representatives of NGOs, of course people infected with the virus or their relatives, but also community groups or leaders. These community actors are often
hard to reach, because community groups or networks are often less formal and
thus visible. Nonetheless, communities play an essential part in African urban
society, for acceptance people with AIDS and their relatives and in supporting
those affected by HIV/AIDS.
Project: Assessment of actions realised since 1995 towards community leaders: training sessions, skills building workshops, support services (...); interviews
with community leaders and representatives of Community-Based Organisations.
Results: enlighten the best practices which facilitate community involvement
for a better integration of sick individuals and their relatives in their communities.
Those activities are training (legal aspects, home visits and nursing, modes of
transmission, etc.), information (documentation, periodicals on HIV/AIDS), sharing
of experiences...
Lessons Learned: Activities should focus on building skills and expertise, raising awareness to improve acceptance of HIV/AIDS affected persons and increase
solidarity with sick individuals and their families, involve leaders as mediators to
solve problems within families (such as the future of children...).
[34136 The community approach in response to problems posed
by HIV/AIDS: The example of SIDA-SERVICE
Mathurin Zo Angono1, Souleymane Mboup2, I. Wone2, E.M. Coil Seck2,
O. Sylla2, M.L. Vadelorge2. 1A.PS.RC.S. Rue de Reims Quartier Rebeuss BP
2407 Dakar; 2University Dkar, Dakar; 3Sida Service, Dakar, Senegal
Objectives: To mobilise the communities and to give them responsibilities of
reducing the spread of HIV in their respective community. To improve quality of

care and provide psychological support to persons living with HIV/AIDS and their
families.
Methology: The program started in april, 1992. Through community mobilisation and sentisation, 25 credible community counsellors with different age,
education, professional background were indentified. They under went training
in a two weeks workshorp. The team members returned to their communities to
undertake their role as community counsellors. An AIDS day center, was created