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

12th World AIDS Conference

Abstracts 34143-34148 715

34143 A residential training programme for female orphans in
an area with high HIV seroprevalence
John Imbwae, M.T. Kelly, I. Kayawe, M. Mwanba, S. Banda, S. Veinreich. Kara
Counselling and Training Trust, PO Box 37559, Lusaka, Zambia
Issue: Orphaned girls vulnerable to HIV/AIDS and abuse in an urban setting with
high HIV seroprevalence require innovative intervention.
Project: Given the increase of orphans and the diminishing coping capacities
of extended families, a residential training programme for orphaned girls was
developed as a pilot project on a farm outside Lusaka, Zambia. 15 girls between
the age of 14 and 18 who were orphans and came from difficult circumstances
were enrolled in a one-year training programme. The girls received training in
literacy, practical skills, assertiveness and self-reliance skills, social skills and
education in reproductive and sexual health. Monitoring and evaluation was done
through focus group discussions and in-depth interviews.
Results: The most common complaints about their living conditions at the
places they had stayed before joining the project were that they did not get
any support, that nobody cared for them and that they lacked clothes and other
commodities. All the girls had dropped out from school because of lack of school
fees. Some said they had been forced to get married or had been mistreated.
The girls valued about the training they received at the project that they learned
how to read and write. Most of the girls thought that the practical skills which
they acquired would enable them to be self-reliant. Most of the girls said that they
wanted to complete school and to set up their own business after having left the
project. Many were worried if they would manage to cope with the problems that
would arise. They thought they would need support, particularly financially.
Lessons Learned: A residential training programme can create an environment for orphaned girls to acquire skills that are useful for their development
and coping with their situation. For the achievements to be sustainable, support
has to be provided after the girls have left the programme. Policy makers and
implementing agencies can draw on the experiences of the project.
34144 Creating community workers for under resourced nations
using income generation programmes as subsidies to
increase staff team
Gary Jim Lamont. PO Box 16082 Vlaebere, Cape Town, South Africa
Wola Nani a caring response to AIDS operates by providing counselling services
and family and community support programmes in so called poorer areas of South
Africa including "townships"
With the current rise in infections being parallelled with the reduction of available funding for programmes Wola Nani increases staff compliment by creating
sustainable job creation programmes. Selected staff at each centre are offered
income generation facilities in response to a contracted period of community work.
For example 15 hours work per week on income generation programme may yield
US$ 100 per month. In response to access to income generation programme
client puts back 12 hours per week to the agency for counselling programmes.
These subsidised staff operate in clinics and move from clinic to community
for follow up of families affected by HIV providing primary health care advice and
counselling as well as support in treatment and prevention programmes.
Linked to income generation programme is a strategic marketing strategy for
goods to sustain the programme.
Wola Nani would like to present a workshop on strategic income generation
subsidies for increasing staff compliment and present in slide and poster display
the overall strategy for developing such a programme.
34145 Guiding principles of vocational rehabilitation and return
to work in the context of HIV infection
Gerry Bally1, T. McAulay2. 1Jeanne Mance Building, Tunney's Pasture Postal
Locator 1918B1, Ottawa, Ontario K1A 1B4; 2British Columbia Persons with
AIDS Society Vancouver, British Columbia, Canada
Issue: Recent therapeutic advances in combination antiretroviral therapy have
stabilized the health of people living with HIV/AIDS (PWAs). Many PWAs not
currently employed are considering the possibility of returning to work. Private
and public disability insurers are reconsidering their policies and procedures
concerning income support benefits to PWAs. Care providers and governments
are reconsidering HIV disease as a disability. PWAs are concerned that decisions
on ongoing income support and disability status will be made in the absence
of research, education, and pragmatic policy development. Despite new therapies, PWAs emphasize the existence of ongoing symptoms, impairments, and
disabilities related to HIV and its treatments.
Project: Members of an AIDS service organization and a government HIV
program worked together to develop a 20-page document which defines the
issues and guiding principles for vocational rehabilitation and return to work in
the context of HIV infection. Issues identified were categorized under the following areas: biomedical issues, and social and work environment issues. Guiding

principles were identified for the following themes: medical science and research,
self-determination, flexibility, safety, responsibility, and income security.
Results: The collaboration between a large AIDS Service Organization and
a government HIV program led to the development of a 20-page document
describing issues and guiding principles for vocational rehabilitation and return
to work. The process identified that prospective research, innovative programs,
education, and policy development must be undertaken in the area of vocational
rehabilitation and return to work in the context of HIV infection.

Lessons Learned: PWAs concluded that for some a return to work can be
a life enhancing event. In the absence of pragmatic, supportive policies and
procedures adopted by private and public insurers, government agencies, and
care providers, return to work can increase suffering and the burden of HIV
disease.
S34146 Training increases service providers' knowledge, skills
and comfort in working with HIV positive and high-risk
adolescents and young adults
Ron Henderson, J. Colgrove, G. Huba. The Measurement Group, Culver City;
Health Initiative For Youth 1242 Market Street, 3rd Floor, San Francisco,
California, USA
Issues: Health and social service providers frequently lack the appropriate
knowledge and skills to offer HIV prevention and care services to adolescents
and young adults. Training is needed to increase providers' understanding of
adolescent development and the biopsychosocial aspects of HIV that are unique
to youth.
Project: Training was offered through a community-based organization in
San Francisco, CA, to providers in five Bay Area counties. Recruitment was
done through direct mailing of flyers followed by telephone and fax outreach.
Training sessions used a variety of modalities, including experiential activities,
presentations by youth speakers, expert panel presentations, and lectures. Topics addressed in the trainings included adolescent psychology and development,
common risk factors for morbidity in youth, biopsychosocial aspects of HIV in
youth, and counseling and assessment techniques.
Results: More than 800 providers completed training sessions of between
1.5 and 24 hours in length. Providers included counselors, educators, case managers, and primary care providers from a variety of professional settings, including
community-based organizations, medical facilities, and public and governmental
health agencies. Attendees reported statistically significant increases on measures of comfort, skill and knowledge about the topics addressed in the trainings.
A series of repeated-measures multivariate analyses of variance and multiple
regression analyses are used to relate the degree of change to pre-existing
differences among the trainees (such as experience, professional accreditation,
probable use for training, and attitudes about HIV/AIDS). Additionally, factual preand post-tests validated increases in knowledge of content areas. All results are
highly significant in a statistical sense and appear to have important practical
significance.
Lessons learned: Training through a variety of modalities increases providers'
knowledge and confidence in addressing HIV and related health issues with HIV
positive and high-risk adolescents and young adults.
34147 Translating perceived costs of volunteerism into personal
and collective gain in AIDS interventions in Africa
Carolyn Baylies, J.M. Bujra, B. Liatto-Katundu, M. Mbilinyi. 'School of Sociology
and Social Policy, University of Leeds, Leeds LS2 9JT; 2University of Bradford,
Bradford, UK; 3NLTPS, Lusaka, Zambia; 4Institute for Development Studies, Dar
es Salaam, Tanzania
Issues: AIDS interventions in African communities with high levels of poverty
have often suffered from limited sustainability, not from lack of concern or commitment, but because of resource difficulties. Projects 'seeded' through external
assistance have often faltered when funding ends, sometimes by virtue of the
frustration of expectations they have generated that participation will be compensated. Resistance to volunteerism, however, can be a rational response to a
situation where immediate household survival needs outweigh fears about future
illness and community welfare recedes to an abstraction.
Project: A project carried out in Tanzania and Zambia which sought to explore
the potential for mobilising existing organizational capacities of women in the fight
against HIV/AIDS found abundant willingness to engage in collective struggle, but
also documented difficulties of ensuring the sustainability and focus. Individuals
sometimes found it hard to reconcile personal costs, measured by income foregone, with potential benefit in the form of greater longevity, whether of themselves
or of the community more broadly.
Results: Our project highlighted the need to confront resource issues, to work
toward collective means of 'cost sharing' and to foster an understanding of how
social and collective benefits compensate for individual input
Lessons Learned: Community interventions must recognise the validity of resource constraints and perceived personal costs. Building on existing networks of
solidarity, particularly among women, and developing notion of shared vulnerability, costs and collective as well as personal benefit, are crucial to the sustainability
and effectiveness of interventions.
S34148 Cambodian female factory garment workers
Mony Tep1, C. Khus2, S. Soth2, I. Wolffers3, S. Verghis4. 1Care Int Cambodia

PO Box 537 Phom Penh; 2Technival Advisor/Project Coordinator Phnom Penh.
Cambodia; 3 Vrye Universiteit/Caram Technical Resource & Advisor Amsterdam,
The Netherlands; 4Caram Malaysia/Regional Partner Kuala Lumpur, Malaysia
Issues: Cambodia is starting to develop after several decades of war, and many
young rural female migrants come to Phnom Penh in search of garment factory
work. Some people do not view these working women as priority groups to target
HIV information, education, and/or training. Society and the garment workers'