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

12th World AIDS Conference

Abstracts 34273-34278 739

342731 The effects of HIV/AIDS care on household resources in
Uganda
Annet Letitia Kyazike1, C.A. Kajura2, M.N. Namuyimbwa1, M. Senabulyal,
A. Abaho3, G.K. Mawanda4. 1HIV AIDS Counsellor, 2Counselling Coordinator;
3Community Trainer; 4Counsellor Client Welfare Officer, TASO ENTEBBE, PO.
Box 235, Entebbe, Uganda
Objective: This Study aimed at determining the AIDS pandemic on family resources. The results provide directon for programs which seek to identify and
address specific needs of families with PWHIV/A.
Method: Study involved 5 FGDs of Caretakers and 5 FGDs of Clients (PWAS),
as well as individual interviews with 50 caretakers. This was carried out between
July and Octover, 1997 in Mpigi District. The interviews were conducted with
the assistance and guidance of HIV/AIDS counsellors of TASO Entebbe branch.
Questions focused on changes that have occurred in the family since a member
was diagnosed with HIV. Interviews were done in respective homes for the sake
of proper assessment.
Results: Both clients and caretakers expressed concern about a variety of
difficulties they face, but they cited certain needs repeatedly e.g. the reduction of
overall family income. 75% of participants preferred home care to hospital care
because it enables them to carry out domestic work alongside caretaking. The
study revealed lack of some skills and knowledge in caring for PWAS.
Conclusion: Programs must address economic difficulties of families with
PWAS by providing aid to the entire family and empowering families to come up
with IGAS. Projects need to address problems of orphans.
34274 Psychosocial and economic support through women's
associations
Patience Chirendal, R. Sabatier2, R. Gomo3, Nhariwa4, N. Dubel, D. Wilson1.
'Project Support Group Psychology Dept., MP167 MT Pleasant University of
Zimbabwe; 2Southern African AIDS Training Programme; Harare; 3Mutare City
Council, Mutare; 4Bulawayo City Council, Bulawayo, Zimbabwe
Introduction: A SAT alliance of peer education projects to reduce STI/HIV transmission among low-income, HIV-vulnerable women in Southern Africa, recognized
the need to develop mitigate HIV impact among HIV-vulnerable women.
Methods: The project supported the development of women's neighbourhood
self-help and support associations. Each association has 10 to 50 members.
Each association drafts its own constitution and elects its own chairwomen, treasurer and secretary. The associations provide members with a range of services,
including health education, childminding, home help, and home nursing during
illness and financial assistance with medical and funeral expenses.
Results: To date, approximately 100 associations have been formed in 50
projects. A study analyzed whether associations provide effective psychosocial
support to members. In a quasi-experimental, non-equivalent, group research
design, 76 members of established associations, 21 members of emerging associations and 48 comparable non-association members completed the General
Health Questionnaire, a psychological health inventory used extensively in Zimbabwe, which has four sub-scales: somatic symptoms, anxiety and insomnia,
social dysfunction and severe depression. Relative to the other groups, members
of established associations reported significantly lower levels of depression, F =
10.34, p _.0001, somatic symptoms, F = 7.1, p -.001, anxiety and insomnia, F
= 5.27, p.01 and social dysfunction, F = 3.88, p <.05. There was a strongly
linear trend, with members of established associations displaying significantly
better adjustment and coping than members of emerging associations, who, in
turn, displayed better adjustment and coping than non-association members.
Moreover, 41% of established association members, reported that they were coping with their problems, compared to 32% of emerging associations and 28% of
non-association members In addition, 54% of established association members
identified associations as their major source of support, compared to 19% of
emerging association members.
Conclusions: These data indicate that women's neighbourhood self-help associations represent a practical, robust and widely applicable strategy to provide
psychosocial support to low-income, HIV-vulnerable, women.
34275 The role of NAPHAM support organization in Malawi
Dickiens Kolondo. NAPHAM, Private Bag 355, Lilongwe 3, Malawi
Objective: To promote health through self-care and support for people living with
HIV/AIDS.
Method: Due to discrimination, inadequate of care both in hospitals and in the
community we the HIV positive people have organised ourselves and started a
support group to give self-empowerment, care and support to each other and to
voice our needs. We do fund raising and engage in Income Generating Activities
to raise funds to support bed ridden members and orphans left by our members.
All activities are carried out by PWAs themselves.
Results: The group started with 4 people in August, 1993. Registered membership has increased to 200 covering 24 districts of Malawi. Between 1993 and

July, 1996, we have lost a total of 15 members. We are caring for 11 orphans.
We have established 5 pilot branches in other regions. Namely Mulanje, Blantyre,
Salima, Mzuzu, and Nkhata Bay.
Conclusion: PWA support groups are playing a major role in changing the
attitude towards people living with HIV/AIDS in the community and promoting
positive living among PWAS. All is needed in recognition and support from both
Government, donor community and individuals.

S34276 Social and cultural factors that interfere with sex
workers' peer education programmes
Ivan Wolffers', R.S. Triyoga2, W. Deville1, D. Yudhi3, R. Hargono2. 1Health Care
& Culture Vrye Universiteit Van der Boechorst Str. 7, 1081 BTAmsterdam, The
Netherlands; 2School of Public Health, Airlangga University Surabaya; 3Hotline
Surya, Surabaya, Indonesia
Issues: International Organisations stimulate peer education (PE) programmes
for sex workers as an effective method to limit STDs and HIV-infection among sex
workers (SW) and their clients. But is it really effective? Is it effective everywhere?
An what are the social and cultural factors that interfere with success of SWs' PE.
Project: In the framework of SW cohort study in Surabaya (Indonesia) qualitative and quantitative data about the PE-programme of the local Non Governmental
Organisation (NGO) Hotline Surya were collected. Knowledge, attitudes and practices of 150 Peer-educated SWs were compared with 500 non-peer-educated
SWs.
Results: Data showed that PE did not always work as expected and that the
high expectations of PE could not always be made true. Social and cultural factors appeared to be very important for successful PE. Traditional gender relations
were among the most important factors having a negative effect on empowerment
of SWs through PE.
Lessons Learned: SWs PE is not taking place in a vacuum. The clients of
SWs have to be educated as well to prevent a situation in which the SWs have to
become social workers that have to prevent HIV-transmission. In addition, social
and cultural factors affecting thinking about sexuality and sex work have to be
approached, especially gender relations.
34277 1 Attitudes towards the new triple-therapies and safer sex:
What a mix!
Rene Lavoie', J. Otis2, R. Leclerc2, B. Turmel2, M. Alary3, R. Noel2. Groupe de
Recherche Omega; 'CP 246 SUCC. C Montreal, Quebec; 2Montreal; 3Quebec,
Canada
Objective: To describe participants' attitudes towards these new therapies.
Methods: The Omega Cohort is an on-going study aimed at assesing HIV
incidence and associated psycho-social determinants among MASM in Montreal.
Enrollment started in October 1996. Men complete a questionnaire and are tested
for HIV every six months. As of October 31, 1997, 774 baseline interviews (TO)
and 431 first follow-up interviews (T1) have been conducted.
Results: 20% of the participants are not aware of these treatments. Of those
who are aware of them we have found contradictory levels of understanding. As
an example 48.5% know that the new therapies help in the increase of CD4 levels,
and 58.9% know that they decrease the viral load in the blood stream. However
85.2% disagreed with the statment that the infected person is less contagious.
They seem to believe that the new treatments do not contribute to the lessening
of safer sex practices among HIV positive men. They seem to have considerable
uncertainty and sceptisism about the clinical results of these medications. Even
though sceptical, they believe that the therapies reduce AIDS mortality. Even
though they still believe that AIDS is a less deadly desease they do not want to
take chances and 97.9% still believe in the necessity of protecting oneself. Even
if a cure were availible 87.9% would not want to became infected by the AIDS
virus. Futhermore they believe that being on these therapies is very demanding.
Finally, we did not find any link between the attitudes toward new therapies and
a lessening of safer sex practices in the last six months.
Conclusion: These therapies are still too new for us to be able to develop
a clear idea of their impact. People are still not fully aware of their impact and
they are confused about their effectiveness. This subjet requires more study,
particulary of a longitudinal nature.
S34278 Income generating activities amongst PLWH/A on the
Pilly Lutaaya Initiative - PLWH/A project
Lucy Nsubuga Nassiwa1, B. Maria Senkezi2, D. Katongole', L. Adupa3. 'Philly
Lutaaya Initiative-PWA, AIDS Information Centre P.O. Box 10446 Kampala;
2UNICEFf Kampala; 3UNDP HIV-AIDS, Kampala, Uganda
Issue: Lack of adequate welfare support presents considerable challenges to persons living with HIV/AIDS. Maintaining quality of life as the disease progresses
requires income security, health care and social support.
Project: The Philly Lutaaya Initiative - People Living with HIV/AIDS was
launched in September, 1991, with a mission of utilising personal experiences
with HIV/AIDS in order to encourage behaviour change. Members of the initiative
remained affiliated to their mother organisations which could not provide adequate
welfare support due to overwhelming numbers. In 1996, the Initiative designed
strategies of promoting skills of PLWH/A through training in Project Management
and boosting their already existing projects by providing loan funds. This was
aimed at providing opportunities for long term planning and sustaining support to
persons living with HIV/AIDS and their families/dependants.
Result: By June, 1997, the initiative was able to support 40 PLWH/A boost

a total of 56 small scale income generating projects. Standards were improved
in areas of need which included health, nutrition, housing, income and social
support. Because of the improvement in nutrition and thus the health status, there
was a decrease in expenditure on medical bills and an increase in man hours
worked; which is a cost benefit.
Lessons Learned: Providing access to initial loan funds and I.G.A management skills with a focus on pro-active long term planning enhances individual's