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

12th World AIDS Conference

Abstracts 43159-43164 879

263*/43159 HIV/AIDS and employment creation
Prisca Nya Kutombwa. 21A Vanpraagh Avenue, Milton Park, Harare, Zimbabwe
Issue: HIV/AIDS tend to spread along pre-existing fault lines of the society, fueled
by societal and structural factors, such as, disorder, poverty, discrimination and
the dependent status of women. The vast majority of HIV+ people live in the
developing world where the economic hardships are soaring caused by unemployment. The expenses incurred from looking after someone with HIV/AIDS may
be unbearable. There is therefore need to look at employment creation for people
living with HIV/AIDS.
Project: Living positively AIDS Counselling in Harare at The Centre has moved
from idling in suport groups into creating employment strategies and sustainable
projects. Without an economic voice, HIV+ people cannot gain control of the
forces dominating their lives.
Results: Every PWA in such support groups works. We have applied for
loans/grants to form cooperatives. Some members who are qualified garment
makers/cooks would be able to make garments for sale and run canteens. The
proceeds from all these business ventures are pooled together and members
receive dividends as salaries at the end of the month.
Lesson Learned: When start up funds are available for these projects, the
group members are able to take control of their lives and health as they become
finacially independent.
43160 Sexual health of young people in east Hararghe and
Harar, Ethiopia
Michael Bailey1, Assefa Tolossa2, Etachew Ayele2, Berhane Desneh3,
Etetu Alemayheu4, Alemrwed W. Semayat5. 1101 East Street Selsey, West
Sussex PO 200DA, Save the Children Fund (UK), UK; 2Save the Children Fund
(UK) Harar; 3Family Guidance Association Ethiopia Nazareth; 4Ministry of
Health Harar; 5TB Centre Health Worker Harar, Ethiopia
Background: Communities in Ethiopia need to be informed of young people's
current sexual health and facilitated to identify priorities for action.
Method: A qualitative survey of attitudes beliefs and experience involving
young people in and out of school and adults in their communities was carried
out. Focus groups and one to one interviews were used for data collection in three
communities, representative of semi-urban, highland and lowland populations.
Stakeholder workshops were held to discuss the research with the communities
involved. The aim of the workshops was to find ways to work together to reduce
the vulnerability to spread of HIV among young people.
Conclusions: Young women are isolated from talking about their sexual behaviour with family or even closest friends. Young men are better informed, they
have freedom to openly inform & support each other. Female genital mutilation
leads to risk of bleeding during sexual intercourse. Religious leadership is critical
to creating an enabling environment for sexual health in East Hararghe & Harar.
43161 The limits of behavior change communication strategy
(BCC) in the prevention of STDs/AIDS among commercial
sex workers (CSWs) and their clients in Cameroon
Nortense Deffo Makandjo1, C.V. Vondraseck2, H.M. Malher3, J.P.T. Tchupo4,
T.S. Saidel5. BP 13888 Yaounde; 2SFPS, Abidjan; 41RESCO, Yaounde,
Cameroon; 3AIDSCAP Washington; 5lmpact, Washington, USA
Objectives: Explain the gag between the knowledge of preventive methods and
the adoption of healthy behaviors among CSWs and their clients, notably the use
of condoms and the notification of sexual partners in case of STD.
Design: Mesure the impact of a Behavior change communication project.
Methods: Qualitative survey using focus group discussion (FGD) among 30
CSWs and 30 clients in 3 towns (Yaounde, Maroua, Kribi) covered by AIDSCAP
project.
Results: From the FGDs heald, it appears that the non use of condoms in risky
situations and the non notification of sexual partners in case of STD are justify by
economical reasons. A CSW in Kribi said "ifa client accept to pay me 5.000 frs cfa.
for a sexual intercourse without condom and 2.000 frs cfa. with a condom, I will
prefer to go with him without condom because times are hard." Furthermore, as
another CSW this time from Douala says "Between dying of hunger today and of
AIDS tomorrow, there is no choice. "As concerning the notification of sexual partners in case of STD, a client from Douala asserts "if I tell her that I have an STD,
I will be obliged to give her money for her own treament which will cost me a lot."
Conclusion: the resistance of CSWs to adopt healthy behaviors despite of their
high knowledge of AIDS preventive methods is mainly generated by economical
presure. Cameroon should follow the example of other African countries which
have started to encourage and fund the creation of micro projects to be managed
by and for CSWs. The success of a BCC strategy for the prevention and control
of STDs/AIDS among this population is at that price.

43162 HIV/AIDS and STD prevention in a rural Arizona Indian
tribe
David Yost, S. Hamstra, L. Roosevelt. United States Public Health Service, PO.
Box 860, White River, Arizona 85941, USA
Issue: HIV seroprevalence studies and STD monitoring showed a significant
rise of STDs and HIV from 1988-1989. A multifaceted prevention program was
instituted to stem this rise.

Project: A coordinated multifaceted prevention program consisting primarily
of targeted education was begun in 1990. Participants included tribal health educators, school officials, and health professionals from the local United States
Public Health Service hospital. Components included establishing school based
pediatricians and clinics, funding Native American HIV speakers, developing peer
produced educational drama programs with high school students, conducting
community educational meetings with public health nursing staff, and traditional
media educational programs using newspapers, bulletins, and radio. The target
audience included all sexually active individuals among the 15,000 patients on
the 1,600,000 acre reservation, although special attention was focused on adolescents and jail populations. As very little IV drug use existed in the community,
a reduction in high risk sexual behavior, and concomitant reduction of STD and
HIV rates, was the primary emphasis.
Results: In 1989, a peak incidence of 202 new cases of chlamydia (24.8/1000)
and 64 new cases of gonorrhea (7.8/1000), were recorded in sexually active (.15
yo) members of the population. New HIV cases peaked in 1990 with 4 cases
(.5/1000). Steady reductions were noted in all categories over the following six
years. By 1996, only 51 cases of chlamydia (5.0/1000) and 33 cases of gonorrhea
(3.2/1000) were reported. This represents a 69% overall reduction in STDs over
six years. No new HIV cases have been found since 1995.
Lessons Learned: Educational prevention efforts targeting schools and using
onsite health professionals and peer produced media can have a positive effect on
STD and HIV rates in Native Americans. Educational efforts other than traditional
media appeared to be a key in the success of this prevention program.
43163 Setting up a home based care programme in Zambia
military for HIV/AIDS clients
Grace Nkamba Kasonde. Defence Medical Directorate Air, HQ Box 31291,
Lusaka, Zambia
Justification: The Home Based Care Programme for HIV/AIDS patients in the
Zambia Military was set up as a response to the AIDS epidemic. The epidemic
has put a prohibitively high demand on the resources of the only referral Military
Hospital in Zambia. Patients with HIV related complaints admitted to the hospital
now constitute about 75% of all admissions. This has resulted in many patients
with acute treatable diseases being denied hospital beds. Military personnel are
deployed in all the provinces in Zambia, where as there is only one referral Military
Hospital situated in Lusaka the capital city. The establishment of HBC services
in all military set ups will enable all chronically ill Patients cop with their own
environment with their families. Due to the nature of establishments of military
contonments, chronically ill patients will be easily identified and reached.
Ojectives: (a) To evaluate, diagnose and treat the physical symptoms and
infections related to sysmptomatic HIV infection in the home setting. (b) To equip
care-givers (community and family members) with the knowledge and skills to
enable them provide better quality care. (c) To provide psychological, social material, legal and spiritual support to the clients and family. (d) To conduct contact
tracing where necessary. (e) To promote community participation in the provision
of HBC in order to ensure sustainability.
When fully established the Home Based Care Programme shall decongest the
only Military Hospital and assist chronically ill patients cope with their disorders
in their own home environments.
|43164 Community HIV/AIDS prevention in Gaza: The first steps
Mohammed Afifi1, Najat Ahmed EI-Astal2, I. Schenker3. 1PO.B. 1137 Rimal,
Gaza; 2PRCS, PFPS, Gaza, Palestinian Auth; 3Jerusale AIDS Project,
Jerusalem, Israel
Issue: The peace process in the Middle-East and the transitions occurring in
the Palestinian population demand alertness to the new risks for HIV. A community based Israeli-Palestinian cooperation in this direction has been successfully
established in the West Bank and Gaza Strip.
Project: Given that there are between 50-100,000 young Palestinian labors
working in Israel and over 20,000 students from Gaza are studying abroad; and
given that Palestinians are going through a transitional phase both culturally and
politically - a new thought is given to the risks and prevention of HIV/AIDS in
Gaza (1,000,000 inhabitants). The Palestinian Authority encouraged all sectors
to cooperate in raising the awareness of the community, and in implementing prevention campaigns. In 1995-1997 four regional training workshops on HIV/AIDS
Education in the Middle-East were carried out by The Jerusalem AIDS Project
(JAIP), in collaboration with the Israeli and Palestinian Ministries of Health, UN
agencies, local NGOs, CHCR (Gaza) and NCIH (USA). As a result of this IsraeliPalestinian cooperation initiative in AIDS prevention - 36 professionals from Gaza
had been trained and certified as AIDS Educators: 10 school teachers, 12 health
professionals, 6 health educators, one Muslim leader, and 7 students. 33% are
women.
Results: Since graduating the workshop the participants became active through
their organizations and on personal bases. They had helped put HIV/AIDS on
the community agenda in Gaza, with the result of increasing numbers of youth

participating in HIV/AIDS education programs. Of the 36 graduates: 10 are very
active on professional levels - being involved either as doctors, nurses or health
educators, while another 15 participants were active regularly in community
based programs, spreading information both in groups and on personal levels. 5
participants could not be traced as active.
Lessons Learned: 31 out of 36, certified AIDS educators, who graduated a
Jerusalem AIDS Project workshop, are currently initiating successfully the first