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

884 Abstracts 43186-43190

12th World AIDS Conference

thirty, many of whom are grandmothers and great-grandmothers) were trained
to perform peer-education activities with strangers on the street as well as with
friends and members of their extended families. A dialogical popular education
process, based on the theories of Paolo Freire, (supported by the Washington
AIDS partnership and the Maryland AIDS Administration) was used to empower
volunteers to identify and address barriers to HIV education on Latin American
immigrant families, the immigrant sub-culture, and the greater society.
Results: A "Listening Exercise" conducted by the participants identified generative themes within the community. Participants analyzed barriers and enablers
to peer-education with strangers as opposed to with extended family members.
The family approach, while perceived by volunteers as more risky and difficult
than that of approaching strangers, provides volunteers with a setting in which
to overcome these taboos and to address issues of personal empowerment. As
mothers and grandmothers, peer-educators enjoy greater credibility in their family
and can positively influence both younger and adult children.
Conclusions: The extended family (a crucial source of support to Latin American immigrants in the US) presents great potential for effective HIV peer-education. Misconceptions against discussions of sexuality are a significant barrier,
Freirian based consciousness-raising helps volunteers to become empowered to
take on these taboos as well as to advocate for the rights of immigrants in the
larger society.
43186 United States activities to reduce perinatal HIV
transmission: Activities within the Health Resources and
Services Administration
Michael Kaiser1, K. Hench1, A. Birney2, L. Delorenzo1, M. Pounds1.
1DHHS/HRSA/CFSB/DCBP/HAB, 5600 Fishers Lane, Rm. 18A-19, Rockville,
Maryland; 2HRSA, Rockville, MD, USA
Issue: To further reduce perinatal HIV transmission in the US, a review of programmatic strategies and barriers among federally funded HIV service delivery
programs was critical to program advancement.
Project: Since 1990, the Health Resources and Services Administration
(HRSA), under the Ryan White CARE Act, has promoted systems of care to
persons infected with, at risk for, or affected by HIV/AIDS. The CARE Act provides funding for services in all States and the hardest hit metropolitan areas, for
health programs targeting outpatient early intervention service providers and organizations providing coordinated services for women, children, youth and families.
In 1997, HRSA reviewed activities targeting reduction of perinatal HIV transmission and enhancement of comprehensive care systems for women, especially
during pregnancy.
Results: The review indicated that inorder to maximally reduce perinatal
transmission, a comprehensive system of care must include: 1) identification
of HIV-infected women, either before or early in pregnancy, through outreach
and voluntary testing with appropriate pre/post-test counseling; 2) routine prenatal care; 3) HIV-specialty care, including access to both ZDVchemoprophylaxis
and state-of-the-art therapies; & 4) maintenance of mother & infant in ongoing
care. Strategies implemented by HRSA grantees include: 1) training providers; 2)
responding to new State laws and policies on perinatal transmission & HIV counseling and testing; 3) improving early intervention through linkages with women's
health programs; & 4) enhancing activities to maintain women in care. Quantitative and qualitative data regarding activities undertaken by HRSA programs will
be presented.
Lessons Learned: A variety of strategies and community-specific care systems are needed to reach all populations affected by perinatal HIV transmission.
Further reduction of perinatal HIV transmission requires commitment from public
& private resources, cultural competence, and ease of access to a comprehensive care system. These lessons may contribute to efforts in other countries
to reduce perinatal transmission by developing community-based care systems
that respond to HIV care needs with community-specific projects designed and
delivered by people living the respective communities.
43187 Shared confidentiality
Joyce Sin Mkandawire. NAPHAM P/bag 355 Lilongwe, Malawi
Objective: Find out the benefit of shared confidentiality to people with HIV/AIDS
and the community.
Methods: Asking volunteers to involve their relatives in counselling whom they
confine most.
Train relatives/guardians in Home based Care.
Involve parents in Home Care Programme after training them.
Results: Volunteers found it easy to share their status to relatives and friends.
Postive altitudes of relatives towards PLWAS has been achieved.
Fear of being stigmatised has been reduced in volunteers.
Participatory approach to different areas in AIDS education has been empowered.
Ignorance of parents on HIV/AIDS basics has been eradicated.
Vollunteers have been accepted and supported in their families after sharing

their status
Conclusion: Shared confidentiality help to reduce ignorance of people in HIV
and promote postive attitudes towards PLWAS. Parents/guardians understood
how HIV is transmmitted and prevented through the shared information hence
they are helpuful in supporting the sick.

43188 The experimentation of the participative approach on the
prevention of HIV/AIDS in an illeterate surburb of Dakar:
Successes and constraints
Baba Goumbala, Magatte Mbodj Gaye, Agnes Diouma Sarr Sagna. Sicap
Liberte III Villa N~ 1920 BP 10297 Dakar Liberte Senegal, Alliance Nationale
Contre Le Sida (ANCS) Dakar, Senegal
I- Facts: Since 1986 NGOs and CBOs along with the government are involved
in large campaigns of information, education and communication within the
communities to try to contain the HIV/AIDS infection in Senegal. Although the
campaigns,have managed to inform and sensitize the community, the latest studies on behaviour change published in 1997 show that 87% of the senegalese
population know about AIDS, its modes of transmission and how to prevent
it. But a sustainable behaviour change has not followed however, because of:
the unsuitability of messages and AIDS; the rigidity of the IEC approach; the
community's perspectives, understanding and needs not taken into account; the
complexity of the process of behaiviour change.
II- Actions: In 1997 "Alliance Nationale contre le Sida" (ANCS) has introduced
a participative approach on the prevention of HIV/AIDS which goes beyond the
classic IEC. This approach unlike that of the classic IEC stems from where the
populations are and not from where we want them to be. Are taken into account
the needs, perspectives and understanding of the communities. They are not
considered as simple recipients but as real actors in prevention activities. The
approach has been tested on a community based association in Yembeul in a
poor neighbourhood of Dakar where 95% of its population are illeterate.
Ill- Results: Given the short duration of the experiment the result will be
appreciated within the framework of the methodology of implementation of the
approach in an illeterate environment.
1- Successes: Capacity building and validation of human resources available
in the community; the population's approval; actions are everlasting; opportunities
to discuss sensitive topics such as sexuality and the relationships between men
and women.
2- Constraints: Adults feeling they are regarded as kids when implementing
the approach through its game and exercise parts.; lack of time and mobility of
the populations in an urban area.
|43189 Project Zorro: A community led assessment of HIV
prevention among gay men
Graham Carr1, Pag Scott2, A. Law3, D.J. Pinson3. 1School of Health & Social
Care, South Bank University 103 Borough Road, London SE1 OAA;
2lndependent Consultant, London; 3Project Zorro, Brighton, UK
Issue: Increasing rates of HIV infection within one of the largest gay resorts in
Europe: Brighton, spurred community led action by local gay men.
Project: Project Zorro may be the largest, community led, organised and funded
needs assessment of HIV prevention among gay men. Believing themselves to
be without an adequate voice a steering group of prominent gay community and
business leaders generated funding from within the community to develop, and
subsequently commission this innovative study. Utilising models of community
empowerment, all research processes were supervised by this group. Its main
aims were: community mapping; analysis of current HIV prevention strategies,
identification of gay men's needs and comparison of the match with current
statutory and voluntary provision.
Results: Project Zorro now has data on over 1,000 face-to-face questionnaires,
and 214 in depth telephone interviews. In addition, data has been widely collected
from local gay businesses, community groups and community leaders. The full
report on this major undertaking will be published in April 1998.
Lessons Learned: Initial findings suggest that the current range of services
have made little impact upon gay men within the community and that gay men
identify their social and peer networks as a major supportive strategy for HIV
prevention.
|43190 Strategies and achievements of a HIV/AIDS prevention
proyect in primary care attention
Griselda Kopecky1, M. Gustafsson2, D. Seiguerman2, J. Galindez2, Z. Reeves2,
M. Bernasconi2. 1Bv. Oroho 91 ZC 2000 Rosario Pcia. Santa Fe; 2Retrovirus
Unit Hospital Escuela Eva Peron Gro. Baigorria Sf, Argentina
Issues: To evaluate health care promotions actions targeted to children and
parents who presents high risk conducts to HIV/AIDS transmition.
Methods: From the pediatric consultation, we proposed ourselves, in 1997,
a project for the preventions of vulnerables families to HIV transmition, having
knowledge that in these marginated communities, in the suburb of Rosario City,
out of 3.000 people average, drug - users are frequent, so are prostitution,
homosexuality, analphabetisim, etc.
Results: We have organized participatives meeting of teenagers mothers with
their babies, in the Health Care Community Center Waiting Room before starting the pediatric clinical and obstetrics consultation, with the presence of the

health crew. The exchange of knowledge between mothers, their childs and the
Health Workers about relatives and friends who have AIDS, experiences with
drug users, evaluations of their own high - risk conducts, etc are often matters of
this community experience.
Conclutions: The continous and permanent information had improved in these
communities, with full participation of the health care team preventive actions in
vulnerable groups (teeneagers, addits, homosexuals, unsafe sex relationships,