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

896 Abstracts 43248-43252

12th World AIDS Conference

Lessons Learned: Effective strategies of education to this population begins
with an acceptance of what they do and who they are, and an understanding of
the level and amount of education required.
43248 1 HIV prevention among travel professionals
Martin Werner. Dep. of Health Research, University of Berner, Niesenweg 6,
CH-3C12 Berne, Switzerland
Issue: Travel setting is an HIV risk situation: estimated 10% of HIV infections in
Switzerland are contracted abroad. Travel professionals require special attention
both as risk persons and as potential resource persons of HIV prevention among
tourists and business people.
Project: On behalf of the Swiss Federal Office of Public Health and in collaboration with the largest tour operators and with Swissair HIV education modules
have been developed and implemented. The measures are aimed at individuals
working in the Swiss travel industry. Objectives of the training program are: 1. to
increase the knowledge of travel professionals about HIV and Safer Sex and 2. to
enable them to transfer preventive messages to tourists (outgoing tourism). The
training modules have been adapted in accordance with the travel professionals'
specific types of customer contact: as sales staff, tour guides, or flight attendants.
Experienced travel professionals are offered optional training while those in vocational training receive compulsory basic education. When ever possible, modules
include issues of travel medicine.
Results: To date 650 travel professionals have been trained. Process evaluation shows significant improvement in knowledge and attitudes concerning HIV
and prevention. One third of the trainees indicate changes in protective behavior after the course. Effectiveness of resource persons as multiplicators of HIV
prevention among travellers is found to be moderate. Due to growing economic
restrictions in the travel industry the optional training program faces a decrease
in participation.
Lessons Learned: Travel professionals benefit personally from courses in HIV
prevention. Compulsary education in HIV prevention during their vocational training is shown to be effective. To reach travellers as a target group the training of
travel professionals as resource persons for HIV prevention should be expanded
and followed by additional measures.
143249 Experiences in peer education approach for intervention
among sex workers in Pune, India
Rajesh M. Jainjangde12, I.S. Gilada3, T.N. Sevekari4. 1Indian Health Orgn.,
Ranjit Complex, 428 New Mangalwar Peth, Pune-411011., 2Project Manager,
I.H. O.-Bombay Pune-41 1011 MH; 3Secretary General, I.H.O.-Bombay
Bombay-400008 MH; 4Indian Health Organisation-Pune Pune-411011 MH, India
Issues: High HIV prevalence is reported in the Sex Workers (SWs) in Pune. Our
NGO began a comprehensive intervention project using peer education approach
among SWs in 1991. The objective was to increase awareness about STDs/HIV,
promote use of condoms and increase its availability and management of STDs.
Project: The project covers about 4000 sex workers (100%) from the largest
red-light area. Peer education is imparted through a three tier structure of Bai
(mother), Tai (sister) and Saheli (friend). Bai is involved in training, counseling and
field area extension. Tai is involved in condom distribution, education and patient
follow up. Saheli is involved in education and helping patients. STD management
through mobile clinic was discounted (1995) and a STD clinic was established in
the red light area.
Results: The condom distribution has increased significantly in the last 5
years.(P = from 5000 in 1991 to 350,000/per month now). Though direct estimates of actual usages are difficult, survey where the used condoms were
counted from the dustbin in the mornings, suggested increased utilization. The
proportion of SWs attending our clinic as well as other private clinics nearby for
their STDs, reveal a decreasing trend. This intervention is not only acceptable
but has lead to empowerment of SWs. A small proportion of senior Tai'slanded
in burn out syndroms. Older and sick SWs perceive issue of rehabilitation as
important.
Lessons Learned: Comprehensive project including STD/HIV awareness,
peer education, training, STD management and advocacy support is effective.
Peer educators are particularly useful in covering newer SWs. Mobile and STD
clinic contribute immensely in STD management. Burn out should be prevented
by field extension and fostering self-reliance empowerment, feeling of ownership
and external partnership for critical issues are vital for long-term sustainability.
Addressing issue of rehabilitation will strengthen the intervention.
43250 Australian responses to the epidemic: The Australian
Graphic AIDS project
Raymond Donovan1, L.K. Chan2. 1University of Newcastle, 166 Sutherland
Street, Paddington NSW 2021; 2University of New South Wales, Sydney 2052,
NSW, Australia

Issue: HIV/AIDS educational campaigns require appropriately focussed information and follow-up interventions. They need to be alert to the immediate concerns,
and the socio-cultural composition of, selected groups, communities and populations. Evidence from international surveys indicates that government strategies
aimed at the 'general' population are not particularly successful.
Project: Australian government programmes, such as the Grim Reaper (1987),
emphasise the strategy of 'prevention for all', aimed at a presumed unitary

heterosexual population. In contrast, Australian non-government organisations
(NGOs) address a range of constituencies with differential needs and partial
knowledge. They also explore and publicise broader issues such as the equity
and legal rights of people living with HIV/AIDS. To date, the Australian Graphic
AIDS Project (AGAP) has documented over 2,000 items from government and
NGO sources including booklets, brochures, condom wrappers, flyers, information kits, cruise cards, pamphlets, posters, stickers and television advertisements.
The AGAP traces the diversity of educational campaigns produced by Australian
federal and state governments, and the state NGOs, and provides critical-graphic
analyses of the materials placed in their socio-historic contexts. The images and
texts are examined in relation to the national strategies, and set against the
overarching political discourses and mediated narratives.
Results: The critical-graphic analysis of the Australian materials indicates:
(1) Government images and texts are cautious compared to the explicit content
of non-government campaigns, and whereas government materials position the
general population as an exclusive category, non-official campaigns target their
constituencies as inclusive communities or groups. The socio-historical analysis
shows (2) Although government arms-length funding of NGOs allows them tacit
concessions in the use of explicit images and texts, this is a negotiable dispensation, since they run the risk of official censorship if they are perceived to overstep
the invisible line of political acceptability and public tolerance.
Lessons Learned: Government sponsored HIV/AIDS strategies which target
homogeneous populations are unsuccessful in reaching their intended audiences.
Australian NGOs are granted latitude in their use of explicit content, but they run
the risk of censorship if they offend official sensibilities.
43251 A culturally acceptable educational approach to reach
women with STDs in Mozambique: Results of the KAP
study, Maputo City, 1995
Rosa Marlene Liquela1, S. Gloyd2, R. Vaz3, N. Chrisman2, A. Ghee2, A. Da
Cuhna1. 1Ministry of Health National STD/AIDS Program, CP 264, Maputo,
Mozambique; 2University of Washington, Washington, USA; 3UNAIDS, Luanda,
Angola
Background: Knowledge, attitudes, practices, sexual and health seeking behavior observed among women at high and moderate risk of contracting STDs
and HIV require a more focussed approach to obtain results in prevention and
treatment of STDs and AIDS in Mozambique. A strategy was researched through
KAP study.
Methods: A cross-sectional study was carried out in Maputo, Mozambique
between August and December 1995. 302 women, either street-based CSWs
or factory workers participated: 100 individual questionnaires were completed in
each group and 40 factory workers and 62 CSWs participated in focus group
sessions. Participants were selected by convenience and motivated to adhere
to the study by giving them the equivalent of 5USD, and free medical care and
treatment for STDs. The study was voluntary, anonymous and not related.
Results: The mean age was 23 for CSWs and 34 among factory workers.
Mean age at first intercourse was 16 for CSWs and 18 for factory workers.
CSWs were found to have 3 to 4 sexual partners per day during weekdays
and 3 to 20 partners per day during the weekend. Factory workers reported on
average I to 2 sexual partners. Monthly mean income varied from 127 to 485
USD among CSWs and was 30USD for factory workers. Symptoms of STDs are
often considered "normal". They are therefor not diagnosed nor treated. Both
traditional and modern treatment is utilized. However, traditional treatment is
considered essential for complete cure. Only 30% of CSWs and 15% of factory
workers considered themselves at risk. Condom use was low. CSWs primarily
use traditional medicines and pills for prevention of STDs. Complex networks of
multiple partnership among both CSWs and factory workers create obstacles to
reduce risk behavior and improve condom use.
Conclusion: This study underscores the need for reinforcing STD educational
programs by taking into account local concepts of sexually transmitted diseases
and healing which differ from western concepts. Syndromic-based educational
programs in local languages, rather than using medical terminology may help
women understand that what they consider as "normal" might actually be "disease".
43252 HIV prevention/sex education among immigrant Latino
gay and bisexual men in New York City
Henry Daniel Castellanos. GMHC 119 West 24 St., New York, NY 10011, USA
Issue: As one of the most impacted groups by HIV in the United States, immigrant
Latino gay and bisexual men need culturally appropriate prevention programs.
Project: New York city has 17% of the AIDS cases in the US, out of them,
30% are among Latinos. Proyecto P.A.P.I., (Poder, Apoyo, Prevenci6n e Identidad - "Power, Support, Prevention, and Identity") is a volunteer-based, harm
reduction and client centered program. Some strategies include: * expanding HIV
prevention to incorporate sex education; * addressing issues of identity and acculturation; * consciously exploring the overlapping of volunteer's and client's roles;

* incorporating volunteers in most of the development steps; * and using parallel
processing techniques during volunteer trainings. This project provides individual
and group experiences for clients and volunteers. Our services provide different
degrees of involvement. These include: one-session informational workshops,
one-on-one counseling, three-session psycho-educational workshops, bi-weekly
discussion groups, and ear-point acupuncture treatment. Volunteer opportunities include: weekly drop-in volunteer meetings, social events, outreach and