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

906 Abstracts 43296-43300

12th World AIDS Conference

themselves as confronted with their own thinking during sex; "ownership" of the
self-justifications is essential.
43296 The role of Shamans and Indian leaderships from de
State of Sao Paulo in STD/AIDS prevention projects
among Indian population
Renato Barboza1, L.B. Oliveira2, E.A.P. Orti2, J.C.B. Pacca1. 1STD AIDS Sao
Paulo State Program, R Frei Canecca 1140, 01307-002 Sao Paulo; 2FundaCao
Nacional de Saude, Sao Paulo, SP Brazil
Issue: After the implementation of a prevention project among the State of Sao
Paulo indian population (4 ethnic groups - Guarani, Kaikang, Krenak, Terena) we
felt the nedd to involve shamans and indian leaderships in the project in order
to sensitize them to the project's importance and make us understand the main
social representations of STD/AIDS among their people.
Project: Two workshops (12 hours each) were implemented, both coordinated
by an anthropologist who knew the native tougues of the four ethnic groups. The
groups were organized according to similarities among them and also geographic
location. The reports were recorded and everybody participated.
Results: From 17 indian settlements in the State, 10 were present. Everybody
agreed that the project was important to decrease STD/AIDS vulnerability among
their people. Almost all consider STD/AIDS as outside diseases, white man's
diseases. They worry with their young because they always contact white people
outside their settlements. Many didn't know the condom or its correct use. They
still think that they will prevent diseases thnough singing and praying. But, after
the workshops, they realized the importance of these diseases. They asked for
prevention activities at the settlements, begining with the master of the family and
having separate activities for women.
Lessons Learned: It is very important to implement STD/AIDS preventive
activities for indian people, together with their leaderships, understanding and
respecting their culture. The systematization of our project's results was important
to guide the teams that are working at the 17 state's indian settlements.
43297 Sexual health management programme for fishermen
community in Sundarban, West Bengal, India
Tapasi Bandyopadhyay, S. Barman. Vivekananda Education Society, 25/1A
Diamond Harbour Road Calcutta, India 700034
Issue: Sexual health seeking behaviour among the fishermen community.
Project: Ignorance, superstition and social stigma lead to the neglect of sexual
health among the fishermen community. Sexual health is not given much priority
among the other issues in the life of a fisherman. They attend to those health
problems which upset their daily schedule and cause economic loss. Discretion
is preferred while seeking treatment for sexually transmitted diseases. Hence,
a study was designed to assess the perception of sexual health and diseases
among the fishing community, their sexual health seeking behaviour and the
availability and accessibility of existing health care services in the community.
Both quantitative and qualitative data were collected through indepth interviews,
group meetings, focus group discussions, questionnaires and mappings from a
sample comprising 994 fishermen and women.
Result: Out of the total sample, 36% males and 30.3% females believe that
sexually transmitted diseases can be cured by traditional healers. Only 16.5%
males and 4.7% females reported that sexually transmitted diseases can be
treated by qualified medical practitioners. Out of the total persons with genital infections, 23.5% had sought proper medical treatment after waiting for an average
period of 12 weeks. Among them 18% sought treatment for their sexual partners.
The existing health care services in the area are absymal and ill managed which
in turn has a negative influence on the health seeking behaviour of the community.
Lessons Learned: A new concept of sexual health management system may
be evolved for the efficient and effective delivery of sexual health services with
the aim to increase the sexual health seeking behaviour of the community and
prevent the spread of Sexually Transmitted Diseases, HIV/AIDS.
S43298 | Seeking innovation in STD/AIDS prevention with men
who have sex with men
Antonio Luiz Martins Dos Reis. Rua Cruz Machado 353/03 Curitiba-PR
80410-170, Brazil
Issues: In late 1993, 33.8% of reported AIDS cases in the city of Curitiba, state
of Parana, Southern Brazil, occurred in male homosexuals. A further 19.2%
was registered amongst bisexual men. At that time there was no specific AIDS
prevention project, either governmental or non governmental, for this population.
Project: A team of 5 "peers", gay men, was trained to carry out outreach work
in cruising areas (public toilets, parks) and also in gay bars, night clubs and
bath houses. A second activity was the promotion of discussion groups aimed
at improving self esteem amongst the target population. During these meetings,
safer sex was also discussed. The project has been in existence since late 1993.

Strategies include printed educational material specific for gay men based on a
gay HIV positive super hero, also represented live by an actor in bars and night
clubs; a tabloid newspaper published every two months dealing with gay issues
and health; teams of two people carrying out discreet outreach work in cruising
areas; a drag queen passing on a safe sex message in night clubs, as well as the
distribution of condoms in exchange for tokens distributed during the outreach
work.

Results: Since late 1993 there have been 40,402 interventions in outreach
situations, 81 discussion group meetings and 49,433 condoms distributed. The
exchange of vouchers for condoms is used as an indicator of intended behavioural
change. The most recent indicator available (period from June to December 1997)
is 21% (vouchers exchanged as a percentage of vouchers distributed). The scope
of the project has been enlarged in 1998 to include the formation of a nucleus in
three cities in the interior of the state of Parana.
Lessons Learned: The importance of the use of peer educators as well as
the adaptation of educational information to the social reality of the target population. The inclusion of the discussion of citizenshipas a means of promoting
self esteem and the subsequent desire to take care of oneself. The importance of
combining safer sex information with other activities of interest to the population,
so that the message is accepted naturally, without embarrassment. The need to
be innovative when passing on the AIDS prevention message.
43299 AIDS risk among juvenile delinquents in detection in Sao
Paulo, Brazil
CamilaA. Peres1, F. Silveria2, O. Cipriano2, J. Barariga3, R. Stall4, N. Hearst4.
1R. Frei Caneca 1140 Sao Paulo, SP; AIDS State Program Health Department,
Sao Paulo, SP; 2AIDS Prevention Studies Nucleus - USRP Sao Paulo, SP; 3State
Foundation for Child Welfare, Sao Paulo, SP Brazil; 4University of California,
San Francisco, CA, USA
Issue: Incarcerated juveniles are increasingly vulnerable to STDs and HIV infection. Despite this fact, there are few studies and educational interventions for these
boys. There is an urgent need to better understand the psychosocial aspects that
influence HIV risk and to develop effective interventions for this population.
Project: A series of focus group discussions and workshops were held with
60 boys aged 13-18 years in government juvenile detention facilities (FEBEM).
Groups explored their lives, themes of interest, spontaneous language, perception
of risk for HIV/STDs, barriers to behavior change, and motivation to participate in
a group intervention.
Results: The majority of boys in FEBEM were involved with mugging and
drugs, especially with "crack cocaine" (they did not report injecting drug use).
They came from extremely impoverished families. Most were illiterate and accustomed to living on the street to get money. Internees said they mugged because
this was the only way to get what they dreamed of in their lives: "money, a car,
and a gorgeous girl". Only 5 of them believed they will be able to change their
lives when set free. They felt most they were currently taking "time off" their
regular criminal life. Only I boy reported that he had never had sex and 5 were
already fathers. They knew about AIDS, HIV and how it can be avoided. But, they
believed risks, like dying, getting HIV, or pregnancy, are part of life. Their main
fear was dying through a bullet from a policeman. Few of them had ever used
condoms since they believed condoms decrease pleasure. After the workshops,
75% of them expressed a wish to act as representatives in AIDS prevention within
the institution and 50% to use condoms.
Lessons learned: Educational groups should analyze problems and construct
solutions that can empower both individuals and groups to challenge and change
their environment. They must encourage respondents to avoid behaviors that
may place them and others at risk for HIV transmission. In addition, peer role
models is a useful tool to increase levels of empowerment, collective action and
also to advocate for responsible decision making, healthy values and norms.
43300 Organizing community of people living with HIV and
AIDS: The Philippine experience
Nenita L. Ortega1, Jeramie Diaz2, Liza Enriquez2, Jun Niceto2. 11066 Remedios
Street, Malate; 2Pinoy Plus Association Inc., Manila, Philippines
Issue: The Philippines has an increasing number of persons getting infected
with HIV everyday, and so is the membership of the sole national organization
of Filipinos living with HIV and AIDS. More of the infected are coming from the
rural areas of the country. They have been discriminated, violated and humiliated.
With incidences such as this, their human rights had continuously been violated.
Access to treatment and other available services had been scarce, if not available.
Description: Every HIV positive individual had been clamoring for a decent
life, non discriminating and non stigmatising society, and an accepting community.
They did not want to be HIV positive, they did not ask for this. They are asking for
equal rights, right to decent employment. Rights as what non HIV people totally
enjoy. They promised to themselves that they will no longer allow violations of
their rights, rights in all aspects of their lives.
Results: Pinoy Plus as an organized community of positive individuals, answering to the needs of their peer HIV positive is the sole national organization of
Filipinos living with HIV and AIDS in the country. Fighting for the rights of positive
individuals they are now in the forefront of further enriching their organization,
documenting violations, evaluating access to every available services including
all kinds of treatment. They gone beyond Metro Manila, creating chapters all over
the country to address the needs and offer support to individuals in need either
directly or indirectly affected by the epidemic. They have learned to teach one

another on how to live with HIV and how to fight for their rights.
Conclusions: There is a need for an organized community of HIV positive
individuals and PWAs in order to advocate for their needs and concerns, fight for
their human rights and equality. Positive individuals must speak out for their rights.
People living with HIV/AIDS are not a problem but they are part to the solution.
They must be partners in any HIV intervention, if not central to any programs on
HIV and AIDS. Once organized, they make a difference, thus, a dramatic impact.