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

12th World AIDS Conference

Abstracts 43313-43317 909

gay men from the community. One month after the training, a follow-up session
is organized with the "multipliers" to discuss their experiencies and difficulties
and explain uncertainties on HIV/AIDS which may have remained. During the
campaign, Project LAMBDA volunteers do outreach work in bars, clubs, saunas,
etc to distribute information and promote participation in the workshops. From
Nov. 1997 to Feb. 1998, a KABP was applied.
Results: During the campaign, over 200 gay men were trained, 9,000 posters,
20,000 leaflets, 10,000 safer sex guides, 5,000 KABP study reports and 200,000
condoms and lubricants were distributed in the Gay meeting places. Results of
the post-tests filled out by the "multipliers" showed an increase in knowledge on
HIV/AIDS, more security to negotiate safer sex with their partners, and resolve
to always practice safer sex. Results of the KABP study from 1997-8 will be
compared to the ones from 1995-6 to measure changes in the community.
Conclusions: As always seems to be the case, recruitment was one of the
major challenges since most gay men are tired of hearing about HIV and would
prefer to ignore it. Other social activities had to be offered to gay men to attend
the workshops to make it more attractive. HIV/AIDS project for Gay men have to
make greater and greater efforts to offer alternate (and innovative) activities to the
community. It is a challenge to convice funders as to their necessity in resource
poor environments.
43313 An experimental attempt to create awareness on STD/HIV
and AIDS among street children in Calcutta
Archana Palibasu. Amaderbari 63 Rafiahmedkidwai Road, Calcutta, India
Objective: To assure better Sexual Health for street children living in our project
communities.
Description: CINI-ASHA a non-Governmental organisation is continuously
striving to ensure better sexual health for our project community. This present
endeavour is targeted to central Calcutta and Tangra areas for a pupolation of
3000 to 3500 street and working children to enforce them about safer sex through
condom promotion.
Street children and their community influences are sexually very active and
floating in nature. Child marriage, drug addiction, childhood pregnancy are the
common scenario of our targeted community and they also used to indulge
themselves in red light areas.
Methodology: Our methodology consist of baseline survey of targeted areas
for filling up specially designed questionnaire, preparation of traning module and
implementation of programmes phasewise which are always modified or updated
by follow up programmes etc.
Result: As a result of continuous motivation and counselling our targeted
populations has proven some facts in figures which reveals a drastic reduction
of STDs, an increase intensity to use quality condoms and above all a sexual
awareness and attitudes for safer sex.
Lessions Learned: The strategies regarding awareness among street children
have to be reviewed according to the need of the community and problems faced.
Motivating through counselling is essential to bring about behaviour change
i.e. adopting condom use. It is better to involve peer educator and community
influencers for social marketing.
S43314 Developing the UK approach to safer sex work with
people living with HIV and AIDS
Gary Scott1, R. Scholey2. THT 52-54 Grays Inn Road London WCIX 8JU;
2Terrence Higgins Trust London, UK
Issue: HIV prevention initiatives relevant to PLWHA in the UK have previously
been limited with little debate about good practice and ethical issues.
Project: To develop principles for good practice and a collaborative approach
to this work amongst HIV prevention and self help groups. Historical obstacles
in the UK to primary prevention with PLWHA, particularly those infected sexually, include a fear of scapegoating them, a view that post-diagnosis counselling
achieved sufficient knowledge of transmission and safer sex and the assumption
that an HIV diagnosis would of itself instigate behaviour change, with maintenance
of safer sex amongst PLWHA needing little support. To counter this neglect, the
Terrence Higgins Trust developed an approach around five themes. (1) encouraging debate about opportunities and constraints for primary prevention work
with PLWHA via conference workshops and a seminar for HIV prevention agencies, producing a report on developing good practice. (2) building a collaborative
approach between agencies to promote a range of initiatives including booklets,
empowerment workshops and further specialist staff. (3) strengthening of existing
links between primary and secondary prevention with training for THT staff and
future support methods planned. (4) collation of research material on sexual risk
taking behaviour, adoption and maintenance of safer sex by PLWHA. This has
also been used to inform and extend the research agenda. (5) collaboration with
other THT staff and sections has ensured inclusion of relevant material e.g. for
HIV infected gay men in national campaigns and resources and in their future
work.
Results: Ongoing debate has been stimulated, collaborative work between ma
jor HIV prevention agencies developed and national campaigns and resources
produced by THT have increasingly and explicitly included material relevant to
and involving PLWHA.

43315 Self awareness among sex workers
Aaron Mwale. Zambia Network of Women Living With HIV/AIDS, Lusaka, Zambia
Issue: Population vulnerable to HIV/AIDS through sex working in Lusaka, Zambia,
require innovative and appropriate intervention and self wareness.
Project: Given rapid increase in the number of sex workers in Lusaka, Zambia
an interview using reformed sex workers as per educators was used. A self
awareness programme, using per educators was lunched, with a drop in centre
with commercial working background. This project includes in its programme
reformed sex workers as per educator, qualified social workers and a Doctor.
Strategies offering alternative survival skills to commercial sex workers, counselling on HIV/AIDS, sex Education accompanied by Condoms Distributions, and
a drop in centre.
Results: The self awreness programme has been very effective among sex
workers. Within workers within a period of one year the number of client increased
from 1000 to 3000. Many sex workers are now activively involved in alternative
survival skills those that still rests have seriously started using condoms. A total
of 4000 sex workers have recieved counselling on HIV/AIDS. 100 have been
recruited at the drop in centre as per educators, and over 2000 are involved in
alternative survival skills.
Lessons Learned: Self awareness among sex workers is very effective when
reformed sex workers are used as per educator, for they know has to convise
their pears.
403*/43316 1 HIV intervention among Chinese MSM in Hong
Kong's "gay saunas"
Graham Donald Smith. AIDS Concern - 17B, Block F, 3 Lok Man Road,
Chaiwan, Hongkong
Issue: Responses to attempts to raise AIDS awareness among users and staff
of saunas for MSM (men who have sex with men) in Hong Kong.
Project: 30% of the accumulated HIV infections recorded in Hong Kong are
attributed to MSM. Given the general reluctance of MSM to identify themselves
as 'homo or bisexual' it is likely that the proportion is understated in Government
collected statistics. An intervention was devised to promote safer sex practices
to MSM. Part of this intervention involved outreach work in saunas used by MSM
for sexual encounters. The outreach work has included regular visits to saunas to
establish a relationship with staff and regular customers, distribution of condoms
and lubricant, distribution of a range of safer sex information materials produced
by and for MSM, and police liaison.
Results: 10 out of 13 saunas for MSM in the territory have accepted regular
visits from outreach workers. Attempts to raise awareness of the possibility of
HIV infection have met with a variety of different responses from sauna-users,
sauna staff, police and government AIDS advisors. Most saunas approached
have accepted the condoms, lube and leaflets but are reluctant to openly distribute condoms to their customers, preferring instead to distribute them only
when customers request them. In saunas where staff have made the condoms
available for the customers to help themselves staff have reported complaints
from some of their customers and an unwillingness on the part of the customers
to dispose of the condoms in a hygienic way. The police are unable to pledge
that condoms on the premises will not be used as evidence that the owner is
operating a vice establishment.
Lessons Learned: Increasing condom usage in saunas for MSM in Hong
Kong requires more than just a supply of condoms/lube. It requires customers
to feel comfortable with condoms/lube being to hand and to be motivated to
dispose of used condoms thoughtfully, it requires owners/staff to feel obliged to
make condoms/lube available and it requires assurances from the government
that condoms/lube will not be used as evidence to prosecute the establishment.
43317 1A European behavioural database
Nathalie Lydie, F.F Hamers, B. Schwartlander. 115 Ave De LEcole De Medecine,
75006 Paris; 2European Centre for AIDS Surveillance, Saint Maurice, France;
3UNAIDS, Geneve, Switzerland
Background: As part of a project conceived by UNAIDS to gather behavioural
indicators from around the world, we have compiled behavioural data from published studies and the grey literature for the 50 countries of the WHO European
Region.
Methods: Information was sought in two ways. Initially a framework for the
bibliographic searches was designed so as to access both national surveys and
local or regional studies. Studies were only selected if a description of sampling
methods and survey instruments was described. Four groups of the population
were specifically targeted and the following indicators chosen: for the general
population, men who have sex with men (MSM) and prostitutes: the extent and
characteristics of sexual partnerships, frequency of sexual contacts and frequency
of condom use; for injecting drug users (IDU): the extent of IDU and sharing of
syringes. Secondly we asked the HIV/AIDS surveillance coordinators from each
country to check our findings and fill in any gaps.

Results: Less than 25% of the countries have carried out large national surveys, all being in western Europe. In these studies, the number of partners over a
given time period was usually documented but the type of sexual partnership (regular, casual) and type of sexual contact (vaginal, oral, anal) were rarely specified.
Condom use was usually reported. In eastern Europe few studies in the general
population have been carried out; for these, fewer indicators were included. However further studies have now been initiated in several eastern Europe countries