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

918 Abstracts 43362-43368

12th World AIDS Conference

43362 Preventive education on STD, HIV/AIDS for women's
prostitution in the Philippines
Alma Gabion Bulawan1. 123 Rodriguez St. Mabayuan Olongapo City, Philippines
Issue: Providing information and education for women in prostitution on issues
concerning reproductive health, with emphasis on the prevention of the spreading
STD and HIV/AIDS.
Project: Buklod Center, Inc., is and NGO in Olongapo, Philippines, working for
women in prostitution. It is a drop-in center for the women in the community sad
for women working in learn providing education and health services.
Buklod has trained seven women who formerly worked in the bars to become
health educators for other women. This group locates women who wish to get
more information about reproductive health and HIV/AIDS. Buklod had invited
these women to attend SGD (Small Group Discussions) and to provide information about how HIV/AIDS is being transmitted and protected one's self. These
meetings was a succesful one, and have been attended to by 200 women monthly.
Our aim is to improve the knowledge about HIV/AIDS in the community, giving
them on how to protect or prevent one's self in preventing further cases on
HIV/AIDS.
Result: Buklod Center provides a health clinic where women and families
can come and do a health-check up (e.g., Papsmear test) and have counseling
concerning health issues. The number of persons attending to this has been
increased since the start of the reproductive health project.
The information provided by this project has proven to have an impact on
people's knowledge about reproductive health and HIV/AIDS.
43363 Training program for social workers in Rio de Janeiro
Gerson Santos, C. Silva, W.B. Marcondes, A.V.S. Menezes, E.T. Santos-Filho.
AV. Rio Branco 135/709, Grupo Pela Vidda/RJ, Rio de Janiero, RJ, Brazil
Issue: The social workers of the Secretary of Social Development of the City
of Rio de Janeiro lack of correct information and specific training on the social
impact of the AIDS epidemic. A program was developed to fill this gap.
Project: A specific training program has been created to qualify the social
impact of the AIDS epidemic. This project focused staff social workers who
develop several social programs in the SSD. Workshop methodology was the
major approach for this program. Strategies including information, counseling on
HIV/AIDS, prejudice issues, gender discussion, sexuality and safer sex negotiation were used in the interventions to build community answers to fight the AIDS
epidemic.
Results: An open questionnaire was used to evaluate the training. Between
April and September 1997, 825 professionals were trained. A total of 165 questionnaires were analyzed, 41% indicated information and 36% indicated strategies
on giving information as the most important contribution of the training program.
Hundred per cent knowledge about blood transmission, but just 14% were aware
about the possibility of vertical transmission and 36% about oral sex.
Lessons Learned: Besides information, more subjective issues concerning
values, feelings and prejudice were checked to be essential regarding qualification. To stimulate the creation of culturally appropriate answers by the community,
continuous strategic development on building knowledge is needed.
43365 Knowledge and patterns of condom use among
commercial sex workers in Kampala City
Simon Sentumbwe, D.S. Nakkazi. Centre for Peace Research, PO Box 12785,
Kampala, Uganda
Objective: To determine the knowledge and patterns of condom use among
commercial sex workers in Kampala City.
Design: It was a cross-sectional descriptive study.
Methods: A combination of accidental and purposive sampling method was
used to select respondents. Data was entered and analyzed using Epiinfo version
6 statistical software.
Results: A total of 201 prostitutes were interviewed. Mean age was 21.8 years.
97% knew about condoms mainly from friends and the radio. Knowledge about
correct and proper use was found to below 70% had ever used condoms, and
only 41.7% used them all the time, mainly to prevent STD& HIV/AIDS and avoid
pregnancy. In 60% of cases, it was the sex workers themselves who suggested,
made the decision and provided the condom to the client. 30% of prostitutes fitted
the condom on the client's penis themselves. 65.9% reported clients refusing
to use condom of which 54.1% accepted unprotected sex with them since they
wanted money. Common problems 62.5% had never experienced any problem.
Conclusion: Factual knowledge about condom was high, however practices
related to condom use still permitted disease spread through incorrect or inconsistent use. There is a need to intensify condom promotion programs among sex
workers in Kampala.

43366 Empowerment processes to improve the quality of life of
people living with HIV/AIDS (PWA)
Anuar Ismael Luna Cadena. Miguel Hidalgo 11, Col. Pueblo Quieto Tlalpan
14040 Mexico, D. F, Mexico
Issue: Empowerment processes to improve the quality of life of PWA through
interactive and partipative workshops.

Project: The aim of the workshops is to create interactive and participatives
spaces to reflect and facilitate discussions. The design of the workshops included
techniques and dynamics focused in exercise targeted on active listening and
strategic questionning. The issues approached during the workshop includes:
(a) Self-organization elements
(b) Networking processes
(c) Advocacy/Lobbying
(d) Daily life skill building (nutrition, fitness, stress management, etc).
(e) Therapies/drugs/alternative therapies
(f) Relationship doctor-client
Results: A major involvement of the participants in the workshop in activities
to improve their quality of life, eg. better attachement to therapies, improved diet,
and sports disciplines. Major interest in organizational activities and networking,
major involvement in activism initiatives, such as access to treatments
Lessons Learned: Without having a previous reflective procces on their own
future, it is difficult for PWA to be aware of the key importance of taking control
over their own lifes. When this process starts, it is possible for PWA to become
involved in organizational activities, networking, advocacy and to develop skills
to improve their quality of life.
29* /43367 HIV-prevention for clients of male sex workers:
An experiment in planned action
Wim Zuilhof, P. Maas Van Der. Amsterdam, The Netherlands
Issue: In the Netherlands HIV-prevention in the field of male sex work is limited
to sex workers. Although there is presumably a relatively high HIV-prevalence in
these circuits where a large number of sexual contacts take place, clients of male
sex workers have not been targeted. Male sex workers regret this. They suggest
that mainly the clients want unsafe sex. There are two reasons for this deficiency.
First, because clients are seen as a difficult target group to reach, both physically
as well as psychologically. Second, because outreach organizations, for reasons
of principle, tend to confine themselves exclusively to sex workers.
Project: In the early spring of 1997 an experimental project for clients of boys
in Amsterdam was started. The objective is to design and carry out effective and
successful interventions for clients. At the same time it will increase knowledge of
this target group and find new ways of getting in contact with them. The project,
with a running time of 15 months and loosely based on the precede-proceed
model by Green and Kreuter, includes thorough preparation, implementation and
evaluation. If the interventions turn out to be successful, they will be implemented
on a structural basis in Amsterdam and other relevant cities in the Netherlands.
In the first phase of the experiment a diagnosis of behaviour, lifestyle and health
risks of the target group is made. This diagnosis is based on written and oral
information by clients who have been addressed 'on the spot'. It derives knowledge about the determinants for unsafe sex and information on ways in which
to communicate with them. Based on the findings, experimental interventions will
be designed for specific subgroups of clients. In these designs it will be taken
into account that, if successful, it should be possible to implement them in other
dutch cities only slightly altered.
Results: The project is still in progress. An important result already is the
enormous increase in knowledge on clients. At the end of June the execution of
the interventions will be completed and a first presentation of the results can be
given during the World AIDS Conference.
Lessons learned: Although the project is still in progress there are already
lessons learned. First, careful planning of action gives insight on the do's and
don'ts when targeting clients of boys. Second, it can be concluded that in contrary
to what is often said, intensive face to face contacts of outreach workers with
clients are greatly appreciated by the latter.
43368 Bio-psychology and social care for commercial sexual
exploitation children for the STD/HIV prevention in Costa
Rica
Rosa Fallas. Calle 10 - Avenida 34, Contiguo Plaza Deportes, Cristo Rey, San
Jose, Costa Rica
Issue: The human rights of many female children- adolecscents in prostitution
are violated nowadays. They live in poverty, drug addiction and high risk to be
infected with STD/HIV. They also have limited access to health services.
Project: The experience started in May 1997 with a stage of insertion charactirized by the identification of the working and meeting sites and the establishment
of empathy. Work is done in weekly sesions in which women receive assistance
in STD/HIV prevention and self-steem education.
The process also includes workshops in subjects such as: sexuality, aggression,
gender, life project, etc.
As part of the project, chlidren in prostitution are also provided with medical
assistance adopted to their lifestyle.
Results: The project is perceived by the chlidren as a space for "themselves",
they share experiences and skills for sexual negotiation (condom use).
The female condom have had a very good acceptance. It is a way of protection
for their own bodies.

This experience have had produced differents responses, from Non Governmental Organizations and Governmental Organizations to improve prevention
and care of the problem.
In order to develop viable and effective prevention projects it is necessary to
consider the needs and differences of each group and gender. Regarding child