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

976 Abstracts 44199-44203

12th World AIDS Conference

for the particular facility and that take into account the rules of that facility and
the degree of the restrictions. The project also gives the inmates tools to better
adherence to their particular regimes tailor them to the particular facilities.
Results: After inmates have a better understanding of how HIV therapies
and treatments, their adherence to them improves, increasing the odds of better
results. Also, the inmates are better prepared upon release to follow up with
treatments in the less controlled environment of freedom from prison.
Lessons Learned: Educational interventions in controlled environments such
as prisons can improve adherence to treatment while provide the inmates with
tools to negotiate the strict rules of correctional facilities.
44199 Is migration a co-factor for the HIV epidemics in South
East Asia?
Ivan Wolffers1, I. Fernandez2, S. Verghis2. 1Health Care & Culture Vrke
Universiteit Van der Boechorst Str. 7 1081 BTAmsterdam, The Netherlands;
2Caram-Asia/Tenaganita, 11th floor, Wisma Yalein, Jalan Masjid India, 50100
Kuala Lumpur, Malaysia
Issues: Due to high economic activity and big differences in wealth, mobility of
people (as well in-country as cross-border) in Southeast Asia is high, bringing
people in their reproductive ages, travelling alone in new contexts where they
will develop new social and sexual networks, without the social control based
on traditional values in their countries of origin. For cross-border migrants there
is also the issue of their legal status, lack of access to HIV-information and
appropriate facilities.
Project: CARAM (Coordination of Action Research on AIDS and Migration) in
Asia links different grass-root research projects in Southeast Asia. The status
of migrants in their new situated is studied through participatory research, concentrating on health, sexuality and knowledge and experience with HIV/AIDS.
Families left behind are researched and also what happens when migrants return
(temporarily of permanent).
Results: Lifestyles of migrants change and put them at increased risk for
HIV-infection, especially in situations where they have none or limited access to
appropriate information and health services (Especially STD-services). In addition, partners of migrants left behind are also at increased risk to get HIV-infected,
partly because of changed lifestyles and partly because of their partners.
Lessons Learned: Migration is a co-factor for HIV-infection in South East
Asia. However, authorities often ignore this issue. They see migrants as labour
force and not as human beings with a sexual identity. In addition, they ignore
the existence of undocumented migrant workers in terms of HIV-information and
STD-services. To limit the size of the Southeast Asian HIV-epidemics policies to
protect migrants from getting infected should be developed.
541* /44200 AIDS, India and the trucking industry
Barun Kanjilal1, S. Forsythe2. 1IIHMR Jaipur, India; 2Liverpool School of Tropical
Medicine, England
Objective: To assess ways in which India's trucking industry will be affected by
the country's rapidly expanding HIV/AIDS epidemic.
Methodology: A set of hypotheses regarding the industry's vulnerability and
areas of likely impact were tested using 7 survey instruments. These surveys
were conducted with truck owners, truck drivers, and industry stakeholders to
assess the impact incurred when introducing the external shock of HIV/AIDS, and
to assess coping mechanisms that were likely to be pursued.
Results: Modelling exercises revealed that the prevalence of HIV among truck
drivers may be as much as 10 times higher than in the general adult Indian
population. Interviews with industry leaders and stakeholders revealed that there
are a number of critical trends that are occurring within India's trucking industry,
including the shortage of skilled drivers. Within the context of these trends, AIDS
is being introduced as an external shock which may affect the viability of the
trucking industry. The analysis indicated that the loss of productivity of drivers is
likely to force some companies to forfeit significant revenues, leading to an exit
from the market. Meanwhile the cost of maintaining existing levels of death benefits is expected to overwhelm many businesses if maintained at current levels.
It was also determined that small companies were less capable of responding to
the epidemic, and therefore AIDS would result in a greater negative impact on
these businesses. AIDS among truckers is also likely to have a negative impact
on many of the stakeholders who rely on the trucking industry, especially the
insurance and finance companies.
Conclusion: Few trucking companies have prepared for the impact of AIDS.
There is a concern that the industry may pursue policies that could harm the
viability and reputation of the industry. Such policies could include eliminating
benefits for truckers and/or performing mandatory HIV testing. Conversely, the
industry still has the opportunity to prepare itself to mitigate the impact of AIDS
through such proactive responses as initiating workplace prevention programmes
and establishing policies regarding workers infected with HIV.

44201 An assessment of socio-economic impact of HIV/AIDS
epidemic among truckers on Indian trucking industry
Barun Kanjilal1, S. Forsythe2, V. Ganesh3, G. Balasubramaniam3. 1IIHMR,
Sanganer Airport, Jaipur-302011; 3Dept. for International Development, New
Delhi, India; 2Family Health International, Arlington, VA, USA
Objective: To assess the potential socio-economic impact of HIV/AIDS epidemic

among truckers on the Indian trucking industry (as a part of a DFID-sponsored
AIDS-control project for truckers in India).
Methods: Data on industry's present economic status and labour relations
were collected through interviews with about 1000 truck owners, 80 truck drivers,
and stakeholder such as insurance and finance companies, and industry leaders from different parts of the country. Sectoral impacts were classified into (a)
direct, such as, social security benefits, health care and death benefits, etc.,
and (b) indirect, such as, loss in output, replacement investments, increase in
number of accidents, and so on. Number of HIV-infected truckers was estimated
through available sero-prevalence data and epidemiological models. Each of the
impacts was then assessed both at sectoral and micro level using quantitative
and qualitative information.
Results: Total projected number of HIV-infected truckers in 2005 AD. worked
out to between 1.3 million an 2.4 million (12%-20% of all truckers). The direct impact would be less significant on the industry due to non-existence of
labour-welfare policy. However, the epidemic is likely to aggravate the shortage
of skilled driver triggering the indirect impacts such as loss in output and increase
in accidents. Due to high demand elasticities, the burden of epidemic is less likely
to be shifted to consumers and the smaller companies would probably be hardest
hit. The shortage would also likely to contribute towards industry's slow progress
towards desired technological change.
Conclusion: While the impact of the epidemic has, for the most part, not yet
been felt in the industry, it is very likely that it would become much more visible
within the next five to ten years. Due to its fragmented and decentralized nature,
the industry is highly vulnerable to external shocks. The study underlines the immediate need for intensive advocacy for cost-effective strategies like workplace
intervention.
44202 | Trans-national population movement and HIV/AIDS in the
mainland South-East Asia
Shakti Paul. ARCM 7-Floor Prajadhipok Bldg. Chulalongkorn University Phyathai
Road Bangkok 10330, Thailand
Issue: Massive trans-national population movement in mainland Southeast Asia
(Cambodia, Laos, Malaysia, Myanmar, Thailand, Vietnam and southern China) is
closely associated with the transmission of HIV/AIDS in the region that require
appropriate intervention at the national, intercountry and regional levels.
Project: This paper discusses data and information on the nature and extent
of trans-national population migration. It examines the HIV/AIDS situation at the
cross-border locations, transportation routes and various migrant and mobile
population groups. It also reviews some of the existing intervention programs
targeting migrants and mobile population and modes of sharing information and
collaboration among the relevant agencies in the regional countries.
Results: Over the past two decades, there have been dramatic increase in
the trans-national population movement in the region. They are migrant labors,
cross-border traders, tourist and visitors, refugees and displaced persons, trafficked women and children and cross-border hill-tribes. While a great majority
of them move deeper inside the country, a significant number of them stay in
and around the border crossing points. HIV prevalence at the border crossing
points and border regions are particularly high, as it is the situation along the
cross-country transport routes. Most of the national AIDS programs do not target
the migrant and mobile population and there is limited exchange of information
on migration and HIV/AIDS among regional countries.
Lesson learned: As the trans-national population movement intensifies, there
are sufficient evidence of association between the human mobility and distribution
of HIV epidemic in the region. Effective HIV/AIDS intervention programs should
be developed for the mobile and migrant population at the national, inter-country
and regional levels.
S44203 1 Immigrants in Japan in the context of the HIV/AIDS
epidemic
Masako Kihara, M.K. Kihara2, H.O. Ohya3, S.I. Ichikawa3. 1CAPS International
Program, Univ. of California, USA; 2Kanagawa Cancer Center Research
Institute, Yokohama; 3Kanagawa Pref. College of Medical Nursing and Medical
Technology, Yokohama, Japan
Background: Immigrants represent a typical minority but are of central importance in HIV/AIDS epidemic in Japan approximately half of the HIV positive cases
reported to the national HIV/AIDS surveillance are foreigners. However, only
minimum attention has been paid on this issue in terms of HIV/AIDS prevention
and care in Japan.
Objectives: To study the trend of immigrants of various nationalities in comparison with the HIV/AIDS surveillance and epidemiological data.
Methods: Analysis on immigrants was performed using data collected from
published immigration statistics during 1985-1995. The national HIV/AIDS surveillance data was also analyzed in terms of nationalities.
Results: Of 1.36 million registered foreigners, permanent and non-permanent
residents were 630,000 and 730,000, respectively, as of the end of 1995. The

latter has increased 1.6 times in the last 10 years largely due to the increase in
those of Asian and South American nationalities (China, Brazil, Philippine, Peru),
while the former remained unchanged. A large increase was also observed in
foreigners illegally staying in Japan, which was approximately 300,000 (M:F =
1:0.7) as of the end of 1995, a 3 times increase from 1995. An increase was noted
in people from South Korea, Thai, China and Peru for both men and women.
Analysis of the HIV/AIDS surveillance revealed that AIDS cases of Asian and