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

978 Abstracts 44209-44213

12th World AIDS Conference

Conclusion: This training course provides tangible net benefits to society.
When summing together additional hours of paid employment by carers + shift
from ER visits to phone consults and substitution of unskilled and volunteer hours
for skilled care, the training provides between $89,114 and $177,231 minimum
in net benefits annually. These benefits may be even greater if one considers
benefits that aren't quantifiable such as increases in carer confidence.
44209 Vulnerability of refugee women to HIV/AIDS infection in
refugee camps in northern Uganda
Marcelina Akwir1, A. Arkangel2, D. Moluma2, J.W. Idro2, J. Homsy3. 1Moyo
AIDS Control Initiative (MACI), Adjaumani; 2MACI, Adjumani; 3MSF-Switzerland,
Kampala, Uganda
Issue: Local beer brewing and selling is a common activity for young refugee
women aged 17-30 years in the Sudanese refugee camps located in Adjumani
district, Northern Uganda. This activity involves selling beer until late at night while
dancing to local music to entertain customers, thus increasing women's chances
of having sex under the influence of alcohol. As a result, unprotected sex with
multiple sex partners and unwanted pregnancies are common. In this refugee
camp, the majority of beer brewers are widows or women who were forced to
separate from their husbands due to war.
Project: Considering the increasing number of local beer brewers and consumers, an intervention was planned to mobilize refugee women and sensitize,
inform and educate them about HIV/AIDS facts.
Results: On-site workshops with local women working as beer brewers and
sellers in the refugee camp were conducted by the project Refugee Women
Mobilizer who is a certified HIV/AIDS woman trainer. The workshops reached 313
women and were conducted in three different languages as women are of various
origins. Women participants found the workshops interesting and participatory,
as they were able to express their problems, concerns and fears. Half of them
are now acting as peer educators, and are able to educate their customers and
the rest of the women in the camps, and to promote condom use among their
clients. This multiplicative approach has enabled the project to reach three times
the number of clients as initially targeted. Women are followed up regularly by
the Refugee Women Mobilizer to support these efforts and help them initiate
alternative income generating activities.
Lessons learnt: Raising income through beer brewing among Sudanese
refugee women is their primary response to cope with forced poverty. This situation is compounded by the fact that it is difficult, if at all possible to know the
prevalence of HIV among refugee populations, who are at risk for many other diseases due to their displacement. Early interventions are thus all the more critical,
and possible provided they are well-focused, participatory and try to address as
well poverty.
44210 Residential summer camp for children with HIV/AIDS:
Benefits and implications
Michael Mizwa. 3202 Weslayan Annex, Houston, Texas, 77027, USA
Issues Addressed: Through careful planning and staffing, a medically safe and
nurturing camp experience can be provided to children infected with HIV. Camp
Hope and Camp Hug, offered to a consistent core of camp participants, increases
trust and security, builds self-esteem, strengthens social ties, and establishes
peer networks for the children and the caregivers. The camping experience creates a level of normalcy that creates a well-child environment barring the typical
issues of HIV children, i.e. disclosure, secrecy, stigma, discrimination, ostracism,
and rejection, thus providing a safe environment to discuss critical issues such
as sexuality and death. In addition, camp can provide for a safe and nurturing environment for affected siblings and adult caregivers, allowing for comprehensive
psychosocial programming augmented by recreation activities.
Description of Project: During 1996 and 1997, AIDS Foundation Houston,
Inc., created Camp Hope, a weekend HIV+ children's camp, and Camp Hug,
a weekend HIV+ family camp. Both camping experiences provided a safe and
beneficial life experiences for children with HIV and their caregivers. In 1998,
Camp Hope will begin a six day summer camp program for approximately 60
HIV+ children, ages 6-16.
Description of Results: Narrative and qualitative results point to a positive
halo effect over time of HIV infected children participating in a camp experience
- increasing self-esteem and creating an atmosphere of trust that allows for
sensitive issues to be addressed. The entire family unit benefits from the camp
experience by openly addressing issues of mortality, sexuality, confidentiality,
treatments, and wellness.
Lessons: With proper medical staffing, HIV+ children can have a medically safe
camping experience that leads to an increased sense of security and self-esteem
and provides a well-child environment that facilitates social development. Longitudinal evaluation shows improved life skills and social development resulting
from the camp experience. Children with HIV need a safe environment for life
experiences that lead to a stronger sense of normalcy and acceptance in order
to increase self-esteem.

44211 Pilot project in Thailand to improve the social and
economic condition of older people caring for PLWAs in
their family
Paul Godfred, S. Kaewkantha. Helpage International, Faculty of Nursing, Chiang
Mai University, Chiang Nai 50200, Thailand
Issue: HelpAge International conducted a needs assessment survey, sponsored by World Health Organisation (WHO), Thailand, to determine the impact of
HIV/AIDS on older people in the highly affected district of San Pa Thong in Chiang
Mai Province. Findings included: (a) Out of a total number of 581 PLWHIV/AIDS,
93 are above the age of 60 years. (b) 90% of people involved in caring for their
children and grandchildren are older people. (c) Parenting grandchildren and
economic support to family, a huge responsibility.
Project: HelpAge International, in collaboration with local organisations, has
started a pilot project to assist older people who are caring for PLWA's. The project
aims to improve the economic and social conditions of older people living with
HIV/AIDS and those caring for children and grandchildren as a result of HIV/AIDS
within the family.
Objectives: 1. Provide income generation opportunities to older people in
need of financial support. 2. Strengthen existing groups and associations of older
people and encourage formation of volunteer groups to assist older people caring
for PLWA's. 3. Develop and provide specific information on HIV/AIDS for older
people and support services to assist them in the caring role.
Follow-up: After one year, and from the experience, the programme will be
extended to other districts in the province and hopefully to other parts of the
country.
44212 Child care arrangements of children whose mothers have
died of AIDS
Andrew M. Boxer1, J.K. Burke2, M. Cohen2, J.A. Cook3, K. Weber2,
P. Shekarloo2, H. Lubin2. 1University of Chicago, 4455 N Manor, Chicago; 2Cook
County Hospital, Chicago; 3University of Illinois, Chicago IL, USA
Objective: This study examined the current living situation and custody status of
children whose mothers were deceased participants of the Chicago cohort of the
Women's Interagency HIV Study (WIHS), a US based multicenter study of the
natural history of HIV disease.
Methods: At 4 Chicago medical centers, 340 women were assessed and interviewed biannually. Between March 1995 and January 1997, 24 participants of the
Chicago WIHS seropositive cohort who had children under 18 years of age died,
leaving a total of 53 minor children. The women were 50% African American, 42%
white, and 8% Hispanic. At baseline the majority of these women were single
(58%), had an average household income less than $1000/month (54%), and had
some drug history of using crack, cocaine or heroin (67%). Twenty-nine percent
(29%) of the women had less than a high school education, and the mean age of
the women at death was 36.3 years (s.d. = 5.8 years). Follow-up of the children
occurred between 6/97 through 12/97. At follow up, residential status of 85% (n
= 45) of the children was available.
Results: The large majority (91%) of children resided with family members.
For almost half of these children, the primary and sole caregiver was the child's
grandparent or grandparents (n = 18, 44%). The remainder were divided fairly
evenly among grandparents and biological fathers together (n = 8, 19%), biological fathers alone (n = 7, 17%) and aunts and/or uncles (n = 8, 19%). Only 9% (n =
4) of children were with non-family members and 4% (n = 2) were in foster care.
Less than 25% of these arrangements were formalized through legal procedures
prior to the mothers' deaths.
Conclusion: In this sample, grandparents in particular kept their families
together and prevented the orphans from entering the child welfare system. Formalized planning may assist HIV+ mothers in arranging optimal future care for
their children. Many grandparents and family members may also require local,
state and federal resources to assist them in raising children who have lost their
mothers to the AIDS epidemic.
44213J The role and needs of children in home care for their bed
ridden parents
Caroline L. Aluoch, T. Omondi, R. Odongo. Tapwak, PO. Box 30583, Nairobi,
Kenya
Objectives: (i) To determine usefullness of children as carers for their bed ridden
AIDS parents. (ii) To explore their psychosocial experiences of pending deaths.
(iii) To obtain first hand information of their needs and expectations.
Method: Tapwak community workers, volunteers and selected orphans embarked on a six months questionaire and interviews targeting youths affected by
AIDS in the environs of Nairobi and Kisumu to determine (i), (ii) and (iii)
Results: Governments, NGOs, CBOs and ASOs should intensify human care
and community education on HIV/AIDS so that increased knowledge will assist
communities to take care of PLWHIV/AIDS at home as hospitals capacity in
Kenya is overstretched.