Program Supplement [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

if they are addicted to glue. Misconceptions about HIV, AIDS and
STDs abound, although many children reported having had
symptoms that may relate to them. One-quarter of children
reported inflamed genitalia, one-third reported skin infections,
and one-half reported chest infections.
Conclusions: There is an urgent need to provide children with
sexual health education and protective measures while living on
the streets. Efforts to assist them permanently off the streets
must address the complex reasons why they are there.
Corresponding author: Kudrati, Mustafa, PO Box 11936, Mwanza,
Tanzania, Tel: [phone], Fax: [phone],
Email: [email protected]
[ LBORo5 ]
Introduction of voluntary counseling and testing services i
n a refugee camp in Kenya
Jagwer, Gregory, Murethi, George, Mwanyika, Esther, Nekesa,
Felister, Marum, Elizabeth (Kenya)
Issues: Despite their vulnerability to HIV infection, refugee
populations in Africa generally do not have access to specific
HIV prevention services such as voluntary counseling and
testing (VCT). There are concerns that refugees may refuse VCT
due to fear of discrimination.
Description: The International Rescue Committee (IRC) provides
medical services to 65,000 refugees from 8 countries living in
Kakuma refugee camp in northwestern Kenya. The "Lost Boys of
Sudan" were processed for resettlement here, and there are still
many single young men in the camp, unlike the more typical
higher concentration of women and children in refugee
situations. AIDS awareness campaigns have been conducted in
Kakuma and knowledge of AIDS is high. In April, 2002, IRC
opened a VCT site, with technical support from the CDC. Health
workers publicized the program in marketplaces, schools,
women's groups, and through community leaders. Two different,
rapid, whole blood tests are used simultaneously in order for
clients to receive confirmed results within one hour.
Lessons Learned: Kakuma's refugee population has been
receptive to VCT. Between April 2 and May 24, a total of 318
clients were seen, of whom 82% were male, reflecting the
preponderance of males in the camp; 90% of clients were aged
30 or younger. Eight clients (2.5%) were found HIV+; 6 male
and 2 female, all aged under 40. Two of the H IV+ clients have
been young males living alone without their families; the
support systems in the camp are inadequate for these young
men. IRC has started a Post- Test Club and offers on-going
counseling and medical care to address this gap.
Recommendations: The acceptance of VCT services in Kakuma
suggests that it is important to offer this service to refugee
populations, especially those who have sought refuge in or
from high prevalence regions. Special services are needed for
HIV+ refugees, especially those separated from their families.
Corresponding author: Jagwer, Gregory, International Rescue
Committee, P.O. Box 62727, Nairobi, Kenya,
Tel: [phone], Fax: [phone],
Email: [email protected]
Let's talk about the Big Thing: a narrative model of South
African HIV support
Squire, Corinne1, Daniel, Lumka2 (United Kingdom; 2South Africa)
Issues: About i in 9 South Africans live with HIV. With relatively
highly developed infrastructure, health and social services, the

country is an important model for African HIV strategies. After
initial silence and stigma, awareness and service development
are increasing and will expand following recent government
decisions to roll out some treatments. However, H IV support
services remain limited, and open communication about HIV is
still problematic.
Description: In 2001, 33 semi-structured interviews about H IV
support experiences, expectations and requirements were
conducted with people infected or affected (3) by HIV, 4/5 of
them women, recruited through HIV service organisations,
clinics and chain referral. In May 2002 followup telephone
interviews were conducted with a subsample. Interviews were
content- and narrative-analysed to ascertain types of support
used, wanted and valued, and narrative forms deployed.
Lessons learned: Interviewees valued non-time-limited peer
support, especially combined with skills-building and income
generation; peri-diagnostic counsellor support; employment
support; and family (rather than friendship) support. They
showed good knowledge of medical support and sophisticated
strategies for maximising treatment opportunities. These
evaluations were encoded in a range of culturally powerful
story genres that drew on popular media, religion, traditional
medicine, and political struggle.
Recommendations: HIV positive, negative and unknown-status
South Africans would benefit from extensive strategic
development of diverse, open and ongoing communities of
interpretive support, including virtual, media 'communities,'
that promote multiple genres of HIV storytelling. Such
storytelling 'communities' can encourage disclosing and nondisclosing acceptance, testing, risk reduction and treatment
adherence, especially when operating alongside treatment
opportunities and training and employment schemes.
Corresponding author: Squire, Corinne, 18 Merton St,
Cambridge, CB3 9JD, United Kingdom, Tel: [phone],
Fax: [phone], Email: [email protected]
LBO O7
The Journey of Going to scale from 28 communities to looo
communities in Eastern Zambia: A systems thinking approach
and Lessons Learned in 2002
Chikunjiko, George, Orobaton, Nosa, Mukuka-Chilaika,
Chilandu, Mutonyi, Simon, Mukwakwa, Catherine, Mlewa,
Andrew, Daka, Daka (Zambia)
Issue: In October 2oo001, Lundazi District Government in Eastern
Zambia requested Thandizani NGO to take its highly successful
community-based HIV/AIDS prevention and care program to
scale. The district government cited that it was no longer
equitable for the program to remain in one area of the district
given that lo% of adults 15-45 years in Thandizani areas have
used VCT services compared to less than 1% in non-Thandizani
areas. The NGO decided to utilize a systems-thinking approach
to implement scale up.
Description: Thandizani NGO was formed in March 1999.The
NGO empowers communities and mobilizes tacit knowledge for
community action. Thandizani also supports community care
networks of care and support as franchises. A systems map
including all key players, partners, structures of influence, and
the interconnections and patterns of collective behavior that
make VCT and people-centered care possible, was developed.
Lundazi District took the unprecedented step to appoint the
Thandizani Director as HIV/AIDS coordinator for the entire
district, creating a new public-private partnership. Briefing
seminars for all ii traditional chiefs were held and
XIV International AIDS Conference BARCELONA - JULY 7-12

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