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

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appropriate behavioral data, and over-confidence in the
protective effects of social and cultural conservatism have
dictated low priority for HIV/AIDS. This paper is a first attempt
to evaluate the risks of an epidemic in 9 MENA countries and
its potential economic costs, while at the same time assessing
the welfare implications of two preventive interventions.
Methods: Model of optimal growth that incorporates an
HIV/AIDS diffusion component where the virus transmission
occurs through sexual intercourse and the exchange of infect
needles among IDUs. Simulation design takes into account
that the economy and the epidemic create a complex system
that is structurally unpredictable. We explore large regions of
the parameter space and characterize the ensemble of
plausible futures given countries' initial conditions.
Results: Only in 16% of the cases explored the prevalence
rates in year 2015 would be below 1%; in 50% of the cases
prevalence rates would be above 3%. On average, GDP losses
across countries for the period 2000-2025 could approximate
35% of today's GDP. In all countries it is possible to observe
scenarios where losses surpass today's GDP. We show that
interventions such as expansing condom use and access to
safe needles act as an insurance policy that increases social
welfare. We also show that delaying action for 5 years can cost
the equivalent of 6 percentage points of today's GDP.
Conclusions: i) the risk of an increase in the HIV/AIlDS prevalence
rate in MENA countries is real; ii) expected costs over the next 25
years could be considerable; iii) there are preventive actions that
can be implemented and the costs of these actions would be
more than compensated by the savings they generate; and iv)
the time to act is today when prevalence rates are still low.
Corresponding author: Robalino, David, 1818 H Street, NW,
Washigton, DC - 20433, United States, Tel: +i 202 458 134o,
Fax: +i 202 477 0036, Email: [email protected]
Track F
[ LBPEF9051 1
Training program for the local pharmacist on syndromic case
management can be very helpful in STD/HIV prevention
program: Bangladesh experience
Chowdhury, AsifAltaf, Jana, Smarajit (Bangladesh)
Issues: Many STD patients including the members of the high risk
and bridging population visit the local pharmacist for the
management of their STDs. And most of these pharmacists do not
have any training on Syndromic case management.
Description: CARE-Bangladesh is implementing HIV prevention
program for the high risk groupsex workers, IVDusers and bridging
population, truckers, sailors for some time. STD case management
by qualified doctor is one of the important component of this
program. Our peer outreach workers are motivating their peers to
use our clinical facilities. Baseline survey showed that all of these
groups have quite high number of STD and also practice very risky
sexual behavior. Most interestingly most of them 6o% do nothing
for the disease, they are suffering. Majority of the rest went tolocal
pharmacist for treatment. So we fell, only motivating the peers by
outreach to use clinical facilities will not help us, so we start
thinking differently. After that we conducted a survey among the
local pharmacist in our working area and found that most of the
pharmacist are just medicine seller and have no formal training.
They also know nothing on syndrome management but prescribing
medicine for STDs causing problem in drug compliance resulting
into reinfection. So a short training prog.on syndromic
management for local pharmacist in our working area is introduced.

Lesson learned: After introduction of this,we have found they are
now prescribing the right drug fo right duration to patients who are
suffering from STDs. They are also talking about drug compliance
because if one of their patients is completely cured then he/she is
telling about this pharmacist to some of his friend. They are also
referring the complicated patients to our clinic. All these measures
have ultimately improved the quality of our program.
Recommendation: CARE-B will expand the program & will work
as resource org. to help others to organize this type of training
in the country.
Corresponding author: Chowdhury, Asif Altaf, 49/1 Babar Road,
Mohammadpur, Dhaka-12o7, Bangladesh, Tel: + 880 2 8114311,
Fax: + 880 2 8114183, Email: [email protected]
SLBPEF9052 1
The activities of HIV/AIDS counselling and care center
of Kermanshah city, Iran for Prevention, Care and Support
of HIV cases, their families and high risk groups
from Oct 2000ooo until March 200oo2
Alae, Kamiar, Alaei, Arash, Mansoori, Davood, Mothamedi Heravi,
Mitra, Namdari Tabar, Hengameh (Islamic Republic of/ran)
Issues: HIV/AIDS care centers has developed with sharing of
peer practices and general population and articulated
problems faced by HIV cases and their familes.
Description: In this program we have coverd 363 HIV positive
patients that by their peer practices we have had 3002
voluntarily counselling in drug users an 59 counsultation in
multipartners, among them 1762 cases had IDU and other high
risk behaviours that were tested voluntarily, by this way we
found 202 new HIV cases, that are 65% of all our case finding.
We have had 6619 repeated counselling and 959 family
counselling. The care activities consist of 265 third HBV
vaccinated and 85 have received first or second doses. All HIV
cases have evaluated for serology, biochemistry and immune
statuse, CXR and PPD test. 34 cases had clinical TB and 134
received INH prophylaxis, 50 PCP prophylaxis, 15 HAART.
10766 free charge syringe and 6274 codom have been
distribution. 76 HIV positive males have non infected wife
during this two years. One mother and two babies have
received HAART prophylaxis. Other activities of H IV cases 20
health care workers and 2 wife received post exposure
prophylaxis. The sharing of HIV cases consist of primary
counseling with new cases, collection of syranges, group
therapy, music and exercise team, professinal support by
sharing of Red Crescent and student comittee.
Lessons learned: The peer based projects has led to effective
ways to care, education and support of people living with HIV.
Recommendation: This paper recommends that practice of
peer development be applied.
Table:The condition of case finding in Kermanshah province
from Iran

Distinguished site
Counselling center
Sentinel site of prisons
Sentinel site of TB clinic
Specialist refer
Blood bank
Other provinces
Total

Number Percent
202 65
64 20.2
5 1.6
17 5.5
16 5.1
5 1.6
309 100oo

Corresponding author: Alaei, Arash, No.72, Sarab Ghanbar St.,
Kermanshah, Islamic Republic of Iran, Tel: [phone], Fax:
[phone], Email: [email protected]
XIV International AIDS Conference BARCELONA - JULY 7-12

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