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

[ LBPEF90531
A rapid study of the knowledge and attitudes about HIV
of the leaders of muslim communities in India
Alam, Shabab, Manning, Greg, Durrany,
Khurramshah, Siddiqui, Nazma, Siddiqui, Gulafshan, Akhtar,
Naved, Alam, Mehtab (India)
Issues: Religious leaders are important members of Muslim
communities. They can act as catalysts or barriers in the
development of responses to HIV. They do not exert their
influence in isolation, but as parts of broader networks of
influence. The need for a multi-sectoral response to HIV
extends to Muslim communities because of specific community
structures and not because of peculiar risks.
Description: A rapid study was undertaken to inform a strategy
for Muslim communities in India to support effective HIV
prevention and care activities. It aimed to identify the
knowledge and attitudes about HIV and responses to HIV of
influential members of two different Muslim communities,
linked by the families who live and move between them. The
study also set out to identify and acknowledge the different
roles of various leaders.
Lessons Learned: Knowledge about HIV is largely restricted to
medical practitioners. HIV is perceived as a medical and a moral
issue, with medical practitioners and religious leaders waiting
to be consulted on it rather than actively disseminating
information. Teachers and family heads are eager to learn and
communicate about HIV, yet do not have the information to do
so. Islam offers a foundation for community care. Men and
women have different knowledge, needs and roles. There is
little identification between the communities and HIV, which is
scientific information without a local history, or a visible human
face, and is understood as? coming from outside?
Recommendations: Intentionally disseminate information in
Muslim communities to create an enabling environment within
the existing structures. Affirm the roles of religious leaders and
medical practitioners as consultants, by enabling them to
provide good information. Affirm and develop the latent inquiry
within the community so they can access good information.
Awareness about HIV should include a social dimension as well
as medical and religious dimensions.
Corresponding author: Alam, Shabab, C4/53, Safdarjang
Development Area, New Delhi, 11o0016, India,
Tel: [phone], Fax: [phone],
Email: [email protected]
SLBPEF9054 ]
Implementing an HIV and AIDS treatment programme
at Debswana diamond company
Fantan, Tsetsele, Villafana, Tonya (Botswana)
Issues: To determine the impact of the HIV and AIDS epidemic
on its mining operations, Debswana Diamond Company
undertook a voluntary and anonymous saliva screening of all
employees. Information gained was used to determine the
feasibility of providing anti retroviral therapy to HIV infected
employees.
Description: Between 1996 and 1999 Debswana management
documented increased HIV/AIDS related morbidity and
mortality among its workforce. Ill-helath retirements due to
AIDS related conditions were 40% in 1996 ad 75% in 1999. In
1996, 37.5% of the deaths were AIDS related, climbing to
59.1% in 1999. Thus a voluntary anonymous saliva test was

conducted at the 5 operations including Head Office in May
1999 to establish prevalence levels by grade and age. This
screening was repeated in June 2001.
Lessons Learned: In May 1999 HIV prevalence was found to be
28.8% across all operations surveyed, while in June 2001 the
overall prevalence was 22.6% (the significance of this decrease
in unclear). Overall participation in these surveys was 74% in
1999 and 72% in 2001. In response to the results of the 1999
survey, the company established a treatment programme in
May 2001 to provide triple therapy for each HIV infected
employee with a CD4 count of 350 or less, or an AIDS defining
illness as well as treatment of one legally married spouse. This
is the first programme of its kind in Sub-Saharan Africa.
Currently, 212 patients are registered in the antiretroviral
programme, 156 patients are on triple therapy, the rest are
being monitored. 72% of those registered are male, 20% are
spouses (male and female).
Recommendations: The company is seeking to improve the
uptake of the antiretroviral treatment programme and to
encourage voluntary counseling and testing among employees.
Employees have also expressed the need for management to
offer new strategies to help HIV negative employees remain
negative.
Corresponding author: Fantan, Tsetsele, PO Box 329,
Gaborone, Botswana, Tel: [phone], Fax: [phone],
Email: [email protected]
SLBPEF9055 ]
Strategies to support treatment adherence in newly released
HIV-positive prisoners
Cloutier, Mark, Vandenberg, Guy (United States)
Issues: HIV-positive prison- and jail- inmates who have been
receiving HAART while incarcerated face a number of
challenges upon their release. Access and adherence to antiretroviral therapy will often take a back seat to finding shelter,
nutrition, income, drugs for those who are addicted, and reestablishing family connections.
Description: Two transitional programs attempt to construct a
compliance strategy that fits developmentally with the clients
needs. The following interventions were implemented to
ensure access to therapy and promote adherence:
- Direct linkages were established between correctional
medical providers and community based primary care
providers who would provide care in our transitional program
after discharge
- All clients were enrolled in the AIDS Drug Assistance Program
(ADAP), and/or re-enrolled in California's MediCal insurance for
medically indigent clients to eliminate cost and access barriers
- Relationships were established with specialty pharmacies
who deliver medications to clients private and/or communal
residences
- The transitional program offer temporary housing, primary
medical care, nursing care, adherence counseling, case
management, psychiatric services, referral to drug abuse
treatment and on site Medi-Set filling.
Lessons Learned: We were able to ensure that all clients
served in these programs, who, did not get lost for follow-up
(i.e.: absconded) immediately upon release, received
prescriptions and nurse case manager support of specific
behavioral strategies. Despite these interventions, many
clients still did not take their medications as prescribed.
Recommendations: The psychological and behavioral impact
of the change from receiving directly observed therapy in the

Program Supplement