Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

238 Abstracts WePeF6601-WePeF6605

XIV International AIDS Conference

sense of personal accomplishment). AIDS care providers in age range 15-25 yrs.
had more burn-out than other age group, (p<0.05).AIDS care providers which had
problems about care had more burn-out than the group which had not. AIDS care
providers in the organization which had not sufficient care providers had more
burn-out than the group which had enough.There were no statistically significant
difference in the score of burn-out of AIDS care providers in other variables.
Conclusions: The results support the hypotheses that there were burn-out (in
low level) in AIDS care providers. The factors which related to burn-out in AIDS
care providers were age, education, numbers of care providers, the problems of
care, success of work, positive reinforcement from work and character of work.
The recommendation for organization which had care services should focus on
psychological surveillance particularly burn-out in AIDS care providers. Atmosphere of the place, the providing of care time & work loading and relaxation
activities were considered.
Presenting author: Sunsanee Smitakestrin, Aids Division, Moph, Tiwanon r.,
Ampur-Muang, Nontaburi, Thailand, Tel.: [phone], Fax: [phone],
E-mail: sansanee@ health.moph.go.th
WePeF6601I Caring for Us: Counsellor supervision and support
to prevent burnout and ensure quality service
provision
D.K. Boswell1, G.M. Sangiwa2, C. Kamenga2. 1Ms, 2101 Wilson Blvd., Suite
700, Arlington VA, 22201, United States; 2Dr, Arlington, United States
Issues: Support for counselors, as well as the quality of counseling differs greatly
across countries and sites. Counsellors often work in settings with high client
load, minimal workplace support and recognition for their role, unfavourable environmental conditions and with few opportunities for mentoring. Counselling as a
helping profession must improve its commitment toward ensuring care and support from "within".
Description: This paper will describe state of the art approaches to supervision
and support for counselors that also address counseling quality assurance. Examples of current innovative efforts will be cited including the application of a
range of counselor VCT quality assurance tools developed and adapted by FHI
with collaborating agencies. Country specific counselor support interventions will
be cited from experiences within the National AIDS Control Program - Eritrea,
Government programmes in South Africa, Thailand and Zimbabwe, as well as
NGO efforts in Zambia, Kenya and Australia.
Lessons Learned: Burnout can be reduced through investment in counselor supervision and support. A variety of mechanisms (peer support, individual and
group supervision, membership of professional associations, training opportunities, and counselor accreditation) are available in industrialized and resource poor
countries to ensure counselor supervision and support. Quality assurance tools
play a role in supervision as well as providing a mechanism for monitoring & mentor/peer/self evaluation.
Recommendations: National norms & guidelines relating to counselor supervision & support to prevent burnout and to ensure quality counseling for clients are
required. National counseling associations should be strengthened and cadres
of counseling supervisors created. Counseling QA tools require broad dissemination. Donors need to invest in training institutions to increase their capacity to
offer counseling supervision training.
Presenting author: Deborah Boswell, 2101 Wilson Blvd., Suite 700, Arlington
VA, 22201, United States, E-mail: [email protected]
WePeF6602I Battering of HIV infected mothers
A. Mundo', S. Oletto', C. Novello2, G. Bartoli', R. D'Elia', E. Rugal,
O. Rampon', C. Giaquinto'. 'IDipartimento di Pediatria, Padova, Italy;
2Fondazione Moschino, Padova, Italy
Issues: in the last year our centre has dealt with cases of wife battering reported
spontaneously by several mothers, whose children were under medical care.
Description: 8 Italian and foreign HIV infected mothers, either married or cohabiting, with one or more under age children, reported events of psychological,
physical and sexual violence by their partner. Those women expressed anxiety
and worry for their physical safety, personal inadequacy or depression, and fear
of the consequences on the psycho-social development of the children who witness violence. In no case children had been abused by their father. The key issues
are as follows:
1. The kind of violence is the same as the classical one found in literature
2. There is a link between the acceptance of the violent situation and the HIV
infection and this can bring about the following situations:
3. The couple continue to exist because they share the same pathology;
4. The infectiousness and the illness make the women feel sexually and emotionally undesirable and are considered by the woman a hindrance to future relationships
5. The relationship with a non HIV infected man raises feelings of gratitude of the

woman towards her partner and strengthens her feeling of guilt and responsibility
for the violence she has suffered;
6. In some cases, the man blames the woman for the infection and thus justifies
his violent behaviour;
7. It is necessary to safeguard the children who witness violence events between
their parents. The attempt to do this on the part of the woman or of the couple
can leave the children in a critical situation for a long time.

Lesson learned: The integration between hospital care and community care is
necessary The Hospital centre is the first to listen to the worries of the families
whose children are under medical care.
Recommendation: Knowledge about home violence is necessary to start programmes to help HIV infected children who experience these situations.
Presenting author: Anna Mundo, Dipartimento di Pediatria, Via Giustiniani, 3,
35128 Padova, Italy, Tel.: [phone], Fax: [phone], E-mail: sandras @ pediatria.unipd.it
WePeF6603I Who cares for the carer
E.S.M. Magada. Counsellor, 15 Phillips Avenue, Belgravia, Harare, Zimbabwe
Issues: hiv/aids home based programmes tend to neglect the informal carer who
in most cases is a woman and issues are that they do not get time off from caring.
they are fearful of contracting hiv/aids and have other responsibilities in the home
or outside the home. The formal carers if any tend to focus on the patient only.
Description: This paper will look at the informal carers stories. These carers will
mainly be caring for hiv/aids patients and will fall under the informal sector, who
in most cases are relations.
The paper is based on an in depth qualitative interview with an aids carer, a
woman living in a semi-urban town of Chitungwiza. Poverty compounded the
problem of this lady carer.
Lessons learned: The hiv/aids informal carer also feels isolated and stigmatised. The informal carer is in need of counselling and access to information about
hiv/aids and stress management courses.
Recommendation: This research recommends that informal carers be acknowledged for the role they play by the state. They should get access to counselling
and testing services. If they wish, help should be offered for them to form a carers
support group where they can meet and share their concerns.
Presenting author: Elizabeth Magada, 15 Phillips Avenue, Belgravia, Harare,
Zimbabwe, Tel.: [phone], Fax: [phone], E-mail: marge@uz-ucsf.
co.zw
WePeF6604 HIV children born to African parents
S. Oletto1, G. Bartoli', A. Mundo', C. Novello2, L. De Paoli, O. Rampon',
R. D'Elia1, C. Giaquinto'. I Dipartimento di Pediatria, Dipartimento di Pediatria,
Via Giustiniani, 3, 35128 Padova, Italy; 2Fondazione Franco Moschino, Padova,
Italy
Issue: The Italian Register for HIV Infection in Children reports that origin from
an endemic area as risk factor for mother to child transmission in Italy increased
from 0% in 1985 to almost 10% in 2000. Of the over 400 HIV affected children
followed by our centre, since 1995 the percentage of Italian newborns has not
changed, while the percentage of African newborns has increased fourfold and in
2001 reached 50% of the total of the newborns.
Description: 45 cases of African newborns followed for HIV diagnosis were studied. Semi-structured in depth interviews to parents were carried out with an evaluation form reporting personal history, illness experience, mother-child relation,
pregnancy/delivery/feeding, parents' socio-professional situation, chances of cultural integration, social problems within the family
The cases were divided into 3 groups:
1. Children with both parents from Africa (71%). Major social problems have been
encountered here, mainly: economic problems (32%), housing problems (59%),
mothers without residence permit (23%) and speaking no Italian at moment of delivery (45%), extra-marriage relationships (18%). 50% the newborns have brothers and sisters living in the family's native country (50%). 100% of the mothers
fear discrimination, 68% experience feelings of loneliness and 64% are unemployed.
2. Children born of African mothers and Italian fathers (20%) from regular of extramarriage relationships, with cultural integration problems.
3. African children in Italian foster families (9%).
Lessons learned: The real problems reported by the families often hide psychological problems caused by traumatic experiences of being mothers, immigrant
African HIV-infected women in Italy. Many parents showed difficulties in expressing their emotions and problems.
Recommendations: Further work is necessary to draw up guidelines for the
health care service to deal properly with African immigrant parents of HIV affected children.
Presenting author: Serenella Oletto, Dipartimento di Pediatria, Via Giustiniani,
3, 35128 Padova, Italy, Tel.: [phone], Fax: [phone], E-mail:
serviziosociale@ pediatria.unipd.it
WePeF6605 Therapeutic group with children: story telling
E.M.B. Padrho', E.M. Sigarini2. 'Ne/son Branco e Angelina Terezina Branco,

Rua Romeo Puigari, 111, Jardim da SaOde, CEP: 04164-000, So Paulo, Brazil;
2Antonio Sigarini e Maria Aparecida Sigarini, So Paulo, Brazil
Issue: The organization of AIDS pediatric assistance, trying to respect anxieties,fears,desires and needs of children and their parents or caretakers has the
scope of providing better aderence to treatment and better quality of life for pacients.