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

266 Abstracts WePeF6729-WePeF6733

XIV International AIDS Conference

Conclusions: Improving the organization and quality of medical services can
have a major impact on adherence. These factors appear to be at least as important as patient characteristics in determining adherence and deserve close
attention.
Presenting author: Regina Tellini, Secretaria de Sadde, Av. Presidente Kennedy,
2030, Praia Grande - Sdo Paulo, CEP 11702-200, Brazil, Tel.: [phone],
Fax: [phone], E-mail: [email protected]
WePeF6729 National strategic plan of HIV/AIDS control in
Morocco
K. Alami. Residence Mourabitine Appartement 48, Rue Mourabitine, Hassan,
Rabat, RABAT Morocco
Issues: The HIV epidemic in Morocco is a low prevalence rate as it is less than
1%, but during the last few years an increase of the AIDS cases and HIV prevalence is observed in some provinces. Since 1987, the country has developed a
national expertise in order to address the problem. This was particularly the case
for the blood safety, the diagnosis and treatment of STI, formal and the informal
education, counselling and voluntary HIV testing and access to ARV therapy.
The national AIDS control programme has realised recently a process of situation
and response analysis and formulated a National strategic Plan (NSP).
Description: The results of the process have allowed the national team to formulate a National Strategic Plan for the years 2002 to 2004. The guiding principles
are based on focusing the most vulnerable groups in the most affected areas
and providing them essential activities. The package of essential activities has
been defined in the NSP for HIV prevention as well as for AIDS impact reduction.
This Plan has also formulated the general strategies for the essential activities
quality insurance as well as for the increase of the geographical coverage, the
political advocacy, the social mobilisation, the cultural appropriateness, the capacity building and resources mobilisation. However there are some areas which
have needed specific strategies such as the accelerated access to ARV, the social communication, the counselling and voluntary and anonymous testing, the
research and innovation.
Lessons learned: Its a very important process for national AIDS control programme and the involvement of all the concerned NGOs and sectors in all the
steps of this process is crucial of the national strategic plan.
Recommandation: Specific strategic objectives and steps have been adopted in
order to guide the formulation of the operational plans of the different actors at
the central as well as the local levels.
Presenting author: KAMAL ALAMI, Residence Mourabitine Appartement 48,
Rue Mourabitine, Hassan, Rabat, RABAT, Morocco, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeF6730 Prevention of mother-to-child transmission of hiv
(pmtct) including community mobilization and
enhanced care and support: experience from
abidjan, cote d'ivoire
A.V. Noba1, H. Angoran1, D. Billy1, C. Maurice', T. Coulibaly-Djenebal,
223 3 13
H. Mangle2, J.M. Tanoe2, N. Shaffer3, M. Nolan, E.R. Ekpinil, S.Z. Witkor3,
M. Laga3. 1Projet Retro-ci, Projet Retro-ci, 01 b.p. 1712, Abidjan 01, Cote
divoire; 2 Hopital general de Port-Bouet, Abidjan, Cote d'voire; 3Centers for
Disease Control and Prevention, Atlanta, United States
Issues: PMTCT pilot projects are needed to guide a nationwide implementation.
The objective of this project was to integrate a PMTCT package (HIV test, AZT,
replacement feeding) in a maternal and child health center (MCHC) strengthened
with community mobilization, medical and psycho-social support, and referral systems.
Description: The program started in February 2001 by the training of health care
workers (HCW) to develop skills and tools for monitoring and evaluation. The
program includes: group counseling sessions, free HIV testing with same-day results, provision of free AZT, counseling of and support to mothers on infant feeding
options, and free infant formula. A referral system was created, and community
mobilization is conducted to improve the uptake of the intervention.
Lessons learned: From April to September 2001, 3,914 pregnant women had
received a group counseling. Of the 698 in their third trimester of pregnancy who
were offered HIV testing, 491 (70%) accepted to be tested. 10% (49/491) of them
were HIV-positive. Of the 27 who had delivered, 22 (82%) took AZT. Only 33%
(9/27) of mothers formula-fed their children. Only 6 (1.2%) partners were tested
for HIV. Physical infrastructure development was critical to improve work conditions of HCWs and to ensure confidentiality and privacy. Community mobilization
involving NGOs, political and religious leaders, local radio and associations of
persons living with HIV/AIDS to promote PMTCT have been established to enhance the program uptake. Finally, a referral system is being developed to care
for mothers and their partners, and children.
Recommendations: Efforts should be made to include community mobilization

and referral to support and care when implementing PMTCT programs.
Presenting author: Av Noba, Projet Retro-ci, 01 b.p. 1712, Abidjan 01, Cote
d'Ivoire, Tel.: [phone], Fax: [phone], E-mail: [email protected]

WePeF6731I The L.I.F.E. Program~: An integrated HIV
risk-reduction and immune-enhancement health
counseling program based on psycho-social
cofactors
J.M. Leiphart, C. Garfield, C. Sandoval. Shanti, 730 Polk Street, San Francisco,
CA, 94109, United States
Issues: Prevention: recent epidemiological data show that HIV infections are on
the rise, particularly among gay men, youth & men of color. Public health planning & funding groups have requested innovative & science-based HIV prevention
models. Psycho-social health counseling has emerged from health psychology
research & is now being implemented for both HIV(-) & HIV(+) people. Treatment: although HAART has provided significant health improvement for many
HIV+ people, many others receive little or no benefit, and/or experience difficult
side-effects, and/or develop drug resistance. A new, complementary treatment
approach - psycho-social health counseling - has shown ability to enhance immunity, slow or halt disease progression, delay symptom onset & extend survival
time in HIV.
Description: The L./.FE Program is an integrated HIV risk-reduction and
immune-enhancement health counseling program; it is simultaneously a "prevention for positives" and "complementary treatment" intervention. L.I.F.E. is based
on PNI & prevention research. Participants are taught how psycho-social cofactors influence both immunity & sexual decision making; they assess performance
on 18 psycho-social cofactors, develop performance improvement plans, and receive 1-1 counseling.
Lessons learned: L.I.F.E. has operated for 11 years in San Diego & San Francisco, California, with 1,400 HIV+ people participating. Program editions operate
for gay men, women, people of color, hemophiliacs, and substance users. The
program is popular with clients, has a high retention rate, and shows efficacy in
reducing risk behavior, improving health behavior performance, enhancing immunity, and reducing symptoms.
Recommendations: HIV prevention & treatment both could benefit greatly from
new programs that incorporate psycho-social cofactors. We are exporting L.I.F.E.
to 6 additional California cities, and have capacity to export L.I.FE. internationally.
Presenting author: Jeffrey Leiphart, Shanti, 730 Polk Street, San Francisco,
CA, 94109, United States, Tel.: [phone], Fax: [phone], E-mail:
[email protected]
WePeF6732 Solution: Comprehensive intergrated HIVAIDS
interventions urgently needed
J.Z.L. Nq'weshemi. Christian, RO.Box 11958, Mwanza, Tanzania
Issues: Hypothesis for the continued HIV/AIDS spread in sub-Saharan Africa is
that the current numerous but sporadic HIV/AIDS interventions are all very limited/inadequate in geographical and content coverage. One finds in one or few
towns, high transmission areas, work places or communities with one or few interventions such as research, peer education, voluntary counseling and testing
or home community care. Such isolated and sporadic interventions will not curb
HIV spread nor have AIDS impact mitigation. In most cases such interventions
are not well integrated nor sustainable beyond the project phase(s).
Description: Eleven years of experience from the Tanzania -Netherlands Support Programme on AIDS Control (TANESA) and Magu district in Tanzania and
from elsewhere requires developing comprehensive integrated HIV/AIDS intervention package in the formal and informal sectors. This include mainstreming
of the interventions, action plans and budgeting. It should also include improving
manpower remuneration as priority resource in any national de velopment enterprise.
Lessons learned: At the conference we will present TANESA/Magu documented
comprehensive HIV prevention package costing USA $ 111,000 was required to
cover a district of approximately 300,000 total population. There was additional
cost for treatment and care.
Recommendations: In order to curb the current HIV spread and mitigation of
AIDS consequences in sub-Saharan Africa comprehensive, integrated interventions packages that include research, prevention, treatment and care are urgently
needed. This requires policy decisions to ensure the needed coordination of players and resources at community, national and international levels.
Presenting author: Japheth Ng'weshemi, PO.Box11958, Mwanza, Tanzania,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeF6733 Clinical guides for management of pregnant
women with HIV infection
E. Hoff1, J. Mandala Kol2, J. McIntyre3, R Van Look2. 1World Health
Organization, AFRO, WHO/AFRO, Parirenyatwa Hospital, PO Box BE 773,
Belvedere, Harare, Zimbabwe; 2 World Health Organization, HQ, Geneva,

Switzerland; 3University of Wiwatersrand, Johannesburg, South Africa
Issues: To support the integration of interventions for reducing the risk of transmission of HIV from the mother to her infant, the World Health Organization
(WHO) has developed clinical guides targeting (1) health professionals who work
with pregnant women antenatally, during delivery and postnatally and (2) program
managers responsible for maternity services.
Description: The four clinical guides cover: Antenatal Care, Voluntary Coun