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

268 Abstracts WePeF6739-WePeF6742

XIV International AIDS Conference

Description: The Department of Experimental Medicine and AIDS Resource
Center has initiated a MTCT program at Namakkal District Headquarter Hospital. As many women visit the outpatient department at the same time, it is difficult
to do individual pretest counseling. Pregnant women in the rural areas need repeated counseling for a better understanding of HIV/AIDS. After counseling many
of these women are willing to get tested for HIV. When ELISA is used for screening, the women collecting their test results were comparatively lower than when
rapid tests are used and the results are given on the same day. Due to cultural
practices, pregnant women hesitate to take AZT in the last trimester of pregnancy
Women living in far off villages find it difficult to attend the follow up clinic due to
long distances. Another factor is that women do not attend the follow up clinic as
they depend on daily wages.
Recommendation: Group counseling is preferable in a rural hospital followed by
individual counseling. Offering test results on the same day improves the number of women collecting their test results. Repeated counseling on the benefits of
antiretrovirals is important for drug adherence. Incentives for local transportation
and meal expenses will improve the follow up of the seropositive mothers and
infants.
Presenting author: Vijaykumari J J, Department of Experimental Medicine &
AIDS Resource Center, Tamil Nadu Dr. MGR Medical University, No.69, Anna
Salai, Guindy, Chennai-600032, Tamil Nadu, India, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeF6739 Program of adherence to the antiretroviral
treatment
S.V. Vera, L.P. Polo. Ambit Prevenci6, Robador, 15, 08001, Barcelona, Spain
Approach to the problem: We present a program to strengthen the adherence
to the antirretroviral treatment. This program focuses on those parenterally drug
users and former drug users who live in a poor situation in the slum quarters of
Barcelona, mainly in Ciutat Vella.
Justification: In Catalonia, AIDS still affects mostly parenterally drug users, who
are also the most important group of AIDS transmission. An adequate adherence to the treatment is crucial to get therapeutic levels in the antiretroviral drug.
Some people has to get over some difficulties to get a good adherence to the antirretroviral treatment because of the sociodemographic features of the marginal
population.
Descriptions: A study on behaviours related to the HIV transmission (Ambit Prevencio, 1998) was carried out, taking as a starting point a street program of exchange of syringes in Barcelona. In conclusion we saw that it was necessary to
design and implement a "Program of Adherence to the Antirretroviral Treatment"
adapted to the characteristics of these people. With this program we deal with the
medical matters of the HIV and the fulfilment of the antirretroviral treatments, and
also the underlying deficiencies that come from their way of life.
Lessons learned:
- It's easier for those who have met their main needs to gain autonomy to be
responsible of their health.
- If you don't meet your main needs it's very difficult to follow the therapy because
of the lack of stability in your everyday life.
Advices:
- To restore the stability of a person is necessary to work with a comprehensive
approach to deal with the multiple causes of his marginal situation.
- Professional must provide a constant, close and long-term help to get and keep
a good adherence to the antirretroviral treatments.
Presenting author: Silva Vera Chafer, Robador, 15, 8001, b=Barcelona, Spain,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeF6740 Double impact: integrating prevention, community
sensitization & mobilization for sustainable
community based care and support by service
delivery for people living with HIV/AIDS & affected
families in rural Andhra Pradesh, India
A.R.S. Solomon1, S. Vijaya', A.R.S. RojaSolomon1, D.S.S. Alfred1,
MS. Kumari', G. Xavier2, R. Solomoon1. 'SHADOWS, Chriala, India; 2Loyala,
Chennai, India
Issue: The PLHA are unable to come out and access the home care services
due to fear of stigmatization and isolation from Community. The lack of information, sensitization and community mobilization causes lack of acceptance inside
the community. Despite the a gap there is no integrated approach simultaneously
for providing treatment, prevention care and support in Andhra Pradesh
Description: SHADOWS, a service organization, started community-based care
and support after the Participatory Community Assessment supported by International HIV/AIDS Alliance. SHADOWS focus on 4 areas. Capacity building for indirect and direct services delivery by volunteers and staff respectively. Community

Mobilization to bring community responses. Linkages with other care providers to
optimum utilization of existing services. Providing emotional support and health
care management to PLHA and affected family members at home making cost
effective. The team during home visits gives the community information, sensitizes for community mobilization. Combining top to bottom and bottom to top
approaches to create enabling environment. Once the factor of fear due lack of
information is gone, the community started to accept the PLHAs
Lessons learned: The volunteers should be carefully selected with capabilities
for attaining good results. The 10 volunteers and 2 CBO, SHADOWS selected
who provided services and motivated the community for care and support. Hence
integrating prevention, care and support, and treatment is very successful and
can be adopted in any developing country. It learned that the clients for voluntary
testing and counseling has increased. The impact mitigation resulted only due to
integrated approach
Recommendation: HIV/AIDS prevention and community sensitization and mobilization should be integrated. The entire community should be reached and the
community-based leaders should be involved
Presenting author: Raja Solomon, Solomon Nursing Home, Solomon Centre,
Chirala, India, Tel.: [phone], E-mail: [email protected]
WePeF6741 Psychological /Neuropsychological interventions
request for HIV+ patients in the HAART age
M.G. Giulianelli, T Speranza, A. Del Maestro, G. Tosi, P. Balestra, R. Balzano,
I. Coletta, M.G. Zaccagnini, A. Antinori. INMI, Rome, Italy
Background: To analyze changes interventions request to the Psychological Service (PS) made by doctors HIV for positive patients, with the aim of a new programmation and organization.
Methods: We have evalueted reasons for interventions requests to the PS between January 1999 and December 2001. Reasons for interventions were classified as shown in the table.
Results: zie table below.
There was a decrease in requests for depression and suicide attempt, an increase of requests for anxiety/depression and for psychological aid in adherence
to therapy (as showed in the table)
Conclusions: In the last years the trend to chronicity of the disease has determinated a different prevalence of psychopatological patterns. Moreover new
combination therapies and a more appropriate utilization of the diagnoistic tests
as well the use of prognostic markers have allowed a better clinical management
of HIV+ patients.
Decrease in depression and in suicide attempt could be correlated to the perception of beeing infected given the belief that one can live with HIV disease.
Increase in anxiety is correlated to the need of adaptation to the new situation.
Increase of Neuropsychological examination due to diagnostic reasons and to the
need of monitoring HAART effects on cognitive functions can be correlated to the
implementation of the interventions offered as well to the increase of the number
of patients followed.
Greater attention must be given to interventions for adherence aid to therapy.
Presenting author: marinella giulianelli, via E.Paladini, 81, 00149 ROME, Italy,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeF6742I Peer support as an important strategy to
effectively mobilise the needed resources and
motivate people to respond positively
A. Sharma', A. Kadam2. 1, D-5, Banganga C.H.S Govando Station, Road OPD.
U.S. Vitamin, Denoar-Mumbai -88, Mumbai, India; 2Swayam Sidoha
Sangmatana Plwma Project, Mumbai, India
Issues: AIDS cases in India 3.86 million HIV infections in the country. Mumbai
city with the population of more than 12 million is estimated to have 0.4 million
HIV infected people facing social, economical, psychological and health related
problems.
Description: The Mumbai Districts AIDS Control Society has motivated a Peer
support project of 500 infected people thereby 1500 affected family members with
cost of $ 8000/yearly budget. Looking at the needs and capacities of support
group, guidelines were developed. The components of Counselling, networking,
advocacy, training the health care staff and social mobilisation are addressed.
This strategy demonstrates addressing the needs of PLWH/A, which in turn works
for the HIV prevention.
Lessons Learned: It is possible to implement a cost effective PLWHA peer support project. Emotional needs of PLWHAs are better met, feel supported & feel
responded positively. The implementation needs to be extra sensitive about the
members of the support group. This project can be a model and a training centre
for the new peers. The commitment of the facilitator is important, display better
results in a small package.

Abstract WePeF6741 - Table
No. Depr. Suicide attempt Anx/Depr Anxiety Adherence Illegal Drug Abuse Alcohol Abuse Anorexia/Bulimia Couselling Neurops. ex. Others reasons
Inter. request. % %% % % % % % % % %
1999 267 30.6 1.4 6.9 4.6 0.4 2.2 1.8 1.4 7.2 22.1 21.2
2000 364 19.2 0.8 9.1 5.5 1.4 5.2 2.7 1.6 5.2 37.1 12.2
2001 402 15.9 0.2 13.7 11.9 1.74 7.2 1.9 0.9 3.98 35.07 7.21