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

270 Abstracts WePeF6747-WePeF6751

XIV International AIDS Conference

WePeF6747 Simbiosis: The experience of a support group for
PWLHAs of poor - resources in Lima
M.J.R. Meiia Jachi, P.J.A. Patti. Mutual Support Group, Domingo Cueto 335 3er
Piso Lince Lima, Peru
Issues: The abstract show the work develope for a Support Group " Simbiosis"
in a Care - Center of Lima Peru for poor resources People.
Description: In Peru exist near to 76,000 people living with HIV and AIDS most
of this people not earn more that $ 1 USD. for daily expenses and are in the age
more productive (16 - 24 years old) only 1% more and less have access to care
and treatment, in this circunstances the HIV+ community response through the
creation of Mutual Self Help Groups like a way for offer emotional support and
care for other HIV+ people.
In the Care Center " Raul Patrucco Puig " dependent of Health Ministery, placed
in Barrios Altos (a poor place in Lima) many HIV+ people receive diagnostic and
counselling, most of this people dont have enough resources for a adequate nutrition and home care.
Here a optimistic group of HIV+ founded the Mutual Support Group " SIMBIOSIS" with the purpose of improve the quality of life of their members and their
relatives, The group provide information, peer counselling and develope actions
for increase the awarness of the communitty and the Health personnel about that
means " Live with AIDS". We developed a coordinate work with the Health workers and authorities, this is very useful for can have a more active participation in
a develope of programs that concerns to our perspectives.
Lessons learned:
- The Groups of PWLHAs are very useful for provide support and resources beyond of the Governement.
- When the PWLHAs are training for improve their own quality of life the changes
are possible.
Presenting author: Raul Aldo Mejia Jachi, Domingo Cueto 335 3er Piso Lince
Lima, Peru, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeF6748I Babies born to HIV infected women in Odessa
region, Ukraine
N. Aryaev, V. Zaporozhan, N. Kotova, E. Starets. Odessa State Medical
University 1212 New York Ave., NW Suite 750, Washington DC, 20005, Ukraine
Issues: The health status of the babies born to HIV positive women are greatly influenced by the health of women. Health care settings with limited resources have
the possibility to focus on the main factors influenced the babies development.
Description: This paper will analyze factors which influence the health status of
babies, born to HIV infected mothers and will make recommendations to improve
the pre- and post-natal care for women and babies born to HIV infected mothers
for health care delivery systems with limited resources.
Lessons learned: The health status of 158 babies born to HIV positive mothers
in 1995-2001 in Odessa region was analyzed. 92% of babies were born after 38
weeks of gestation, 29% of all babies have retardation of fetus development. In
the group of babies with retardation of fetus development, 55% of mothers were
injected drug users, 75% of mothers smoke, 52% of women had Hepatitis B or C,
tuberculosis, syphilis or other STIs in their anamnesis. Compare to the group of
babies without retardation of fetus development - only 6% of mothers used drugs,
10% smoke and 20% of women had above-mentioned infections.
Recommendation: According to the data, the health status of babies born to HIV
infected mothers are greatly influenced by the health status of the women. The
research recommends the specific improvement in prenatal and postnatal care of
women and babies born to HIV infected women for health care delivery settings
with limited resources.
Presenting author: Zoya Shabarova, 1212 New York Ave., NW, Suite 750, Washington DC, 20005, United States, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
WePeF6749 Care and support for orphans and vulnerable
children based on strengthening family and
community support structures in Cambodia
C. Prang. Family Health International, c/o Fhi Cambodia, PO Box 2586, Phnom
Penh I/I, Phnom Penh
Issues: the growing demand for care and support of orphans and vulnerable
children in cambodia is creating the need for new ways to improve coping mechanisms among families and communities. greater knowledge of HIV/AIDS in communities can reduce discrimination against PLWHA but this alone does not help
poor families in supporting orphan children.
Description: increasing coping mechanisms for families and communities promotes sustainability and effectiveness of care and support programs. Providing

knowledge and skills to care for the orphan children combined with supporting
recipient families by integrating other development programs such as microcredit,
agriculture, vocational training, psychosocial support and access to affordable
medical care can help meet families needs in caring for orphan children.
Lessons learned: some poor families volunteer to adopt children orphaned
by AIDS, and some refuse. collaboration with local authorities is one method
of increasing community support for foster care. Community members are now
aware and concerned of the problems of orphaned and vulnerable children, but

due to poverty, they do not have the ability to solve their problems and support
their needs. The creation of village based volunteers can help address these issues, encourage families to foster orphans and provide the knowledge and skills
needed to meet their basic needs.
Recommendations: strengthening the capacity of families, communities and
community based organizations to care for and provide follow up support for
orphan children by collaborating with local religious leaders, organizations providing vocational training opportunities, social workers, and authorities, continues
to decrease discrimination against children affected by AIDS and other chronic
illnesses, and reinforce the importance of children remaining in families and not
in institutions.
Presenting author: Chanthy Prang, c/o Fhi Cambodia, PO Box 2586, Phnom
Penh III, Phnom Penh, Cambodia, Tel.: [phone], Fax: [phone], Email: [email protected]

I WePeF6750

Psychosocial support provided by a group as a
resource to improve adherence to HAART in a
context of universal access to antiretroviral
medication for people living with HIV/AIDS
(PLWAs) from disenfranchised communities, in Rio
de Janeiro (RJ), Brazil

M.P. Fortuna1, C. Carneiro-da-Cunha2, M.I. Linhares-de-Carvalho3.
'Ambulatorio do Banco da Providencia, Ambulatorio da Providencia, Rua
Francisco Eugenio 348, Sao Cristovao 20941-120, Rio de Janeiro, Brazil;
2 0swaldo Cruz Foundation, Rio de Janeiro, Brazil; 3Ambulatorio da Providencia,
Rio de Janeiro, Brazil
Issues: In an outpatient facility in downtown RJ, an adherence group was established to provide support to persons living in the streets/shelters, under parole,
and alcohol and/or illicit drug abusers, helping them to adhere to HAART in a
context of universal access to it
Description: The group began in March 2001 and meets once a week for 90
min. Currently, 32 PLWAs are actively engaged, with a mean age 41 years old;
being 9 of them women and 23 men; 4 of them illiterate and 17 of them with less
than basic education. Main goal is to provide comprehensive care, inserting adherence to HAART in a broad frame. Role-playing and psychodrama techniques
have been used to improve communication and psychological skills and to target
barriers to optimal adherence. Visual arts resources have been used to give "materiality" to complex/subjective concepts/procedures such as immunity, viral load,
side-effects, and untoward consequences of non-adherence
Lessons learned: With the help of visual/drama resources adherence to the
group itself improves substantially as well as adherence to HAART of former
"problematic" patients, for whom HAART is particularly challenging. Adherence
has been worked out in a broad sense of active engagement of PLWAs in their
treatment and true interaction with providers, institution, families, and the broad
community. The group offered the chance to share living experiences, expressed
in the very language of daily life, giving materiality to ideas people previously perceived as beyond their understanding or a privilege of well-educated people/high
or middle-class patients
Recommendations: This successful experience should be carefully evaluated
and extended to other settings where people who are currently under particular risk to be infected with HIV in Brazil, i.e. living in disenfranchised communities, can share living experiences in a dynamic way, using culturally-sensitive
resources and tools
Presenting author: Monica Fortuna, Ambulatorio da Providencia, Rua Francisco Eugenio 348, Sao Cristovao 20941-120, Rio de Janeiro, Brazil, Tel.: +55
21 25687912, Fax: + 55 21 25132211, E-mail: [email protected]
WePeF6751I Re-organizing AIDS care, treatment and support in
Israel
D. Chemtob1, A. Leventhal2, N. Bessudo-Manor1, I. Yust', Y Berlovitz3.
1Department of Tuberculosis & AIDS, Department of Tuberculosis & AIDS,
Ministry of Health, POB 1176, Jerusalem 91010, Israel; 2Public Health Services,
Jerusalem, Israel; 3Deputy Director General, Ministry of Health, Jerusalem,
Israel
Issues: Easy access to specialized care and adequate psychosocial support are
major issues for compliance to treatment for people living with HIV (PLWHIV) in
developed countries. The current Israeli policy of prior administrative agreement
by the Health Maintenance Organizations (HMO's) for each visit and exam, together with getting the drugs at local pharmacies, were seen by HIV professionals
as serious obstacles to treatment, especially for new immigrants, unfamiliar with
this system, who account for more than half of the new cases. A new policy for
treating HIV/AIDS in Israel, designed jointly by the Ministry of Health (MOH), the 4
HMO's and the major AIDS NGO, is expected to remove almost all administrative
barriers for the patient, by supplying her/him with most of the medical and supportive care, including anti-retroviral and other drugs, directly, i.e. at the regional
HIV centers.
Description: The new policy stipulates specialized treatment solely in 7 regional
centers, supervised and coordinated by the MOH. These centers will be responsible for outreach, diagnosis, medical treatment, drug supply, psychosocial support
and follow up for PLWHIV and their relatives and partners, and the costs will be
covered at a flat rate directly by the HMO.