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

XIV International AIDS Conference

Abstracts WePeF6752-WePeF6756 271

Lessons to be learned: We hope that by minimizing administrative procedures
(including access to drugs) and increasing psychosocial support, we will be able
to increase significantly the compliance to treatment, currently estimated to be
less than 50%. The policy adopted is population-oriented rather than patientoriented, providing integrated services "under one roof" at a regional level, with
incentives for providers by the technique "the money follows the (correctly treated)
patients".
Recommendation: By the time of the Barcelona conference, we will be able to
present the first steps of the implementation of this new program. In particular,
process evaluation will be using first in order to monitor it.
Presenting author: Daniel Chemtob, Department of Tuberculosis & AIDS, Ministry of Health, POB 1176, Jerusalem 91010, Israel, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeF6752 THT Direct: a gateway to HIV services and
information
S. Mercer', A. Billington1, N. James2, C. Dixon1. 1 Terrence Higgins Trust,
Terrence Higgins Trust, 52-54 Grays Inn Road, London, WC1X 8JU, United
Kingdom; 2Division of Public Health Sciences, Nottingham University,
Nottingham, United Kingdom
Issues Demand for support services for people living with HIV in the UK is increasing. Previously, there was no co-ordinated or systematic way for people with
HIV with multiple needs to access a range of services from different organisations.
Description Terrence Higgins Trust (THT),a voluntary sector HIV organisation,
has developed a new service in order to address this.'THT Direct' is a pilot service which acts as a gateway to HIV services and information for people living in
London, accessible by telephone and email. Operational since June 2001, THT
Direct aims to: improve access to all HIV services and information; assess clients'
needs; provide clear, accurate, current and comprehensive signposting, referral,
information and advice; make referrals to THT services or other service providers.
The skills mix in the staff team provides a broad range of experience in advice giving, information provision and a choice of languages. Accessibility is maximised
by evening opening hours, a choice of method of contact and an automated menu
(available to callers when phone lines are engaged or closed) which provides information on services and a message service.
Lessons learned The pilot service has managed increasing demand for access
to information, advice and services efficiently and effectively. The high level of
demand for the service demonstrates that telephone and email based services
are not only acceptable to, but popular with, clients. Evening opening hours and
the convenient methods of accessing the service enable clients to access service from their homes, using a method of their choice, when they choose. Results
from an ongoing evaluation of the pilot show people with HIV have high levels of
satisfaction with the service. THT intends to make the service available nationally.
Recommendations Large national HIV organisations should consider offering a
similar 'one stop' model of service delivery to people living with HIV.
Presenting author: Suzy Mercer, Terrence Higgins Trust, 52-54 Grays Inn Road,
London, WC1X 8JU, United Kingdom, Tel.: [phone], Fax: [phone]
4563, E-mail: [email protected]
WePeF6753 The clinical field of observance: statement of the
experience of a network in Paris suburbs
C.W. Winter, R.S. Salicru, D.V. Vilarrubla, E.A. Echevarria, B.J. Bensimhon,
R.C. Rigal, A.A. Adinguera. Ramm-VIH, CH/ Andre Gregoire, 56, boulevard de la
Boissiere, 93105 MONTREUIL Cedex, France
Issues: A combination of medical, social, psychological and educational factors
contribute to create the conditions of a successful and longlasting adherence to
antiviral therapy. We tried to sum up a decade of experience of a local, multidisciplinary network in this matter.
Descriptions: We collected the stories of patients who experienced different
kinds of difficulties regarding attendance to HIV consultations and adherence to
their treatment. The interest of the collection arises from the heterogeneity of the
authors (hospital physician, general practitioner, patient, social worker, psychologist, nurse, community workers), who, whereby sharing the same hypothesis: <
there is no untreatable patient >, appreciate their patients situation from different points of view. Furthermore, the patients were given the stories to read and
offered to add their own comment. The work (written in French) will be presented.
Lessons learned: The question of observance constitutes by themselves an entire clinical field, involving medical, social and psychological aspects, which has
yet largely to be explored (and systematized.)
Recommendations: Local multidisciplinary networks working with PWA are able
to solve a lot of problems of observance who could seem at a first glance unsolvable, proving therefore that "there is no untreatable patient". Doing so, they
contribute to develop a new clinical field.

Presenting author: Richard Salicru, CHI Andre Gregoire, 56, boulevard de
la Boissiere, 93105 MONTREUIL Cedex, France, Tel.: [phone], Fax:
[phone], E-mail: richard.salicru @ chi-andre-gregoire.fr

WePeF6754 Enabling effective and sustainable care
pedagogues - a developing country experiment
E. Ramachandar, S.M. Maddur, N. Sumathi, N. Sreenivas. Karnataka Network of
Positive People (KNP+), Bangalore, Karnataka State, India
Issues: Existing scenario of care and support services in a developing country
like India is expensive and not sustainable. Lack of continued care is another
important concern. Dependency on institutional care has resulted in failure of effective rehabilitation. Lack of an Effective State policy has also added to poor
intervention.
Descriptions: This prompted Karnataka Network of People Living with HIV/AIDS
(KNP+: a non-profit initiative setup by HIV positive people) to envisage on an ambitious project of implementing home-based care by involving people living with
HIV. The project provides care and support services such as Home visits, Referrals, Hospital visits, and Testimonial Counselling. The project also influences
policymaking at the state level. Advocacy issues at workplaces and NGO forums
have been an integral part of the project. A new initiative has been the issue of
availability of Antiretroviral drugs, a memorandum has been submitted for consideration. The network has been using its influence to act as a pressure-group in
the development of a friendlier HIV/AIDS policy in India. The project has also begun a day-occupational facility where made-to-order paper bags and handicrafts
are made and sold for a profit.
Lessons learned: Occupational rehabilitation has played an important role in
empowering people living with HIV. Access to antiretroviral drugs is essential to
improve the overall quality of life. Involvement of the family has promoted better
family attitudes and friendlier approach to HIV positives, more and more families
have got involved in care of their loved ones who are infected with HIV. Majority of
PWHAs have found their own business ventures utilizing the various micro-credit
schemes.
Recommendations: To influence the State in increasing budget provisions for
care and support services. All government hospitals to provide total access to
medical services. To make ART drugs more affordable by providing subsidies.
Presenting author: Elango Ramachandar, #13, 5th A Cross, K.P Agrahara,
Bangalore - 560023, Karnataka State, India, Tel.: [phone], Fax: [phone], E-mail: elangoraam @ hotmail.com
WePeF6755 The "New Look" Project: a proposal to improve
public health services in STV/AIDS
E.Z. Lopes', M.L.F. Melol, A.V Pinto', E.T Antonio', R.C.F Guimaraes',
R.M.C. Tellinil, S. Chen2, N. Hearst3. 1Praia Grande STD/AIDS Program, Sao
Paulo, Brazil; 2Johns Hopkins Bloomberg School of Public Health, Baltimore,
United States; 3University of California, San Francisco, United States
Issues: Universities and technical schools in Brazil do not usually prepare professionals for optimal communication with the mostly poor and uneducated patients
served by the public health care system.
Description: This program aims to train health professionals in Praia Grande's 13
public clinics in a model of interaction with patients based on respect and acceptance. The program focuses on providing skills for the prevention and treatment
of STI/AIDS and diminishing prejudice against marginalized populations. The program has three phases. The first conducts workshops with clinic staff. The second encourages community-based organizations serving vulnerable populations
to create partnerships that involve clinic personnel in activities outside the walls of
their clinics. The third phase is ongoing monitoring of the success of these efforts,
intervening where necessary with additional training and to strengthen community
linkages.
Lessons learned: 188 health professionals from 13 health centers participated in
workshops that covered topics including personal values, prejudice, vulnerability,
professional ethics, counseling, safe sex, prevention and treatment of HIV/AIDS,
prevention of drug abuse, and public health. These professionals, more familiar
with didactic models of training, were challenged by group activities that required
their active participation and emotional involvement. Eventually, however, they
were able to overcome this and apply lessons learned to improve their interactions with patients. The second and third phases of the project are currently being
implemented.
Recommendations: Programs such as this have the potential to improve the
interaction of public clinics with the populations they serve and thereby improve
STI/AIDS prevention and care. This is a difficult challenge, however, and further
evaluation and development of such programs are needed.
Presenting author: Regina Tellini, Secretaria de Saude, Av. Presidente Kennedy,
2030, Praia Grande - Sao Paulo, CEP 11702-200, Brazil, Tel.: [phone],
Fax: [phone], E-mail: [email protected]
WePeF6756 A comprehensive and practical protocol for use in
programs to prevent mother to child transmission
of HIV infection: Western Cape Province, South

Africa
M.J. Besser, F. Abdullah, A. Boulle, N.T. Naledi, M. Cotton, D. Futterman,
Z. Mazwi. Provincial Administration of the Western Cape, PO. Box 16239,
Vlaeberg 8018, Cape Town, South Africa
Issues: In January 1999, the first program to prevent transmission of HIV from
mother to child (PMCT) was opened in Khayelitsha in Cape Town, Western Cape