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

274 Abstracts WePeF6765-WePeF6770

XIV International AIDS Conference

WePeF6765I Training program developed to respond to the
HIV/AIDS epidemic in Botswana
K. Hensle1, P. Ncube2, C. Bussmann3, G. Nick1, C. McFeeley', RP. Mazonde2,
R. Marlink'. 1Harvard AIDS Institute, Harvard AIDS Institute, 651 Huntington
Avenue, Suite 631, Boston, MA 02115, United States; 2Ministry of Health,
Gaborone, Botswana; 3Botswana-Harvard Partnership for HIV Research and
Education, Gaborone, Botswana
Issues: With limited resources and a lack of continuing HIV/AIDS medical education, the ability of health professionals in Botswana to offer the most current AIDS
care practice is hindered. Available materials and educational activities offer little
consideration to providers in resource scarce settings. These issues, accompanied by the Government of Botswana's decision to develop and implement an
antiretroviral therapy program, demands increased AIDS care training opportunities specific to Botswana.
Description: In 2000, the Ministry of Health and the Harvard AIDS Institute performed a district by district needs assessment to ascertain AIDS care educational
needs and practices. Results indicated a high-level of interest in a training program tailored to the specific challenges facing Botswana. Based upon these results and qualitative feedback provided by a program reference group, the KITSO
AIDS Training Program was formed, with funding support from the Merck/Gates
initiative in Botswana. KITSO (or "knowledge" in Setswana) is a modular-based
program, combining a collaboratively developed curriculum, traditional and innovative instructional methodologies, and cutting-edge medicine. KITSO seeks
to ensure that health professionals have competence and confidence in the latest practices of HIV/AIDS care. KITSO launched in 2001 with in-country training
courses on HIV care and ART in order to prepare the Botswana's physicians,
nurses, pharmacists, and pharmacy technicians for ART implementation. Additional activities include the development of a "training of trainers" initiative and
instruction on other HIV-related topics.
Lessons learned: A collaborative, country-specific program, such as KITSO, can
have a positive impact on the training of health professionals.
Recommendation: The KITSO AIDS Training Program serves as a model to others interested in developing training efforts that meet specific educational needs
and cultural practices.
Presenting author: Kimberly Hensle, Harvard AIDS Institute, 651 Huntington Avenue, Suite 631, Boston, MA 02115, United States, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeF6766 IImprovements in reducing HIV patient isolation in
a pilot treatment program in Nigeria
J. Lytton', B.A. Boyle', A. Adenekan2, Y Ogun2, 0. Ogunsaken2, 0. Dawodu2,
R. Falola2, S.C. Ball', J.L. Jacobs'. 'New York WeillCornellMedical Center,
center for special studies, new york presbyterian hospital, 525 east 68th street
box 566, new york, ny 10021, United States; 2Ogun State University Teaching
Hospital, Sagamu, Nigeria
Issues: A significant stigma is attached to HIV/AIDS in many developing countries. This stigma frequently results in HIV-infected persons being socially isolated
and neglected.
Description: In May 2000, the New York Presbyterian Hospital began the
"Starfish Project", which collects unused medications in the US and sends them,
along with training and education, to medical providers at a teaching hospital in
Sagamu, Nigeria. To date, more than 60 patients have been offered on-going ARV
treatment through the project. The project encourages the development of patient
support groups and communication with their families.
Lessons learned: The program has increased communication about and reduced the stigma associated with HIV/AIDS. Prior to the program, most patients
had never spoken to another person about HIV, less than 50% of patients had told
any family member about their diagnosis, and only 3 had attended a community
support group. With treatment, patients reported feeling better and an increased
sense of optimism that supported disclosure. Nine months after medications were
available, the majority of patients had disclosed to their immediate family. In many
cases, after disclosure families became active participants in treatment and over
90% of families report that the patient's health has improved since initiating treatment. In addition, over 35 patients now regularly attend a monthly patient support
group. Working with a community based organization, patients organized a group,
elected a chairman, became educated regarding their rights and invited speakers
to explain programs available to them. This increase in communication has fostered the dissemination of information, a change in attitude toward HIV/AIDS and
a sense of belonging for people who were isolated.
Recommendations: Antiretroviral programs in developing, countries should focus on both providing health care and opportunities for improved communication
among patients, their families and peers.
Presenting author: jennifer lytton, center for special studies, new york presbyterian hospital, 525 east 68th street box 566, new york, ny 10021, United States,

Tel.: [phone], Fax: [phone], E-mail: [email protected]

WePeF6768 Housing for undocumented immigrants in New
York City
A. Lugg. African Services Committee, African Services Committee, 429 West
127th. Street, New York City New York 10027, United States
Issues: New York City is facing one of the worst homelessness crises for PLWA's
since the beginning of the epidemic in 1981. It affects all New Yorkers, including
the approximately 450,000 African immigrants currently living in NYC.The problem is exacerbated even more so for the undocumented PLWA's whose access
to services are hindered by legal status,language,and stigmatization. There is a
housing safety net for PLWA's but for the undocumented immigrant this net is only
accessible through a CBO that can outreach to this population and connect them
to services such as the Sustainable Living Fund.
Description: Through the Housing Opportunities for People With AIDS, for the
past three years, African Services Committee has provided housing placement
and supportive services to approximately 130 undocumented African immigrants
with AIDS. Primary needs addressed are substandard housing and homelessness.Clients receive emergency and long-term rental assistance for up to two
years, during which time they can adjust their immigration status through 'deferred action' by on-site legal services which are offered in tandem with housing
services.
Lessons learned: An in-house emergency rental assistance program available
as an intermediate resource for first-time undocumented PLWA renters is essential to any housing model for this population.An array of direct on-site supportive
services such as case management, food pantry and nutrition counseling provided by culturally sensitive and linguistically appropriate staff, enhance housing
placement assistance services resulting in near 100% housing retention rates,
self-sufficiency, improved treatment adherence and overall, a healthier quality of
life.
Recommendations: Basic to the acquisition of housing is access to work authorization or public entitlements. It is highly recommended that legal services be
provided simultaneously to housing services in order to sustain housing acquisition and retention.
Presenting author: Amanda Lugg, African Services Committee, 429 West 127th.
Street, New York City, New York 10027, United States, Tel.: [phone], Fax:
[phone], E-mail: amandalugg @hotmail.com
WePeF6769 The importance of tracking and referral in
community childcare of children affected by AIDS
E.K. Phillips. HOPE worldwide, P o box 1460, Morningside, 2057, Gauteng,
South Africa
Issues: Tracking and referral of children affected by AIDS presents challenges
such as stigmatization and breach of confidentiality of vulnerable groups that
need long term support. What are the advantages of tracking and referral? How
can these challenges be overcome?
Description: The Siyawela Model for community childcare involves community
support for children, community mobilization, and community liaison. The liaison
team involves a nurse, social workers and PLWHA's who track children identified
by institutions in Soweto and these children are referred to appropriate support
services in each community. Manuals and contracts are distributed to all network
donors and recipient agencies and referral forms are developed by PLWHA's in
Soweto.
Lessons learnt: Tracking and referral systems are best developed by management staff from the community. Partners must be carefully trained. Risks and benefits must be explained to all the clients and their families. Tracking and referral
systems require careful development and management.
Recommendations: Tracking and referral systems for children must be established before support systems are overwhelmed with children affected by AIDS.
Technical assistance is very beneficial, but channels of community communication must be developed to meet the local needs of the clients.
Presenting author: Edward Phillips, P o box 1460, Morningside, 2057, Gauteng, South Africa, Tel.: [phone], Fax: [phone], E-mail:
nicolagrainger@ hopeww.org
WePeF6770 Importance of focus group discussions in the
development of support groups for children
P. Ntuli. HOPE Worldwide, Gauteng, South Africa
Issues: What do PLWHA's want? Often decisions on care and support are made
for PLWHA's by government or health services. How does PLWHA input affect
support services? Does PLWHA input affect outputs and outcomes? What input
can be received from children affected by AIDS?
Description: Focus group discussions were held with 12 different support groups
in Soweto in order to improve support services. The following priorities were identified:

1. disclosure to children
2. future planning for children
3. testing for children
4. access to medical care
5. care for caregivers (i.e. jobs)
6. basic needs (i.e. food etc.)
7. care and support for orphans