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

XIV International AIDS Conference

Abstracts WePeF6800-WePeF6804 281

WePeF6800 Medical and social care of People Living With
HIV/AIDS (PLWHA) in Africa: the experience of the
Day Care Center (DCC OPALS/CRF) in Dakar
N.F. Nqom Gueye1, T. Tran-Minh2, S. Mboup3, S. Badiane4, L. Astel5,
M. Gentilini2. 1CTA OPALS CRF, CTA Hopital Fann, BP 16760, Dakar, Senegal;
2OPALS / Croix-Rouge Frangaise, Paris, France; 3Hopital Le Dantec -
Bacterio-viriology Dpt., Dakar, Senegal; 4CHU FANN - Infectious diseases Dpt.,
Dakar, Senegal; 5Croix-Rouge Frangaise, Paris, France
Background: Report on the Outpatient Clinic (DCC run by OPALS and the
French Red Cross) at
Fann University Hospital
Methods: The Outpatient Clinic or Day Care Center, which opened in August
1998, set up a medical structure for counseling and caring for PLWHA, with
screening services, medical and psychological follow-up, dispensation of medication and monitoring of treatments including antiretroviral agents (ARVs). It has
a technical capacity that makes it possible to perform routine tests as well as more
specific tests (CD4, CV) in liaison with the main bacterio-virology laboratory, and
a regularly supplied pharmacy.
Results: A total of 710 registration forms (patients followed regularly) were filled,
with an average of 300 consultations per month. 166 house visits were made
with the consent of the patients or as follow-up calls on lapsed patients. 52 group
discussions were organized on various topics relative to PLWHA's daily life, confidentiality, therapeutic management... The Bok Jef association held 16 meetings.
616 day hospitalizations were registered. Patients attending the clinic are middleaged with an average of 37 years of age and a sex ration of 1.
Most PLWHA do not have a job and the vast majority of them come from Dakar
suburban areas. The main opportunistic infections reported are digestive, dermatological and pulmonary symptoms. Having multiple heterosexual partners is
the risk factor most frequently encountered. HIV1 prevails with patients in stage
B and C. 150 patients are on ARV treatment, most of them on triple combined
therapy.
Conclusion: The diversity and the quality of the services offered by the DCC,
the number of patients followed on ARVs, the increase in attendance and the
lesser pressure on the Infectious Diseases Unit at Fann Hospital are proof of the
valuable role and the success of the Day Care Center.
Presenting author: Ndeye Fatou Ngom Gueye, CTA Hopital Fann, BP 16760,
Dakar, Senegal, Tel.: [phone], E-mail: [email protected]
WePeF6801 Training community educators on HIV/AIDS
home-based-care in Durban: processes and
outcomes
C.S. Ntshele. Medical Research Council, P 0 Box 70380, Overport, 4067,
Kwazulu Natal, South Africa
Issues: Recent survey has shown that 4,2millon people in South Africa are infected with HIV. This results in the burden of diseases in the clinics and hospitals
with attendant shortage of staff. Many infected people are discharged with minimal care.
Description: The aim was to a) Mobilise communities to care for their infected
and affected, b) To create a link between community-clinic-hospital and c) To encourage income generating projects for the infected and affected.
Community educators from seven (7) Local Authority were trained to participate
in health education campaigns. The educators were selected by community they
served. Thirty (30) were trained in Home-Based-Care (HBC). Training was provided in Immune System, Sero-conversion, Prevention and management of infection, Nutrition, Exercise, Infection Control, TB Management-DOT, Disclosure,
Role of traditional healers, Self Help Projects, Treatment of opportunistic infections at home, Proper disposal of waste, Religious aspects, Death and dying and
Care of orphans.
Lessons learnt: The HBC training of the community resulted in intersectional
collaboration between various community structures. The training resulted in the
formation of support groups and HIV disclosures within the community setting.
Recommendations: Training and educating the community educators and communities will contribute to the provision of care and support of HIV infected individuals in poor resourced settings. More funding should be injected into these
self-help programmes in the developing world.
Presenting author: Smangaliso Ntshele, P O Box 70380, Overport, 4067,
Kwazulu Natal, South Africa, Tel.: [phone], Fax: [phone], E-mail:
Smangaliso.Ntshele @ mrc.ac.za
WePeF6802 The impact of effective and sensitive models of
care and treatment in increasing feelings of
adequacy and self worth and the desire to live
longer and better among sero positive minors

L. Mallik. Institution, Sanlaap, 38B, Mahanirban Road, Kolkata - 700 029, West
Bengal, India, India
Issue: Most sero positive minors as they come into systems of psycho social rehabilitation have displayed signs of low lying to severe depression and the lack of
will to plan for the future.
The isolation and abuse sero positive minors in prostitution face socially, emotionally and physically. Depriving them of basic needs of food, shelter, care and the

complete breakdown of their levels of self esteem, gradually reduces in them the
capacity to fight for survival.
Description: Minors are trafficked into Prostitution increasingly as they are believed to be free of HIV or cleansers of it. Sero positive minors are not only victims
of the virus but of emotional, social stigmatisation and abuse. There is need for
systems of support and care that address issues beyond just basic ones. Most
of these young girls come with histories of abuse and institutionalized violence.
The dispensability of the girl child in the family leads to her being trafficked into
prostitution. The violence and objectification that she is exposed to in the trade
only reaffirms her feeling of worthlessness. When her positive status is revealed
to her, the immediate fear is of social rejection, from family and State. At no point
in her entire life cycle does she ever get to experience living with dignity. Low self
esteem that automatically builds up is further detrimental to her positive status
as it incapacitates her to fight for survival. The Paper would include descriptions
and experiences of systems of care, which have addressed beyond just the "Basic Needs" and the impact it has had on the survivor, in comparison to those
systems, which have not.
The recognition that systems of care and support along with information dissemination can enhance feelings of adequacy, self worth and capacitate sero positive
individuals to seek a wholesome life. The strength that is received from such systems of care and support helps the individual in dealing with life proactively.
Presenting author: Laila Mallik, 38B, Mahanirban Road, Kolkata - 700 029, West
Bengal, India, India, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeF6803 Home care for people living with HIV/AIDS in
Mozambique: preliminary results
L. Emberti Gialloreti1, G. Liotta2, E. Buonomo 3, G. Guidotti1, G. Creton 4,
P. Narciso 5, M.C. Marazzi6. 1Community of Sant'Egidio, Community of
Sant'Egidio 3a, Piazza Sant'Egidio 3a, 00153 rome, Italy; 2Public Health Dept. -
University of Tor Vergata, Rome, Italy; 3Public Health Dept.-University of Tor
Vergata, Rome, Italy; 4Sue Ryder Care, Rome, Italy; 5 INMI L.Spallanzani,
Rome, Italy; 6LUMSA, Rome, Italy
Background: The present paper is aimed at evaluating the activities of an out-ofhospital care service for People living with HIV/AIDS in Matola-Maputo (Mozambique)
Methods: The service provides both home based care for people living with
HIV/AIDS having a poor functional status and outreach services for residents
through a mobile unit which runs weekly visits. The area served has a population
of 50,000.
Results: Since August until November 2001, 18 patients have been cared for by
the home service and 851 patients were supported by the mobile unit, for a total
of 1,135 visits
The majority of patients are adult females. Pulmonary and Extra-pulmonary Tuberculosis and Wasting Syndrome are the most frequent clinical presentations.
The staff delivered a wide range of services like symptom observation, therapy
administration, nutritional supplementation, portable filter devices supply to enable families to drink safe water, transportation to hospital for diagnostics or medical consultations, household chores, child care. Children under on year old are
15.1% (128). The highest prevalence pathologies are intestinal infections (more
than one fourth of the diagnosis) and skin diseases (about 17%). Malnutrition at
different levels has been observed in more than 10% of the visits as well as some
occurrences of oral candidiasis (1.3%)
Conclusions: In a HIV high prevalence country, as Mozambique is, a service
which provides both community health care and home care addressed to People
living with HIV/AIDS allows to set up a continuum of care. This kind of service
is able to select patients with impaired health status and help them to face their
diagnostic and care needs. It also identifies HIV/AIDS patients before their health
status is in total decline, thus performing a cost-effective prevention work together
with care of opportunistic infection.
Presenting author: Leonardo Emberti Gialloreti, Community of Sant'Egidio 3a,
Piazza Sant'Egidio 3a, 00153 rome, Italy, Tel.: [phone], Fax: [phone]
197, E-mail: [email protected]
WePeF6804 Healing through sharing: the impact peer and self
support activities has on the individual with
respect to healing and self-growth
L. Mallik. Institution, Sanlaap, West Bengal, India
Issue: Due to abuse and social stigmatization sero positive minors have displayed
signs of fear, shame and withdrawal as they come into systems of rehabilitation.
A significant change in their outlook however has been observed with the help of
peer support and information generation.
Description: The paper will describe experiences of those sero positive children
coming into rehabilitation programs and how they initially displayed symptoms

of fear, withdrawal and low self-esteem. Information that was given to them regarding HIV/AIDS and their status was handled very intellectually With the introduction of Peer and Self-support activities in the form of a support group for
HIV positive girls which aimed to create a "safe space" in which fears and issues
very personal by nature could be addressed. A space where one discovered that
certain traumatic experiences were common and shared. A space in which one
learned to give expression to what was originally suppressed and hidden.