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

282 Abstracts WePeF6805-WePeF6809

XIV International AIDS Conference

Glimpses of the scenario before the initiation of such peer support activities, the
need and evolution of such a group and the initial problems, a gradual change in
attitudes and last but not least activities bringing about the transfer of an individual
from the role of a Victim to a Survivor and Advocate.
Conclusion: A recognition of the fact that peer and self support programs are
constructive ways of bringing about healing and self growth especially among
those who have experienced trauma in some form and have low levels of self
esteem and worth.
Presenting author: Laila Mallik, 38B, Mahanirban Road, Kolkata-700029, West
Bengal, India, India, Tel.: [phone], Fax: [phone], E-mail: lailamallik@ hotmail.com
WePeF6805I Care and support for caregivers, including family
care providers
R. Dullaert. Sizanani Village, RPO. Box 1372, Bronkhorstspruit, South Africa
Issues: This abstract addresses the need for a "care for the carers" programme
for two group of people: for caregivers working in a hospice for terminally ill patients suffering from aids related illnesses and for home based carers working in
communities with a high percentage of people infected with HIV/AIDS. This abstract wants to emphasize that you cannot let nurses and other caregivers work
in a hospice were people die on a daily basis without giving attention to the caregivers themselves.
Description: In October 1999 Sizanani Village (South Africa) started St. Joseph's
Care Centre as a Hospice for terminally ill patients. Whereas the hospice is open
for all terminally ill patients, around 95% of them are aids patients. In July 2001
I was asked to do every 3 weeks a "care for the carers" session with the staff of
the hospice. In November 2002 the Home based care team got its wanted capacity of 13 home based carers, working in two different townships Ekangala and
Rethabiseng. We decided to do also care for the carers every three weeks with
this team.
Lessons learned: Care for the carers can help caregivers to cough out their experiences with death, aggression of patients, bereavement, and a feeling of being
powerless. It also works to mention irritations and misunderstandings amongst
the team and to understand each other better and build up a better team spirit. In
a session we try to find time for coughing out but also for focussing on a certain
theme to build up skills.
Recommendations: Do not make groups larger than 12 persons, ask the persons that join to keep everything that is shared in strict confidentiality, encourage
caregivers to tell each other openly what irritates or disappoints them of each
other. Try to tackle these questions. It is important to learn that there are borders.
More energy has to be put in spiritual counselling of patients, addressing aggression, depression and denial. How to address a patient showing this behaviour?
Presenting author: Ricus Dullaert, PRO. Box 1372, Bronkhorstspruit, South
Africa, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeF6806I Sustainable access to ARV-therapy in low
W prevalence regions in Sub-Saharan Africa (SSA)
H.L.M. Van Renterghem1, N. Pirotte2, T. Lievens3, P.A. Some4. 1International
HIV/AIDS A/lliance, IPC/BF 06 BP 10220, Ouagadougou, Burkina Faso;
2AQUADEV Ouagadougou, Burkina Faso; 3STEP / ILO, Ouagadougou, Burkina
Faso; 4Initiative Privee et Communautaire delutte contre le V/H/SIDA (IPC/BF),
Ouagadougou, Burkina Faso
Issues: Policies for access to ARV in SSA tend to be based on cost analysis
and political & media debate. Few propositions are made for setting up programs
for access to ARV for poor rural populations in SSA based on sustainability and
cost/benefit.
Description: We present results of a reflexion on integrated HIV/AIDS actions
by a micro-health insurance (MHI) program, a micro-finance organisation and an
HIV/AIDS community support organisation. Although SAA is hardest hit by AIDS,
in many countries and rural areas the epidemic is relatively low and stable with
adult prevalence between 0 to 5%. This is particularly true where national averages are under 7,5%; 24/45 countries. The number of PLWA in short term need
(2y) of ARV in these areas is estimated at <1 million and <1% of the adult population (112 million). Community based HIV/AIDS responses integrating access to
VCT, stigma reduction, psychosocial support, participation in MHI and access to
micro-credit and IGA for PLWA are an economically and socially sound basis for
introducing ARV, with the community supporting the cost (up to 75%) of the therapy, through shared risk of health expenses (MHI), increased economic capacity
of PLWA (IGA) and increased psychosocial support for PLWA. International solidarity funds must accompany setting up and sustaining this kind of programs,
complementing cost of ARV, assuring hazard funds for MFI & MHI, and reinforcing health and psychosocial services. Increasing numbers of PLWA under ARV
are coped with by their increased contributive capacity, increased solidarity, decreased cost of ARV and long term decrease of HIV incidence.

Lessons learned: Access to ARV based on psychosocial and socio-economic
support for PLWA in low prevalence areas in SSA is an option for controlling the
spread and the impact of the epidemic.
Recommendation: More analysis and experience are needed to understand the
impact of large scale access to ARV in low prevalence areas. Pilot programs need
to be set up

Presenting author: Henk Van Renterghem, IPC/BF, 06 BP 10220, Ouagadougou, Burkina Faso, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeF6807I A culturally specific peer support group model
addresses barriers to care, treatment adherence
and acculturation concerns of HIV positive latino
immigrants in San Francisco, CA
E.E.H. Hernandez, S.J.Z. Zepeda, D.M. Moncada. San Francisco AIDS
Foundation, 995 market street, suite 200, san francisco, california, 94103, United
States
Issues: Migration to the US from Latin America causes depression, isolation,
fear, withdrawal and more. These issues are compounded by HIV infection; all
require modification of the delivery of psychosocial and treatment interventions in
a group modality.
Description: The San Francisco AIDS Foundation began providing integrated
psychosocial and treatment support services to Spanish speaking, HIV positive
individuals 3 years ago, at which time an existing peer support group was modified to include both components. Group facilitators, all native Spanish speakers,
include a licensed clinical social worker and a treatment advocate trained as a
physician. Data were collected through facilitator observations and standardized
surveys completed by members every 4 months.
Lessons Learned: The use of culturally relevant interventions increases the efficacy of interventions by creating a familiar environment for the client. The group's
existing cultural perception of the world is leveraged to help members receive
and integrate new information about HIV status, treatment and other medical
conditions including mental health. Members report increased awareness of HIV
treatment and self advocacy, and present improved treatment adherence, as evidenced by decreased medication failure. Sense of connection to other group
members has improved, as evidenced by social interactions between group members outside group sessions. Acculturation has improved, as evidenced by members joining other groups and taking active roles within the host culture.
Recommendations: A culturally specific peer support group to facilitate interventions among a group of HIV positive Latino persons improved overall health and
well being of group members. Continuation and expansion of peer support programs facilitated by members of the same cultural backgrounds will dramatically
improve outcomes recognized to be important in the long term care and survival
of people with HIV.
Presenting author: edgar hernandez, 995 market street, suite 200, san francisco, california, 94103, United States, Tel.: [phone], Fax: [phone], E-mail: [email protected]
I WePeF6808 Baseline evaluation profile of the rwanda family
package: capacity expansion for wrap-around care
for hiv-infected mothers and their families
P. Bouey1, E. Goosby', D. von Zinkernagell, R. Durazzol, A. Binagwaho2,
A. Kagame3, F Ngabo3. I Pangaea Global AIDS Foundation, pangaea global
aids foundation, 995 market street, suite 200, san francisco, california 94103,
United States; 2Bureau de la Premiere Dame, Kigali, Rwanda; 3Centrale Hopital
de Kigali, Kigali, Rwanda
Background: The Rwanda Family Package is a capacity-expansion project offering wrap-around care for HIV-infected mothers accessed through mother-to-child
transmission (MTCT) projects at two community clinics in Kigali. The medical
component of this project focuses on expanded treatment of STIs and Ols, use of
antiretroviral (ARV) medications for an eligible cohort (CD4<200, VL>10,000, or
an 01), and prevention of further infections.
Methods: Evaluation efforts target the longitudinal monitoring of health status,
quality of life (Medical Outcomes Study-HIV[MOS]), ARV adherence, prevention,
and care delivery. Baseline data are collected from all HIV-infected women who
enter MTCT, and follow-up occurs at quarterly intervals for ARV recipients and
semi-annual intervals for others.
Results: Baseline data from 200 clients offer a preliminary overview of the project
sample. HIV prevalence is about 16% at both sites, and Ols are dominated by
TB. MOS data exhibit lower functional levels, consistent with patterns from South
Africa and Uganda.
Conclusions: These data describe the starting point for each client upon entry
into this expanded service and the preliminary profile of the epidemic as experienced at these two clinics. Longitudinal data collection will allow the monitoring
of care for each client and of the success of this local capacity expansion effort.
Presenting author: david mckey, pangaea global aids foundation, 995 market
street, suite 200, san francisco, california 94103, United States, Tel.: [phone].
7003, Fax: [phone], E-mail: [email protected]

WePeF6809I Expanding horizons in public policies: facing the
interactions between poverty, exclusion and AIDS
M.H.C. Couto. Social Medicine Institute, Rua Uruguai 98/ 101, Tijuca, Rio de
Janeiro - RJ, cep:20510-060, Brazil
Issues: The Brazilian public policy on HIV/AIDS, which emerged as a result from
strong collaboration between the civil society and public servants and authorities