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

320 Abstracts WePeG6958-WePeG6961

XIV International AIDS Conference

fected patients. There was a high rate of long hospital stays. Treatment costs were
high and benefits low, since patients often discontinued treatment and presented
early onset of disease and low survival rates.
Methods: In June 1996, we decided to implement the Aids Care
Program, an integrated and managed global health care proposal. Outpatient
services were centralized with a specialized technical team deeply focusing on
prevention, control and rehabilitation. A Technical Protocol was prepared so as
to standardize services: physicians, social assistants, nutritionists, psychologists
and other professionals guaranteed access to "cocktail" drugs, specific lab tests,
referral to
Specialized Hospitals and Home Care. We also intensified educational actions at
the workplace:
Carnival, Valentine's Day, December 1, Continued Educational Lectures, others
communication means and Installation of a Condom Machine inside the plant.
Results: By December 31 2001, the Program assisted 82 HIV-infected individuals with the following results: 61 are under outpatient care, 1 is under home care
and 20 have died. The number of hospitalizations was reduced by 90% and the
program's comparative data show an annual HIV+/Aids cost reduction by approximately 40%. Qualitative results include: high program compliance rates; higher
clinical control, decrease of work absences, better quality of life, reintegration to
society and work, and a higher degree of satisfaction among employees.
Conclusion: By rationally organizing services offered, the Aids Care Program
reinforces the quality of the Health Care Model adopted by Volkswagen in approaching
HIV/Aids-infected persons within its population.
Presenting author: Reynaldo Paz, Rua Aruja, 95 ap.1, Paraiso- Sao Paulo-SP,
CEP:04104-040, Brazil, Tel.: [phone], Fax: [phone], E-mail:
[email protected]
WePeG6958I Community based response to HIV in Greece
N. Papadopoulos', P. Vyras', E. Chatsidi2, E. Stavrakaki2, G. Tremoulis2,
I. Matziris2, A. Gryllionakis2, D. Peios2, N. Xirouhakis2. 'ELPIDA, Filoktitou 1-5,
Vironas 16232, Athens, Greece; 2 Venizeleion Hospital, Herakleion, Greece
Issues: Community Based Organizations (CBO) operating in Greece are described for the purpose of providing a picture of the services they offer to HIV+
persons and to draw an example for related actions elsewhere.
Description: The involvement of CBO in the fight against HIV has produced self
help activities and advocacy actions in the Greek society since the beginning
of the epidemic. In order to examine such response a survey was carried out
through: 1. Semistructured interviews with members of CBO. 2. Questionnaires.
3. Review of activities and achievements.
Lessons learned: The role of voluntarism has been very important in improving
the life of HIV+ persons in Greece. By directly involving them in decision making
and by designing services for their welfare CBO were instrumental in containing
the social impact of HIV Information and prevention campaigns were regularly
carried out aiming to eliminate discriminative actions against patients and demanding an upgrade of the services provided by government agencies. These
actions may serve as a model for similar initiatives undertaken by organizations
in other regions.
Recommendation: An effective response to HIV must comprise mobilization of
community resources for the following goals: 1. Raise sensitivity in the public towards HIV+ persons. 2. Make adequate medical and psychological care readily
available. 3. Involve patients in advocacy actions. 4. Achieve a functioning cooperation between the voluntary sector and government agencies.
Presenting author: Nikolaos Papadopoulos, Filoktitou 1-5, Vironas 16232,
Athens, Greece., Greece, E-mail: [email protected]
WePeG6959 A grass-roots 'access to treatment' campaign in
Thailand
D. Wilson1, W. Chinvarasopak2, P. Tanud3, N. Tienudom4. Medecins Sans
Frontieres, 311 Ladphrao 101, Wangtonglarng, Bangkok, 10240, Thailand;
2Program for Appropriate Technology In Health, Bangkok, Thailand; 3Thai
Network of PWHA, Bangkok, Thailand; 4AIDS ACCESS Foundation, Bangkok,
Thailand
Issues: Medecins Sans Frontieres (MSF) campaigns for increased access to
HIV/AIDS treatment in developing countries.
Description: In 1990, the Thai government proposed an "AIDS Bill" which would
require testing without consent. Thai NGOs formed a coalition and lobbied against
this proposed violation of human rights. The bill was dropped, leading to an early
understanding amongst Thai AIDS NGOs of what they can achieve by colaition
building.
In August 1998 the US Government pressured Thailand to introduce additional
patent law restrictions. Demonstrations by Thai PWHA and NGO workers outside
the US Embassy in Bangkok and theThai Ministry of Public Health became the

subject of international media attention. MSF provides an international link in the
Thai campaign and provides information about the impact of globalisation on drug
prices. MSF also facilitates links between PWHAs, NGOs and professional members of civil society, including generic drug manufacturers and lawyers, leading to
generic production of four antiretroviral medicines in 2001.
Lessons learned: Coalition building is a key factor in the success of the Thai
campaign, which provides a clear issue on which people can work together.

Recommendations: International organisations lobbying for increased access to
HIV treatment in developing countries must recognise the need for joint ownership
of this issue by all the different members of civil society involved.
Presenting author: David Wilson, 311 Ladphrao 101, Wangtonglarng, Bangkok,
10240, Thailand, Tel.: [phone], Fax: [phone], E-mail: msfbthai
@ksc.th.com
WePeG6960 Mentoring to build the capacity of CBOs to
improve service delivery in under-resourced areas
of South Africa
M. Burley. National Department of Health, HI V/AIDS/STI & TB Cheif Directorate,
South Africa, Department of Health, AIDS Directorate, Private Bag X828,
Pretoria, 0001, South Africa
Issues: Under-capacity and poor resourcing of many South African NGOs compromised the implementation of the HIV/AIDS National Strategic Plan. Government funding had to reach community-level to support prevention services and
care initiatives appropriate to local perceptions and priorities. Community organisations were providing good quality services, but lacked the skills or infrastructure
to access or manage Department of Health funding. Government wished to encourage the development of the NGO sector, but feared that direct influence might
compromise the sector's autonomy.
Descriptions: The solution, in each of South Africa's provinces, was to link moredeveloped second-tier NGOs in a mentoring relationship with the primary-tier
CBOs to build sustainable organisational structures. Despite provincial variations,
all programmes:
* use the common "Toolbox Manuals"
* provide CBOs with direct one-to-one mentoring
* focus on the development of project management capacity
In some cases intermediary NGOs acted as guarantor for funds for a group of
CBOs.
Lessons learned:
a Intermediary capacity-building NGOs can customise a national health system
at local level
* Partnerships strengthened provincial DoH options for service delivery
* Prior local commitment to the support of CBOs is essential
* Strengthened CBOs provide focal points for further networking and support
" Donor commitment reduces competition and promotes collaboration between
CBOs
Recommendations:
* Augment organisational support with improved service delivery training
* Ensure continued commitment from National and Provincial government
* Promote direct funding for CBOs that achieve the required standard
* Encourage mentored CBOs to share their skills and knowledge with other CBOs
* Document the mentoring process
* Develop and publish 2nd edition "Toolkit Manual" incorporating new learning
Presenting author: Marian Burley, Department of Health, AIDS Directorate, Private Bag X828, Pretoria, 1, South Africa, Tel.: [phone], Fax: +27(0)12
323 7323, E-mail: [email protected]
WePeG6961I Designing training activities for health and
support services providers in a multiethnic city:
challenges and lessons from the South Florida
TPED
D.C. Travieso-Palow, L.A. Crandall. University of Miami, Department of Family
Medicine, Miami, FL, United States
Issues: The University of Miami was awarded a Targeted Provider Education
Demonstration grant to support training of health and support service providers.
The grant targeted racial and ethnic communities impacted by HIV/AIDS. Development of training was a challenge because South Florida has a multiethnic community in which there is no clear majority group and more than half the population
was born outside the United States.
Description: Two culturally diverse advisory groups that represented (1) consumers and (2) academicians identified and validated traning topics, reviewed
information from formal needs assessments, recommended training strategies
and reviewed curricula. A "Training of Trainers" for culturally diverse trainers from
multiple community-based organizations allowed scientifically accurate information to be adapted to trainees. An adult learning model emphasized active engagement of learners and connection of materials to life experiences. TPED staff
trained the trainers and assured quality by monitoring the training sessions.
Lessons Learned: The statutory basis of TPED produced trainees that were extraordinarily diverse in terms of education, experience, and ethnicity. A training of
trainers approach was a useful and successful adaptation to ethnic diversity, but
audiences which included great diversity of educational/experiential background
sometimes required compromises in the content of the materials. Staff turnover

in the agencies served was higher than anticipated and hindered the ability of the
project to build lessons upon previously completed curricula.
Recommendations: Programs to train non-prescribing providers ideally should
be segmented so that persons with lengthy experience and/or advanced training
are separated from persons with little education and experience. Cultural competency training of a diverse cadre of trainers is necessary in a multi-ethnic community.