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

XIV International AIDS Conference

Abstracts WePeG7074-WePeG7077 345

Lessons learned:
1. Eliciting effective leadership, mobilising involvement and overcoming denial
2. Planning and managing a comprehensive inter-sectoral programme 7073
3. Measuring results: information, monitoring and evaluation systems
4. The inter-sectoral approach works!
5. De-centralization to local AIDS programmes
6. Building capacity for effective implementation
7. Taking sub-programmes to scale on affordable, sustainable models.
Recommendations:
- To be effective, the programme needs to be comprehensive, inter-sectoral, implemented to scale and co-ordinated locally
- A comprehensive plan with monitoring and evaluation systems is needed to
evaluate progress and outcomes.
- Implementation models need to be affordable, sustainable and integrated at
local level.
Presenting author: Liz Floyd, Private Bag X 085, Marshalltown, 2107, Johannesburg, 2000, South Africa, Tel.: [phone], Fax: [phone], E-mail:
monicatyron @yahoo.corn
WePeG7074 Cooperation project between institutions and
AIDS non-governmental organisations in
Catalonia: 1992-2001
R. Mansilla1, A. Gimenez1, R. Aguileral, R. Burgueral, J.L. Martinez-Alonso1,
A. Recasens1, J. Colom2. 1Programa per a la Prevencid i I'Assistencia de la
Sida. Departament de Sanitat i Seguretat Social, Programa per a la Prevencid i
I'Assistbncia de la Sida, Departament de Sanitat i Seguretat Social. Generalitat
de Catalunya, Travessera de les Corts, 131-159, 08028 Barcelona, Spain;
2Direccid General de Drogodependencies i Sida. Departament de Sanitat i
Seguretat Social, Barcelona, Spain
Background: to present the results of the cooperation between the Program for
AIDS Prevention and Assistance in Catalonia (PPAS) and the Non-Governmental
Organisations (NGOs) involved the field of AIDS in Catalonia between 1992 and
2001; and to evaluate the dynamics of this project of cooperation.
Methods: the information was obtained from an evaluation of the projects presented, in accordance with the criteria laid down by PPAS: establishment of priorities, effectiveness /efficiency, geographic duplicity and viability. Information was
also taken from the evaluation reports of activities carried out by a range of organisations and from the activities run jointly by PPAS and AIDS/ NGOs.
Results: Seventy-one AIDS/NGOs in Catalonia presented 263 different projects
between 1992 and 2001. PPAS financed 136 of them (52%), in accordance with
the criteria already mentioned and the interventions established as priorities. The
total budget assigned amounted to 5,896,504.33 euros. The nature of interventions has evolved; in 1992 50% were secondary prevention measures, whereas
in 2001 70% were primary prevention measures.
Conclusions: The cooperation between PPAS and ONGs is essential for providing access to prevention measures to groups that have little contact with the sociohealth system. Overall, the cooperation can be considered positive, as it has permitted the exchange of experiences and the identification of specific needs, not
only regarding the population, but also the social agents. The advantages and
disadvantages of cooperation projects of this kind will be discussed in more detail.
Presenting author: Rosa Mansilla, Programa per a la Prevenci6 i I'Assistencia
de la Sida, Departament de Sanitat i Seguretat Social. Generalitat de Catalunya,
Travessera de les Corts, 131-159, 08028 Barcelona, Spain, Tel.: [phone]
410, Fax: [phone], E-mail: [email protected]
WePeG7075 Effective Municipal AIDS Programme - Combining
Sectoral Efforts
D. Padi. Gauteng Health Department, GALA, South Africa
Issues: Local and Provincial Government collaborate on building Local Intersectoral AIDS programmes based on common strategy and plans.
Description: The provincial AIDS strategy translates into local inter-sectoral
AIDS programmes to ensure services reach those at greatest risk. Local coordination is necessary to combine the contributions of all sectors and address
local priorities. The provincial co-ordinators strategy and plans ensure the development of 20 government departments and 15 non-governmental sectors on a
common strategy and plan. Political leadership of the inter-sectoral response is
good. The World AIDS Day campaign in 2001 combined all sectors in join local
door-to-door campaigns. Teams targetted areas of greatest need and linked families to local services. NGO funding is allocated, based on provincial strategy and
guidelines and local programme plans. Services are mapped to maximise equity.
Special interventions have been introduced in high-risk settings.They include peer
education, STI services and Periodic Presumptive Treatment (PPT) for sex workers. Local government capacity is being developed to achieve local programme

planning and co-ordination. Monitoring and evaluation systems are being developed.
Lessons learned and Recommendations:
1. AIDS efforts of local and provincial government cannot be separated.
2. De-centralization to local AIDS programme ensures effective delivery of services, combining all sectors. De-centralisation also builds intergration and community involvement.

3. A mind-shift is needed from health-based to inter-sectoral programme and plan.
4. Capacity must be created at local level through training, technical support and
appropriate allocation of resources and budgets.
5. Political commitment and mobilisation of communities and sectoral groups are
essential.
6. Programme infrastructure in the form of local operational plans, monitoring and
evaluation systems still need to be established in our area.
Presenting author: Dan Padi, GALA, South Africa, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeG7076 Introducing HIV/AIDS to the health sector reform
agenda in the Dominican Republic
M.C. Wiese', J. Shields de Leiva2. 1FHI/DR, FHI/AIDS Institute, 2101 Wilson
Blvd., Suite 700, Arlington, VA 22201, Dominican Republic; 2FHI/ AIDS Institute,
Arlington, VA, United States
Issues: Since the first AIDS case was identified in the Dominican Republic in
1983, the struggle to confront the the epidemic has been constant. Despite much
effort, the epidemic has been steadily growing due to migration, increasing sex
work activities, undercover homo-bisexuality, gender inequities, poverty, increasingly marginalized urban and sub-urban areas, limited formal education, and early
sexual debut. In 1999, an attempt was made to integrate civil society and both the
Public and Private sectors in the struggle against AIDS. NGOs, CBOs, government and private entities worked together to design and implement a Provincial
Operational Planning system to address the HIV/AIDS situation in the DR.
Description: This presentation will explore the process used to develop the
Provincial Operational Planning System and its integration into the National
Strategic Health Plan.
Lessons learned: The standardized process was developed, including workshops that combine basic information and multi sector work groups, audiovisual
techniques (overheads, flip cards, maps, music and games) with participants' experiences and following the action lines established in the National Strategic to
develop clear steps for action. As a result of this excersice, twenty-nine Provincial Work Plans were developed and the same number of follow up committees
were created with the participation of GOs, NGOs, CBOs, PLWAs, Armed Forces,
Churches, neighborhood associations, Mothers' clubs, and others.
Recommendations: It is easier to detect gaps in planning and implementation
when there are different community representatives involved. It is possible to plan
with this level of participation. Coordinated actions between different sectors lead
to better results. Many marginalized and highly vulnerable grous can be active
participants in the planning process.
Presenting author: Jennifer Shields de Leiva, FHI/ AIDS Institute, 2101 Wilson
Blvd., Suite 700, Arlington, VA 22201, United States, Tel.: [phone], Fax:
+1 703.516.9781, E-mail: [email protected]
WePeG7077I Of steady boyfriends, lunch boys and secret
lovers: Sexual partnerships among young people
in South Africa
L. Ndhlovu1, J. van Dam2, M. Tuoane3, Z. Mzaidume4, B. Rasego4, S. Moema4.
SPopulation Council Horizons Program, PO Box 2823, Randburg, 2125, South
Africa; 2Population Council, Washington DC, United States; 3University of
Lesotho, Maseru, Lesotho; 4Mothusimpilo Project, Carletonville, South Africa
Issues: Concurrent sexual partnerships increase the risk of sexually transmitted
infections, yet we still possess very limited information about such partnerships
among young people in most countries in the world. We examined the social
context and impact for spread of HIV/AIDS of sexual partnerships among young
people using two data collection techniques.
Description: In 2000 we conducted a cross-sectional survey among 769 male
and female youth in Carletonville, a mining town in South Africa. Nine in-depth
interviews and 5 focus group discussions complemented the survey.
Lessons Learned: Survey data depicted young people relatively at low risk for
HIV infection. 24% of those under 25 years reported they were not sexually active,
and those who were sexually active had on average only one regular or casual
partner. An impressive 60% stated that they would use condoms to prevent HIV
infection with casual partners. In contrast, in this population high levels of HIV
infection (over 66%) have been documented among young women aged 23 to 25
years.
The qualitative data revealed that young people were part of extensive sexual networks linked through entertainment areas; hotels, bars and 'bash parties' where
exchange of sex and material goods took place. Males viewed concurrent relationships as "cool" and as necessary "backup" while girls engaged in them largely
for financial support. Though HIV risk was acknowledged by both sexes, effective
protection against STIs was greatly compromised by inconsistent condom use
and a false sense of security based on expectations of faithfulness of primary
partners.

Recommendation: This study underscores the need for formative research to
develop interventions for youth that address their 'risk reality' going beyond standard strategies of condom promotion and health education.
Presenting author: Lewis Ndhlovu, PO Box 2823, Randburg, 2125, South Africa,
Tel.: [phone], Fax: [phone], E-mail: [email protected]