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

XIV International AIDS Conference

Abstracts ThPeD7663-ThPeD7667 505

ThPeD7663 The response to HIV and STI epidemic among ThPeD7665 GOINGO collaboration in initiating and sutaining
commercial sex workers in the town of Shymkent an outreach clinic for female free-lance sex
"itkgr in Cd i b Cit, Philin in a

T. Rodina1, S. Valieva2. 1Regional Dospensary for Skin and Vebereal Diseases,
STI Center, Zhibeck Zholy Street, Shymkent City, Post Code 486035,
Kazakhstan; 2Research Institute for Skin and Venereal Diseases, Almaty
Kazakhstan
Dramatic five fold annual increase of HIV cases in the Southern Kazakhstan was
primary a result of unsafe drug-injecting behavior. However the contribution of
sexual transmission of HIV is growing up as well. Brief assessment performed in
2000 had showed that the total number of street commercial sex workers (CSW)
in Shymkent City came to 1500. They had totally about 1 million sexual contacts
a year. CSW expressed both high-risk injecting and sexual behaviors. About 10
per cent of them injected drugs, 75 per cent did not use condoms regularly and
78 per cent were never seeking for STI care in the official health settings.
Regional STI center supported by UN Theme Group had taken a leadership in
HIV prevention among CSW. The access to STI care was improved through the
establishment of five friendly cabinets in different areas of the town, where CSW
are provided with affordable anonymous out-patient STI treatment based on syndromic approach, as well as information, education and counseling. There was
founded a Crisis Center, where CSW are eager to get counseling and shelter
if necessary. Support to the formation of NGO dealing with HIV/AIDS prevention among CSW was provided. Members of CSW groups have become involved
in training and peer education process. Informational materials were developed,
tested, published and permanently disseminated. Condom supply as well as syringes and needles exchange programnmes for those who use drugs were put
into operation.
During one year it has become possible to cover about 50 per cent of the assessed number of CSW in Shymkent with preventive interventions. 322 of 717
CSW having appealed to the friendly cabinet during the year 2001 were treated
at least for one STI or STI-linked syndrome.
National leadership in HIV/AIDS prevention, allocation of governmental resources, permanent dialogue with NGOs, mobilization of CSW in HIV/AIDS counteraction ensures sustainability of the intervention.
Presenting author: Tatiana Rodina, STI Center, Zhibeck Zholy Street, Shymkent
City, Post Code 486035, Kazakhstan, Tel.: [phone], Fax: [phone]
15 63, E-mail: [email protected]
ThPeD7664 Breaking the silence around sex work in Morocco
R. Lamzaini, S. Kdada, S. Bisbis, A. Chogairi. AMSED, Rabat, Morocco
Background: Despite the recognised vulnerability of sex workers to HIV, there
are few HIV prevention programmes in Morocco mobilising sex workers to respond to their needs. The main reasons for this are stigmatisation of sex work,
and the difficulties programmes face in trying to reach sex workers, especially in
rural areas.
AMSED, through its NGO/HIV support programme, has developed in partnership
with a community organisation an approach which responds to the situation and
needs of female sex workers, and which aims to provide the support needed to
effectively prevent HIV and STIs.
Methods:
- Participatory needs assessment and 12 month programme with female sex
workers
- Selection of "aide-educatrice" (outreach education and support worker) with
relevant skills and background
- Training of aide-educatrice in participatory prevention skills, including group facilitation and peer education
- Regular visits to participants, to discuss issues including those related to sexual health, vulnerability, attitudes, information on STIs and HIV and prevention of
STIs and HIV
- Accompanying participants to clinics for STI diagnosis and treatment
-Training, supply of condoms
- Integration of participants into NGOs development activities, including literacy
and micro-credit
Results:
- Organisation of group sessions and individual discussions with participants,
covering topics such as self esteem; skills in condom negotiation with clients
- Recognition by participants of need for protection against STIs and HIV/AIDS
- At present, 80% of participants report ability to negotiate condom use with
clients
- Many participants visit the NGOs premises to get condoms or request support
/ company in visiting sexual health services
Conclusions: The risk of HIV and STI infection has been reduced amongst participants. Some have diversified their sources of income through involvement in
the NGOs development programmes and are now less dependent on sex work.
Presenting author: Aicha Choqairi, AMSED, 11 rue al Maarif, Quartier Aviation,
Rabat, Morocco, Tel.: [phone], Fax: [phone], E-mail: amsed
@ iam.net.ma

woJIr ein Il.nUu Lty, ErlilppJines
I.P. Abellanosa. Government, City Health Department, Cebu City, Philippines
Issues: Cebu City is a highly urbanized area with red light districts frequented
by foreigners and local people. For many years, STD/Aids prevention and control
activities were focused on esrablishment-based sex workers. The law required
them to have weekly check-up at the Social Hygiene Clinic (SHC) and to attend
lectures on STD/AIDS. But liitle has been done for street-based free-lance sex
workers (FLSW) who are practicing more risky behaviors: more sex partners, low
condom use rate, and high STD prevalence.
Description: The SHC tried to access FLSW to tell them about the services of
the clinic which is 15-30 minutes away from their area. We met the pimps and
managers and ask them to bring the girls to the clinic for regular check-up. Only
a few came who also stopped coming after the 2nd visit. We decided to have
an outreach clinic within the area where they live and work. The barangay captain allowed us to use his office as our clinic at least once a month. There was
a slight improvement in the inflow of patients, we were seeing 15-20 FLSW per
clinic visit. But there were did not avail our services and some who did not come
back for their next schedule for the following reasons: fear of being arreste, room
was too hot with many holes on the walls. Some were just indefferent or were
misinformed, and refused to come.
Lessons learned: To address these issues, we asked the assistance of some
NGOs. One provided us with an air-conditioned room with privacy for our examintaion. The other NGO assisted through health education and counseling and
condom promotion. The NGOs outreach workersand peer eductors encouraged
FLSW to come during scheduled visits. Now we are seeing 45-60 FLSW/visit and
the frequency of check-up increased to twice a month. The barangay officials
submitted a resolution to institutionalized the STD/AIDS prevention activities in
the barangay. Other barangays expressed their intention to have a similar clinic
for free-lance sex workers in their area
Presenting author: Ilya Abellanosa, City Health Department, Gen. Maxilom Ext.,
Cebu City, Philippines, Tel.: [phone], Fax: [phone], E-mail: ilya
@cvis.net.ph
ThPeD7666 Survey about male sex work on the internet
R. Akeret1, U. Hincziza2, B. Vandenbroucke3, P. Vriens4, M. Okoliyski5,
R. Lukasik6, M. Georgescu7, D. Kohler8. 'Swiss Aids Federation, Zurich,
Switzerland; 2Verein Wiener Sozialprojekte, Vienna, Austria; 3NZW Mosaik
Adzon, Brussels, Belgium; 4Municipal Health Centre, Amsterdam, The
Netherlands; 5National Centre of Public Health, Sofia, Bulgaria; 6 Tada,
Warsaw, Poland; 7Aras, Bukarest, Romania; 8Aids Hilfe Bern, Bern,
Switzerland
Issues: gather information about men selling sex to men through the internet and
to find out if there are specific needs for them and if they are interested in interventions through the internet. Is there a new group of male sex worker other than
known by service providers?
Description: 7 countries within the European Network of Male Prostitution (Austria, Belgium, Bulgaria, Poland, Romania, Switzerland, Netherlands) observed the
web at the same time for all relevant sites and chatrooms in their countries in a
first step. The survey was carried out for 3 months with a minimum investment
of 25 hours per month. Then every country approached male sex workers actively with a short specifically developed questionnaire in order to gather more
information. Finally every country wrote a short evaluation report on it.
Lessons learned: The outcome in the different countries varies due to many
factors. But it is clear that a growing number of men uses the internet to sell sex
and that a high number of men is not yet in contact with any service providers.
The amount of men interested to receive specific interventions through the net is
varying as well but it is clear that new intervention strategies have to be developped.
Recommendations: Agencies need to be sensitized and trained in using the
internet and its facilities. The commercial sex market on the net needs to be
mapped in order to develop proper and effective intervention and prevention
strategies on the internet.
Presenting author: Rene Akeret, ENMP regional coordinator, Swiss Aids Federation, P.O. Box 1118, 8031 Zurich, Switzerland, Tel.: [phone], Fax: +41 1
447 11 12, E-mail: [email protected]
ThPeD7667 Vulnerability conditions of female commercial sex
workers (CSW) in Brazil
J.M.J. Andrade1, K.M.A. Guimar.es1, A.M.M. Godoi1, E. Merchan-Hamann1,
D. Serafim2, L. Ribeiro2. 1University of Brasilia, Brasilia, DF Brazil; 2STD/Aids
National Coordination, Braslia, Brazil
Background: A nation-wide study was carried out in order to evaluate the impact of interventions to prevent STD, HIV/AIDS transmission. We evaluated 7
Non Governmental Organization (NGO) projects and 1 Governmental project ad
dressed to female CSW. Three aspects of vulnerability were considered: (1) individual knowledge and practices regarding means of transmission / prevention
of STD/HIV; (2) social and environmental stressors; (3) empowerment and social
organization.