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

510 Abstracts ThPeD7688-ThPeD7692

XIV International AIDS Conference

cially where services are absent. Mobilizing and involving key actors in the programs should be one of the key strategies.
Presenting author: Joy Abraham, B-307, Nirmal Park No.3, S.V.Road, Navghar
Road, Bhayandar East, Dist.Thane, Maharashtra, PIN 401 105, India, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeD7688 Safe migration strategies urgently required for the
prevention of trafficking in South Asia
C. Costello Daly1, V. Sharma Mahendra2, P. Bhattarai3, C. Evans'. 'Consultant,
Horizons Program, New Delhi, India; 2Population Council/Horizons Program,
Population Council/Horizons Program, 53 Lodi Estate, New Delhi, 110003,
India; 3 The Asia Foundation, Kathmandu, Nepal
Background: Trafficking of women and adolescent girls in South Asia is associated with mobility, poverty, human rights violations, and prostitution which increase their risk of HIV/AIDS. Yet many trafficking prevention efforts discourage
migration altogether, even for women who want to travel or voluntarily seek employment elsewhere.
Methods: Review of key project documents and interviews with 10 NGOs working in trafficking prevention in Nepal. Survey of 1269 randomly selected adolescent girls, 43 focus group discussions, key informant interviews, and Participatory
Learning and Action techniques in three districts in Nepal.
Results: Most NGO trafficking prevention programs discourage women's migration and fail to provide advice or assistance to those who want to migrate safely.
IEC messages encourage women and girls to stay in their villages to prevent
trafficking, although 40% of adolescent girls want to move out of their current villages, especially those with higher levels of education (p=0.001), and 85% want to
travel to urban areas. Only three NGOs gave advice on what to do if approached
by someone for work or marriage. While such advice takes the first step of acknowledging that women and girls migrate, it is often not enough to safeguard
them. For example, advice to be wary of strangers is inadequate since surveyed
girls more frequently implicated family (33%), other relatives (58%) and community members (70%) than strangers (11%) as traffickers.
Conclusion: To protect women's rights to livelihood and take into account the realities of female migration, efforts to prevent trafficking must distinguish between
voluntary migration and trafficking. To encourage safe migration, strategies are
needed that provide effective protection for migrating women and adolescent girls
without taking a paternalistic approach.
Presenting author: Celine Costello Daly, Population Council/Horizons Program,
53 Lodi Estate, New Delhi, 110003, India, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeD7689 Improved targeting of HIV/AIDS interventions
through analysis based on phenomenological and
interactionist theories: The Belize case study
D. Hernandez Rosete1, M. Rosberg2. 'Institution Nacional de Salud Publica,
Ciudad de Mexico, Mexico; 2 University of Belize, Belize City, Belize
Background: This paper notes the generally poor impact of anti-HIV/AIDS interventions targeted at vulnerable populations, which has been broadly observed
in Belize and elsewhere. It also reports the behaviour of commercial sex workers (CSWs) in the same region, who can articulate the risk of HIV/AIDS and the
importance of condoms during intercourse, and yet, who make a deliberate exception to this practice for boyfriends and steady customers for reasons unrelated
to income or force.
Method: Using phenomenological points of view (Schutz, Diaz), this apparently
irrational and risky lapse is experienced as an internal coping mechanism in the
face of apparent threats to external ontological security Qualitative and quantitative data on Commercial Sex Workers (CSWs) migrating between Guatemala and
Belize are used to provide both rich and statistical information. Interaction theories (Barth, Greenfield & Strickon) are used to define the external context of dangers which objectively require pro-active and protective measures, but which must
seem overwhelming and without recourse to any external response by CSWs.
Results: Linkages are made among the three issues (socio-cultural stigmatization and isolation in a moralizing climate; internalization of defenses; and, voluntary exposure to risk) which rationalize the observed behaviours of CSWs with
boyfriends and steady customers.
Conclusion: Study results suggest a need to adjust targeted interventions for
greater impact relating the strategic choices being made to the context of vulnerability.
Presenting author: Daniel Hernandez Rosete, Leon Garcia #3, Colonia Presidentes Ejidales, Coyoacan, D.F, Codigo Postal 04470, Ciudad de Mexico, Mexico,
Tel.: +52+56+07+04+27, Fax: +501+2+32667, E-mail: [email protected]

ThPeD7690 Keys of effective responses for HIV/AIDS
prevention at the border areas (Thai-Myanmar)
Nuntawun Yuntadilok, AIDS division, Thailand
N. Yuntadilok. AIDS Division, Ministry of Public Health, Nonthaburi, Thailand
Issue: The close link to HIV/AIDS epidemic at Thai-Myanmar border is migration of Burmese to Thailand. These migrants are vulnerable to HIV infection due

to illegal status, low education, lacking of AIDS information and inaccessibility to
health services. Urgent application is needed.
Description: Having aware of this problem,Thai Government requested UNAIDS
support to solve the problem. The Thai-Myanmar joint project was initiated and
implemented in 4 sites, the activities done were; consultative meeting between
Ministers of Public Health to set up policy and agreement; border health committee meeting to plan the appropriate action; local staff meeting to implememt the
interventions; recruiting and training potential Burmese health volunteer to work
with Burmese migrants
Lessons learned: Though local Myanmar staffs had tried their best, many obstacles and barriers from the restriction of the Central government discouraged them
from making proper decision and action. By political view, the border areas population is minority, neither source nor host countries cares about their quality of
life. As health aspect, these population must have rights to access to basic health
services. Illegal status obstructed them from accessing to health services. Thai
government solve the problem by registering and issuing work permit. Gos and
NGOs network must be established to facilitate and bridge the gap. It is essential
to recruit potential volunteer who has the same subculture, understands beliefs
and lifestyle and can easily reach the target group to work as a behaviour change
communicator.
Recommendation: Keys for effective HIV/AIDS prevention at the border are; political commitment without discriminating by races, ethnics or boundary, decentralization to the local staff to encourage them to perform appropriate action to protect
not only borderline population but also the mainland population from HIV/AIDS infection.
Presenting author: Nuntawun Yuntadilok, AIDS Division, Ministry of Public
Health, Tivanont Road, Nonthaburi 11000, Thailand, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeD7691I HIV testing and observance in an African HIV +
immigrant women cohort
P. Arsac, J. Nembo, N. Ballouche. Internal and infectiology medicine
unit, regional hospital, Internal medecine unit, Regional hospital, 45032, Orleans,
France, France
Objective: to determine the factors interfering with observance and follow-up in
a immigrant african women cohort
Methods: All Hiv+ african immigrant, living in France from 1985,consulting in
2001,in our unit were enrolled.We studied age,HIV testing circumstances, time
spent in France before diagnosis,children number,employement,HIV stage and
treatement.Observance was estimated with attendance to medical visit,CD4
count and viral load.
Results: 31 women were enrolled,all from subsaharian Africa,transmission was
only sexual route,34 yo mean age (17-66),14 were in France from one year or
less,4 more than 4 years.2 was the average number for children.15 women had
a regular job.10 women had been HIV + detected during pregancy or sterility
check-up,6 because of an HIV + partnership, 6 because of non opportunistic infections.2 were HIV 2 positive.18 women were A CDC stage,8,C CDC stage.24
had an antiretroviral treatement,14 of them with a protease inhibitorObservance
was considered to be adequate in 21 patients.
No correlation was found between observance and child bearing and HIV CDC
stage.
Observance was best in older women,with a regular job.
Conclusions: In immigrant population, gynecologists and obstetricians play an
important role in detecting HIV+ women.Access to HIV testing has to be improve
to detect non AIDS defining illness patients.Social services, facilitating job access,are a important key in such population to improve observance and follow-up.
Presenting author: Philippe Arsac, Internal medecine unit, Regional hospital,
45032, Orleans, France, France, Tel.: [phone], Fax: [phone].
47, E-mail: [email protected]
ThPeD7692 Safer at home? Male labour migration and HIV risk
behaviour in South Africa from a rural perspective
B. Wolff', M. Collinson2, S. Tollman3. 1London School of Hygiene and Tropical
Medicine, medical research council, PO. 49, entebbe, United Kingdom; 2Health
Services Development Unit, Acornhoek, South Africa; 3 Witwatersrand School of
Public Health, Johannesburg, South Africa
Background: The effect of male labour migration on the spread of HIV depends
on risk behaviour upon exposure to sexual networks in both home and work areas. Most research on migration and risk behaviour is based on urban samples
or mining areas. Little is known about the behaviour of rural men or migrants once
they return home.
Methods: 857 migrant and non-migrant men age 20-45 from a random sample of
a recent population census in the rural Agincourt subdistrict in Northern Province
were interviewed between December 1999 and April 2001. Fieldwork was con
centrated on weekends and holiday periods when migrants return. The response
rate was 58 percent.
Results: 43 percent of men report more than one partner in the last year. 91%
of these reported concurrent partnerships. The risk of multiple partnership in the
last year was marginally lower for migrant men (OR=0.058, p=0.075) and rural
unemployed men (OR=0.064, p=0.058) compared to the reference group of rural
employed men, controlling for age, education, current marital status and migra