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

570 Abstracts ThOrF1410-ThOrF1413

XIV International AIDS Conference

local staff of international organizations. However there is limited documented experience with providing HIV/AIDS treatments to staff of AIDS NGOs. Yet these
organizations often face a relatively high burden of HIV-related illness and death.
Description: In 2001, an international development NGO contacted its partner
organizations in 17 countries to ascertain their interest in receiving technical support to explore if and how to provide medical treatment for staff living with HIV,
and to address broader issues of stigma and discrimination in the workplace.
In 2002, three countries were identified for a pilot project to provide technical
support to (i) research access to treatment in the local context, the needs of the
organization and the range of possible strategies that could be adopted; (ii) provide workshops and technical support to address stigma and discrimination in
the workplace, including the development of a workplace policy on HIV/AIDS; (iii)
assist develop a medical benefits policy for the provision of HIV/AIDS treatments;
and (iv) provide technical support in the form of financial planning for the assessment of the impact of HIV on the organization and the creation of a staff fund
and/or other mechanisms to provide an agreed level of treatment and care to
staff.
Lessons learned: Ten organisations responded requesting technical support.
This paper will report on the challenges and opportunities encountered during
the pilot phase, as well as future options to be explored.
Recommendations: AIDS NGOs should explore ways to retain and keep healthy
staff living with HIV. Options will vary according to the local context. Drug prices
are falling in many countries - donors should support such initiatives.
Presenting author: David Patterson, Canadian HIV/AIDS Legal Network, 417
Saint-Pierre St, suite 408, Montreal QC H2Y 2M4, Canada, Tel.: [phone]
x228, Fax: [phone], E-mail: [email protected]
ThOrF 410 Breaking the silence: an HIV-related educational
intervention for final year medical students
S. Houston', J. Mielke2, I. Chitsike2, I. Gangaidzo2, S. Mutetwa2, A. Chingono2,
S. Ray3. 1University of Alberta,Edmonton, Alberta, Canada; 2University of
Zimbabwe, Harare, Zimbabwe; 3SafAIDS, Harare, Zimbabwe
Background Lack of open discussion at political, community and personal
levels is a major obstacle to an effective community response to HIV. Nondisclosure/discussion of HIV, even when clinically apparent, is common in practice, reinforcing the "conspiracy of silence". Doctors have not been well prepared
to address HIV with patients.
Methods: Consultation with university and community doctors, a community HIV
organization and medical students confirmed the scope of the problem and suggested the content of the training.
Audience: final year medical students.
Format: 3 X weekly half day sessions.
Topics: Individual medical benefits of informing the patient of his/her HIV status
and discussing testing.
Public health (transmission reduction) benefits of informing patients with suspected HIV.
Ethical obligations of doctor to patient, to share important information, including
suspicion/diagnosis of HIV.
Practical tools and strategies for raising the issue of HIV at the bedside.
Coping with our own psychological response to large numbers of HIV patients.
Patients' expectations and wishes.
Community resources to support patients with HIV.
Role play (local professional theatre group)-portrayed some of the above issues.
Results: Active participation by students in all 3 sessions.
Evaluation form completed by students:
- Unanimous support of need for such a course.
- Strong positive evaluation of all elements, (mean score out of 5: 3.6 for "public
health benefits" to 4.6 for the role play session).
Conclusion: There is a critical need to provide medical students with the knowledge, ethical basis, skills and resources, to address HIV with patients. This "minicourse" appeared to be a useful supplement to this end. Future efforts should
concentrate on integrating these lessons into the curriculum (now being initiated
at the University of Zimbabwe) and providing similar training/support to doctors
already in practice.
Presenting author: Stan Houston, 2E4.11 WC Mackenzie Centre, University of
Alberta, Edmonton, Alberta, Canada, Tel.: [phone], Fax: [phone],
E-mail: shouston @ ualberta.ca
ThOrFi 411 Increased recognition and support for structured
supervision and building a model of suprvision to
prevent HIV/AIDS Counsellor burnout
A. Maria, N. Paranthaman, V.R. Nanmozhi. South India AIDS Action Programme,
Hill Top Apartments, No.5, North Raja Street, Alandur, Chennai 600 016, India
Issue: Structured Supervision in the field of Counselling as a concept is new in

India, owing to workload and emotional drain counsellors get burnt out and space
to ventilate is limited, therefore building structured supervisory system and establishing a cadre of trained supervisors is inevitable.
Description:
- Affiliation with supervisory training organisation
- Structured training design specific to the context of HIV/AIDS Counselling intervention in South India

- A total of 21 supervisors wee trained to support 55 counsellors working the
district government hospitals of Tamil Nadu
- Site Supervision of counsellor at work place, discussion with Medical and
paramedical staff
- Individual Supervision with counsellor, to ventilate feelings, clarifications etc.
- Structured peer supervision in small groups
- Periodic review and restructuring of programme with counsellors
Lessons Learned:
- Enhanced professional counselling skills in counsellors and significant reduction in feelings of burnout
- Significant fall in counsellor drop out
- Increased motivation of counsellors to seek advanced trainings to improve capacity and skills
- Efficiency of counsellor enhanced being a member of the medical and paramedical team
- Increased co-operation from medical and paramedical staff
- Training guidelines for supervisory practices in South Indian context available
- Increasing availability of trained supervisors
Recommendations:
- Policy to include supervisory training as part of VCTC training
- Policy to incorporate structured supervision in institution based counselling services and government based VCTCs
- Easier access to supervisory training and supervision for counsellors
Presenting author: Maria Benno, Hill Top Apartments, No.5, North Raja Street,
Alandur, Chennai 600 016, India, Tel.: [phone], Fax: [phone], Email: [email protected]
ThOrF 412 Caregivers of children with HIV/AIDS: patterns of
problems and solutions
P.S. Hansell, W. Budin, D. Jeski, J. Ciglia. Seton Hall University, Seton Hall
University, College of Nursing, 400 South Orange Avenue, South Orange, N.J.
07079, United States
Issues: Caregivers of children with HIV/AIDS experience numerous problems
that threaten the integrity of the family system. Inorder to maintain the integrity of
the family system while facilitating and promoting effective coping inorder to mitigate stress, effective problem solving is essential. Accordingly, there is much to
be learned from a qualitative analysis of the patterns of caregiver problems and
caregiver solutions.
Description: A secondary analysis was conducted on data that was generated
from an intervention study. These data were taken from the monthly flow sheets
that were completed by the investigator and caregiver subjects. Within these
data are documented the process of problem identification-solution-resolutionobjective and subjective outcomes. Data were analyzed using a qualitative analysis software program, as well as expert validation inorder to achieve content
analysis that was used to determine themes of caregiver problems and themes
of caregiver solutions.
Lessons learned: The themes of problems identified for these caregivers clustered according to the following themes:the health care system; physical well being of caregiver and child; emotional well being of caregiver and child, social issues, domestic issues, and vocational issues.
Lessons learned: The patterns of problems experienced by these caregivers
of children with HIV/AIDS were numerous with many similar patterns of caregiver
problems identified. Solutions to these clusters of problems were problem specific
and focused on the effective use of problem solving strategies.
Recommendation: Caregivers of children with HIV/AIDS present health care
providers with highly complex patient care situations. Effective problem solutions
are achieved for those caregivers who are able to develop problem solving strategies aimed at problem resolution. HIV/AIDS is one of many problems in need of
a solution that challenge the HIV/AIDS caregiver's family each and every day of
their life.
Presenting author: Phyllis Hansell, Seton Hall University, College of Nursing,
400 South Orange Avenue, South Orange, N.J. 07079, United States, Tel.: +1
973-761-9015, Fax: [phone], E-mail: [email protected]
ThOrF1413 Burnout prevention - keeping the fire burning
R Nagaraja. TARSHI, 49, Golf Links, 2nd Floor, New Delhi - 110003, India
Issues: addressed: In India, where more and more people are being diagnosed
with HIV/AIDS, the few qualified health-care professionals and counsellors that
exist work under tremendous emotional and other pressure. The pressures are
manifold in a culture that promotes silence around issues of sexuality and consequently HIV/AIDS. Under such circumstances, burn-out rates are high and doubly
damaging to the work where there is always a need for qualified and dedicated
professionals. Drawing on our experiences of operating a telephone helpline on
sexuality and reproductive health in India this paper explores the possible causes

of burnout in this context.
Project description: The TARSHI (Talking About Reproductive and Sexual
Health Issues) helpline has received more than 50,000 calls from women and
men of all ages and socio-economic backgrounds. They speak on the helpline
about their concerns around sexuality, sexual health problems, contraceptive decisions, HIV/AIDS, and intimate relationships. The helpline is operated by trained
counsellors. The counsellors on the helpline are all women; post graduates in