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

XIV International AIDS Conference

Abstracts ThOrF1414-ThOrF1463 571

social sciences and having undergone intensive 8-10 week training on issues of
sexuality, and related concerns. The TARSHI helpline began in 1996 and in the
past six years has had to deal with issues of burnout.
Lessons learnt: Burnout costs a lot both in terms of morale and management.
The costs in terms of time and monetary resources spent in looking for, recruiting and training new counsellors for the helpline are also high especially when
working on limited funds. The paper explores various forms of burnout, possible
causes and aggravating factors that may be peculiar to our context.
Recommendations: The paper also discusses strategies used by TARSHI to
combat burnout and attempts to evaluate these strategies. These insights may
benefit others working in similar fields whether or not they use a helpline as a
means of reaching out.
Presenting author: Prabha Nagaraja, 49, Golf Links, 2nd Floor, New Delhi -
110003, India, Tel.: [phone], Fax: [phone], E-mail: tarshi@vsnl.
com
ThOrF1 414 1 Therapeutic home care assistance- Taking care of
caretakers: A health service experience in Sao
Paulo city, Brazil
I.A.R. Ferreira Gomes da Silva. STD/AIDS Coordination of Sao Paulo City
Health Departament, Avenida Nova Cantareira, 4504 apartamento 56 b, Sdo
Paulo-SP, 02340.002
Issue: From among the Brazil's answers to Aids epidemic, Therapeutic Home
Care has been an important strategy to the care of people who need to be attended in their homes.This way, the family context makes evident the relevance
of caretakers figure. The caretakers role,however,means many times an accumulation of tasks to themselves, besides of changes in their interpersonal relationships, including the forgetfulness in take care about themselves.
Description: According to this context, in order to provide these caretakers mental health, it was realized in one of Sao Paulo city's health services, an attention
programme destined to them; 24 caretakers participated in this work, most of
them were mothers from 25 to 82 years old,during the 2000/2001's.
Activities were developed in public places, like Parks,and City Sport Centers, not
attached to hospital environment, where it were realized free themes discussion
meeting, relaxing technics, dances, walks and others leisure activities, in which
the health professionals of Therapeutic Home Care Assistance also have participated.
Learning lessons: The programme carried out its purposes and the caretakers have become much fortified in order to carry out their role with the patients,
increasing their trust, their self-esteem,their perception and care about themselves,normally much far from their dailyFinally, the programme has provided the
caretakers approach and integration with the multiprofessional staff.
Short advices: The "Care to the Caretakers" shows itself to be an important
way of guarantee the work of Therapeutic Home Care Assistance, and it can be
extended to other health services destinated to HIV/AIDS people.
Presenting author: lara Ferreira Gomes da Silva, Avenida Nova Cantareira,
4504 apartamento 56 b, Sto Paulo-SP, 02340.002, Brazil, Tel.: [phone],
E-mail: [email protected]
ThOrF1 461 Policy of the Female Condom - An Approach of
Gender in the Prevention of (to) Sexually
Transmitted Disease/Aids in Women
K. Souto, D. Doneda. National STD and AIDS Programme Office, SEPN 511
Bloco C, 70750-543, Brasilia DF, Brazil
Issue: The Policy of Female Condom Distribution in Brazil has a clear gender
approach. In governmental and non-governmental settings, educational interventions and all prevention actions are planned and executed directly by women and
men who participate in the projects. This approach guaranteed high acceptance
and involvement of the women in the activities and adherence to the use of the
female condom and the adoption of safer sex practices. This process facilitated
the negotiation with the sex partners of the use of the male condoms.
Description: The implementation of the policy of female condom distribution
called for a training program of the health professionals and community health
workers of governmental and non-governmental organizations. Methodologically
the it is seen as key issue that the women are aware of their vulnerability to
STD/HIV/Aids and are susceptible to rethink their practices. Women's groups are
set up to improve the negotiation with their sex partners, for the use of the male
condom. In these meetings gender issues such as power relations are related to
the affective, sexual relationships.
Learned lessons: Three points can be stressed: the importance of the gender
approach in the educational interventions which made it possible that women
became aware of their vulnerability to SDT/HIV/Aids; the training of health professionals and community health workers in a gender perspective was decisive
for an innovative approach; the distribution of the male condom alongside with

the female condom, contributed to the improvement of the negotiation among sex
partners.
Recommendations: The Brazilian experience shows that it is necessary to advance in the introduction of the gender perspective in prevention actions and treatment in DST/Aids. It is urgent to support initiatives to reduce the cost of the female
condom aiming to increase funds for research and advocacy for the development
of alternative prevention methods such as microbicides.

Presenting author: Katia Souto, SEPN 511 Bloco C, 70750-543, Brasilia DF,
Brazil, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThOrF14621 What do health care providers think about
microbicides? Views from five NYC agencies
S. Hoffman1, K.L. Morrissey2, J.E. Mantell2, T.M. Exner2, L.P. Brothers3,
J.Y. Lee3, C. Pili2. 1IHIV Center for Clinical & Behavioral Studies, Mailman
School of Public Health/Columbia University, New York, United States; 2HIV
Center for Clinical & Behavioral Studies, HIV Center for Clinical & Behavioral
Studies, 1051 Riverside Drive, Unit 15, United States; 3Mailman School of Public
Health/Columbia University, New York, United States
Background: The acceptability and uptake of microbicides will likely be heavily influenced by the attitudes of health care providers, who play a major role in
providing information about and access to women's contraceptive and disease
prevention methods. In this qualitative interview study, we sought to understand
the perspectives of providers and counselors about new and emerging HIV/STD
and pregnancy prevention technologies.
Methods: One-hour in-depth interviews were conducted with 82 providers involved in "hands-on" HIV/STD and/or pregnancy prevention counseling in four
types of settings: family planning clinics, STD clinics, a hospital ob/gyn service
and AIDS service organizations. The interview addressed knowledge, attitudes,
obstacles to acceptability and strategies for promotion of a wide range of disease and pregnancy technologies. Audio-tapes were transcribed and coded, using open coding followed by axial coding.
Results: Providers were enthusiastic about microbicides, although most lacked
specific knowledge of the likely characteristics of potential products. Major concerns were safety, efficacy, potential irritation, product feel/consistency and cost.
There was an implicit expectation that a new product will be close to 100% effective. However, when queried about a less effective product, a range of views
about a harm reduction approach was expressed. Most providers were unaware
of the nonoxynol-9 (N-9) microbicide trials, but many were confused about the
conflicting recommendations they had heard in relation to N-9 products.
Conclusions: Providers need to be involved at every level of microbicide development to enhance acceptability. Their responses to the unsuccessful N-9 trial will
likely influence their reaction to a new product. Advocates and educators need to
find ways to communicate information about decision-making when products are
considerably less than 100% effective.
Presenting author: Susie Hoffman, HIV Center for Clinical & Behavioral Studies, 1051 Riverside Drive, Unit 15, United States, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThOrF1 4631 Improving the assessment of microbicide
acceptability
J.E. Mantell1, B.L. Myers2, G. Ramjee3. 1HIV Center for Clinical & Behavioral
Studies, New York, United States; 2 HIV Prevention & Vaccine Research Unit,
South African Medical Research Council, HIV Prevention & Vaccine Research
Unit, South African Medical Research Council, PO Box 658, Hlabisa 3937,
South Africa; 3HIV Prevention & Vaccine Research Unit, Medical Research
Council, Durban, South Africa
Introduction: With the burgeoning research on the acceptability of microbicides,
there is an urgent need to examine the strengths and weaknesses of existing
acceptability tools.
Methods: Electronic databases and abstracts of recent HIV/STD meetings were
searched for studies that presented primary quantitative or qualitative data on the
acceptability of potential vaginal products to prevent HIV/STIs.
Results: Of the 38 acceptability studies included in the review, most (n=25) focused on heterosexual females and males from the general population, with fewer
studies of among MSM, female sex workers, and drug-involved populations; less
than 10% of studies targeted adolescents exclusively. Only 6 studies included
data from couples, and only one focused on couples. Individual interviews were
the primary data collection technique. Given the absence of an effective microbicide, most studies measured perceptions of attitudes toward surrogate or hypothetical products.
Conclusions: Extant research has provided important preliminary insights into
the potential acceptability of microbicidal products, but a number of gaps exist.
Our review suggests four key focal points for advancing the assessment of microbicide acceptability: (1) inclusion of new populations (health care providers,
key opinion leaders, couples, gay men, the married); (2) increased focus on
processes (partner dynamics, sexual risk behavior, dual protection strategies,
changes over time); (3) uniform measures (use of theoretical framework as guide,
accounting for cultural specificity, sexual practices); and (4) marketing (promotion and integration with other methods in "real world" settings). Use of multimethod qualitative and quantitative data collection strategies, including computerassisted, with assessments at multiple time points, will help to further understanding of the promoters and impediments to microbicide acceptability.

Presenting author: Benjamin L Myers, HIV Prevention & Vaccine Research
Unit, South African Medical Research Council, PO Box 658, Hlabisa 3937, South
Africa, Tel.: [phone], Fax: [phone], E-mail: landon.myer@mrc.
ac.za