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

XIV International AIDS Conference

Abstracts ThOrFl475-ThOrFl478 573

they replicated the educational workshops, accompanied by trained psychologists, covering a total of 650 persons. Afterwards, the 650 workshop participants
shared the preventive messages with their neighborhood friends, while distributing condoms and educational materials. A behavioral sex practices survey was
administered to the participants of the replication process.
Lessons learned: Young men and women living in displacement circumstances
due to war are more vulnerable for acquiring STDs. According to the survey results, their sexual life start at early ages, and is characterized by unsafe practices:
60% of females and 89% of males had their first intercourse before reaching 15
yrs.; 14.5% of males and 11% of females reported consistent condom use; 6% of
participants reported previous STDs. It must be mentioned the great level of commitment showed by participants, with the objectives and contents of this project.
Recommendation: These interventions should be promoted and maintained in
all regions where displaced communities, victims of war conflict, are temporarily or definitively accommodated. Parents and adults in general should also be
involved.
Presenting author: Ricardo Garcia Bernal, Carrera 7 No. 74-21 Piso 9, Colombia, Tel.: [phone], Fax: [phone], E-mail: [email protected].
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ThOrF1 475 A cross-border HIV prevention intervention for
injection drug users (IDUs) in Ning Ming County
(Guangxi Province), China and Lang Son Province,
Vietnam
T.M. Hammett1, D.C. Des Jarlais2, W. Liu3, D. Ngu4, N. Son4. 1AbtAssociates
Inc., abt associates inc., 55 wheeler street, cambridge, ma 02138, United States;
2Beth Israel Medical Center, New York, NY, United States; 3Guangxi Center for
HIV/AIDS Prevention and Control Nanning, China; 4National AIDS Standing
Bureau of Vietnam, Hanoi, Vietnam
Issues: The China-Vietnam border lies athwart a major heroin trafficking route
along which injection drug use and HIV have spread. There is substantial crossborder movement for drug purchase, sale, and consumption, and rapidly rising
HIV prevalence rates due to sharing of injection equipment: about 10% HIV prevalence among IDUs in the targeted area, even higher in some contiguous areas.
Description: Information from meetings among project partners, visits to
prospective sites, and formative research among IDUs, government officials,
pharmacists, and community members was used to design a comprehensive
peer-based intervention. Strategies focus on social marketing of pharmacy vouchers (good for new syringes and other merchandise) in exchange for used syringes
and large-scale, safe disposal of used injection equipment. Four sites in each
country were chosen for the intervention: a provincial or county capital and three
smaller towns closer to the border.
Lessons learned: This is the first cross-border HIV prevention intervention targeting IDUs. Because of the involvement of two countries, county and provincial
agencies, and sensitive issues such as drug use, development of the project required extensive discussion among U.S.-based researchers, in-country collaborators, and potential funders beginning in 1997. Changing political situations necessitated changing project sites and partnerships at the provincial and county/local
levels. Continued consultation and several visits in 2000 and 2001 were required
to make final decisions on specific sites and forge necessary local support. Ongoing community education and outreach will be required, focusing on law enforcement and security personnel, pharmacists, health officials, and the general
community.
Recommendations: More such interventions are needed to control cross-border
HIV transmission and build international collaboration. Work should be initiated
immediately because of the time required for project development.
Presenting author: theodore hammett, abt associates inc., 55 wheeler street,
cambridge, ma 02138, United States, Tel.: [phone], Fax: [phone], E-mail: ted [email protected]
ThOrF 476 HIV/AIDS prevention training for world food
programme-employed truck drivers in Ethiopia
P. Kashyap, H. Negassa, A. Daoudi, J. Lewis. United Nations World Food
Programme, Adda Ababa, Ethiopia
Issues: Ethiopia has the second largest number of people living with HIV/AIDS
in Africa. Truck drivers are typically at high risk of contracting and spreading HIV
due to their mobility and extended periods of time away from home. The UN
World Food Programme (WFP) employs over 2000 truck drivers to deliver relief
food from the Port of Djibouti to distribution points throughout the country.
Description: Phase I: In the first large scale training of its kind in Ethiopia, a local
NGO trained over 2000 WFP-employed truck drivers and assistants in HIV/AIDS
awareness and prevention. After a rapid baseline assessment of the truck drivers'
needs, 12 trainers along with regional health officers ran three, two-hour daily
sessions for 60 consecutive days. Sessions dealt with a range of risk-reducing

behaviors and included time for participants to share personal experiences. Tshirts, cassette tapes of prevention songs, educational materials to share along
their routes, and condom "starter kits" were offered to drivers at the end. All participants received a card certifying their attendance. Phase II (ending late 2002)
provides one-year of follow-up and support through the use of peer educators.
Lessons learned: The truck drivers and management of the transport companies
found the trainings to be timely and the content highly relevant. The face-to-face

interaction and participatory approach by professional HIV/AIDS educators was
especially useful in dispelling myths and misinformation. Collaboration among UN
agencies, NGOs and private companies was key to the success of the initiative.
Recommendations: Periodic HIV/AIDS prevention trainings should be provided
so as to keep up with the hiring of new drivers and assistants as well as to refresh
the knowledge of those already trained. New multi-sectoral partnerships should
be established to reinforce the HIV/AIDS prevention messages and expand support services for the truck drivers and their assistants.
Presenting author: Purnima Kashyap, c/o United Nations World Food Programme, PO.Box 25584, Code 1000, Adda Ababa, Ethiopia, Tel.: [phone],
Fax: [phone], E-mail: [email protected]
ThOrFil 477 Reaching vulnerable populations with HIV/AIDS
prevention - the example of Sub-Saharan migrants
in Switzerland
C. Kopp, B. Zuppinger, S. Matuschek, T Spang. Swiss Federal Office of Public
Health, Swiss Federal Office of Public Health, CH-3003 Bern, Switzerland
Issues: HIV/AIDS prevention faces the challenge to continuously reach new vulnerable populations. Based on epidemiological data showing increased rates of
HIV infections amongst Sub-Saharan migrants in Switzerland (SSM) in 2000, the
Swiss Federal Office of Public Health (SFOPH) is initiating a prevention project
with this population.
Description: The National HIV/AIDS Program provides the framework for planning and implementing HIV/AIDS prevention in Switzerland. One of its 14 goals
aims at reaching vulnerable groups more sustainably. Existing projects address
men who have sex with men, male sex workers, migrant female sex workers, male
clients of sex workers, and, also within the National Strategy Migration & Health,
various migrant populations. In order to plan prevention with SSM, the SFOPH
mandated a rapid assessment in 2000. Based on its results and recommendations, the project was put out to tenders in 2001, and it is starting in 2002.
Lessons learned: The rapid assessment showed that SSM are a comparably
small and heterogeneous population. Although they have some organizations and
media, social networks are mainly structured via key persons and oral communication. Communication on sexuality rarely breaches gender boundaries, and
HIV/AIDS is often still a taboo subject. As SSM are often marginalized and stigmatized, they may face many problems other than HIV/AIDS.
Recommendations: While target-group specific approaches have proven very
effective in Switzerland, they continuously have to be adapted to the specific situation of each group. In the case of prevention with SSM, this will include the coordination of projects aimed at different sub-groups, collaborating closely with key
persons and organizations from the target group for gender-specific prevention
along oral forms of communication, extending interventions also to other aspects
of health promotion and empowerment, and avoiding that SSM become newly
stigmatized through their association with AIDS.
Presenting author: Christine Kopp, Swiss Federal Office of Public Health, CH3003 Bern, Switzerland, Tel.: [phone], Fax: [phone], E-mail:
[email protected]
ThOrFo478 Operationalizing an effective community
development intervention for reducing HIV
vulnerability in female sex work: Lessons learned
from the Sonagachi Project in Kolkata, India
N. Bandopadhyay1, K. Ray1, A. Banerjee1, S. Jana2, A. Saha', D. Kerrigan3,
V. Sharma Mahendra4. iDurbar Mahila Samanwaya Committee, Population
Council/Horizons Program, 53 Lodi Estate, New Delhi, 110 003, India; 2CARE
Dhaka, Dhaka, Bangladesh; 3Johns Hopkins University, Baltimore, United
States; 'Population Council/Horizons Program, New Delhi, India
Background: The Sonagachi Project in Kolkata, India has been recognized by
UNAIDS as a 'best practices' model for its use of a "community development approach" to HIV prevention among female sex workers (SW). Little research has
been conducted to identify the core elements of "community development" interventions as they relate to HIV prevention. The current study sought to explore
and document the core elements of an integrated community development and
HIV/STI prevention program among SW.
Methods: 51 focus group discussions and 79 in-depth interviews were conducted
with SW, peer educators and other key stakeholders such as project staff, brothel
managers and pimps in 11 red light areas in Kolkata. In addition, focus groups
were also conducted with representatives from the police and media. A review of
project documents, media reports and police records was also undertaken.
Results: The following strategies were identified as increasing collective ability to
negotiate safe sex/reduce HIV risk: (1) Facilitate sense of community among SW
through community meetings, fairs and protests; (2) Decrease perceived powerlessness among SW through human capacity building seminars; (3) Increase
access & control over material resources via micro-credit and cooperative bank
ing; (4) Increase social participation through autonomous organization of SW and
self-governing; (5) Facilitate social acceptance of SW by involving sex industry
and civil society stakeholders.
Conclusion: An effective community development approach to HIV/STI prevention must make community participation real by: building human and community
capacity to participate, creating the social space for participation, and transferring
project ownership to the community