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

656 Abstracts ThPeG8276-ThPeG8280

XIV International AIDS Conference

ThPeG8276 Reducing stigmatization and discrimination in
aging populations
T.M. Mischan. PLWH, San Diego, CA, United States
Issues: Due to ageist stereotypes, most local communities and planning bodies focus current care, treatment, social service, outreach and prevention programs toward younger populations and lack culturally specific and age appropriate health promotion and prevention messages towards HIV/AIDS issues in older
populations. As a very clear at-risk demographic, the older populations are rarely
targeted with HIV/AIDS prevention education or care and treatment information.
Lack of awareness, knowledge, risk-perception and prevention education may be
as instrumental in the transmission of HIV infection as additional risk factors in
the older adult population.
Description: The aging, ethnically diverse population with HIV/AIDS is increasing and living longer in urban and rural areas. They face additional challenges
with multiple chronic health conditions related to disease management. Stigmatization from ageism, sexism, racism, homophobia, and poverty coupled with HIV
contribute to despair, depression and complicated health care behaviors in an
already vulnerable population. Community volunteers and peer support provide
educational seminars, workshops and health fairs to an already largely silent invisible population.
Lessons learned: Aging and geriatric HIV/AIDS places a great demand on communities for help and social resources since most individuals delay testing and
present in later stages of disease manifestation for medical care. Providing a
safe, confidential, culturally and age specific environment benefits individuals
and communities while improving utilization of local resources. Communication
with healthcare providers, peers, and family members concerning intimate details
about life presents additional barriers to testing and treatment.
Recommendation: Design, fund and implement age and culturally appropriate
prevention messages, treatment services, and social services programs toward
naturally aging infected and affected HIV/AIDS population.
Presenting author: T Mark Wayne Mischan, 4324 35th Street, San Diego, California, 92104, United States, Tel.: [phone], Fax: [phone],
E-mail: letitbso@ netzero.net
ThPeG8277 Regional seminars on citizenship and prevention:
a strategy to strengthen action among men who
have sex with men
R. Jesus1, M. Giovanetti2, M.B.P. Mello2, C.G. Meirelles2, S.P MSM Forum'.
IDeliberative Forum of Organizations Working on HIV Prevention Among MSM,
Rua Santa Cruz, 81, Vila Mariana, Sao Paulo, 04121000, Brazil; 2STD/AIDS
State Programme of Sao Paulo, Sao Paulo, Brazil
Issues:The Regional Seminars on Citizenship and Prevention are a strategy of
the Deliberative Forum of Organizations Working on Prevention among MSM in
the State of Sao Paulo to expand the involvement of professionals from society
at large with these topics. The purpose is to increase the coverage of preventive
actions toward the intended population.
Description: Seminars were held in five regions of the State of Sao Paulo in the
year 2001. The local NGO's (members of the Forum) were in charge of the organization of each event, in a joint effort with municipal health authorities, with
the support of STD/Aids State Coordination The goal of Seminars is to discuss
prevention and citizenship with professionals in the areas of health, education,
law, and activists of the GLBT movement, and also other people and institutions
committed with human rights, in order to address the issues of violence suffered
by this population. Each Regional Seminar produced a report with proposals for
actions aimed the target population in the area, and at the end of the cycle a
document has been prepared to serve as a guide for prevention actions a public
policy on STD/Aids prevention throughout the State of Sao Paulo.
Lessons Learned: As a result, partnership was set up with the Brazilian Bar of
Lawyers (OAB) for legal counseling, participation in the subcommittee on violence
in the several City Councils, making room for addressing issues arising from violence among GLBT people in Police Stations, address these topics at schools
and preparation of proposals to improve the care of STD/Aids on the prevention
and assistance level.
Recommendations: By discussing issues of HIV prevention among MSM in a
regionalized and enlarged manner, involving other sectors of society, going beyond the health concerns, actors are strengthened on local level and are able to
provide context-sensitive and feasible responses to the demands arising in each
part of the State
Presenting author: Roberto de Jesus, Rua Santa Cruz, 81, Vila Mariana, Sao
Paulo, 4121000, Brazil, Tel.: [phone], Fax: [phone], E-mail:
prev@ crt.saude.sp.gov.br

ThPeG8278I Reducing stigma and discrimination against
people affected by HIV through enabling local
councils and communities
B. Balasubramanian, A. Anand, R.W. Angeline, B. Anthony Francis,
D. Geetharani, S.P.V. Pandiyammal, I.G. Premila Mercy, V. Sankararaj,
M. Singaram, D. Sridher, M. Varalakshmi, S. Nataraj. Institution(siaap), 4, 1 st
street, Kamaraj avenue, Adyar, Chennai, Tamilnadu
Issue: Fear and suspicion surrounding HIV among rural communities in India has

often led to stigma and discrimination of people with HIV and their families. An
initiative to mobilize local communities and village governance to address stigma
and discrimination of people with HIV and AIDS is ongoing in 13 districts in Tamil
Nadu since 2000.
Method: Identifying specific areas where incidence of stigma and discrimination
were reported; Setting up community counselling services; Providing referrals
and follow up support for treatment and care of
RTIs/STIs/HIV/AIDS with government hospitals; Sensitizing village councils to
mobilising local lawyers to take up legal cases; Liaison with district administrations for support; Working with village councils to frame and pass resolutions of
support; Publicizing the event in the media.
Lessons learned: 75 resolutions passed by village councils, supporting people affected by HIV and AIDS. No further report of stigma or discrimination from
these areas; Affirmation of support documented in official language and format,
and publicized; Public testimonies by non-local affected people to ensure greater
protection; Information and facts around HIV and AIDS can be augmented with
community based counselling services; Structured sensitivity sessions have to be
held with local councils and other leaders.
Recommendations: Project to be extended to other areas to cover all panchayats in Tamil Nadu; Guidelines for interventions developed; Tapping into community goodwill strengths and appealing to traditional values of neighbourliness and
support should be an important strategy to create an enabling environment.
Presenting author: Ragupathy Balasubramanian, 4, 1 st street, Kamaraj avenue, Adyar, Chennai, Tamilnadu, India, Tel.: [phone], Fax: [phone], E-mail: [email protected]
I ThPeG8279 Advocacy and Capacity Building initiatives with the
Health Care Sector - Experiences of the Lawyers
Collective HIV/AIDS Unit
A. Khanna, T. Tandon. Lawyers Collective HIV/AIDS Unit, Lawyers Collective
HIV/AIDS Unit, 7/10, Botalwala Building, 2nd floor, Horniman Circle, Fort,
Mumbai 400023, India
Issues: In India, human rights violations and discriminatory practices within the
health care system have made access to health care an ordeal for PLWHA. Experiences of PLWHA include forced testing, breach of confidentiality, discrimination
- refusal of treatment, inappropriate treatment, isolation etc). Reasons for this include fear, non-compliance with ethical/legal standards, lack of information and
infrastructure for universal precaution. Litigation is rarely considered, due to fear
of disclosure and urgency of treatment.
Description: Advocacy efforts with the health sector have been initiated with the
objectives of sensitisation and capacity building of health care workers (HCW).
The objective is to impress upon HCW the need to adopt public health strategies
based on respect for rights of PLWHA. The advocacy exercises entail dialogue on
legal, ethical and rights issues. They are differently structured for doctors, nurses
and ward boys, factoring in their contexts and concerns. Analysis of these efforts
led us to include concerns of HCW e.g. occupational exposure and the right to a
safe working environment.
Lessons learnt: Bringing change in the health care system requires dissemination of information of legal, ethical and rights issues and placing of rights in
practical contexts. This must be accompanied by attitudinal change, which implies tackling prejudices related to sex and sexuality.
National Policy mandates universal precaution and PEP in public health care institutions. These are not widely practiced.
Recommendations: Efforts must address attitudes, systems and practices in the
health care system. Efforts must build capacity of PLWHAs and care workers to
enable them to assert the right to health care. Options for litigation in the context
of health services must be created including anti-discrimination legislation
Presenting author: Akshay Khanna, Lawyers Collective HIV/AIDS Unit, 7/10,
Botalwala Building, 2nd floor, Horniman Circle, Fort, Mumbai 400023, India, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
ThPeG8280 Reducing stigmatisation and discrimination
S. Huidrom. Legal lines (hiv/aids) unit, c/o Lifeline building, Moirangkhom makha
sougaijam leirak, Imphal 795001, India
Issue: reducing stigmatisation and discrimination of plwha's
Description: (a) project: to strive for dispelling the current fearpsychosispessimism & disillusioment from the minds of the plwha's and for releiving the tension of the present situation and elsewhere by upholding the human dignity. (b) experience: as the plwha's contend with difficulteven devastating,health problem and issues of loss,frequently face discriminaton in the workplace,healthhcare,public accomodation and servicesand housing and acess to
education. (c) service: (i) focus on information, education and counselling(i.e.c.).
(ii) free legal support and sevices that will educate plwha's about their rights.
(iii) taking up cases in the law courts and other forum without fees. (iv) experi
enced sharing and various interaction programmes associated with law, ethics
and human rights. (d) advocacy: advocate the rights of the plwha's (if not free
from disease, free from fear, discrimination and social stigma).
Lessons learned: becoming more aware abouts their fundamental rights.
plwha's and their family members are ready to open up their problems associated with discrimination and stigmatisation, they are ready to take up cases in
the law courts and other forum. however the number of cases are still low due