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

XIV International AIDS Conference

Abstracts ThPeG8367-ThPeG8370 675

specific objectives of the study was to collect data which will be used to increase knowledge levels and understanding of the special vulnerability of children/adolescents to HIV/AIDS infection and the impact of HIV/AIDS on them, their
families and in the community.Key Informant studies, Focus Group Discussions,
household interviews, case studies and secondary sources have been used for
collection of qualitative data for carrying out the Rapid Situational Assessment.
The study provides an understanding of the special vulnerability of children to
HIV/AIDS infection and the impact of HIV/AIDS on them, their families and community. It focuses attention on the increasing number of orphans and advocates
for implementation of supportive policies and programmes to protect the rights of
the children/adolescents in HIV/AIDS prevention and care.
The study analyses the current responses of the government, NGOs and the civil
society and focusses attention on the increasing number of orphans. Fear, discrimination, ignorance and social stigma associated with HIV/AIDS leave children
isolated with their grief and suffering as they watch parents and other loved ones
die and their families languish. The infected children are denied treatment at the
state and district hospitals. With a large number of children(approximately 30.000)
already affected in Manipur, providing large scale non- institutional care becomes
one of the greatest challenges. The scale of the problem requires building a multisectoral response among a considerable range of partners- state government,
CBO's and the donor agencies.
Presenting author: Jyoti Mehra, 605, Sector 14, Gurgaon-122001, Haryana, India, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeG8367I Empowering children and adolescents infected and
affected by HIV/AIDS. An NGO's project in Brazil
E.F. Cruz, K. Antunes, S. Queiroz, M.P. Silva, E.P.S. Cardoso, A.J.T. Godinho.
Group for Life Incentive (GIV), Rua Capitdo Cavalcanti, 145, So Paulo, Sdo
Paulo, 04017-000, Brazil
Background: Prevention actions for children and adolescents, in general, and
support for those living with HIV/AIDS, in particular, are in large demand in
Brazil. Children and adolescents infected or coming from families with
HIV/AIDS are either neglected or targeted by intervention actions that do not take
into account their affective and cognitive developmental characteristics, nor their
understanding about their HIV-positive status or that of their parents.
Methods: Since 1996, our NGO GIV directs a project called LIVE CHILD AND
ADOLESCENT aimed at children and adolescents infected or affected by HIV.
The project's main objective is to empower these children and adolescents to
deal with their HIV-positive status or that of their parents and to provide them with
prevention tools.
As part of the project, children meet three times a month with other children and
adolescents from the community and work to discuss topics such as diversity,
AIDS, gender relationships, prevention, prejudice and solidarity. Particular emphasis is placed in issues such as disclosure, adhesion and sexuality. In addition,
the adolescents carry out prevention and education campaigns at schools using
the puppets Daniel Leticia Tom and Aninha. Educational material has been produced such as a Journal (JOCAS), the book (Daniel and Leticia talking about
AIDS) in partnership with the NGO Casa Siloe, a video, and a poster about the
rights of the children and adolescents in collaboration with the NGO AFXB do
Brasil.
Results: One of the most important aspects of the project is the freedom, embracement and harmony that children and adolescents infected or affected by
HIV feel about their condition. Parents' guidance towards an appropriate disclosure process is also crucial.
Conclusions: It is of major importance the creation of intervention projects in
which HIV-infected children and adolescents have their condition
Presenting author: Elisabete Cruz, Rua Capit.o Cavalcanti, 145, S.o Paulo,
Sio Paulo, 04017-000, Brazil, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
ThPeG8368 The impact of Ryan White care act funding on
pediatric HIV/AIDS morbidity and mortality
S. Abramowitz1, P Alcabes2, E. Frank1, K. Krasinski'. 1NYU School of
Medicine, N United States; 2Hunter College of the City University of New York,
NY, United States
Background: Ryan White CARE (RWCA) Act funding impact on clinical outcomes of 650 infected and uninfected children in an urban pediatric infectious
diseases clinic was assessed between 1985 and 1999.
Methods: Study data included computer databases supplemented by chart abstraction. Independent variables: RWCA phases of funding (pre funding (I), program implementation (II), program institutionalization (Ill)); demographics; treatments (PCP, MAI, MAC prophylaxis; HAART; maternal zidovudine); clinic and
hospital visits. Clinical outcomes were: disease progression, survival, hospital
izations, opportunistic infections, perinatal infection, and developmental functioning. Laboratory outcomes were: CD4% and viral load. Within and between phase
comparisons were undertaken. Hierarchical regression procedures in the Poisson or logistic framework were used to analyze temporal effects, including grouplevel associations of RWCA program implementation with clinical care and outcomes.
Results: RWCA funding resulted in: 1) service delivery to a minority population of

women and children; 2) improved care access measured by enrollment in prenatal care and for children, age at first visit; and 3) Phase related (I, II, III) declines
in: rate of development of mild symptoms (1.3%/yr, 0.9%/yr to 0); progression
from asymptomatic to AIDS: (19.5%/yr, 10.2%/yr, 3.1%/yr); proportion aged >
30 days at 1st visit (13.7%, 8.7%, 0); CD4% loss: (0.23, 0.08, 0.07); mortality
rate (person years): (18, 6.4, 2); and increase in prenatal antiretroviral therapy:
(1.3%, 27.4%, 93.7%). Cognitive scores declined from ages 13 forward, despite
improved clinical outcomes.
Conclusions: Cognitive delay, common to children from urban settings, is likely
further exacerbated by the socioemotional and physical strain of parental HIVinfection. Future Ryan White goals need to address the mental health needs of
infected children, of affected siblings, and of children of infected adults.
Presenting author: susan abramowitz, NYU School of Medicine, 550 First
Avenue, Room NB-8E11, NY, NY, United States, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
ThPeG8369 Empowering young people in cross border
communities to combat the impact of HIV and
trafficking
N. Aye1, K. Maher2, J. Chandy1. 1Save the Children (UK), Southeast & East
Asia and the Pacific Regional Office, Bangkok,; 2Save the Children (UK), China
Programme, Beijing, China
The HIV/AIDS epidemic in Southeast Asia and Yunnan Province (China) is greatly
exacerbated, amongst other factors, by the mobility of populations, drugs, and
trade. In recent years the growing demands of the sex industry for HIV negative sex workers has contributed to a rise in the trafficking of children and young
women.
During 1999-2001 Save the Children, UK (SC UK) undertook a participatory study
with vulnerable children and young people in the Mekong Delta border areas to
gain a deeper understanding of the risks and vulnerabilities they face.
The first phase of the study identified a range of inter-related root causes of vulnerability to HIV and trafficking including limited access to education, health and
social services, lack of skills and job opportunities, poverty, and poor knowledge
of children's rights.
Lessons learned: - Strengthening protection of children and young people, building their resilience and empowering them to take control of their lives helps them
to address HIV and trafficking in their communities.
- Risk behaviours are often associated with the survival strategies of vulnerable
children and young people faced with limited choices. Providing alternative life
choices is essential to reduce these risk behaviours.
Recommendations: - In communities experiencing socio-political change, children and young people should be provided with information to guide their life
choices which should then be respected.
- Partnerships must be developed at local and national levels, with ethnic minority and dominant ethnic groups. Where political and cultural tensions exist, it is
important to respect local conditions and build community capacity in culturally
and politically sensitive ways.
- Rights based approaches to HIV/AIDS should take shape in politically sensitive
ways, which consider and acknowledge the limitations and constraints in which
local law and justice systems operate.
Presenting author: nwe nwe aye, save the children (UK), southeast & east asia
and the pacific regional office, 10th floor, maneeya centre north building, 518/3
ploenchit road, lumpini patumwan, bangkok 10330, Thailand, Tel.: [phone]
1286, Fax: [phone], E-mail: [email protected]
ThPeG8370 Changes in behaviour, practice and policy in
HIV/AIDS prevention: Participatory work with
young people in the Lao People's Democratic
Republic
E. Klien. Save the Children (UK), Laos PDR Programme, Save the Children
(UK), PO Box 1146, Vientiane, Lao People's Democratic Republic
Issues: Laos is undergoing rapid change, with a rapid evolution towards a marketled economy. Changes of this nature, after years of relative isolation, are creating
new challenges for young people, among them those related to sexual and reproductive health and HIV/AIDS.
Description: During 1997 and 1998, a participatory action research was undertaken by the Vientiane Municipal Women's Union and Save the Children, UK (SC
UK). The 'Listening to the Voice of Young People' project highlighted young people's thoughts, feelings about life and their aspirations in Vientiane.
Two findings became evident. Young urban people are at high risk due in large
part to their lack of life skills and their poor understanding of HIV/AIDS prevention
strategies.
The Vientiane youth centre for health and development project was initiated
largely as a direct result of this research. Although it only opened in early March

2001, the project has trained 9 counselors, 120 peer volunteers and 36 peer educators. Through outreach activities contact is established with vulnerable groups
of young people directly in their community. In addition, there is on site the first
youth-friendly confidential sexual and reproductive health clinic in the Lao PDR.
Lessons learned/Recommendations: Some of the lessons that were learned
and recommendations that were highlighted during the development of the Vientiane youth centre included: