Abstract Book Vol. 1 [International Conference on AIDS (16th: 2006: Toronto, Canada)]

Monday
14 August
Pc ste r,

MOPE0875
Home based sex workers, a most hidden population
and HIV/AIDS - an experience from Dhaka,
Bangladesh
S.S. Islam', A.S.M.E. Hoque2, S. Akhter3. 'Peoples Development Community
(PDC), Executive, Dhaka, Bangladesh, 2CARE Bangladesh, HIV Program,
Dhaka, Bangladesh, 3Peoples Development Community (PDC), HIV/AIDS
Intervention, Dhaka, Bangladesh
Issues: Hidden characteristics of home based sex workers make them more
vulnerable to HIV/AIDS in Bangladesh.
Description: There are many home-based sex workers in different city of
Bangladesh. Home based means 'women who live in the society as a ordinary
family and sell sex in secret ". Generally they select densely populated
residential area and rent house for operating sex business. They hide their
sex trade and avoid police & other interferences. In Bangladesh, there are
around 0.2 million sex workers of different categories operating through out
the country. Among them a significant number of sex workers are home based
& gradually it is increasing. Brothel, street and hotel based sex workers are
comparatively easier to identify through their peer and other techniques and it
is possible to operate activities on HIV/AIDS prevention. But it is very hard to
reach home-based sex workers as they are operating sex business in hidden.
They frequently change residence to maintain confidentiality and to avoid the
legal barrier and social stigma. They operate sex business through pimps and
also contact clients through telephonic communication. The pimps are not
much familiar in the community about their business.
Lessons learned: Peer based intervention following the snowballing
techniques might be an effective strategy to reach the hardcore population
like home-based sex workers. Involving pimps in the intervention activities
might be another effective strategy in promoting safer sex practices among the
home-based sex workers
Recommendations: National level advocacy is essential to remove legal
barriers and reducing harassments against the hidden population like home
based sex workers in respect to promoting safer practices to prevent HIV/
AIDS.
MOPE0876
Responding to the signs: a peer-led voluntary
counselling and testing programme for the Deaf in
Kenya
M. Taegtmeyer', K. Henderson2, P. Angala2, C. Ngare3. 'Liverpool VCT Centre,
Liverpool, United Kingdom, 2Liverpool VCT Centre, Nairobi, Kenya, 3National
AIDS and STD Control Programme, Nairobi, Kenya
Background: Existing voluntary counselling and testing services for HIV (VCT)
have failed to meet the needs of vulnerable and disabled people. There are no
previously published reports of HIV services for the Deaf community in the
developing world.
Methods: This paper describes the establishment of the first VCT services for
the Deaf in Kenya. The services use trained counselors who are themselves
Deaf alongside a unique peer education programme. Data were collected using
routine national data collection tools and entered and analysed in Epi Info using
simple descriptive statistics.
Results: During the 18 month period 1383 Deaf and 1034 hearing clients were
seen. Deaf clients were statistically similar to the hearing clients at the same
sites in gender (OR 0.9, p=0.2), rates of pregnancy (OR 01.1, p=0.8), and in
expressed reasons for coming (OR 0.9, p=0.3). Deaf clients were older (OR
0.7, p=0.01), less educated (OR 0.23, p=0.0001) and more likely to attend as
a group for counselling. Deaf clients were less likely to attend VCT when they
had a new partner and less likely to perceive themselves as having been at
risk (OR 0.7, p=0.007). However, unprotected sexual exposures were similar
in the two groups. The majority of Deaf clients heard of VCT services through
the peer education programme. HIV prevalence rates were 7% among the
Deaf VCT clients, data that are comparable to the 2003 Kenya Demographic
Health Survey.
Conclusions: This paper establishes the acceptability and feasibility of Deaffriendly VCT services in Kenya. It confirms the importance of peer education
programmes in a community inadequately accessed by national mass media
campaigns. Data revealed that Deaf VCT clients are as vulnerable to HIV as their
hearing counterparts yet they do not perceive their risks to be as high, making
the efforts to reach this under-served community even more important.
MOPE0877
Building family circles of care and support for
vulnerable children and families affected and
infected by HIV/AIDS
L.K. Mwewa, C. Tonga. Lupwa Lwabumi Trust, Lusaka, Zambia

Issues: The HIV/AIDS pandemic has devastated families in Zambia leading to
an unprecedented number of vulnerable children with no access to education,
shelter, food and health care. Adequate resources must be channelled to orphans
and vulnerable children (OVC), their families and caregivers. Community
leadership and resources must be mobilised to redress the situation.
Description: Lupwa Lwabumi Trust facilitates the establishment and
strengthening of family circles which build the social capital that provides
support, resources and a safety net around children. Families are part of twolevel circles; the first circle comprised of five families facilitates opportunities for

vulnerable families to connect with other families and address family problems.
A larger circle comprised of ten families provides secondary support services
and a forum to identify and addresses root causes of the community's problems.
This approach builds on past Zambian history of collective responsibility in
caring for the vulnerable.
Lessons learned: Given the necessary resources, skills and platform,
vulnerable families and their communities are ready to address their own
challenges and provide support for one another. Vulnerable families who are
often isolated from community support networks must initially be integrated
into smaller groups before joining larger circles. Genuine involvement of all
community members (especially the vulnerable) in community activities
helps reduce stigma and leads to openness, disclosure and empowerment to
participate in problem solving.
Recommendations: Rebuilding and strengthening community care and
support systems based on African traditional values facilitates individual
and community support systems. Participatory needs assessments and an
institutional review is needed to deepen understanding of community needs
and explore community structures for support mobilisation. Follow-up studies
to document the effectiveness of the approach in addressing social, economic
and psychosocial needs, as well as determine repricability of the family circle
model in other countries are needed.
MOPE0878
Attending the prevention of parent to child
transmission of HIV (PPTCT) programme at
St Annes Hospital Brunapeg, Bulawayo, Zimbabwe
R.M. Mbatha', L.S. Nkomo', L. Nyawo2, I.G. Mbatha2, T. Lunga2,
A.S. Meque'. 'Women's Comfort Corner, Administration, Harare, Zimbabwe,
2Marque Women's Foundation, Administration, Harare, Zimbabwe
The World AIDS Campaign for the years 2002 - 2003 focused on stigma and
discrimination and human rights. The main objective of the campaign was to
prevent, reduce and ultimately eliminate HIV and AIDS related stigma and
discrimination whenever it occurs in all forms.
The study sought to investigate the impact of stigma and discrimination
on women attending the Prevention of Parent to child Transmission of HIV
programme (PPTCT) at St. Anne's Hospital in rural Brunapeg, by investigating
the impact of HIV on their livelihoods, families and relationships, the aspects
of the PPTCT programme that could lead to the stigmatisation of women, their
experiences of disclosure to their partners and significant others, their views on
how stigma can be alleviated in their community and the benefit of counselling
in dealing with discrimination.
Background information on HIV/AIDS, stigma and discrimination were
researched. The Literature review focused on how stigma is a violation of
human rights, and that in many ways it affects not only people living with
HIV/AIDS but also their families and care givers.
A qualitative research design using the Case Study approach guided the
researcher in data collection and analysis. The participants comprised of thirty
women who had received Voluntary Counselling and Testing in the PPTCT
programme at the hospital. The Questionnaire and Standardized Open ended
Interview were used as data collection instruments
The findings on the impact of stigma revealed that stigma demobilises women
to come forward and receive VCT, leads to the deterioration of interpersonal
relationships, further re-infection and prevents advocacy and the capacity of
civil society to fight the HIV pandemic.
This research was mainly intended to provide information that would assist HIV
positive women, AIDS service organisations and policy makers to advocate for
changes that would alleviate the stigma attached to being HIV positive and
explore benefits of male participation.
MOPE0879
Reducing youth vulnerability in Ethiopia through
social purpose enterprise
E. Fikre Eshete. Hiwot AIDS Prevention Care and Support Organization,
Program, Addis Abeba, Ethiopia
Issues: Poverty among young adults creates vulnerability to HIV infection by,
for example, pushing many - especially women - towards transactional sex
work as a survival strategy. The threat is great for the oldest children of adults
who are bedridden or have died due to AIDS. With responsibility to support
younger siblings and/or care for sick parents, and stigma posing a barrier to
securing employment, prostitution can be the only option available.
CBOs in Ethiopia are working to reduce the vulnerability of older AIDS orphans
through the creation of"social purpose enterprises" such as woodworking shops.
For participating youth, the benefits include: developing employment skills;
earning income, reducing pressure to engage in sex work; developing a peer
network; heightened self-esteem and reduced stigma. However, developing
youth-led enterprises in poor urban environments presents challenges such
as: how to identify market-viable businesses, provide work options that young
people are interested in, and sustain with little subsidy?

Description: The above challenges are being addressed in innovative ways by
two CBOs in Ethiopia that were established and are operated by people infected/
affected by HIV. CAP AIDS - a Canadian charity - has partnered with both
to support the development of social purpose enterprises, and has observed
important benefits that this strategy provides vulnerable young people.
The proposed presentation will compare and contrast examples of social
purpose enterprise developed by these CBOs to show how they have adapted
to the needs, vulnerabilities and circumstances of older orphans in their
communities.

XVI INTERNATIONAL AIDS CONFERENCE * 13-18 AUGUST 2006 * TORONTO CANADA * ABSTRACT BOOK VOLUME 1