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

MOPE0959
HIV and disability grants in the context of ARV
treatment: is a basic income grant the answer?
M. Richter, C. Hardy. AIDS Law Project, Johannesburg, South Africa
Issues: A number of people with HIV/AIDS (PWAs) have been accessing social
security in the form of a disability grant in South Africa. With the advent of
public sector anti-retrovirals, many PWAs who become healthy are now losing
this form of monthly income. In a country where there are extraordinary levels
of unemployment, the formation and implementation of creative new strategies
to cushion the impact of withdrawing social security from healthy PWAs are
imperative.
Description: This paper will argue that it is essenltial that the state provide
alternative forms of relief in order to support PWAs, as well as to ensure the
success of an anti-retroviral programme that is envisaged to become the
biggest in the world. The provision of a Basic Income Grant is proposed and a
number of constitutional arguments are explored.
Lessons learned: Guarantees of social security and the progressive realization
of other socio-economic rights are vital components of an adequate response
to the HIV/AIDS epidemic, and a comprehensive treatment and prevention
programme. The lack of appropriate social security creates several barriers to
accessing ARV treatment, from the adverse impact on people who lose their
grants to perverse incentives for people to refuse ARV treatment in order to
remain sick and continue accessing a grant.
Recommendations: The proposal of an extension of a disability grant to all
healthy PWAs or creating a special "HIV grant" raises a host of ethical and legal
questions in a context where AIDS should be 'normalised'. A Basic Income
Grant would avoid these problems. In the interim, it is vital that alternative
forms of social security and support are established to assist PWAs.
MOPE0960
Participatory budget analysis as a tool to improving
effective and accountable utilization of allocated
funds for HIV/AIDS prevention and impact
mitigation- case study of some Nigeria communities
I. Okekearu', I. Madueke2, H. Ogbonna2, O. Ogbureke2. 1ActionAid
International, Nigeria, SRH/HIV&AIDS, Abuja,FCT, Nigeria, 2ActionAid
International, Nigeria, Governance team, Abuja,FCT, Nigeria
Issues: Lack of funds to manage HIV issues is a big challenge in developing
countries especially where the will to utilize such insufficient fund is lacking.
The experience of some communities in Nigeria is that inability to engage the
affected, highly illiterate communities in planning and design of programme
and budget line expenditure has resulted in poor fund utilization.
Description: The Participatory Budget Analysis (PBA) as against budget
analysis (often done by expert) allows for communities active participation
and engagement in the monitoring and evaluation of budget allocations and
expenditure. It also affords opportunities for communities to relate budgets to
their daily lives. The process uses trained community facilitators to mobilize
communities for action and engage leaders.
Experience has shown that PBA process can ensure community participation and
influencing of proper government budgetary allocation and funds management.
This process includes organization of accountability forums, poverty match,
and use of religious institutions to bring leaders to account.
Lessons, Best practices and Achievements: The use of trained community
facilitators ensures that project implementers are not seen as those pushing
for the change, and creates community ownership. It eschews possibilities of
misunderstanding between government and the development agencies.
Local trained facilitators have galvanized support of community members to
bring their elected representatives to accountability forums. This has promoted
community consciousness and engagement in planning HIV&AIDS programmes
and quality life for PLWHA.
Recommendations/Comments: Proponents of this methodology need to
ensure mastery of advocacy skills and ability to mobilize community. This will
ensure that the Government or Gatekeepers are not unnecessarily agitated by
the process.
MOPE0961
Promoting a comprehensive approach to social
security to meet the needs of children made
vulnerable by HIV/AIDS in South Africa
K. Allan, P. Martin. The Alliance for Children's Entitlement to Social Security,
Cape Town, South Africa
Issues: An estimated million South African children aged 2-18 are HIV
positive. Thousands of babies are born positive to infected mothers. Of the
50 000 children requiring ARV treatment only 4000 receive treatment. Many
are also poor which aggravates the severity and impact of the disease as they

are unable to access medical care and are also deprived of essential resources
in the fight against AIDS. Neither adequate cash grants, free nutrition and
schooling nor an adequate and comprehensive social security system exists for
these children. The means tested Child Support Grant (CSG) is limited to 14
and thus excludes the highly vulnerable 14 to 18 age category where HIV/AIDS
prevalence is particularly high. Limited support to children following the death
or illness of parents / caregivers exists in the form of the Foster Care Grant but
this option is administratively costly and burdensome.

Description: A comprehensive social security system that provides children
made more vulnerable by HIV/AIDS with grants, health, nutrition, schooling
and basic services is essential to address their daily needs - but also to escape
the poverty trap that is perpetuated by the HIV pandemic. The Alliance for
Children's Entitlement to Social Security (ACESS) seeks to achieve this
objective through its 1000 strong alliance of children's sector organisations
which engages with policy and law reform processes through advocacy;
lobbying for policy change; developing literacy materials; undertaking training;
and integrated multi-stakeholder grants and services campaigns.
Lessons learned: Research shows a real link between social security
investment and improved living conditions for vulnerable children.
Recommendations: ACESS recommends that all stakeholders promote the
adoption of a comprehensive social security system, encompassing grants,
benefits and services, addressing the needs of all vulnerable children. This
includes the need for cash grants, as well as access to children's basic rights.
MOPE0962
Reporting sharp injuries and blood and body
fluid exposures among health care workers in a
developing country
D.A. Adewole', T.O. Lawoyin2, B. Stringer3, T. Haines4, C. Iwisiw3,
A.O. Oluwatosin2, IF. Adewole2. University College Hospital, Community
Medicine, Ibadan, Nigeria, 2College of Medicine, University College Hospital,
Ibadan, Nigeria, 'University of Western Ontario, London Ontario, Canada,
4McMasters University, Hamilton, Canada
Background: Health Care Workers (HCW) are at risk for occupational exposure
to blood-borne pathogens including hepatitis B and C and HIV. Injuries from
needles and other sharp devices used in healthcare and laboratory settings
and exposure to blood and body fluids are associated with the occupational
transmission of these infections which are the most commonly transmitted
pathogens during patient care. This study is part of a larger study (NigerianCanadian-partnership) and was designed to assess the reporting practices
among HCWs in Ibadan, Nigeria.
Methods: Data were collected using a pre-tested questionnaire from 1517
HCWs in three of the 5 government hospitals (71.3% of eligible workers).
Results: Of these, 1155 (76.1%) of them have ever had accidental pricks or
cuts, but only 218 (18.9%) reported such injuries to the appropriate clinics.
Only 7 (10.0%) of the laboratory workers, 15(6.1%) of the Physicians and
83 (14.3%) of the nurses reported accidental injuries compared with 88
(52.1%) of the hospital attendants/ward orderlies. Majority of these HCWs,
1285 (84.7%) had also been in contact with blood and body fluids. Of these,
only 194 (15.1%) reported to the clinic. Health attendants/ward orderlies 79
(47.3%) were more likely to report accidental contact with blood and body
fluids than the other more senior health workers. Physicians followed by
laboratory workers had the lowest reporting rates (4.1% and 6.3%). Of those
that have had accidental injuries, only 272 (23.6%) report completing a full
course of hepatitis B vaccination and quite a large number 173 (15.0%) have
never had any hepatitis B vaccine.
Conclusions: Very few HCWs who are exposed to sharp injuries and blood and
body fluids in the facilities report such exposures.There is a need to reassess
the reporting strategies and work place policies so as to promote a safer health
care environment and ensure that workers are better protected against HIV
and Hepatitis.
MOPE0963
China "national poverty county" PLWHAs self-help
groups - Xia County
B. Gao1, Y. Xing2, X. Lil, Z. Zhang2, T. Wang2, K. Legins3. 'Xia Country CDC
Shanxi province, Yuncheng, China, 'School of Public Health, Peking University,
Beijing, China, 'UNICEF, Beijing, China
Issues: Xia County, Henan Province is a designated national poverty county;
there are 169 reported HIV cases as of Nov. 2005; and the main mode of
transmission was plasma donation which peaked around 1994. Blood donation
was a key source of income for many rural, poor residents. The compounded
impact of AIDS and poverty has required innovative approaches to addresses
the needs of people living with HIV/AIDS [PLWHAs].
Description: With the support from UNICEF and other sources, the local Chinese
Center for Disease Prevention and Control [CDC] and other government sectors
worked together to establish PLWHAs self-help groups in 30 villages covering 5
townships of Xia County, providing services to all people reported to be living
with HIV/AIDS in 2004-05. PLWHAs in three villages of Xia County pursued
micro- enterprise - "Huang tudi" [Yellow Earth] - as a project to improve their
quality of life. Through the "Yellow Earth" project, over 45 PLWHAs [25, 10 and
10 per group in each village] received grain and cotton seeds. Rabbits, pigs and
cows are distributed to those who will raise animals. Training agriculture and
husbandry experts was provided.
Lessons learned: PLWHAs groups in collaboration with the government can
provide innovative approaches for alleviating poverty and addressing the needs

PLWHAs. Micro-enterprise served to provide resources for households affected
by AIDS and provide opportunities for PLWHAs to contribute to their household's
and society. PLWHAs now feel they lead better lives, and are providing support
to other members of their own self-help groups and exchange experiences
between villages.
Recommendations: Consider establishing PLWHAs self-support groups in
Chinese national poverty counties and promote micro enterprise as a means
of creating financial independence and promoting the positive effects self help
group, leading to local implementation of national policies and regulations.

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