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AIDS Care: Psychological and Sociomedical Aspects of AIDS/HIV Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/caic20
AIDS in Asia I. S. Gilada
a
a
Consultant Skin and STD Specialist, Indian Health Organisation, J. J. Hospital Compound , Bombay, 400008, India Published online: 25 Sep 2007.
To cite this article: I. S. Gilada (1991) AIDS in Asia, AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 3:4, 391-394, DOI: 10.1080/09540129108251596 To link to this article: http://dx.doi.org/10.1080/09540129108251596
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions
391
AIDS CARE, VOL. 3, NO. 4, 1991
AIDS in Asia I. S. GILADA
Downloaded by [Temple University Libraries] at 22:48 10 January 2015
Consultant Skin and STD Specialist, Indian Health Organisation, J. J. Hospital Compound, Bombay-400008, India
The Seventh International Conference on AIDS accorded importance to AIDS in Asia, and an Indian, Dr Ramlingaswami spoke at the opening ceremony. But the number of presentations from Asia was low. Of the 494 oral presentations only 9 (1.8%), and of the 2,897 poster presentations only 57 (2%) were from the Asia. In total only 1% of the delegates were representing 60% of the world’s population! In contrast, the satellite meetings like the Workshop on Asian Solidarity against AIDS by the Indian Health Organization and a Special Session by the WHO on AIDS Prevention and Control at the National level with 4 speakers from Asia were keenly attended.
Clinical science and trials Hasan (MB2389) highlighted the predictive importance of intravenous drug use in patients with renal failure and warned that the incidence of HIV infection in dialysis patients will increase in future. Tanphaichitra (MB2452) described patterns of AIDS in the tropics: (1) Wasting and AIDS dementia complex (2) Secondary neoplasms, and (3) Opportunistic infections: Histoplasmosis, penicilliosis, salmonellosis and melioidosis were reported in their patients with some frequency unlike the western hemisphere, Australia, New Zealand and Africa, Li
Patrick (MB2453) described the clinical features of the 45 cases, reported to the Department of Health in Hong Kong, of which 25 had respiratory symptoms; PCP was the commonest infection whereas T B seems to be gaining ground in Hong Kong. Of these 25 were homo/bisexuals. Shinichi (WB2 149) evaluated the efficacy of beta-IFN by changes of the number of HIV proviruses in blood. Four weeks regimen of beta-IFN did not affect the number of HIV proviruses in peripheral blood mononuclear cells. l’etersen (WB229 1) reported that TI-23 (IgG1 with a high neutralizing activity against CMV) is well tolerated. Improvements was noted in gastrointestinal symptoms. Favorable result was noted in retinitis progression. Sirivichayakul (WB2420) found the Multitest using CD4 4assessment and DTH skin test to be useful in the prognosis of patients with HIV infection.
Epidemiology and prevention Jarlais (MC20) compared long-term and recent trends in seroprevalence and AIDS risk reduction among drug injectors in New York City and Bangkok. Despite the many cultural differences, behavior changes produced stable seroprevalence with moderate seroconversion in both cities. New injec-
Downloaded by [Temple University Libraries] at 22:48 10 January 2015
392 FLORENCE S U W R I E S : I.
S. GILADA
tors and IVDUs not in treatment appear to be critical in prevention programming. Sakondhavat (MC3086) reported on use of the ‘Female Condom’ among sexually active Thai women with high risk behavior. In 50% of all commercial sex episodes barrier protection was used. Experiences of initial innovators may spread and ‘peer pressure’ may help. Choi (MC3235) reported 52 of the 136,539 (0.038%) heterosexual and 12 out of 1,308,209 (0.0009%) sex industry workers were seropositive; 2 of 600 hemophiliacs (0.33%) and 18 of 3,472,658 (0.0005%) blood donors were seropositive in South Korea. Results of 4 biannual national sentinel surveys to assess the extent of HIV infection and the trend of HIV spread in Thailand were presented by Ungchusak (MC3246). HIV prevalence was highest among IVDUs, female sex-workers and male STD-patients. Sehgal (MC3249) reported on 23,000 blood samples screened in North India. Sixty samples tested positive and 10 had AIDS of whom 8 died within 2-6 months of diagnosis; none had KS. HIV-2 antibodies were also detected. Shiu Hung (MC3284) reported increasing incidence of HIV among heterosexuals in Hong Kong. Hemophiliacs, homo/bisexuals were identified as target groups. Rubsamen-Waigmann (MC3291) reported on HIV-2 in Bombay; the distribution pattern was identical to the pattern in the Ivory Coast. Vanichseni (MC3332) while discerning the relationships between HIV testing and sexual behavior in IVDUs, noted that HIV testing and counselling can be utilized as a method of reducing HIV transmission among IVDU’s in Bangkok. Ramnathan (WC3074) observed that, though HIV infection has not reached the male commercial sex workers in Tamil Nadu, they should be considered vulnerable and encouraged to use condoms. Sawanpanyalert (WC3097) reported seroconversion rates in 2 groups of sex workers in Chiangmai as 4.8% and 3.4% per personmonth respectively. Transmission seemed to be unrelated to price or number of sex services. Archibald (WC3141) presented a
comparative study of serum-pooling strategies for HIV screening in Dominican Republic, Trinidad, Ecuador and Philippines. Sensitivity and specificity are not greatly affected using the assays. In a study of STD-clients in Taipei, Hwa-Chen (WC3142) found that risk was greater for homosexuals with Trepenoma. Eberle (WC3145) reported on a Retrotest for antibodies against currently known retroviral agents with similar or better sensitivity and specificity than currently licensed tests that detect antibodies against HTLV-1 or HIV1/HIV-2. Paladin (WC3 152) discussed the feasibility of testing antibodies to HIV from filter paper eluates, Particle Agglutination and Line Immunoassay. Storage and transport conditions were not critical. Thus, blood collection can be from areas remote from testing sites. Samundi (WC3236) described a sudden surge of HIV infection in women from the general population attending Antenatal Clinics. Of the sample, 65% were uninformed about STD and AIDS. Kurimura (WC3334) studied blood-borne transmission, the main route of infection with HIV and HCV in IVDUs and suggested that very rapid spread of HIV may be the cause of seronegative HIV infections and suppression of anti-HIV antibodies may be effected by actively growing HCV.
Social and behavioral science A study of the psychosocial determinants of
risk-taking and preventive behavior related to HIV and AIDS in Metro Manila by Tiglao (MD 108) yielded interesting findings on the sexual behavior of the general population, prevalence of condom use and myths and misperceptions about transmission and causes of HIVIAIDS. In Phase 1 of a multisite project on prostitution and HIV transmission in Mexico, Thailand and Ethiopia Kaufman (TuD108) found that heterogeneity in forms of sex work exist within and across sites and determines risk and epidemiologic projections; superficial similarities in workplaces crossculturally are inadequate
Downloaded by [Temple University Libraries] at 22:48 10 January 2015
AIDSINASIA
indicators of intervention needs; dimensions such as economic need, autonomy in client selection, relationship to manager, and culture/class specific gender role ideals are useful for defining subgroups of female sex workers and clients. Sakondhavat (WD53) suggested that a condom-only policy in brothels can succeed if managers and brothel workers show solidarity in rejecting non-condom using clients. Laws to promote condom use may not be needed if brothels are given the opportunity to implement condom-only policy. Crane (WD56) discussed the importance of reaching out to groups like street children, gays, sex workers and their clients, through local NGOs’ which were found to be better placed than the governmental agencies to work sensitively and effectively with marginalized groups. Swaminathan (WD58) in his study of the commercial sex seekers in the city of Madras observed that the men felt AIDS to be a ‘foreign’ problem, thought that they could identify infected women and beIieved “all STDs are curable” if treated early and if untreated would progress ’ to leprosy or AIDS; they also thought that condoms are to be used solely as contraceptives, extensive body contact during sex facilitates the spread of STDs, that condoms can’t prevent this and that they decrease pleasure. Monzon (MD4054) highlighted the inadequacy of ‘condom use history’ in assessing risk practices in female sex workers. Histories may be influenced by a variety of factors, history taking and use of government clinics for studies, skewing favorable responses. Thanprasertsuk (MD4059) discussed a survey of condom use and methods of condom usage assessment among female sex workers. Sittirai (MD4113) presented findings of a survey of partner relations and risks. A large number of Thai men had multiple sex partners. The low use of condoms places many women at risk through their relationships with higher risk male partners. Fulayfil (MD4161) reported drug abuse (with 77.7% positivity rate) as the most important mode of spread followed by
393
sexual transmission (10.7%) in Baharain. 7.3% of the HIV-positive were aliens and none were drug users. Ravinathan (MD4232) discussed contraceptives and heterosexual transmission of STD and HIV infections. A significant prevalence of STD was found in women seeking Family Planning Services at a clinic in Manali, but were HIV negative. It was inferred that condom be promoted. Shanmuganandan (MD4256) found the prevalence of seropositivity was 7 per 1,000 among persons with high risk behavior, more in urban than the rural women. In Philippines, Ravelo (WD4008), concluded that a community-based approach can be effective in increasing condom use. Gillies (WD4029) discussed an ongoing study, to determine the factors pertaining to sociodemographic, sex practices and friendship, which can be used in intervention strategies. Okanurak (WD4164) in a KAP in dentists reported moderate level of knowledge; 72% had a positive attitude toward HIV patients. However, most had no routine infection control. A CME for the dentists was recommended. A trial to improve AIDSrelated attitudes and professional competence of health care workers, was conducted by Santa (WD4169) in metro Manila hospitals. The predominant negative attitudes were: fear, reluctance and stigmatization of patients. Programs were developed, pretested and implemented. A significant increase was found in the knowledge and attitudes scores in the index group. Role plays were the most effective strategy. Singh (WD4186) described risks of acquiring HIV infection through contamination of laboratory slips and blood sample containers. 13.23% containers and 14.47% lab slips were contaminated with blood in the form of drops and stains. Jimerson (WD4272) presented a 4 country research report on ‘hotlines’ in AIDS information campaigns. Hotlines are effective research tools for developing, monitoring and evaluating broader-scale AIDS prevention strategies. Margo (WD4273) discussed social marketing in effective campaigns on AIDS. Electronic and
Downloaded by [Temple University Libraries] at 22:48 10 January 2015
394
FLORENCE SUhUvlARIES: I. S. GILADA
print media, hotline and public relations programs were set up to support the campaign. A positive effect on the target population-‘Miguel Joven’ was found. Gilada (WD4293) suggested that a sequence HIV prevention campaign may be more effective in non-literate and unempowered communities. The target population comprised women in prostitution in 2 different areas in Bombay. One group received a sequenced program of contact, self-organization, focussed discussion, street campaigning, condom distribution and print campaign. The second group were exposed to street campaigning and condom distribution alone.
Workshop: AIDS
Asian
solidarity against
A satellite workshop to highlight the need for networking for AIDS related issues in Asia, was organized by Indian Health Organisation. Deputy Director of the Global Program on AIDS, Dr Dorothy Blake in her inaugural address, highlighted the need for the integration of HIV/AIDS services with MCH and Family Planning programmes and felt that AIDS should be on the Political Agenda. According to the GPA every hour 5,000 new lives are affected by HIV and women are most vulnerable. Kurimura (Japan) reported on Japan’s policy of mass screening. Out of 110 millions tested 400 AIDS patients (300 hemophiliacs and 100 homo/bisexuals) and 1,700 HIV positive were detected. Roy Chan (Singapore) reported 80 HIV positives from Singapore in the half million tested. Don Douglas (Thailand) informed of the 3 stages of the epidemic in Thailand: (i) Less than a dozen HIV positive in 1985, (ii) 1% of the IV drug users were found HIV positive during 1986-87, 16% in 1988 and 44% in July 1989, (iii) heterosexual spread-40% of prostitutes are HIV posi-
tive. In 1991 among the military recruits 5 6 % and among the blood donors 6% were found HIV positive. Projections are 0.2 million HIV infections by the end of 1991 and 2-7 millions by the end of 2000. Ofelia Monzon (Philippines) reported that the first case was in 1985, and by 1990 there were 248 HIV positives; the predominant mode of spread is heterosexual transmission, most being prostitutes. Gunavan (Indonesia) described a low prevalence, with 20 cases and 20 HIV positives. Gilada (India) informed that the first AIDS case was reported in 1986. The incidence of HIV among women in prostitution in Bombay was 0.5% in 1986, 1% in 1987, 3% in 1988, 10% in 1989, 20% in 1990 and 30% in mid 1991. Over 10% of the patients attending STD clinics in Bombay in 1990-91 were HIV positive. In blood bank screening 8 per 1,000 were HIV positive. The workshop concluded with group discussions on the regional issues v25 u vis HIV/AIDS and a resolution to for a network of NGOs’ in Asia.
Conclusions The most important conclusion at the Seventh conference was that there needs to be a greater global participation in the efforts of the Asian countries. Workers in these regions need to be supported and provided better representation at international forums to enrich their work and create a global fraternity. Anxiety was written on the faces of most of the participants from Asia; let us hope that this is not to be compounded by feelings of abandonment and isolation. Though at present the Asian efforts are largely towards prevention and containment of the epidemic, in the future, they will need herculean assistance in the management of problems that they are already facing.
AIDS Care: Psychological and Sociomedical Aspects of AIDS/HIV Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/caic20
AIDS in Asia I. S. Gilada
a
a
Consultant Skin and STD Specialist, Indian Health Organisation, J. J. Hospital Compound , Bombay, 400008, India Published online: 25 Sep 2007.
To cite this article: I. S. Gilada (1991) AIDS in Asia, AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV, 3:4, 391-394, DOI: 10.1080/09540129108251596 To link to this article: http://dx.doi.org/10.1080/09540129108251596
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/termsand-conditions
391
AIDS CARE, VOL. 3, NO. 4, 1991
AIDS in Asia I. S. GILADA
Downloaded by [Temple University Libraries] at 22:48 10 January 2015
Consultant Skin and STD Specialist, Indian Health Organisation, J. J. Hospital Compound, Bombay-400008, India
The Seventh International Conference on AIDS accorded importance to AIDS in Asia, and an Indian, Dr Ramlingaswami spoke at the opening ceremony. But the number of presentations from Asia was low. Of the 494 oral presentations only 9 (1.8%), and of the 2,897 poster presentations only 57 (2%) were from the Asia. In total only 1% of the delegates were representing 60% of the world’s population! In contrast, the satellite meetings like the Workshop on Asian Solidarity against AIDS by the Indian Health Organization and a Special Session by the WHO on AIDS Prevention and Control at the National level with 4 speakers from Asia were keenly attended.
Clinical science and trials Hasan (MB2389) highlighted the predictive importance of intravenous drug use in patients with renal failure and warned that the incidence of HIV infection in dialysis patients will increase in future. Tanphaichitra (MB2452) described patterns of AIDS in the tropics: (1) Wasting and AIDS dementia complex (2) Secondary neoplasms, and (3) Opportunistic infections: Histoplasmosis, penicilliosis, salmonellosis and melioidosis were reported in their patients with some frequency unlike the western hemisphere, Australia, New Zealand and Africa, Li
Patrick (MB2453) described the clinical features of the 45 cases, reported to the Department of Health in Hong Kong, of which 25 had respiratory symptoms; PCP was the commonest infection whereas T B seems to be gaining ground in Hong Kong. Of these 25 were homo/bisexuals. Shinichi (WB2 149) evaluated the efficacy of beta-IFN by changes of the number of HIV proviruses in blood. Four weeks regimen of beta-IFN did not affect the number of HIV proviruses in peripheral blood mononuclear cells. l’etersen (WB229 1) reported that TI-23 (IgG1 with a high neutralizing activity against CMV) is well tolerated. Improvements was noted in gastrointestinal symptoms. Favorable result was noted in retinitis progression. Sirivichayakul (WB2420) found the Multitest using CD4 4assessment and DTH skin test to be useful in the prognosis of patients with HIV infection.
Epidemiology and prevention Jarlais (MC20) compared long-term and recent trends in seroprevalence and AIDS risk reduction among drug injectors in New York City and Bangkok. Despite the many cultural differences, behavior changes produced stable seroprevalence with moderate seroconversion in both cities. New injec-
Downloaded by [Temple University Libraries] at 22:48 10 January 2015
392 FLORENCE S U W R I E S : I.
S. GILADA
tors and IVDUs not in treatment appear to be critical in prevention programming. Sakondhavat (MC3086) reported on use of the ‘Female Condom’ among sexually active Thai women with high risk behavior. In 50% of all commercial sex episodes barrier protection was used. Experiences of initial innovators may spread and ‘peer pressure’ may help. Choi (MC3235) reported 52 of the 136,539 (0.038%) heterosexual and 12 out of 1,308,209 (0.0009%) sex industry workers were seropositive; 2 of 600 hemophiliacs (0.33%) and 18 of 3,472,658 (0.0005%) blood donors were seropositive in South Korea. Results of 4 biannual national sentinel surveys to assess the extent of HIV infection and the trend of HIV spread in Thailand were presented by Ungchusak (MC3246). HIV prevalence was highest among IVDUs, female sex-workers and male STD-patients. Sehgal (MC3249) reported on 23,000 blood samples screened in North India. Sixty samples tested positive and 10 had AIDS of whom 8 died within 2-6 months of diagnosis; none had KS. HIV-2 antibodies were also detected. Shiu Hung (MC3284) reported increasing incidence of HIV among heterosexuals in Hong Kong. Hemophiliacs, homo/bisexuals were identified as target groups. Rubsamen-Waigmann (MC3291) reported on HIV-2 in Bombay; the distribution pattern was identical to the pattern in the Ivory Coast. Vanichseni (MC3332) while discerning the relationships between HIV testing and sexual behavior in IVDUs, noted that HIV testing and counselling can be utilized as a method of reducing HIV transmission among IVDU’s in Bangkok. Ramnathan (WC3074) observed that, though HIV infection has not reached the male commercial sex workers in Tamil Nadu, they should be considered vulnerable and encouraged to use condoms. Sawanpanyalert (WC3097) reported seroconversion rates in 2 groups of sex workers in Chiangmai as 4.8% and 3.4% per personmonth respectively. Transmission seemed to be unrelated to price or number of sex services. Archibald (WC3141) presented a
comparative study of serum-pooling strategies for HIV screening in Dominican Republic, Trinidad, Ecuador and Philippines. Sensitivity and specificity are not greatly affected using the assays. In a study of STD-clients in Taipei, Hwa-Chen (WC3142) found that risk was greater for homosexuals with Trepenoma. Eberle (WC3145) reported on a Retrotest for antibodies against currently known retroviral agents with similar or better sensitivity and specificity than currently licensed tests that detect antibodies against HTLV-1 or HIV1/HIV-2. Paladin (WC3 152) discussed the feasibility of testing antibodies to HIV from filter paper eluates, Particle Agglutination and Line Immunoassay. Storage and transport conditions were not critical. Thus, blood collection can be from areas remote from testing sites. Samundi (WC3236) described a sudden surge of HIV infection in women from the general population attending Antenatal Clinics. Of the sample, 65% were uninformed about STD and AIDS. Kurimura (WC3334) studied blood-borne transmission, the main route of infection with HIV and HCV in IVDUs and suggested that very rapid spread of HIV may be the cause of seronegative HIV infections and suppression of anti-HIV antibodies may be effected by actively growing HCV.
Social and behavioral science A study of the psychosocial determinants of
risk-taking and preventive behavior related to HIV and AIDS in Metro Manila by Tiglao (MD 108) yielded interesting findings on the sexual behavior of the general population, prevalence of condom use and myths and misperceptions about transmission and causes of HIVIAIDS. In Phase 1 of a multisite project on prostitution and HIV transmission in Mexico, Thailand and Ethiopia Kaufman (TuD108) found that heterogeneity in forms of sex work exist within and across sites and determines risk and epidemiologic projections; superficial similarities in workplaces crossculturally are inadequate
Downloaded by [Temple University Libraries] at 22:48 10 January 2015
AIDSINASIA
indicators of intervention needs; dimensions such as economic need, autonomy in client selection, relationship to manager, and culture/class specific gender role ideals are useful for defining subgroups of female sex workers and clients. Sakondhavat (WD53) suggested that a condom-only policy in brothels can succeed if managers and brothel workers show solidarity in rejecting non-condom using clients. Laws to promote condom use may not be needed if brothels are given the opportunity to implement condom-only policy. Crane (WD56) discussed the importance of reaching out to groups like street children, gays, sex workers and their clients, through local NGOs’ which were found to be better placed than the governmental agencies to work sensitively and effectively with marginalized groups. Swaminathan (WD58) in his study of the commercial sex seekers in the city of Madras observed that the men felt AIDS to be a ‘foreign’ problem, thought that they could identify infected women and beIieved “all STDs are curable” if treated early and if untreated would progress ’ to leprosy or AIDS; they also thought that condoms are to be used solely as contraceptives, extensive body contact during sex facilitates the spread of STDs, that condoms can’t prevent this and that they decrease pleasure. Monzon (MD4054) highlighted the inadequacy of ‘condom use history’ in assessing risk practices in female sex workers. Histories may be influenced by a variety of factors, history taking and use of government clinics for studies, skewing favorable responses. Thanprasertsuk (MD4059) discussed a survey of condom use and methods of condom usage assessment among female sex workers. Sittirai (MD4113) presented findings of a survey of partner relations and risks. A large number of Thai men had multiple sex partners. The low use of condoms places many women at risk through their relationships with higher risk male partners. Fulayfil (MD4161) reported drug abuse (with 77.7% positivity rate) as the most important mode of spread followed by
393
sexual transmission (10.7%) in Baharain. 7.3% of the HIV-positive were aliens and none were drug users. Ravinathan (MD4232) discussed contraceptives and heterosexual transmission of STD and HIV infections. A significant prevalence of STD was found in women seeking Family Planning Services at a clinic in Manali, but were HIV negative. It was inferred that condom be promoted. Shanmuganandan (MD4256) found the prevalence of seropositivity was 7 per 1,000 among persons with high risk behavior, more in urban than the rural women. In Philippines, Ravelo (WD4008), concluded that a community-based approach can be effective in increasing condom use. Gillies (WD4029) discussed an ongoing study, to determine the factors pertaining to sociodemographic, sex practices and friendship, which can be used in intervention strategies. Okanurak (WD4164) in a KAP in dentists reported moderate level of knowledge; 72% had a positive attitude toward HIV patients. However, most had no routine infection control. A CME for the dentists was recommended. A trial to improve AIDSrelated attitudes and professional competence of health care workers, was conducted by Santa (WD4169) in metro Manila hospitals. The predominant negative attitudes were: fear, reluctance and stigmatization of patients. Programs were developed, pretested and implemented. A significant increase was found in the knowledge and attitudes scores in the index group. Role plays were the most effective strategy. Singh (WD4186) described risks of acquiring HIV infection through contamination of laboratory slips and blood sample containers. 13.23% containers and 14.47% lab slips were contaminated with blood in the form of drops and stains. Jimerson (WD4272) presented a 4 country research report on ‘hotlines’ in AIDS information campaigns. Hotlines are effective research tools for developing, monitoring and evaluating broader-scale AIDS prevention strategies. Margo (WD4273) discussed social marketing in effective campaigns on AIDS. Electronic and
Downloaded by [Temple University Libraries] at 22:48 10 January 2015
394
FLORENCE SUhUvlARIES: I. S. GILADA
print media, hotline and public relations programs were set up to support the campaign. A positive effect on the target population-‘Miguel Joven’ was found. Gilada (WD4293) suggested that a sequence HIV prevention campaign may be more effective in non-literate and unempowered communities. The target population comprised women in prostitution in 2 different areas in Bombay. One group received a sequenced program of contact, self-organization, focussed discussion, street campaigning, condom distribution and print campaign. The second group were exposed to street campaigning and condom distribution alone.
Workshop: AIDS
Asian
solidarity against
A satellite workshop to highlight the need for networking for AIDS related issues in Asia, was organized by Indian Health Organisation. Deputy Director of the Global Program on AIDS, Dr Dorothy Blake in her inaugural address, highlighted the need for the integration of HIV/AIDS services with MCH and Family Planning programmes and felt that AIDS should be on the Political Agenda. According to the GPA every hour 5,000 new lives are affected by HIV and women are most vulnerable. Kurimura (Japan) reported on Japan’s policy of mass screening. Out of 110 millions tested 400 AIDS patients (300 hemophiliacs and 100 homo/bisexuals) and 1,700 HIV positive were detected. Roy Chan (Singapore) reported 80 HIV positives from Singapore in the half million tested. Don Douglas (Thailand) informed of the 3 stages of the epidemic in Thailand: (i) Less than a dozen HIV positive in 1985, (ii) 1% of the IV drug users were found HIV positive during 1986-87, 16% in 1988 and 44% in July 1989, (iii) heterosexual spread-40% of prostitutes are HIV posi-
tive. In 1991 among the military recruits 5 6 % and among the blood donors 6% were found HIV positive. Projections are 0.2 million HIV infections by the end of 1991 and 2-7 millions by the end of 2000. Ofelia Monzon (Philippines) reported that the first case was in 1985, and by 1990 there were 248 HIV positives; the predominant mode of spread is heterosexual transmission, most being prostitutes. Gunavan (Indonesia) described a low prevalence, with 20 cases and 20 HIV positives. Gilada (India) informed that the first AIDS case was reported in 1986. The incidence of HIV among women in prostitution in Bombay was 0.5% in 1986, 1% in 1987, 3% in 1988, 10% in 1989, 20% in 1990 and 30% in mid 1991. Over 10% of the patients attending STD clinics in Bombay in 1990-91 were HIV positive. In blood bank screening 8 per 1,000 were HIV positive. The workshop concluded with group discussions on the regional issues v25 u vis HIV/AIDS and a resolution to for a network of NGOs’ in Asia.
Conclusions The most important conclusion at the Seventh conference was that there needs to be a greater global participation in the efforts of the Asian countries. Workers in these regions need to be supported and provided better representation at international forums to enrich their work and create a global fraternity. Anxiety was written on the faces of most of the participants from Asia; let us hope that this is not to be compounded by feelings of abandonment and isolation. Though at present the Asian efforts are largely towards prevention and containment of the epidemic, in the future, they will need herculean assistance in the management of problems that they are already facing.
