Abstract Book_SAARC Conference00018

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					Key Words: HIV/AIDS, Condoms use, pre and post                         Conclusion: Based on this study the risk of HIV/AIDS is very
intervention.                                                          high among the hotel based sex workers of Dhaka city.
                                                                       Appropriate initiative is needed to increase the level of
37. RISK ON HIV/AIDS AMONG HOTEL BASED                                 knowledge about safer sex among HBSWs.
                                                                       Keywords: HIV/AIDS, STI, HBSW, Bangladesh
Karim Md. R, Haque Md. M                                               38. PATCH IN THE GUT: DOES IT POINT
Department of Population Dynamics,
National Institute of Preventive and Social Medicine                   Gurung B, Gurung S., Yegneswaran P. P., Pai G., Bairy I,
                                                                       Department of Microbiology, Department of Gastroentrology,
Mohakhali, Dhaka1212. Bangladesh
                                                                       Kasturba Medical College,
33/7 Tajmahal Road, Block-C,
                                                                       Manipal University, Manipal, Karnataka, India
Mohammadpur, Dhaka -1207, Bangladesh.
                                                                       Introduction: Esophageal Candidiasis (EC) is infection of the
Tel: 880-1712154791
                                                                       esophagus, the tube that connects the mouth to the stomach.
Fax: 880-2-9898798                                                     It is caused by the overgrowth of Candida, the normal flora of
E-mail:                                            human body in the mouth, gastrointestinal tract and vagina
                                                                       as well as in skin. Candidal esophagitis has received special
Introduction: The commonest risk behavior for HIV/AIDS
                                                                       attention ever since beginning of the HIV epidemic. The
across Asia is the trading of sex for money. In the context of a
                                                                       incidence of overall rate of esophagitis among patients infected
conservative society such as Bangladesh, the issues
                                                                       with HIV has been reported to be as high as 15-20%.
surrounding sexuality and STDs are stifled, stigmatized and
                                                                       Esophageal candidasis is one of the diagnostic criteria for
hence hidden. This study aimed to assess the risk of HIV/
                                                                       AIDS and a lowered CD4 lymphocytes count <200mm3 is major
AIDS among the hotel based sex workers (HBSWs) which
                                                                       predisposing factor for the development of candidiasis in HIV
may help the policy makes in implementing programs to
                                                                       infected person.
prevent spread of HIV/AIDS.
                                                                       Objective: To understand the dynamic relationship between
Objectives: To assess the risk of HIV/AIDS among hotel based
                                                                       CD4 count and the occurrence of esophageal candidiasis a
sex workers in Dhaka Metropolitan area.
                                                                       retrospective cohort study was carried out in our tertiary care
Methodology: Data was collected from seven residential                 set up in Coastal Karnataka State, Manipal.
hotels and three NGO clinics (Drop in centre for hotel based
                                                                       Study: From September 2006 to September 20008.
sex workers) at old Dhaka, Motijheel and Mohakhali. Face to
                                                                       Retropositive patients with symptoms of odynophagia,
face interview of 120 hotel based sex workers were done using
                                                                       dysphagia or retrosternal burning pain with presumptive
a pre-tested semi structured questionnaire.
                                                                       diagnosis of EC later confirmed with mycological findings were
Results: Average age of the respondents was 17 years.                  included in the study. All the patients were hospitalized and
57.50% received foreign clients and 80.83% had non                     the upper digestive tract was examined endoscopically and
commercial sexual relation. 51.67% were infected with sexual           esophageal scraping was sent to the mycology laboratory for
transmission infection (STI). Around 97% sought treatment              KOH mount and culture. The diagnosis was confirmed by
for last STI but 37.77% of them selected wrong professionals           10% KOH calcoflor microscopy and CD4 counts established
for treatment. About HIV transmission 79.17% said of sexual            by Flowcytometry.
act, 39.17% unscreened blood, 15% sharing of needle syringe,           Result and Conclusion: The predominant species involved
6.67% mother to child and 20.74% do not know about HIV                 were Candida albicans, Candida glabrata and Candida
transmission. About knowledge on HIV prevention 81.67%                 guilluermondi. The risk factors, therapeutic management and
know about use of condom, 38.33% blood screening, 14.17%               prognosis of esophageal candidiasis in the study group will
use new needle syringe and 3.33% know avoid commercial                 be discussed in the light of their utility as a marker in HIV
sex as a HIV prevention method and 18.33% hotel based sex              Infected Patient.
workers do not know any prevention method. Nobody said of
using condom constantly.

34 ---------------------------------- Abstracts-SAARC Second Conference on TB, HIV/AIDS and Respiratory Diseases – 2008, Kathmandu, Nepal
39. A REVIEW OF THE USE OF NATIONAL HIV                                        to disclose is embedded within an emotional, social and
    OCCUPATIONAL POST EXPOSURE                                                 economic context.
    MANAGEMENT GUIDELINES AT A                                                 Objectives: To ensure proper treatment
                                                                               Methodology: Two in depth interviews were undertaken with
Jayawardena K. A. S1., Yapa N. M. A. S1., Weerakoon A. P.2
                                                                               thirty patients enrolling an ART program, the first at the onset
 STD Clinic, Kandy, Sri Lanka                                                  of treatment, the second after four months. To explore the
 Deputy Provincial Director of Health Services, Nuwara-                        community context to participant experiences interview were
eliya, Sri Lanka                                                               taken with nine lay people reported to be providing support to
                                                                               each of these participants in order. For an understanding of
Introduction: Health care workers are at higher risk of HIV                    the institutional context within which treatment occur, two
infection through accidental exposure to infected blood and                    health care providers were interviewed about attitudes of
other material. Thus appropriate management of occupational                    health staff towards patients seeking ART.
exposures and regular monitoring of such procedures become
important elements of work place safety. Ministry of Health                    Results: factors associated with disclosure and support echo
has introduced a standard exposure report to record the                        those previously reported; positive state of mind, sense of
incidents of occupational exposures.                                           personal responsibility and agency, belief in treatment efficacy,
                                                                               and lower AIDS-related stigma. This study suggests that these
Objectives: To describe types of occupational exposures and
                                                                               determinants are inextricably linked to deep-seated social
categories of health care workers who sought post exposure
care. To evaluate the use of National HIV occupational post                    inequalities. Patientsí marital status, gender and age shape
exposure management guidelines at the STD Clinic.                              their support needs and navigate around social and economic
                                                                               barriers. Strategies include for example using a confidante to
Methodology: A descriptive study was conducted at the STD                      negotiate on the patientís behalf without explicit disclosure.
Clinic Kandy. Exposure reports of all health care workers who                  However, patients were more likely to disclose to personal
sought occupational post exposure care at the STD Clinic                       careers in order to secure continued support.
between 1st of January and 31st of December 2007 were
analyzed.                                                                      Conclusion: we know about disclosure and adherence in
                                                                               government ART programs in Nepal comes from early
Results: Of the total (60) there were 11 males and 49 females.                 initiators. Such people are expected to have strong materials
Majority of them were nurses (31) followed by labourers (12),
                                                                               or social capital, or be skillful in securing support and avoiding
medical students (8), doctors (6), and others (3). The largest
                                                                               social approbation. Programs and policies need to be
exposure type was percutaneous injuries (52). All Source
persons (49) and exposed persons (57) who underwent HIV                        cognizant of and responsive to the pervasive social inequalities
testing at the time of initial consultation were HIV negative.                 that strongly restrict the lives of the majority of people who
Exposure cord was not marked in 43 (72%) and incorrectly                       have not yet sought treatment and those having difficulty with
marked in 9 (15%) exposure reports. None of the exposed                        adherence.
individuals had been received post exposure prophylaxis and
undergone HIV testing after 6 months of exposure.                              Keywords: Getting around Disclosure and Adherence

Conclusion: Nurses are the largest category of health care                     41. TREATMENT ADHERENCE - INVOLVEMENT
workers who seek occupational post exposure care. Exposed
persons should be motivated to attend follow up HIV testing.                       OF PLHIV
Doctors should be encouraged for proper documentation of
                                                                               Sharma R
exposure reports and follow up exposed persons.
                                                                               Population Foundation of India,
40. GETTING AROUND DISCLOSURE AND                                              B-28, Qutab Institutional Area, Tara Crescent
    ADHERENCE                                                                  New Delhi ñ 110016, India
                                                                               Tel: +91-11-41016988/+91-9312179659
Pun H K
                                                                               Fax: +91-11-42899795
Naulo Ghumti Nepal-Shrp                                                        E-mail:
Pokhara, Kaski, Nepal                                                          Introduction: ART is life long treatment PLHIV who have
Tel: 977 061 5 21962                                                           started taking ART might stop it abruptly because of the
Fax: 061 539675                                                                challenges associated with it. Hence a through monitoring
E-mail:                                                 mechanism is needed so that PLHIVs taking ART strictly
                                                                               adhere to the medicines. PLHAs on ART in particular need
Introduction Disclosure is strongly associated with the uptake                 continuous counseling at various stages and social support in
of ART, Adherence and HIV prevention. The ability of individual                order to adhere to the life long treatment.

Abstracts-SAARC Second Conference on TB, HIV/AIDS and Respiratory Diseases – 2008, Kathmandu, Nepal ----------------------------------------------   35
Objectives: To strengthen free ART distribution program by             other services for their need0(need provide by other agencies
promoting treatment adherence along with other care and                and defined as more critical in increasing quality of life).
support services through treatment counseling centers.
                                                                       Objectives: The study seeks to examine whether a volunteer/
Methodology To supplement and strengthen the counseling                peer driven social support is as, or more effective, than
and other services provided at the government ART centers,             traditional professional support service in improving an HIV
establishment of Treatment Counseling Centers at the public            positive clientís ability to live more independently, non-
ART centers was envisaged. A team of three counselors- two             stigmatized, and receive satisfactory service with better quality
professional counselors and one peer counselor motivate and            of life. As the number of those living with the disease and
prepare clients to accept their status, build social support and       corresponding mental health and/or drug and alcohol problems
refer them to the respective District Level Networks of people         grow, and government money and availability of staff becomes
                                                                       critically scarce, there is, and will continue to exist, an emergent
living with HIV/AIDS (DLNs).
                                                                       need to find an alternative intervention for effective social
Results: Under the program ìAccess to Care and Treatment-              support for people living with HIV.
ACTî 50 Treatment counseling centers (TCC) are being
                                                                       Methodology: Drawing on the convenience sample of PLWA
established. TCCs are promoting treatment adherence,                   (N= 143) methodology, extensive field research was conducted
psychosocial and family support to PLWHAs, healthy lifestyle           in eight NGOs facilities and one government facility. Structured
and safe sex practices among the PLWHAs. TCC act as the                questionnaires were administered to elicit information on the
vital link between the ART Centers and the District Level              demographic, quality of life, client satisfaction from service,
Networks of people living with HIV/AIDS (DLNs) so that                 and social support between September 2008 and October
PLWHAs can remain in the larger care and support system.               2008. Besides interviews, group and informal discussions were
Availability of professional counselors and a peer counselor           held to cross-check and verify the reliability of the data.
to share burden of work of the ART counselors through ACT
project enhanced acceptance of TCCs.                                   Results: The multivariate analysis of data focused primarily
                                                                       to test the correlation between two types of intervantions: time
Conclusion: TCC helped in improving treatment adherence,               expent by volunteer with client, and satisfaction level from
reducing defaulters, stigma to HIV and influencing peer norms.         service and quality of life. The study has found that
However, an operational guideline is required for the                  respondents getting support service through HIV infected
implementation uniformity.                                             volunter were less stigmatized, more satisfied from the service
                                                                       and had better quality of life than the PLHA getting support
Keywords: HIV/AIDS, PLHIV, Treatment Adherence,                        survice through professional or non infected volunteer.
                                                                       Conclusion: Recommendations were made for agencies to
                                                                       consider utilizing HIV infected volunteers in a professional
42. SOCIAL SUPPORT FOR PERSON LIVING                                   capacity to meet need of PLHA. Future research could focus
    WITH HIV: A COMPARISON OF THE                                      on further role of HIV infected volunteer in terms of providing
    EFFECTIVENESS OF THE PROFESSIONAL                                  home based care.
    DRIVEN SERVICE                                                     43. OCULAR MANIFESTATIONS IN HIV
                                                                           POSITIVE AND AIDS CASES IN NEPAL AND
Yadav S                                                                    ITS CORRELATION WITH CD4+ T
Graduate School of International Development                               LYMPHOCYTE COUNT
Department of International Development,
Nagoya Univerity, Nagoya, Japan                                        Lamichhane G, Gamage W, Shah D. N., Sharma S,
                                                                       Chaudhary M.
Kanaya Moto Machi 2-16 -Toyokawa city 442-0066 Aichi Japan
Tel: +818051042049, E-mail:                   Department of ophthalmology
                                                                       B. P. Koirala Lions Center for Ophthalmic Studies
Introduction: The HIV/Aids epidemic has placed an
increasing burden on public health facilities in developing            Tribhuvan University Teaching Hospital
countries that are already functioning with limited resources.         Maharajgunj, Kathmandu,
There are many NGOs and community based organizations                  Nepal.
in Nepal that are active in providing social support to people         Email:
living with HIV. This study is a cross-sectional exploratory
research to evaluate and compare effectiveness of HIV                  Background- AIDS is a multi systemic disease caused by
infected volunteer support and non-HIV infected volunteer              Human Immuno-deficiency Virus. Ocular manifestations have
(professional) support for those living with HIV in terms of           been reported in approximately 70-80% of HIV cases. HIV
helping them handle the stigma which, in turn, is linked to            has the capability to affect every organ and system in our

36 ---------------------------------- Abstracts-SAARC Second Conference on TB, HIV/AIDS and Respiratory Diseases – 2008, Kathmandu, Nepal

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