Community Symposia dealt with a number of issues related to community action and
HIV/AIDS. The formats for these symposia varied according to issues, but all symposia
focused on interactive exchange including case studies, demonstrations, and workshops. The
following is a summary of some of the key issues addressed by the five symposia.
Commercial sex and health
Sex workers, representatives of sex work organisations, people who work with sex workers
and members of AIDS organisations highlighted the following issues :
- Sex workers' organisations wish to create alliances
with others AIDS service organisations, human rights organisations, the private sector and
- Community development programmes and networking
programmes are essential in order to protect the health of sex workers.
- Research must lead to interventions which in turn
must lead to empowerment.
- Sex worker research must be properly documented and
use sound epidemiological methodology and involve sex workers from the conception to the
delivery of the outputs.
- Safer sex programmes are possible and effective for
intravenous drug using sex workers.
- Male sex workers sexuality must be properly
understood in order to deliver appropriate programmes.
- Clients must not be demonized.
- Case study : situation in Russia
- Sex work is not illegal therefore, in Moscow,
residency permits are used as a form of control;
- De facto controls result in both police corruption
and corruption related to organised crime;
- Police sometimes require monetary bribes and monthly
- Participants discussed pragmatic ways of achieving
change in a number of sectors: international agencies, national governements, corporate
sector, community-based services, opinion leaders and the media.
- Strategies that have been successful were presented,
using case examples.
Long-term survival with HIV
Long-term survivors discussed the conditions leading to survival and the personal
situation of survivors.
The factors discussed were :
- Healthy life style;
- Positive outlook;
- Psychological support;
- Access to experienced doctors;
- Access to appropriate treatment.
- Research must be carried out in order to gain
understanding of HIV as a long-term condition and, in particular, the psycho-social needs
of people with long-term HIV.
- The human rights of long-term survivors must be
- Communities and institutions surrounding long-term
survivors must recognise the difficulties of their situation. «Coping is easier sometimes
and harder all the time». These include the difficulty of sustaining compliance with
treatment particularly when a person feels healthy. «The better you get, the more
difficult it is to comply».
- Some issues discussed displayed the gap between the
North and the South such as job security, including the right to return to work after
extended periods of sick leave, for long-term survivors. The debate about the right not to
take treatments versus very limited access to treatment in the South was another example
of the gap.
Participants agreed that nutritional interventions for PWAs are critical and agreed on the
- Nutritional interventions must adopt a holistic
approach taking into account the availability and condition of basic utilities in the
specific local context where interventions are to be delivered such as poor water supply
or limited access to food.
- Nutritional interventions must further take into
account the culture, religion, level of education and other societal factors of the
population. For instance, in some cultures, fasting is part of nutrition; some other
cultures use food as a process of healing.
- Nutritional guidelines should be directed to and
practised both by PWAs and health educators.
- Donors must ensure that any food donated is of good
quality and nutritionally balanced.
- Research must be done into the effects of protein
intake for PWA.
Religion and HIV
Representatives of various Christian denominations, the Muslim faith, Buddhism and the
Jewish faith gathered to discuss issues relating to the role of religions in the struggle
- The strong prevalence of Christian approaches to
spiritual and moral guidance in the field of the religious reaction to HIV is detrimental
to that of other faiths.
- Certain moral positions of the Roman Catholic Church
are conducive to accentuating gaps on issues of gender and sexual orientation, which
affect the efficacy of different responses to HIV/AIDS.
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