TAIWAN LOURDES ASSOCIATION

2011 ANNUAL WORK REPORT

BACKGROUND INFORMATION

HIV EPIDEMIC DEVELOPMENT IN TAIWAN

The total numbers of HIV cases by December 31, 2011 were 22,020. 92.57% are male and 7.43% are female. The new cases in 2011 were 1,967. The major risk factors for transmission in 2011 were MSM (man who have sex with man) with 1,523 new cases. The government provides Methadone treatment and free syringe; however, there are 126 new IDU (Intravenous Drug Users) cases in 2011. Compared to 2010, all the statistics above are increased and the new cases hit the 3rd record high in the Taiwan epidemic history.

89.33% of the HIV/AIDS population is between 20-49 years old. The people infected with HIV/AIDS are getting younger and the main risk factor is through unsafe sex. It is important that the HIV/AIDS prevention education should start at school. The Ministry of Education needs to revise the students’ textbook to include the AIDS education.

TAIWAN LOURDES ASSOCIATION

Taiwan Lourdes Association is a non-profit organization. It has its main office in Taipei (North of Taiwan), a branch office in Taichung (Central Taiwan) and a LGBT Health Culture Center named Taichung GDi. The PLWHA accounts for about 3/5 of HIV/AIDS population in these two areas. There are 22 staff members work at Taiwan Lourdes Association, including 12 professional social workers, 8 coordinators for peer support and activities, 1 assistance and 1 accountant. We have 102 volunteers to assist various programs.

It is our goal to improve the quality of life of PLWHA through our various care and support services and programs. We advocate for human rights of PLWHA. We endeavor to eliminate discrimination against PLWHA through the educational programs.

IMPLEMENTATION OF THE SERVICES

People living with HIV/AIDS not only suffer from physical illness and the side effects of the treatment, but also endures the psychological and social difficulties because of discrimination and rejection. We have learned from our experience of working with PLWHA and find out that the needs and problems of the PLWHA are involved with psi-psycho-social aspects. Therefore, the teams of Taiwan Lourdes Association’s professional social workers evaluate their needs from the following aspects: 1) Basic life needs, 2) Knowledge on HIV/AIDS, 3) Emotional needs, 4) Social support, 5) Human rights, and 6) Special needs. It is our goal to improve their quality of life and basic human rights through case management and liaison with the community resources to provide community care to them.

The services and programs Taiwan Lourdes Association provided in 2011 were as follows:

(1)  Case Management

We provide care and support to the clients through regular contact and visit. We provide HIV information, liaison with organization for resources, organize support and self-development groups. In 2011, there were total of 1681 simple cases opened, 73% of which were satisfied and 22% of which remand open for further services. There were 68 cases (4%) of which switched to multiple-needs cases. In 2011, 344 cases were opened for those who had multiple needs. Social workers assessed the needs of the clients and establish their care plans. There were 170 cases remained from last annual year and 150 cases were closed. The reasons for closed cases were 53% needs has been satisfied, 29% lost contacts, 8% were in prison and 8% were dead.  

The basic information about those 344 opened cases is as follow:

Gender & Age: 89.5% of our clients were male and 10.5% were female. 23% were 21-30 years old, 36% were 31-40 years old and 30% were 41-50 years old. It shows that the middle age clients are increasing, in addition, the older age group is increasing as well. Therefore the ageing problem is starting to become an important issue for our clients. The employment, care and housing needs of the older age have become impending. On the other hand, the younger age group are mostly MSM, therefore the school safer sex education and HIV/AIDS prevention are desperately need to be increased.

The drug addiction problem: 45.7% of our clients have drug addiction problems.

The following services were provided through the case management program:

Financial Aid: Some PLWHA did not have means to pay for rent, living expenses and medical expenses, especially those who had just been released from the prisons. We provided financial aid of many kinds including rent, medical or meals expenses to clients in need for getting basic living needs. In 2011 the total people times of financial aid were 2,197 and total amount of financial aid was US$102,635 (US$1=NTD29). 40% was given for living expenses, 12% was for rent, 5% was for medical care and 40% was for shelter house.

Residential Facilities: We have rented 4 different locations with 14 beds to provide temporary accommodation to those who have housing needs. In 2011, 52 people stayed in our residential facilities with the total of occupancy of our accommodation facilities of 175 people times. The average stay of a client is 82 days with the residential rate of nearly 80%. The social workers provide financial aid and support during their stay in the accommodation facilities. A co-coordinator is appointed to provide meals, assistance in employment interview and doctor’s appointment for them. The total amount of meals delivery were 5,859 times and 700 times of social workers visits.

Support through telephone: The social workers contact the clients regularly in order to giving support and respond to their immediate needs. In 2011, we made 4,149 times telephone calls.

Employment Services:  The stability of employment can secure their financial resources and quality of life. Therefore, in 2011 we assisted 139 times/clients for employment opportunities seeking and interviews. 

Referral Services: The reasons for referral include financial aid, housing needs, human rights, medical care, employment, etc. In 2011 we referred 68 times/clients to 18 other organizations for resources connection, human rights and others.

(2)  Counseling Services

We provide counseling services to the PLWHA and their families. In 2011, we provided 19 sessions of therapy to those who are more disturbed clients. 2,517 sessions of guidance/counseling were provided for giving support to the clients. We provided 1,038 times of information counseling to those who needed HIV, treatment and self-care information.

(3)  Outreach Services

In 2011 we visited 236 times/people at hospitals and homes. We regularly visited HIV outpatient clinics and inpatient wards in AIDS hospitals (54 times). We provided HIV information and support to them. We also visited some clients at their homes (182 times) when they were house-bound or needed support. Other locations (135 times) including local government health department or public spaces for clients who do not want to be exposed.

(4)  HIV/AIDS Information Services

Information services: We provided the services through telephone calls, e-mail, web message board and Wednesday on-line chat room. As the people infected with HIV are getting younger, web bulletin board and Wednesday on-line chat room provides a good and confidential channel for them to communicate among themselves or the professionals. The social workers and the peer coordinators (who are HIV Positive) reply to their questions about HIV test, treatment, policies on HIV issues and give them support. In 2011, the on-line chat room and e-mail reply served 699 people times (439 were positive and 260 were negative), we also provided 1,193 times (878were positive and 315 were negative) of information services on telephone and 83,514 click times (78,100 were positive and 5,414 were negative) of information services on web bulletin board. The output of telephone and web message board services were both increased than last year.

Educational Services: We invited health workers to our Friendship Centers to provide information services to people infected with HIV. The public health workers came to Centers for 13 times and 301people received the services.

(5)  Peer Support Services

Lourdes Association operates two Friendship Centers for PLWHA, one in Taipei and the other in Taichung. People infected with HIV/AIDS in Taiwan live a very isolated life. It is our goal that our HIV friends can support each other through our various supporting programs and activities. 4,031 participants (1,458 were IDU) visited our Friendship Centers in 2011. Our HIV positive staff members and volunteers welcomed and chatted with them during their visits.

We provided the following programs in the Friendship Centers in 2011:

Workshops: 4 workshops with topics related to treatment and self-care were launched with 54 participants.

Newly diagnosed gay men support group: We launched a small support group mainly for those newly diagnosed HIV positive people. They could share their experience of the difficulties they encounter and ask any questions of their concern, such as treatment, disclosure of their status to friends, discrimination, etc. The support groups for newly diagnosed gay men have been very popular and well attended. They easily build up support among themselves and reduce the level of fears and isolation. We launched 30 sessions of support groups with 228 participants. Both numbers are gradually increased then last year.

Middle Age Support Group: This group targets those over 45 years old heterosexual clients. They feel they are marginalized from the HIV young gay men, because they are not familiar with web services and have different interests from the younger generation. The support groups help them to gain mutual support and share their loneliness as they are aging. We organized 8 activities with 67 participants.

Wednesday on-line support network: People infected with HIV/AIDS may access the MSN service at night. We train the co-coordinators who are HIV positive to provide peer support through on-line chat room system. We provided 50 times of MSN support network with 1,035 participants. The participants of this service have increased this year due to the renewal of our chat room system. Most of them were young gay men. On-line support network can overcome the difficulties of disclosure of status. The PLWHA who do not want to expose their identities may obtain support and information through this program.

Reading Group: We organized 16 sessions of a reading group with 89 participants. They read the books and learned to be aware of their own emotions, accept uncertainty and to be free in spirit.     

Self-development workshops: The participants stay a weekend in a Catholic Spiritual Center. The workshop aims to give spiritual care through deep sharing, meditation, painting, music and psychodrama. In 2011, we launched 2 workshops with 25 participants.

HIV community social group: We work closely with the hospitals in Taoyuan and Taichung to form the social group for PLWHA can get to know each other, sharing their life experience and support each other. We total organized 14 social group with 127 participants.

HIV peer training and empowerment group: We cooperated with Taoyuan’s government health department to provide training programs for HIV peers, offer them the self-care skills, knowledge on HIV and communication skills courses. There are total of 9 groups with 58 participants. Most of the participants had become peers support volunteers. They had reached 263 newly diagnosed cases and participate in 28 different educational advocacy events.

Love to smile women support group: In Taiwan, most of the HIV infected females does not have much support from the government or from other NGOs, therefore, Taiwan Lourdes Association start to launch the women support group in 2011. We held 2 session of women support group with 7 participants. Due to various reasons the support group are now temporary stopped but will be restart again this following years.          .    

Recreational activities: We organized outings for a day or a weekend, meals together, special programs for festivals and Christmas. A total of 45 activities were launched with 894 participants. Usually the Christmas Party attracts most participants. Some HIV friends only participate in yearly Christmas Party to see other old friends.

Memorial services: To show those HIV friends who have passed away were remembered by the workers and other HIV friends. We organized 4 memorial services with 69 participants.

AIDS CONFERNCE

We organized a Happy Life Conference for MSM PLWHA. The theme of the Conference is "Positive, be positive" and 89 MSM PLWHA from 7 different region in Asia and 20 professional health care providers participated in it. 5 professional experts from overseas who have many years working experience in HIV/AIDS organizations were invited as speakers. The topics include how to deal with difficult emotions, personal experience of being PLWHA and disclosure, preparing for aging, new HIV treatment, intimate relationships and co-infection. The Conference was very successful and fruitful. Three of the participants who has a positive attitude and happy life style were also elected as the "The Happy Life PLWHA of the Year" .

SERVICES FOR HIV DRUG USERS

According to the Department of Health, there were about 6,574 drug users infected with HIV/AIDS through sharing needles until December 31, 2011. They account for 29.85% HIV/AIDS population. The new cases of IDU have decreased. It shows that the methadone and needle exchange programs and education are effective.

About half of the HIV drug users are in prisons. There is an urgent need to work with HIV drug users when they are released from the prisons in order to avoid relapse into addiction and criminal activities. Many of them are rejected by their families for their offences and criminal records. Some of them have been in and out of the prisons for a couple of times. Most of them are from low social-economic families and have very low education achievement levels. The HIV drug users need support and social work intervention.

Lourdes Association provided case management and counseling services to the drug users.

(1)  Case Management for HIV Drug Users

In 2011 we had 155 clients (45.1% of the total clients) who are drug users. Nearly all of them have criminal records and they were released from the prisons. Most of them are male. The basic information about the 155 clients is as follows:

Age: 7% were 21-30 years old, 80% were 31-50 years old and 13% were 51 plus. It shows most of the drug users were middle age.

The status of the clients: 93% were ex-prisoners, 3% were prisoners and 4% were the others.

The social workers assess their needs and try to obtain resources of treatment, housing, employment and referral for them.

(2)  Care and Support Services to the HIV Prisoners

Prisoners who are infected with HIV/AIDS are very isolated in the prisons. There is strong discrimination against HIV prisoners in the justice system. The HIV prisoners are segregated from other inmates and have very few activities and support. Therefore the prison visit is one of our major outreach services, and correspondence service is also provided. Sometimes, negotiating with prison officers on behalf of prisoners has been one of our most difficult tasks for the prison services.

Prison Visits: the social workers and volunteers regularly visited HIV prisoners in 16 prisons and detention centers. We provided HIV treatment, self-care information and tried to build up trust relationships with them. In 2011, 410 times/people made visits to the prisoners and detention centers.

Group Counseling for HIV Prisoners: The social workers and the therapist volunteers gave group counseling to three different stages of HIV prisoners the newly diagnosed, preparing to leave prisoners and all the others. In 2011 we provided 226 times of group counseling with 6,006 participants. The social workers also provided 158 sessions of individual counseling.     

Correspondence Services: We provided information and gave support through letters. In 2011 we replied 259 letters to those prisoners.

(3)  Harm Reduction Support Groups

In order to help the HIV infected IDU group to regain their dignity and health, Taiwan Lourdes Association held the IDU harm reduction support group 3 to 4 times a month. Teach these clients the ideas of "harm reduction" and motivate their drives to be productive or protective to themselves or others. We use harm reduction perspectives to serve with HIV drug users. We help them to reduce the harm of drugs on themselves, their families and society while they are still under the influence of drug. We explore drug issues, their relationships with drugs and families, emotional management, self-acceptance, etc. We also make referrals to methadone clinics and needle exchange programs. 85 Harm Reduction support groups were organized with 952 participants in 2010.

AIDS WORKERS WORKSHOP

Workers who work with PLWHA need support among themselves for sharing their knowledge, experiences and skills on HIV/AIDS, and their experience of working with PLWHA. We organized 8 AIDS workers workshops with 199 participants.We also organized 10 sessions of specialized workshops in different hospitals to help the local case managers, public health workers and social workers. There are total of 250 participants involved. 

PUBLICATION SERVICES

Lourdes Association is the only HIV organization which provides publication services to PLWHA in Taiwan.

Monthly Newsletter: We published 1,500 copies of a monthly newsletter with the latest HIV/AIDS information on treatment, self-care and government policies on HIV/AIDS. The Electronic Newsletters also were sent out by e-mail with 8,081 times/people.

Booklets: In 2011 we published the following booklets: “Common Sense About HIV – School Edition” with 1,000 copies; “Side Effect Counseling Memo” with 2,000 copies; “New Taipei Queers Life Guidebook” with 2,000 copies; “Taiwan Lourdes Association Annual Report 2011” with 2,500 copies; “Lourdes On-line Radio CD” with 50 copies; “Medication Treatment 2ndedition” with 2,000 copies; “Side Effects and Responds 2nd Edition” with 2,000 copies; “HIV/AIDS Common Sense” reprint with 10,000 copies. All the publications were sent to the AIDS hospitals, prisoners, AIDS NGOs and PLWHA, and could be downloaded on our web site. The online download and reading date are as follow:

HIV/AIDS EDUCATION

Education is one of the most important methods to eliminate discriminations and stigmas against HIV/AIDS. We are often been invited to give training courses or talks on HIV transmission and prevention, caring for people living with HIV/AIDS and the skills of working with PLWHA. In 2011 we were invited to give 95 sessions of speeches. The total participants were 6,973 which included health workers, social workers, prison guards, prisoners and students.

 ADVOCACY AND CREATIVE ACTIVITIES

In 2011, Taiwan Lourdes Association had cooperated with other organizations and participated in some HIV/AIDS related advocacy groups including Long-term Care Supervision Alliances and HIV/AIDS Action Coalition. These two groups are both dedicated in fighting the basic human rights for HIV infected people or people who are in need.

Taiwan Lourdes Association also launched a PLWHA group name "Positive League" . By using the empowerment, action research and social diffusion theory as the base of researching methods to recruit the HIV infected gay men who possess the leadership qualities. Through various operations like real life practices and internet exercises etc. to build up their voices, excited their powers and abilities to break through the limitation and fears of coming out. Starting from how to recruit HIV positive gay men to participate in this project and induced them to invest more concerns toward the subjects like AIDS/HIV policies and preventions. Through the processes of weakening awareness and action involvements, establishing the practical knowledge in the related fields. Hoping to influence other HIV infected people and the society with the Positive League’s course of action and personal life story.

Taiwan Lourdes Association also held the 28th International Candlelight Memorial at New Taipei City with 800 people participated in this event. We also participated in the Taipei, Taichung and Kaohsiung LGBT parade and try to raise the HIV/AIDS prevention awareness to the public.

RESEARCH

We conducted one survey: "The Living Situation of PWLHA in Taiwan" 347 PLWHA were participated in this research respectively. 86% were male and the female account for 14% of the survey. Main age group were 31 to 40 years old (43%). 144 were prisoners and 203 were people from the society. 61.7% of the interviewees are concerned about the treatment expenses due to the recent possible policy changes, 59.4% of PLWHA are concerning about the cure invention issue. 59.1% of the interviewees are concerning about their health issue; more than 50% are concerning about the human rights issue for PLWHA. In addition, 75.5% reported on time hospital visit on a regular basis, and 31.7% is co-infected with Hepatitis C, 14.7% is co-infected with Hepatitis B. The top 3 concerned issue related to the treatment are 1. Worry about side effect. 2. Worry about been disclosed because of taking medicine. 3. Worry about treatment failure.  

OUTREACH WORK IN CHINA

In partnership with German Misereor, Sister Teresa Hsieh, the Board Member and Paul Hsu, the Director of Lourdes Association visited Xi-An, Shen-Yang and Ji-Lin Diocesan Social Service Centers and a Project for Beijing labor workers 9 years in a row. They gave social work training to the Priests and staff members of the diocesan social service centers. They also gave training to those Sisters and lay people who worked with HIV/AIDS, children care and health care. There are total of 7 sessions with total of 81 hours were organized, with 264 participants. The training is focused on the integration of service, faith and self-development.

STAFF MEMBERS TRAINING AND SUPERVISION

Attending training courses: The staffs of Taiwan Lourdes Association are strongly encouraged to obtain on-going training. There are total of 129 times of training courses. Each staff member averaged training courses is 89.5 hours. The courses included HIV treatment and counseling, social work treatment skills, group work, case management, psycho-social assessment, skills on computer software, public relationships, fundraising, etc. 

Supervision: The full-time supervisors give individual and group supervisions regularly. The social workers may obtain the knowledge, skills and support they need, especially the issues of emergency intervention, social work ethic, emotional and pressure management, and personal safety measures and efficiency in paperwork. In 2011, 161 times of individual supervision and 165 group supervisions were provided.

International Experience: It is very important to exchange HIV/AIDS field working experience with other countries. Three social workers and peer coordinators visited total of 15 different organizations in HIV related fields located in China, Hong Kong and Korea, shared and learned experience of working with HIV/AIDS. 2 staff members attended the 9th ICAAP at Bussan, Korea to exchange their working experience with other health care provider from around the globe.

VOLUNTEERS RECRUITMENT AND TRAINING 

(1)  Volunteers Recruitment

We organized 4 volunteer recruitment training courses with 75 participants, but only 6 became volunteers. In our prospect, although the successful rate was low (8%), those participants obtained accurate HIV information and accepted people living with HIV/AIDS through our training course. It can reduce the discrimination against PLWHA in society.

(2)  Volunteers Training and Supervision

We have 108 volunteers in 2011. The volunteers provide the services of administrative work, prison visits, correspondence service and assisting in activities. We organized 2 on-going training workshops with 23 participants and 3 group supervisions with 44 participants. The topics of the training cover HIV/AIDS policies and laws, ethics, self-awareness, empathy skills, emergency protection, etc.

(3)  Peer Buddy Service Volunteers

We have trained people living with HIV/AIDS as volunteers to provide buddy services. There are now total of 3 peer buddy volunteers in our association.  They have learned the skills of being helpers and about confidentiality. They provide one-by-one or two-by-one services. They share with the newly diagnosed HIV friends their own experience of overcoming the difficulties of becoming HIV positive. They also help the newly diagnosed PLWHA to build up support network. In 2011, 12 HIV friends were referred to the peer buddy service volunteers.