TAIWAN LOURDES ASSOCIATION

2010 ANNUAL WORK REPORT

BACKGROUND INFORMATION

HIV EPIDEMIC DEVELOPMENT IN TAIWAN

The total numbers of HIV cases by December 31, 2010 were 20,057. 92.16% are male and 7.84% are female. The new cases in 2010 were 1,679. The major risk factors for transmission in 2010 were MSM (man who have sex with man) with 1,275 new cases. The government provides Methadone treatment and free syringes; however, there are 105 new IDU (Intravenous Drug Users) cases in 2010.

89.25% of the HIV/AIDS population is from 20-49 years old. The people infected with HIV/AIDS are getting younger. It is important that the AIDS prevention education should start in schools. The Ministry of Education needs to revise the student’s textbook to include AIDS education.

The government set up three MSM Health Centers in North, Central and South Taiwan. It aims to provide health services and AIDS prevention education to MSM group.   

TAIWAN LOURDES ASSOCIATION

Lourdes Association is a non-profit organization. It has its main office in Taipei (North of Taiwan) and a branch office is in Taichung (Central Taiwan). The PLWHA accounts for about 3/5 of HIV/AIDS population in these two areas. There are 17 staff members including 11 professional social workers, 5 coordinators for peer support and activities, 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 suffer from physical illness and the side effects of the treatment. They also endure the psychological and social difficulties because of discrimination and rejection. We have learnt from our experience of working with PLWHA that the needs and problems of the PLWHA are involved with psi-psycho-social aspects. Therefore, the team of Lourdes Association evaluates 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 Lourdes Association provided in 2010 were as follows:

(1)  Case Management

We provide care and support to the clients through regular contact and visits. We provide HIV information, liaison with organizations for resources, organize support and self-development groups. In 2010, 313 cases were opened for those who had multiple needs. Social workers assessed the needs of the clients and establish their Individual Service Plan. 138 cases were closed. The reasons for closed cases were 53% needs had been satisfied, 40% lost contacts, 4% were in prison and 3% had died.  

The basic information about those 313 opened cases is as follow:

Gender & Age: 90% of our clients were male and 10% were female. 22% were 21-30 years old, 38% were 31-40 years old and 26% were 41-50 years old. It shows that the middle age clients are increasing. The employment, care and housing needs of the middle age have become impending.

The drug addiction problem: 41% 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 to clients for getting basic living needs. In 2010 the total times/people of financial aid were 1,129 and total amount of financial aid was US$33,214. 67% was given for living expenses, 18% was for rent and 12% was for medical care.

Residential Facilities: We have rented 4 different locations with 14 beds to provide temporary accommodation to those who have housing needs. In 2010, 38 people were admitted into our temporary accommodations. 108 people times stayed in our residential facilities. The average stay of a client is 110 days with the occupancy rate of 70%. The social workers provide counseling, 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 meals were delivered to 3,183 times/people and 624 times of visits from the social workers and co-ordinators.

Support through telephone: The social workers contact the clients regularly in order to giving support and respond to their immediate needs. In 2010, we made 2,688 times telephone calls.

Employment Services:  The stability of employment can secure their financial resources and quality of life. Therefore, in 2010 we assisted 384 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 2010 we referred 2,388 times/clients to 18 other organizations for resources (1,988 times), and human rights (292 times).

(2)  Counseling Services

We provide counseling services to the PLWHA and their families. In 2010, we provided 13 sessions of therapy to those who are more disturbed clients. 3,394 sessions of guidance/counseling were provided for giving support to the clients. We provided 1,430 times of information counseling to those who needed HIV, treatment and self-care information.

(3)  Outreach Services

In 2010 we visited 462 times/people at hospitals and homes. We regularly visited HIV outpatient clinics and inpatient wards in AIDS hospitals (176 times). We provided HIV information and support to them. We also visited some clients at their homes (126 times) when they were house-bound or needed support. Other locations (160times) 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 message board and Wednesday on-line chat room provides a good and confidential channel for them to communicate among themselves. 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 2010, the Wednesday on-line chat room served 965 times/people (717 were positive and 248 were negative). We also provided 1,011 times (756 were positive and 255 were negative) of information services on telephone and 1,040 times (598 were positive and 442 were negative) of information services on web message board. The output of web message board services was increased than last year.

Educational Services: We invited health workers to our Friendship Centers to provide information services to PLWHA. The public health workers came to Centers for 12 times and 196 times/people 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 PLWHA can support each other through our various supporting programs and activities. 3,341 participants (1,315 were IDU) visited our Friendship Centers in 2010. 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 2010:

Workshops: 3 workshops with topics related to treatment and self-care were launched with 40 participants.

Newly diagnosed gay men support group: We organized small support groups 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 organized 22 sessions of support groups with 112 participants.

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 5 activities with 44 participants.

Wednesday on-line support network: PLWHA 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 46 times of MSN support network with 888 participants. The participants of this service have decreased this year due to the reason of change in internet behavior (Facebook, Twitter). 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 28 sessions of a reading group with 176 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 2010, we organized 3 workshops with 40 participants.

HIV community social group: We work closely with the HIV/AIDS hospitals. We organized PLWHA support groups in Taoyuan Hospital and Taichung Veteran Hospitals. PLWHA can get to know each other, sharing their life experience and support each other. We organized a total of 7 social groups with 61 participants.  

HIV peer training and empowerment group: We cooperated with the health department of Taoyua City to provide training programs for HIV peers. The programs included self-care skills, knowledge on HIV and communication skills. There are a total of 9 sessions 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.    .    

Recreational activities: We organized outings for a day or a weekend, meals together, special programs for festivals and Christmas. A total of 52 activities were organized with 831 participants. Usually the Christmas Party attracts most participants. Some HIV friends only participate in yearly Christmas Party to see other old friends.

Memorial services: Those HIV friends who have passed away were well remembered by the workers and other HIV friends. We organized 3 memorial services with 42 participants.

AIDS CONFERENCE FOR IDU

We organized a Conference for PLWHA who are Intravenous Drug Users (IDU). The theme of the Conference is "Harm Reduction Learning and Self-Care Implementation" 33 IDU PLWHA participated in it. Two professional experts who have many years working experience in HIV/AIDS organizations were invited as speakers. The topics include harm reduction, personal experience of being PLWHA and disclosure, preparing for aging, new HIV treatment, intimate relationships and co-infection of hepatitis C. The Conference was very successful and fruitful. The participates also elected the “The IDU PLWHA of the year” The PLWHA who has a positive attitude and happy life style was elected.

SERVICES FOR HIV DRUG USERS

According to the Department of Health, about 6,448 drug users are infected with HIV/AIDS through sharing needles up until December 31, 2010. They account for 32% 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 2010 we had 130 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 130 clients is as follows:

Age: 9% were 21-30 years old, 76% were 31-50 years old and 14% were 51 plus. It shows most of the drug users were middle age.

The status of the clients: 92% were ex-prisoners, 3% were prisoners and 5% 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 18 prisons and detention centers. We provided HIV treatment, self-care information and tried to build up trust relationships with them. In 2010, 435 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 the rest of them. In 2010 we provided 265 sessions of group counseling with 10,015 participants. The social workers also provided 157 sessions of individual counseling.     

Correspondence Services: We provided information and gave support through letters. In 2010 we replied to 157 letters for those prisoners.

(3)  Harm Reduction Support Groups

We use harm reduction perspectives to work 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 drugs. 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. 81 Harm Reduction support groups were organized with 677 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 17 AIDS workers workshops with 297 participants.We also organized 5 sessions of specialized workshops in different hospitals to train the local case managers, public health workers and social workers. There are total of 93 participants involved. 

PUBLICATION SERVICES

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

Monthly Newsletter: We published 1,000 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 7,021 times/people.

Booklets: In 2010 we published the following booklets: "IDU PLWHA Self-care" with 2,000 copies; "Families of PLWHA" with 3,000 copies; "HIV Information for Newly Diagnosed" with 5,000 copies; "The Art of Disclosure" with 3,000 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 follows:

HIV/AIDS EDUCATION

Education is one of the methods to eliminate discrimination 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 2010 we were invited to give 138 sessions of talks. The total participants were 7,824 which included health workers, social workers, prison guards, prisoners and students.

RESEARCH

We conducted one survey: "The Life Situation of PWLHA in Taiwan" and 407 PLWHA replied to the questionnaires. 94% were male, main age group were 31 to 40 years old. 56.8 % were heterosexual and 36.6% were MSM. 80% of the respondents replied that HIV/AIDS had influence on their daily life, 40% of PLWHA feels lonely and have negative self-value. 43% of the respondents experience discrimination from the medical personnel; more than 45% are not satisfied with the medical care service. However, the compliance, good doctor and patient relationship and social support network are the key factors for their psychosocial and spiritual life. 

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. 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, child care and health care. 5 training sessions with a total of 77 hours and 139 participants were organized. The training is focused on the integration of service, faith and self-development.

STAFF MEMBERS TRAINING AND SUPERVISION

Attending training courses: The staff members are strongly encouraged to obtain on-going training. Each staff member averaged 63.5 hours in training courses. 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 2010, 207 times of individual supervision and 24 group supervisions were provided.

International Experience: It is very important to exchange experience of working HIV/AIDS with other countries. Three social workers and peer coordinators visited 15 HIV related organizations in China, Hong Kong and Ireland and shared and learned experience of working with HIV/AIDS. One social worker and volunteers attended the 18th International AIDS conference in Vienna.

VOLUNTEERS RECRUITMENT AND TRAINING

(1)  Volunteers Recruitment

We organized 2 volunteer recruitment training courses with 76 participants, but only 14 became volunteers. In our perspective, although the successful rate was low (37%), 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 102 volunteers in 2010. The volunteers provide the services of administrative work, prison visits, correspondence service and assisting in activities. We organized 3 on-going training workshops with 44 participants and 3 group supervisions with 59 participants. The topics of the training cover HIV/AIDS policies and laws, ethics, self-awareness, empathy skills, emergency protection, etc.

(3)  Buddy Service Volunteers

We have trained people living with HIV/AIDS as volunteers to provide buddy services. They have learned the skills of being befrienders 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 a support network. In 2010, 11 HIV friends were referred to the buddy service volunteers and 8 of them joined the PLWHA support groups.