TAIWAN LOURDES ASSOCIATION

2012 ANNUAL WORK REPORT

 

BACKGROUND INFORMATION

 

HIV EPIDEMIC DEVELOPMENT IN TAIWAN

The total numbers of HIV cases by December 31, 2012 were 24,239. 92.96% are male and 7.04% are female. The new cases in 2012 were 2,224 which account for the top 3 highest record ever. The major risk factors for transmission in 2012 were MSM (man who have sex with man) with 1,718 new cases. The government provides Methadone treatment and free syringe as harm reduction strategies and successfully lowers the new IDU (Intravenous Drug Users) cases to 81 in 2012. Compared to 2011, other than the IDU cases, all the statistics above are increased and the new cases hit the 3rd record high in the Taiwan epidemic history.

 

89.49% 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 educations should start early 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) and a branch office in Taichung (Central Taiwan). The PLWHA accounts for about 3/5 of HIV/AIDS population in these two areas. There are 22 staffs work at Taiwan Lourdes Association, including 13 professional social workers, 7 coordinators for peer support and activities, 1 assistance and 1 accountant. We have 179 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 2012 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 2012, there were total of 8,138 people times simple cases opened, 76% of which were satisfied and 20% of which remand open for further services. There were 72 cases (4%) of which switched to multiple-needs cases. In 2012, 312 cases were opened for those who had multiple needs. Social workers assessed the needs of the clients and establish their care plans. There were 150 cases remained from last annual year and 130 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 312 opened cases is as follow:

 

Gender & Age: 89.5% of our clients were male and 10.5% were female. 25% were 21-30 years old, 32% were 31-40 years old and 37% were 41-50 years old. It shows that the middle age clients and younger 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. In addition, the increase of younger age clients had raise our awareness about the epidemic among younger generation.

 

The drug addiction problem: 45.7% of our clients have drug addiction problems. 70% of our clients had the experience in using recreational drugs.  

 

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 2012 the total people times of financial aid were 2,333 and total amount of financial aid was US$93,139 (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 5 different locations with 16 beds to provide temporary accommodation to those who have housing needs (including one exclusively for female). In 2012, 48 people stayed in our residential facilities with the total of occupancy of our accommodation facilities of 172 people times. The average stay of a client is 82 days with the residential rate of nearly 90%. 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 7,124 times and 532 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 2012, we made 2,126 times telephone calls.

 

Employment Services: The stability of employment can secure their financial resources and quality of life. Therefore, in 2012 we assisted 107 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 2012 we referred 75 times/clients to 19 other organizations for resources connection, human rights and others.

 

(2)   Counseling Services

We provide counseling services to the PLWHA and their families. In 2012, we provided 20 sessions of therapy to those who are more disturbed clients. 2,126 sessions of guidance/counseling were provided for giving support to the clients. We provided 1,067times of information counseling to those who needed HIV, treatment and self-care information.

 

(3)  Outreach Services

In 2012 we visited 365 times/people at hospitals and homes. We regularly visited HIV outpatient clinics and inpatient wards in AIDS hospitals (89 times). We provided HIV information and support to those in need. We also visited clients at prisons (202 times) with total of 4,892 people times and mail respond for 370 times. 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 2012, the on-line chat room and e-mail reply served 1,067 people times, we also provided 1,193 times (878were positive and 315 were negative) of information services on telephone and 93,524 click times 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 care 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 234 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 our HIV friends can support each other through our various supporting programs and activities. 3,173 participants (1,058 were IDU) visited our Friendship Centers in 2012. 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 2012:

 

Workshops: 9 workshops with topics related to treatment and self-care were launched with 181 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 36 sessions of support groups with 238 participants. Both numbers are gradually increased then last year.

 

Middle Age Support Group: This group targets those over 45 years old MSM 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 12 activities with 89 people times 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 885 participants. We also start to invite famous people like doctor or well known PLWHA to be the honor guest for the chat room. The participants of this service have decreased this year due to the renewal of our chat room system and the newly introduced APP social network system. Most of the participants 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.

 

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 2012, we launched 2 workshops with 24 participants.

 

HIV community social gathering: We work closely with the hospitals in Taipei, 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 gathering with 147 participants.

 

HIV peer training and empowerment group: We cooperated with Taipei government health department CDC to provide training programs for HIV peers, offer them the self-care skills, knowledge on HIV and communication skills courses. There are total of 12 times with 125 people times participants. Most of the participants had become peers support volunteers. They had reached out to 273 newly diagnosed cases and participate in 24 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 continue to coordinate the women support group in 2012. We held 10 session of women support group gathering with 7 participants. Due to various reasons the support group are now temporary stopped but will be restart again in the following years. .

 

Recreational activities: We organized outings for a day, single mingle or a weekend getaway, 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 59 participants.

 

(6)  Female Shelter House

Started from Feb. 2012, Taiwan Lourdes Association established a new shelter house for HIV infected females. Including Taipei and Taichung, there are 3 units available. There are total of 2 clients take advantage of this new service and with total of 175 days on average and 4 times of house meetings and one-on-one counseling. Every week the life care peer will visit the shelter house and prepare some nutrition supplies and needed materials to maintain the clients’ health and assist them to gain a stable life style and be independent.

 

 

AIDS CONFERNCE

 

We organized a Healthy Life Conference for IDU PLWHA. The theme of the Conference is "Positive, be positive" and 45 IDU PLWHA from different region in Taiwan and 10 professional health care providers participated in it. 3 professional experts from different fields 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/HCV/HBV treatment and co-infection. The Conference was very successful. Three of the participants who have a positive attitude and healthy life style were also elected as the "The Healthy Life PLWHA of the Year" .

 

 

SERVICES FOR HIV DRUG USERS

 

According to the Department of Health, there were about 6,686 drug users infected with HIV/AIDS through sharing needles until December 31, 2012. They account for 27.58% 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 before 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 2012 we had 162 clients (44.8% 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 162 clients is as follows:

 

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

 

The status of the clients: 90% were ex-prisoners, 5% 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 17 different prisons and detention centers. We provided HIV treatment, self-care information and tried to build up trust relationships with them. In 2012, 276 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 others. In 2012 we provided 202 times of group counseling with 4,892 participants. The social workers also provided 114 sessions of individual counseling.

 

Correspondence Services: We provided information and gave support through letters. In 2012 we replied 370 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 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. 51 Harm Reduction support groups were organized with 498 participants in 2012.

 

 

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 46 AIDS workers workshops with 413 participants.We also organized 9 sessions of specialized workshops in different hospitals to help the local case managers, public health workers and social workers. There are total of 232 participants involved.

 

 

PUBLICATION SERVICES

 

Lourdes Association is the one of the few HIV organization which provides publication services to PLWHA in Taiwan.

 

Monthly Newsletter: We published 1,500 copies every month 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 9,121 times/people.

 

Booklets: In 2012 we published the following booklets: "Taiwan ARV manual" with 1,000 copies; "The Rainbow of Life – HIV positives' stories" with 2,000 copies; "Health Partner" with 2,000 copies; "Taiwan Lourdes Association Annual Report 2011" with 2,500 copies; "Taiwan ARVs medication poster" with 500 copies; "Universal precaution – school edition" with 2,000 copies; In addition, we renew the ole booklet including "Manual for the newly infected 2012 edition" with 2,000 copies and "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.

 

Taiwan Lourdes Association have 28 different online booklets for free online reading and download. The total download times for 2012 are 45,356 times. The most popular online booklet is “HIV/AIDS positive families”, accounted for 13,478 times of downloads. It shows that the need and support for positives’ families had become more and more important than before. In addition, in year 2012, Taiwan Lourdes Association published 7 different articles in international conference or communities’ journal, in order to share our experiences with other organizations or workers in this field.    

 

 

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 2012 we were invited to give more than hundred sessions of speeches. The total participants were 10,696 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 29th International Candlelight Memorial at Taichung City with 200 people participated in this event ( due to the weather). 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" 436 PLWHA were participated in this research respectively. 89% were male and the female account for 11% of the survey. Main age group were 31 to 40 years old (40%). 144 were prisoners and 292 were people from the society. We found in the survey that most of the PLWHA still facing serious disclosure issue but the trend had turn from the family to the society or working place. On the other dimension, the lack of pressure release had become another important issue. PLWHA started to avoiding or looking for abnormal channels when dealing with pressure which leads to negative influences toward their health. Taiwan Lourdes Association will continue our services in helping PLWHA to deal with these issues as our future developments.

 

 

OUTREACH WORK IN CHINA

 

We launched a training workshop with the Caritas Shengjing Social Center of Liaoning in Shenyang (http://www.csscln.org) to increase the effectiveness of professional case management skill, conducting multiple services to hard-to-reach PLWHA populations using an enhanced service model. We provide 10 local staffs and volunteers from Shenyang and other cities with a wide array of skills training and activities, teach them the basic concepts of case management, how to approach clients, gain their trust, and help clients access their needed services, improve their quality of life. This includes opportunities for skills practice regarding health behavior change and concepts of motivational interviewing. Help local social groups develop systems and methods to evaluate the impact of their services on their clients’ mental and health outcomes. Participants also learned how to use a variety of data sources for program evaluation.

 

In addition, Taiwan Lourdes Association also invited 2 core staffs of the center to visit Taiwan for 14 days. They took this opportunity to see the practicle practice of case management skill, also take the time to understand the computer interface. Both staffs indicated this experience had broadered their vision in the practical service aspect. Both staffs had learn and understand the practice of the HIV/AIDS related services in Taiwan and had gradually helped them to implement the Taiwan Lourdes case management model to their PLWHA services at local base and will start to establish their own operating interface at China.

 

Taiwan Lourdes Association had partnered with Association of Couple and Family Therapy in Taiwan (http://www.acft.org.tw) to launch a 4 days family therapy workshop in Xi'an. Alliance with Social Service Center of Xi'an, introducing the family system intervention vision. Demostrate how to implement couple theorpy in different fields and how to evaluate the family in a positive way from participants self family experience. There are total of 20 participants including workers at NGOs, health care givers, students and nuns from Hebei had join the workshop to understand the critical techniques to contact with the families and learn how to work sufficiently with their clients. We had also train the participants' family assessment skills; enable them to a broader vision to define the core issues their clients dealing with.

 

We assist to do the group supervision for health care providers who doing the family works for local impoverished families' children, help them to understand the needs of disadvantaged mobile children and better assist them. Other then the above, we had participated in the HIV/AIDS conference as a honored speaker to share our prestigious experiences in the PLWHA support and care field for HIV/AIDS related workers from China, Hong Kong, Macao and Taiwan. This conference also provided us the chance to interact with other NGOs in China and exchange our experiences. in addition, we recruited members from the hospitals and valunteers from the university to participate in the workshop and assisted them to manage their cases in a family system prospect. We will plan for the university speech for the 2nd year during the project.

 

Taiwan Lourdes had started a 2 years project in helping the suburb city of China like Bianxian. In the first year, Taiwan Lourdes launched a 5 days system training workshops to provide marriage cunsuling classes and help the locals to establish systematic views of family service network. The participants were able to learn how to provide counseling services to married couple and further avoid the occurrence of domestic violence. Although the expectation was not as good as expected but all the participants were very enthusiated about the workshop and expecting to paticipate again next year. We will adjust the course structure accordingly for the 2nd year. Taiwan Lourdes will held a 5 days seminar to assist the local to developed a domestic violence service intervention network.

 

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 106 times of training courses. Each staff member averaged training courses is 40 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 2012, 140 times of individual supervision and 116 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 10 different organizations in HIV related fields located in China and Hong Kong shared and learned experience of working with HIV/AIDS. 2 staff members attended the IAS at Washington D.C., US to exchange their working experience with other health care provider from around the globe. The director also take part in the Foreign Administration Department of the Taiwan government project and applied as an intern at ACAS Canada for 2 months.

 

 

VOLUNTEERS RECRUITMENT AND TRAINING

 

(1)  Volunteers Recruitment

We partnered with United Hospital and organized 2 volunteer recruitment training courses with 93 participants. The 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 115 volunteers remained in 2012. The volunteers provide the services of administrative work, prison visits, correspondence service and assisting in activities. We organized 11 on-going training workshops and group supervisions with 179 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 2 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 2012, 10 HIV friends were referred to the peer buddy service volunteers.