Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Mo.D.1936 - Mo.D.1942

Monday, July 8, 1996

based initiative has shown that it is possible to mobilize target groups ever in difficult t et
tings using strategies that can be identified lessons leax nt therefore include te eeds t
adpt messages to reflect pecular circumstanceOs, tire, mood and disposition of on nutr.
The need to cover the whole of Lagos throught this medium therefore co0me irt,)eathve
if we are to sistain the fight against AIDS.
Peter Ujornu, -e I t.h Matters IInc, 3, St pe0lu Street, Palrnr ove, Lagos
Mo.D. 1936
IMPACT OF HIV MEDIA CAMPAIGNS ON DEMAND OF COUNSELLING AND
TESTING
Nurra Giuseppna, Ippolito G, iCar di F, Pure V, Petrosilo N, Antonucci ( Aloisi 1., Orchi N,
Sarnpaolesi A, De Cari C.00entro di Rife irento AIDS-- (Ispedale Spallanz0ni, Roroa Itly
Objective: Fo evaluate the efets of the national AIDS Irofor ration Campains (0 II) in
the content of first tioe -IV testitont ends at the maj o or ounseling anrd l ti Site (C TS)
in Roone.
Methods: )emographic and behavio ral da ta wer e collected prospectively fog indviduls
tested for HI tV I antibodies betwee n June 1985 and June 1995, at the CTS of Spallaz ani
Hospital, Rome. (tnly subjects who had no previous test are considered in the aIalyfis.
Results: A total of! 5,608 indviduals were tested of whom 47.6~o were woren. Of the
mren tested 18. I% were heterosexual. Overal, 1.6% women and 3.6% ncen tested HIV-a tibodyfpositv iethe r ii fr of tieople attendins yeatro 0yib oCS raised fror t tin 1985 to
2.828 in 1995. iain rea0sons reported for,eeking a test during the canpign were: higph
numboer/occasional heterosexual partners (2 7.6%), previous or curtrent inrtravenous dr use
(9.1%), heter oexual intercourse with HIV infected people or with drug addicts (I 1.5%),
pregnancy (I 9. 1%) and hor0o hisexuality (3.4~). No differences were ohbserved io comparison to the pre campaign period. The mean number of people testing positive each month
remained constant, thcus producing a decr'easing rate of seropositivity.
Conclusions: Ouo data may indicatle that the campaign did le d to ae increase in public
awareness of the risk of AIDS and suggest ttat monitor ing of HIV counseling and testing
requests can be a useful toot in the evaluation of tloe impact of an infor mation carnpaign.
G. lusr, entr0 o di s Riferrneto AIDS ()sp. Sprlarnzani Via Por tuense, 2CO 9 Roma Italy
Phoie 39-6-559422 tf oI9-6 059,j2
Mo.D. 1938
SOCIAL NETWORK IN A COMMUNITY OF INJECTING DRUG USERS ATTENDING
A NEEDLE EXCHANGE PROGRAM IN QUEBEC CITY
Nod Lina*, Lachance, C, Alary, M f'Marquis, G" '. Centre de Sante P Ihlque, Quebec,
QC, Canada; Pointt t Reperes, Qurbec, Q(C, ta0nada.
Objectives: to under tand et strucure of the social network of ii injection drog users (IDU)
n order to yield new basis for IV risk reduction inoervertions.
Methods: Among IDU attenders of the Qubec City Needle Exchange Program (NEP)
f-orn October 1991 to iovesfber 1995, 8 1 subjects answered a questionnaire on risk
behaviors and were etsed for HIV using the FIA and RIPA procedure on oral fluids. A subsample of IDUi's (n-25) with the heaviest risk behaviors, who spent most of their time with
other dr users es os studied with a quaitativ e approachir. Data were collected by semistructured taped interviewos and contert analysis was performed. A detailed analysis of their
risk behaviors (needle sharing arnd sexual partners) and ther social contacts (relationships
within and otside their drug networkt) was carried out.
Results: The social network of IDU's is intimately structured by their drug consursption and,
for steady users, does riot extend much outside their drug network.The core of the network are women engaged in prostitution to support their consumption (exposed to HIV
transmission by sharin needles and unprotected sexual relations). Fellow drug users often
provide room for prostitution an d share needles with prostitutes.The IDU male prostitutes
(mostly bisexual) share the same networl< as the females.They are less exposed through
needle transmission, but have risky sexual behaviors.The IDU street youths share links with
both steady injectors and non injectors.They share injection material principally with each
other and occasionally with female prostitutes. Understanding the organization at the confluence of prostitution and IDU networks yields a pratical basis for social intervention aiming to reduce HIV transmission.
Conclusion: Based on detailed knowledge of the social network of high risk IDU's, two levels
of intervention are suggested. Firstly HIV risk reduction in the community of daily drug users
must build on the most significant cooperative links within their collective self -organization,
and sterile material should be curr ently available. Secondly, street youths with less deteriorate
social network should be targeted by using significant peers to discourage IV drug use.
Lina Noel, Cerntre de Sante publique de Quebec, 2400 d'Estirnauville, BeauporIt, Quebec,
Canada, GIE 7G9
Mo.D. 1939
FEMALE IDUS - PROFESSIONALISATION OF SELF-SEEN NON PROFESSIONALS
Cazka._lay.Tarsermnro. ullem, FIlen, Claudia
Issue: Female IDI sexworkerI's aore at hih rik but do root access poeventionr and educatonal props rsrio nsdo 0 01 percev ttrn Ieorosetnes or 0need of pro Icssins aIor0 i senworkrop.
Project: (noses sewor! er upply cion'elloro for fonale!Dbf sewool o:rs in a surounding
excludoop clicor crest cu nsel or-ett ngs /n atosphere s created tat is perceived by
the ID~s 0s 00 offer if adnore raother Ihas soa cororselt sop session.Trrs supplies she IDs witho
profession t s wleipe hboot prover l 5t11 Trod IlV; prevenling physcal violence whle
nwrine hous; spract001 o o his in educed sexooal techniques; seff-defense stratepies.
Results: By center staff reported posit ve feedback about acquired self conidence concern
inp streelt0 sdroopi or p istotutron.
Lessons Learned: conoale fIt sewoo er accept and benefit from training by po ostitutes
offered iri programs tat present alternatIes to classical cornsellor cliert-settins.
Maya, Czajka,, Mdonna e.V., ousstahstr asse 33. 44793 Bochum, Germany Fon: 0049 234
Ah70/ Fax [phone]

Mo.D. 1940
FEMALE PUERTO RICAN DRUG ABUSERS: PERCEPTION OF HIV RISK, HIV INFECTION,AND PREVENITIVE PRACTICES
Vera Mildred,, ', c Izarry A, Santos M, Rodrguez J, Perez R, Rodriguez G. University
of Puerto iticc ', ti 0ienrces Campus, Puerto Rico.
Objective: xnmine th'e;orception of HIV risk, HIV infection, and preventive practices
among femnale Puerto Rican injected and non-injected drug abusers.
Methods: Information was collected about three hurndred and fourteen female injected
(n 171) and non-tinjected (n- 143) drug abusers. Outreach activities were conducted at
eleven street locations throughout the island. Participation in the study was voluntary. Data
about risk behav iors with clients and partners were collected via a structured interview.
Blood samples were tested for- antibodies against HIV. Pretest counseling was provided.
Appointents were cheduled for providing test results and follow-up counseling. Measures
of association and Iogistc regression analysis were used to identify factors associated with
perception of risk for HIV
Results: T-Ire data reveal that among female sex workers 50% of non injected drug users
and approximately 70% of injected drug users perceive that they are at high risk for- HIV
infection. The rate of I- IlV infection is higher among drug injecting sex worker s.The data also
show that inconsist ent condo m use with partners s among the strongese t factors associated
with a high perception of risk for HIV.
Conclusions: Programs aimed at HIV prevention among injecting women need to address
not only safer njection practices, but also should address participants living situations The
participation of sexual partners needs to be encouraged in prevention programs.
Mildred Vera, School of Public Health, Medical Sciences Campus, PO Box 365067, San Juan,
PR 00936-5067 Telephone: [phone] Fax: [phone]
Mo.D.1941
HIV RISK BEHAVIOR AND STAGES OF CHANGE
Sorensen, JamesL., Miller, M., Delucchi, K., Dilley, J., Piotrowski, N., Okin, R. University of
California (San Francisco), San Francisco, CA
Objective: In a randomrrized trial of case management for HIV infected substance users we
examined how ready clients were to change their substance use and related this to their
risk of transmitting HIV infection.
Data comes from 137 patients recruited from medical wards of a general hospital.
Methods: As part of study intake, subjects were asked about their needle use and sexualt
behaviors in the last 30 days.They also completed a readiness to change instrument [the
University of Rhode Island Change Assessment (URICA) scale].The sample was 73% noen,
42% were Af rican Americnand 42% Caucasians, mean age was 39 years, and 64% were
homeless or living in h otels. Using the procedures of DiClernente and Prochaska we con
ducted a cluster analysis of URICA scores that revealed 5 groups: Participation (n=62),
Ambivalent (n- 26), Contemplative (n=25s), Uninvolved (n20), and Precontemplative (n-4).
Results: A statistically significant relationship between needle use and stage of change was
found (p= 00I1). Subjects in the Participation cluster had higher severity on several ASI composite scores, while those in the Ambivalent cluster had more psychiatric and health problems. Ambivalent subjects were more likely to deny needle use (4 II%) vs. other- groups.This
group was also lower on both number and fiequency of several needle behaviors combined (p<.05). Differences in sexual behavior were not found.
Conclusions: The Stages of Change concept may be helpful in articulating the problems of
HIVinfected substance us ers. Future analyses will examine how treatment readiness predicts response to case management.
J.L. Sorensen, Bldg 20,Ward 21, UCSF/SF General Hospital, 1001 Potrero Ave, San Francisco,
CA, 941 I 0. Ph: 41 5-206-3969: Fax:[phone]; email:[email protected]

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Mo.D. 1942
A SOCIO-ECONOMIC AND MEDICAL ANALYSIS OF HIV POSITIVE CLIENTS
ENROLLED IN A METHADONE MAINTENANCE TREATMENT PROGRAM
Steinbock Clemens, Bone, P. Sharp,V.The Spellman Center for HIV Related Diseases, St.
Clare's Hospital, New York City, NY USA
Objective: To review the socio-economic background and medical profiles of HIV positive
clients enrolled in the Methadone Maintenance Treatment Program (MMTP) at the
Spellman Center:This program is exclusively designed for HIV positive patients and also
provides inpatient, outpatient, psychiatric, and dental care to MMTP clients.
Methods: 208 charts of all clients enrolled in the MMTP in 1995 were analyzed. A review
of admission and discharge forms required by New York State, MMTP charts, and medical
records at the outpatient clinic was conducted.
Results: The mean census for the year 1 995 was 105 clients with an average of I12.3
months in the program (15% were over 24 months) and an average methadone dosage of
63 mg.The majority of the clients were male (75%) and Hispanic (47%). On admission, 63%
had nrot finished high school, 99% were not employed, and the source of income was 67%
home relief and 18% SSI/SSA. A review of social contacts showed that 47% live alone, 48%
were never married, 40% had no children and 90% said that they did not have a significant
other. Most clients were referred to the program by the legal system (42%).The three most
common reasons for discharge were 'non-compliant/lost contact' (3 %), death (25%). and
incarceration (I 9%).The medical assessment indicates an average CD4 count of 317 and
that 44% of cients wer e on antiretroviral therapy. On average, each client had 25 outpatient visits (14 medical and 7 psychiatric) in 1995. 71% had been seen by psychiatrist and
64% received psychiatric medication.The main psychiatric diagnoses were depression
(41 I%), psychotic disorder (17%), and anxiety (I 6%).
Conclusions: This review indicates that HIV positive clients in the MMTP live in low functioning ernvironments because they are isolated (47% lived alone, 90% had no signifi cant
other), do not work (99% were root employed, 85% live on welfare), and have a history of
criminality (47% were referred by legal system, 19% were discharged because of incarceration). Furthermore, the results indicate that clients are immunocompromised (average CD4
count of 317) and had extensive psychiatric disease (71% had seen psychiatrist, 64% of
clients received psychiatric medication).This study shows the importance combining
methadone programs for HIV positive clients with medical services.
Clemens Steinbock, 415 West 5 I st Street,The Spellman Center for HIV Related Diseases, St
Clare's Hospital, New York City NY 10022; USA Phone: [phone] Fax: [phone]