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

Tu.C.572 - Tu.D. 133

Tuesday, July 9, 1996

Tu.C.572
TRENDS IN HIV INCIDENCE IN DIFFERENT TRANSMISSION GROUPS IN THE
UNITED STATES
Rosenberg PS*, Biggar RJ. 'Epidermiology and Biostatistics Program, Nationa Cancer Institute
Issue: To estimate HIV infection rates in different age, sex, race, and expos.: groups.
Project: HIV infection rates are estimated by back calculation from national AIDS surveillance data on the basis of the incubation distribution. The period of analysis ended on I
January 1993 to avoid bias frorm the expansion of the AIDS case definition.
Results: Between 630,000 900,000 Americans were living with HIV infection as of I January
1993, and about 50,000 new infections were occurring each year during 1987 1992.
Incidence among homosexual men was declining in whites, African Americans, and
Hispanics, but with smraller declines among rmen aged 1 8-25. About 20,000 infections were
occurring each year via this route among men of all ages. Infection rates (number of men
infected via homosexual contact per 100,000 menr in the general population) were 3-fold
higher in young minority men compared to whites. Incidence among injection drug users
declined moderately in every group, to I 4,000/year; but rates in 1987-1992 were notably
high among African American mnen older than 30 years. Heterosexually-acquired infections
appear to be increasing inr all groups (I 3,000/year), with the highest infection rates in minority women aged 17-24 years.
Lessons Learned: About 20,000 persons aged 18 to 25 became infected each year during
1987 1992.While most infections occurred through homosexual contact and injection drug
use, heterosexual I trarnsrnission appears to have increased the most rapidly
Philip Rosenberg, 6 130 Executive Blvd. EPN/403, Rockville, MD 20852,Tel: [phone],
Fax: [phone]
Tu.C.573
ESTIMATION OF THE HISTORICAL AGE-SPECIFIC HIV INCIDENCE IN CANADA
Yan, *, Huntley J.A.1, Sutherland, D.*. i1Bureau of HIV/AIDS and STD, Health Canada;
**Dept. of Stat. & Act. Sci., University of Waterloo
Objective: To determine historical trends of the HIV incidence in Canada with respect to
age-at infection and bir th cohorts.
Methods: The back-calculation is applied to data firom the AIDS Cases Reporting
Surveillance System in Canada. the method utilizes measurement of reporting delay trend
of AIDS diagnosis, and external knowledge of HIV to AIDS disease progression process to
estimate the expected historical HIV incidence over time.The age-specific back calculation
further utilizes the age at AIDS diagnosis to estimate the expected historical HIV incidence
over both calendar time and age- at infection.
Results: The historical HIV incidences are jointly estimated with AIDS reporting delays for
selected populations by exposure categories, including Men Having Sex With Men (MSM),
injecting drug use (IDU), heterosexual transmnission and among womren.The HIV incidence
by age-at-infection is obtained for the MSM and compared with the historical HIV incidences estimated separately by birth cohorts.
Conclusions: The HIV infections are ris Estimated Historical HIV Infections Among MSM
ing rapidly amrong women and among om1 96-.
the exposure categories for IDU and 40" *-",
heterosexual transmission. The analysis
300 " " in 1960 -indicates a resurgence of HIV infections,e ae
at the end of 1980's among MSM fol 20I
lowing an initial decline after 1985.This
- - ' ~ ~ ter 1965
pattern is predominant for MSM with..Rso m W~* ie.....
age-at infection between 15 29. '".t ".,
Comparison with estimates based on._birth cohorts shows that the rising - I m I S
trend after 1988 corresponds to those v,orHn ht.icon
born after 1965.They were at low or no risk during mid-1980's, but increasingly became
susceptible to HIV infection due to onset of sexual activities.These findings are important in
planning both prevention and care programmes for the future.
PingYan, Ph.D. Bureau of HIIV/AIDS and STD, Health Canada PL 0202A,Tunney's Pasture,
Ottawa, Ont. KIA 0L2 Canada Tel. [phone]; FAX: [phone]; e-mail: [email protected]
Tu.D.130
FOSTERING LINKAGES BETWEEN THE AIDS COMMUNITY AND THE VIOLENCE
AGAINST WOMEN MOVEMENT
Heise, Lori, R VaoGuptaG**,Weiss E",Whelan D". Health and Development Policy
Project (HDPP),Wasfington, D.C.; ilnternational Center for Research on Women (ICRW),
Washington, DC, UIJSA
Issue: Research shows that violence is a deterrent for women in negotiating HIV preventive
behaviors and that early sexual abuse is associated with risk-taking behavior among women.
There has been little coordination and dialogue between the violence against women sector and the AIDS community to learn from each other and coordinate efforts.
Project: ICRW conducted I7 studies in 13 developing countries. Many examined the relationship between violence, HIV risk, and women's ability to reduce their risk.The HDPP
analyzed the lessons learned frorn the violence against women movement for empowering
women and the implications for HIV/AIDS programs and policies.
Results: Findings from the 17 studies reveal that many adolescent and adult women have
been forced to have sex and are reluctant to discuss infidelity and condom use for fear of a
partner's violent reaction. he violence against women movement is worldwide. Its relevant
strengths for the AIDS community include: an understanding of gender power dynamics and
how to meet womers immediate needs; existence of local committees that coordinate
community responses; and individual and group attention for systems advocacy emotional
support, and modeling new behaviors.
Lessons Learned: Drawing on the findings fhom both projects and examples fiom developed and developinrg countries, the presentatron will discuss how AIDS NGOs and policymakers can: advocate for legal refor e. monitor reforms even when codified as law, ensure
that messages do not capitalize on mocho or aggressive behavior to promote condoms,
involve anti-violence advocates in program planning, and use social marketing techniques to
change social norms on violence against women.
Geeta Rao Gupta, ICRW, 1717 Massachusetts Ave., N.W, Suite 302, Washington, DC

20036, Phone: [phone] Fax: [phone] email: [email protected]

Tu.D.13 I
CONSEQUENCES FACING WOMEN LIVING WITH HIV/AIDS IN ZIMBABWE
Nyaravi Hwayire',e Iilar ia Sibanda*, Shellice Phinri-. '1Harre,s,aS ita for \orn with
HIV/AIDS (HAS )
Issue: To assess the neees ad problems of women living with HIV/AI[S i i Zirnbabwe.
Project: Data was collected from interviewing 8 support gr oups wsithl apro nrnitely 30 to
50.Women each group of i non working wornen living with HIV/AIDS.
Results: 80% of the women are divorced or widowed and only 20% of these wom 'ar-are
married. About 90% of the women faced discrimination in health, educationa, professional
and legal rights. Rural women were at higher risk due to ignorince. ChIild in ( I IIV potive
mothers suffered social exclusion from the communitly.
Lessons Learned: Specific needs of wormen livin, with I IV/AIDS,sh 15 a a I r ' h-,"
through appropriate research, health care and ppeertioa (, 1a a1. I IIV/'I[)', I a 'v, lent
among women with low economic satus.
Ms Nyarayi Hwayire, PO BOX 6690 H-arare Zirnhabwe.Tel i. 263 I700/i00i
Fax: [phone] I
Tu.D. 132
HIV RISK AND PROTECTIVE FACTORS IN HIGH RISK WOMEN: LOW INCOME
MINORITY WOMEN,WOMEN IN DRUG TREATMENT,AND INCARCERATED WOMEN
St. Lawrence, I.S., Eldridge, G.D., Little, C.E., Shelby M.(., Brasfield, I. J. lsc ar at
University, USA
Introduction: HIV infection among low incomne minority women. firnale dr ug users, and
incarcerated women in the US is increasing rapidly due to needle-sa shar in. unprotected sex
ual activity with high risk partners, and the social, cultural, and econom e imrpediments that
constrain women's self-protective behavior:n This study assessed I IV a elated Ikn owledge and
attitudes, risk behaviors, and competence engaging in self-protective belavior to guide the
development of risk-reduction interventions for these three groups of worinre.
Method: Low income minority women in the community (N - I 165), woarner outordered into drug treatment (IN = 155), and inucarcerated women (N 158) comnpleted
paperand-pencil measures of AIDS related knowledge, attitudes,,r and behavior, drnonstriat
ed condom application skills, and role-played responses to audiotap'd Iiurnal y auif tIigh
risk coercive situations. 77% of the total sample was AfrI ican-An e a n.
Results: Women in drug treatment were al highest risk for HIV aid-ct. in and evidenced the
lowest levels of protective skills for implementing selif-protective behavior (Pultivariate F -
9.86, p<.000 I). Minority women in the cornnmunity were at lIowest ra,k arnd evident ed the
highest levels of skill and resources for self protection.

Variable
# Sex Partners in Past Year
High Risk Sex Acts in Past Year
% Lifetime STL)
% Injected & Shared Needles
% Cocaine Use
% Condom Use
Self Esteem

CommunIty Drug I reatentia Ir 'art nanid Ip.5 20.9 2.1
6.6 153.7 12.1
28.4% 57. I% 3.9%
1.2% 22./7% 13.3~,
1.2% 76.6% 25.3%
45.8% 28.9% 28.,
40.2 34.5 37.1.00001
00001
0001
00001
00010 I
0000 I
0001

Summary: The results have implications for integrating HIV ris k r eduction pro:rns into conmmunity-based programs for minority womren, drug treatmen t programs, anl d r ehabitation pro
grams in prisons recognizing the unique needs, constraints, and strr mths n arpipnaltion.
Janet S. St. Lawrence, Ph.D. Jackson State University PO. Box 1700, Jackson, ar M 1 92 17. USA
Tel.: [phone] Fax: (60 I) 968 8216
Tu.D. 133
THE EFFECTS OF PHYSICAL ABUSE ON HIV-RELATED RISK PRACTICES AND
SEXUAL HEALTH OF AFRICAN-AMERICAN WOMEN
Wingood, Gina M*, DiClermente, Ralph J.*. *University of Altarrla at Birr nil arn,
Birmingham, AL,ISA
Objective: To examine the consequences of having a physically abusive pr trier' on IHIV
related health and risk behaviors of young adult African Amerr icaon une.
Methods: From February 1993 through December 199,, 165 Af icai-Anermcr wonnraen,
18-29, were recruited using street outreach ihrom a le-avina in ow< '.oaniao'mar ii inunlty ia Sarn
Francisco, CA. Data were collected usong a fa ce--to face inter view. fh assocition betweern
having a physically abusive partner and womens' I IlV-related healtl and risk beltnors was
assessed using contingency table analyses for categorical data and t-tests fuor parn etnc
data. Relative risks and their 95% confidence intervals were cailculated to assess the magnitude of the association between having a physically abusive partrer and woemens' I I1ic-elated health and risk behaviors.
Results: Overall, 17.6% (n=29) of women reported that ra the p ast thre inot htheir
sexual partner had either hit or slapped them. VWom en who were in a a ayji Ally.iusin
relationship, relative to women who were nriot in a phy icaliy iabusive relationip, were
more likely to have a partner who threatenred to be physically abusive when asked to use
condoms (RR=9.2, 95% Cl = 2.5-34.6). were more likely to have a partnert who,val s vertally abusive when asked to use condoms (RR 6.9, 95% C l = 4. I - I 1.6), were nor e likely to
perceive that their partner would be verbally abusive if asked to use c ondor ms (RR1-. I,
95%CI = 1.7-9.7), felt more isolated (RR= 1.7, 9.5% C I = 1. I 2.7), vwon ed more about
acquiring HIV (RR=2.0, 95%CI - 1.1 -3.6) and were morne emotiorally dependent on their
partner (RR= 1.6, 95% Cl = I.1-2.3).
Conclusions: HIV prevention programs tailored to women need to address physicail abuse
and power imbalances in relationships that may reduce the likelihood of HIV preventive
interventions enhancing womens' adoption of safer sex practices.
G.M.Wingood, 120 MJH, 1825 University Blvd., Birminrgh. rn, AL, 35291, Pl in
Telephone: [phone] Fax: [phone] emai: gwirngoodclhib. so.. uab. edu

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