Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

12th World AIDS Conference

Abstracts 13402-13405 167

Project: Ethnographic sampling, qualitative interviews, and systematic text
analysis were used to explore definitions of community and perceptions of community strengths among African Americans in Durham, NC; gay men in San
Francisco, CA; and injecting drug users (IDUs) in Philadelphia, PA. Community
advisory boards collaborated with research teams at each site.
Results: Among the 76 people interviewed, definitions of community and
perceived strengths differed considerably. Across the sites, common themes in
defining community included references to place or locale, shared perspectives
and common interests, familiar people such as family and friends, community as
a result of shared activities, the role of diversity or differences, and concern about
discrepancies between definitions of community and lived reality or experience of
community. Within sites, frequently cited strengths included the ability to survive,
an ethic of sharing, and the common bond of drug use (IDUs, Philadelphia);
political power, diversity, ability to survive, and caring support (gay men, San
Francisco); and religion, community resources, and the ability to mobilize around
issues (African Americans, Durham).
Lessons Learned: "Community" is often seen as more of an ideal than a
lived reality among populations most affected by HIV in the US. To be effective,
collaborations may need to support local efforts to bring reality closer to the ideal.
One way to do this would be to assess and build on the particular strengths
valued by community members.
13402 An intervention for changing high-risk HIV behaviors of
African-American, drug dependent women
Ruth Harris, Scott Kavanagh, Hetherington Bausell. University of Maryland, 685
W Baltimore Street, Baltimore, MD, USA
Objectives: The purpose of the study is to test the effectiveness of an AIDS
education intervention for methadone-dependent, African-American women. The
study emphasized empowerment techniques within a framework of peer counseling skills to promote personal control as well as supplement ability to communicate
with others and, ultimately, potential for positive impact on other members of the
community.
Design: Experimental prospective, randomized controlled study.
Methods: Methadone-dependent, African-American women were randomly
assigned to an experimental (n = 107) or a control group (n = 97) where the
experimental group participated in a peer counseling and leadership training
(PCLT) program over an 8-week period, followed by 8 weeks of reinforcement.
The program was designed to reduce AIDS high-risk sexual behavior, increase
self-esteem, decrease depressive affect, and increase AIDS knowledge and
the women's community-based AIDS prevention communication activities. The
women completed pretest questionnaires and a series of posttests at 2, 4 and 7
months after volunteering.
Results: Compared to the controls, there were statistically significant differences in three of the outcomes for the experimental group: the experimental
group reported a significant increase in numbers of safer sexual behaviors (p =.029), showed decreases in depression (p +.001), and reported engaging in more
AIDS-related, community-based communication activities regarding prevention (p
=.005).
Conclusion: Study results suggest than an intervention program consisting
of empowerment counseling designed to foster an increased sense of individual
and community responsibility can be effective in changing self-reported high-risk
sexual behaviors. Programs like PCLT enable women to accept control of their
lives and further the effect of AIDS prevention messages they carry back to their
communities.
360*/13403 Integrating AIDS prevention into family planning
program in southern Yunnan, China
Zunyou Wu1, J.P. Zhang2, C.M. Wang3, L.L. Dong4, X.Q. Bi2, S. Duan5,
Z.R. Li4. Chinese Academy of Preventive Medicine, 27 Nanwei Road Beijing
100050: 2 Yunnan Anti-Epidemic Station Kunming; 3Longchuan Family Planning
Program Longchuan; 4Longchuan Anti-Epidemic Station Longchuan; 5Dehong
Anti-Epidemic Station Mangshi, China
Objectives: To set a model on which AIDS prevention is permanently included
into family planning routine services and which can be potentially expanded
throughout China where one-fourth world population reside.
Methods: The project consisted of two components: training and integration.
Training-of-trainer strategy was used to train family planning staff on reproductive
health and prevention of HIV/AIDS. The integration had focused on disseminating
messages on HIV transmission routes and prevention measures and promoting
condom use among young men and women in the routine services of family planning. Two out-reach teams were also trained and sent out to reach young men
and women in 10 selected villages which were heavily hit by AIDS. The project
was assessed by conducting both process evaluation and out-come evaluation.
Results: Two new policies were issued to facilitate integration. 79 staff were
trained at initial workshop and 293 staff were trained in 13 secondary workshops.
Six month after the initial workshop, 7 clinic clients were interviewed privately

and they all had received AIDS information sheets and 5 had condoms with
them. AIDS education was included in premarital education schools. It showed
that AIDS prevention had been fully integrated into routine services of family
planning program throughout Longchuan County. Condom distribution increased
from 49,000 in 1996 (before program) to 81,400 in 1997 (after program). Among
surveyed 448 subjects at baseline and 392 subjects at the end of project, the
knowledge of three transmission routes of HIV infection increased from 44% to

92%, the knowledge of at least two prevention measures increased from 24% to
91%, while condom use rate among villagers increased from 7% to 21%.
Conclusions: Integrating AIDS prevention into family planning program in
Longchuan was successful. It raised awareness, increased knowledge and promoted condom use while it had not affected family planning services. It is
recommended to the Ministry of Health and the National Family Planning Committee that integrating AIDS prevention into family planning program should be
implemented nationwide in China.
235*/13404 Setting the stage for a family intervention: Results
from focus group studies of Puerto Rican mothers
and adolescent daughters
Ruth Nina-Estrella1, G. Rivera-Rivera1, I. Cunningham', A. Gullon-Rivera1,
K. Sikkema2, J.A. Kelly2. 1HIV Research Center, UN. of Puerto Rico, Rio
Piedras Campus PO. Box 23345, San Juan, Puerto Rico; 2CAIR/Medical
College of Wisconsin, Milwaukee, WI, USA
Objectives: The family can be an effective institution in the prevention of sexual
risk behavior regarding HIV and STDs. In order to develop intervention programs,
however, it is important to assess mother-daughter knowledge and communication
about HIV and STD sexual risk behavior, sexuality and gender roles.
Methods: The sample contained 28 adolescents (ages 12 to 15). Three focus
groups of 8 to 12 participants were formed. Eight mothers of adolescents formed
another focus group. All of the participants lived in a large public housing project
with a high rate of teenage pregnancy, AIDS and STDs in San Juan Metro. The
same question guide was used in each group to elicit information on areas such
as mother-daughter relationships, sexuality, gender roles, and communication.
Results: Mothers and daughters shared several characteristics: (1) Low levels
of knowledge about STDs and HIV/AIDS, sexual development and the relationship
of sexual risk behavior to HIV and STDs (2) Negative attitudes toward sexual roles
of men and a perception of gender roles as traditional and rigid (3) Common views
about boyfriends. Several differences exist between mothers and daughters, especially with regard to their perceptions of each other. A great discrepancy exists
between how mothers and adolescents perceive mother-daughter relationships.
Most mothers see themselves as friends of their daughters. Many adolescents,
however, refer to their mothers as "bochincheras" (blabbermouths) with whom
they do not share sexual confidences, for fear everyone may learn of their confidences. Daughters reproduce many of the social constructions of sexuality and
gender roles of their mothers.
Conclusions: To fortify the role mothers can have in the prevention of sexual
risk behavior, it will be necessary to increase knowledge about sexuality and
gender roles among both mothers and adolescent daughters, and then to provide
information to both as to how to communicate more effectively regarding sexuality.
The data provided in this study will aid in the development of interventions in
which both mothers and daughters can learn how to better communicate about
sexuality, gender roles, and HIV risk.
S13405 A rapid assessment on the health care seeking behaviors
of selected populations in Metropolitan Manila, the
Philippines
Laufred Hernandez1, R.H. Imperial2. 1Off of the Chancellor, Univ of the Phil
Manila, 8/F Phil Gen Hosp, Taft Avenue, Manila; 2Univ of the Phils
Manila/Cemshad, Manila, Philippines
Objectives: To identify the constraints on STD service utilization by the members
of the community (barangay/groups). To determine and compare the actual and
desired STD health care seeking behaviors of the general community and selected population groups including its gap and constraints on the use of existing
sources of STD care.
Design: Purposive convenient cluster techniques and ethnographic field methods.
Methods: Interview questionnaires were conducted between 5% to 8% of each
sample population (i.e., female and male sex workers; MSM, youth/students, displaced persons from Smokey Mountain [largest garbage disposal area in Manila];
transport workers; and, seafarers and dockhandlers in 2 districts in Pasay City
and 5 districts in Manila. The questionnaire contained questions on respondents'
actual and desired health seeking behaviors. Structured interviews were also
conducted among the vulnerable groups and key informants (i.e., community
doctors, leaders).
Results: A total of 3,186 respondents were analyzed. Inspite of their awareness of existing medical personnel in their community (68%), 54.5% of the total
respondents do not participate/avail medical treatment. Cough and colds (30.3%)
and fever (25.6%) were the chief illnesses among the respondents for the past
6 months; 56.4% self-medicate. They have had bouts with gonorrhea and crab
lice. Key informants opined that lack of funds for an STD facility and cooperation
among community dwellers hinder an effective health seeking behavior strategies.
Conclusion: This is the first study conducted in the country where health
care seeking behaviors of Filipinos were analyzed. Results of this study will

pave the way for the design of a culturally-appropriate health seeking behavior
interventions by vulnerable groups.