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

12th World AIDS Conference

Abstracts 13560-13564 197

Main Results: (1) - Within the Pupils: 57% think that their peers talk a lot about
AIDS; 58% think that all/many of their peers believe in the existence of AIDS in
the world and 63% in Togo. Preference of themes: 34% of personalized advice of
prevention; 27% of medical information; 23% of illustrations on the reality of AIDS
in Africa; 10.5% of messages of solidarity of the youth. 88% think that the booklet
will increase the believe on AIDS, and 89% the desire to protect themselves and
peers. 67% say they discuss with their parents about the prevention of AIDS.
(2) - Within the Parents: 73% think that their neighbours talk a lot about AIDS;
62% think that all/many believe in the existence of AIDS in the world, and 67%
in Togo. The most useful for their children: Preventive medical information (41%);
illustrations of the reality of AIDS in Africa (29%); concrete personailized witness
(25%). 58% of parents say they discuss about AIDS with their children. Trumps
found in the booklet especially to arouse a dialogue between parents and children.
Propositions: more witness/advices given by Togoleses.
(3) - Within the Teachers: many trumps found in the booklet. Remarks: too
much exemples considered out of Togo; insufficente images of HIV carriers in
good physical condition.
Conclusion: the school environment by its demultiplicational potential information is an important sector in IEC of HIV/AIDS and Sexualy Transmitted diseases
in the school curricula, CAP study in the groups of pupils and teachers of primary
and secondary schools.
13560 Not preservative using, a risk into the universitary
community
Pedro Cesar Lopez Pezo. Francisco Lazo 2650-12 Lima 14, Peru
Problematic: The undergraduates do not have risk perception and omit the use
of preservative in their sexual practices.
Project: The GAM HORIZONTE, began a knowledge survey, aptitudes and
practical upon to the use of the preservative in universitaries. The results were
alarming, 63% of the polled said not to use condom by the following reasons: The
intensity of the pleasure is different due to the barrier of the condom, the youths
believe that what is most important is confidence on their couples, the women
should not have condoms with himself since is indicium of their infedility, etc.
The direct intervention was through meetings in those universitaries wich attest
their condition of persons living with HIV/AIDS as of supposed previous and it is
reforced practice of the correct use of condom. Finally, it is taken an exit survey
par to measure the impact of the intervention.
Results: 87% of the universitaries have increased their risk perception as of to
know that in the university exist persons or companions that live with HIV/AIDS
as consequence of the do not use of the preservative and of the others conditions
worked. Now they see the use of the condom as a vital need and seek the way
of obtain them.
Learned Lessons: Not using of condom within the university community is a
possibility of latent risk that exists while the students do not perceive that all are
vulnerable to the infection. Of other side, it can be increased the perception of
the risk when students that live with HIV attest their condition of such within the
university.
13561 Introducing participatory AIDS and sexuality education
into a reproductive rural health project for adolescents
and youths
Rosa Rita Alvarez1, E.A. De Moya2, S. Acosta1, J. Romero1, V. Cruz1,
R. Gutierrez1. 1 Viriato Fiallo 30, ENS. Julieta, Mujeres en Desarrollo
Dominicana (MODE) Santo Domingo; 21nstituto Sexualidad Humana/UASD,
Dominican Republic
Issue: AIDS and sexuality education in the rural areas of the Dominican Republic
has traditionally been blocked by parents' claim for exclusive authority over their
children's experiences, teachers' manifest lack of knowledge and skills on subjectmatter, as well as adolescents' perception of cultural irrelevance and consequent
lack of involvement in these initiatives. Increasing HIV transmission, return migration from the USA and Cable TV have created an urgency for changing these
inadequate attitudes.
Project: MUDE has launched the first participatory AIDS, sexual and reproductive health project with adolescents and youths in 15 rural communities. It
incorporates group instructional modules, community organization practice, participatory action-research, resource mobilization and solidarity with persons living
with HIV as new tools for AIDS prevention.
Results: Fifteen field-work coordinators were trained as 'Technical Supports'
in 1997 for carrying culturally sensitive sex research and transferring new educational techniques to adolescents and youths in rural areas. Ninety high-school
students were trained as 'Multipliers' by coordinators in the first semester of
1998 to introduce sexual and reproductive health into their own families. They
have also started creating 'Youth Health Clubs' in each community. Parents and
teachers have made this initiative theirs', becoming enthusiastically involved with
it. A deeper and reciprocal understanding of each group's culture and experience
is being constructed.

Lessons Learned: Most resistance to AIDS and sexuality education in rural areas seems to be a function of the lack of cultural relevance to potential
stakeholders, and their consequent lack of involvement in project design and
implementation. Once these aspects were taken into account, none of the rural
communities has wanted to be left behind by the Project.

I13562 Promoting dual protection for HIV/STI and pregnancy
prevention in Zimbabwe
Joanne E. Mantell12, E. Weiss3, C. Thompson4, W. Sambisa4, M. Ojermark4.
1832 Broadway, 10th Floor, New York, New York 10003; 2HIV Ctr for Clin &
Behav Studies/Col U, New York, NY; 3lnd. Consultant, Harrington Park, NJ,
USA; 4John Snow Inc/Seats, Harare, Zimbabwe
Issues: The most effective and frequently used contraceptive methods in
Zimbabwe (oral contraceptives and injectables) provide no protection against
HIV/STIs, while condom use, which prevent HIV/STIS, for family planning (FP)
is low. Since condoms are not aggressively promoted for either FP or disease
prevention in FP clinics, the need to motivate women and their partners to use
a barrier method is pressing. This will require a shift in FP's clinical orientation
from contraceptive method efficacy to concurrent protection from pregnancy and
HIV/STIs.
Project: To demonstrate the feasibility of increasing dual protection (DP)
norms and behaviour, and operations research project combining a clinic-based
programme, community-based outreach and social marketing will be implemented
in Epworth, an informal settlement near central Harare. Key mutually reinforcing programme components are: (1) clinic-based education and counselling and
enhancement of the clinic management information system (MIS) to document
condom distribution and use: (2) training of clinic and community-based providers
in DP conceps and practices; (3) expansion of the supply and distribution of male
and female condoms in the clinics and in the community by community-based
distributors (CBD) and other community-based workers; (4) development of a
youth-oriented reproductive health programme; (5) expansion of the social marketing of barrier methods; (6) development of DP IEC materials; (7) development
of DP management goals and objectives for health services; and (8) evaluation
and monitoring of all intervention activities, including programme costs and quality
of care.
Results: As the project is in the start-up phase, no results are available.
The high HIV seroprevalence among childbearing aged women in Zimbabwe,
coupled with high rates of other STIs and women's difficulty in negotiating safer
sex, argue strongly for intensifying efforts to increase barrier contraceptive use
among FP clients. For long-term sustainability, maximal use of existing community
resources and strengthening infrastructure capacity were important considerations in project design.
S13564 Protective behavior among men in Sao Paulo City
Elisabeth Vieira1, M.E.L. Fernandes2, W.V. Villela3, M.F. Rea3, E.D. Franco2,
G.R.C. Ribeiro2. I Rua Heitor Penteado 47 Casa 3, Sumarezinho Sao Paulo:
2ADF-Associagao Saude Familia, Sao Paulo, SP; 31nstituto Da Saude, Sao
Paulo, SP, Brazil
Background: AIDS is the major cause of death for women aged 20-34 in Sao
Paulo city, the largest South American metropolis. The Ministry of Health has
reported that heterosexual transmission is responsible by 50% of all AIDS transmission in the country. In order to understand which aspects of male sexuality
are more involved with protective behavior a study was carried out from May to
December of 1997.
Methods: Six focus group discussions were conducted in order to improve a
basic survey questionnaire approaching several aspects of reproductive health.
A total of 597 working men aged 21 to 50 years old were randomly selected to
be interviewed in public places taking into account social classes and geographic
districts of Sao Paulo city. Statistical analysis using frequency, t-test of mean and
Chi-square was performed in order to test association among the variables.
Results: Knowledge on AIDS and STD were strikingly high being associated
with social class and schooling (p < 0.000). The t-test was applied to compare
the mean number of partners between married and single men and it was found
significant. While single men had a mean of 4.45 sexual partners, married men
had 1.48 sexual partners. Infidelity was reported not being accepted by most
men (62.2% for men and 78.4% for women). Condom use was reported to be
used in extra marital relationship by 16.4%, used with the partner by 13%, to be
used occasionally by 13.6%, used by 18.3% of men who had no partner and not
used at all by 38.3% of men. Condom use was found associated with young age,
not being married and greater perception of risk (p < 0.05). Changes in sexual
behavior due to AIDS epidemic were reported and found associated with young
age. Married men with more than 3 partners and single men with more than 4
sexual partners in the previous year were classified as MGNP (Men with greater
number of partners). They totaled 19.4% of surveyed men. It was not found any
difference from the other men regarding age, social class, schooling, income
or number of children. They are more likely to be single, had they first sexual
intercourse younger than the other men and are more likely to use condom (p
< 0.05). They also have more liberal moral principles for sex life for male and
female behavior and are less likely to resist to unprotected sex (p < 0.05).
Conclusion: Almost 60% reported only one sexual partner in the previous
year and the number of partner's increases if the men are single. This data is
consistent with the finding that infidelity is not acceptable by more than 60%
of men and it is in opposition to the stereotype of Latin men being unfaithful.

There were probably behavior changes in the male population in So Paulo since
the beginning of the AIDS epidemic. These changes are related to condom use
among young people. Data points about the urgent need to target MGNP by
STD/HIV prevention programs.
Funded by The Ford Foundation.