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

12th World AIDS Conference

Abstracts 14134-14137 209

tion. 87.1% of the respondents agreed that HIV/AIDS infected person should
be encouraged and cared for. 94.0% respondents believed that using condom
during sex can prevent HIV/AIDS infection 71.1% respondents had involved in
AIDS prevention activities. Among 519 or 72.1% of respondents who ever had
sexual intercourse 46.5% reported ever using condom and only 13.7% of them
using condom frequently. Only 6 respondents reported that they had sexual intercourse with none regular partners and 2 of them did not use condom. The
main sources of information were TV (95.1%); commune radio (74.2%); health
workers (69.2%); friends (54.9%); radio and panels (50.0%) newspapers (43.7%);
pamphlets (40.7%); AIDS communicators (33.1%); and relatives (30.3%).
Conclusions: Main sources of information were TV, commune radio, health
workers, friends, radio, panels, newspapers, pamphlets, AIDS communicators,
and relatives. The knowledge and attitude levels of HIV/AIDS prevention are
high. However, the percentage of respondents who use condoms during sexual
intercourse is low.
14134 Knowledge about STD/AIDS and sexual behavior of risk
in adolescents at Lambayeque, Peru
Victor Soto. Francisco Cabrera 240, Chiclayo, Peru
Objetives: To determine the level knowledge about STD/AIDS and sexual behavior of risk in adolescents at Lambayeque.
Design: Descriptive, transversal, prospective.
Methods: Using polietapic sample, we employed distrital planes in urban and
rural places, then with sistematic sample obtaining household probability and
adolescents to living in representative house, completed an anonymus survey at
their home with permission of parents.
Results: 1,803 adolescents into 12-19 years old (894 male, 909 female) at 16
conglomerates, answered the questionnaire.
(1) Knowledge about AIDS it's very deficient, only 10% approved, level in males
is better to females; exist association with School, Sex, Old
(2) Exist great difference in sexual behavior by sex:coital prevalence was 36.5%
in man and only 12.5% in women;Cayalti y Tuman two agrarian cooperatives
were more coital behavior in both sexes (62-50% male, and 31-32% females),
Third part with experience practice risk coition; 72% women, 51% man have
never used condom because "don't like"
The knowledge level about STD/AIDS it's very deficient and the experience
coital it's more in man that women, one third of them to practice sexual coition of
risk and they never used condom because don't like employ it.
154*/14135 Self-acceptance of gay identity decreases sexual
risk behavior and increases psychological health
in US young gay men
Craig R. Waldo, S.M. Kegeles, R.B. Hays. USCF Center for AIDS Prevention
Studies, 74 New Montgomery St., San Francisco, CA 94105, USA
Objectives: To examine the relationships between self-acceptance of gay identity
and sexual risk-taking behavior and mental health in gay men aged 18-27. A
secondary objective was to explore the role of gay community involvement, social
support for gay identity, and sexual orientation disclosure to these variables.
Design: Cross-sectional analysis of a longitudinal prospective cohort from 3
mid-sized US cities.
Methods: Data reported by 301 young gay men are analyzed via structural
equations modeling in LISREL VIII. Constructs examined are displayed in Figure
1. HIV Sexual Risk-Taking is defined as unprotected receptive or insertive anal
intercourse or receptive oral sex to ejaculation. Each latent construct was estimated with three composite indicators with maximum likelihood procedures. A
measurement model analysis was performed to ensure that all constructs were
measured adequately (see fit statistics in Figure).
Social Support for
Gay Idcntity.11 07.28 (.07)
38 (.07)
40 (.08) Psychologital
Gay Cotmma ity 1 7 Self-A nceptan ce of
Ianvolva'ncna t. 8 \( Idaatity iltath
-.13(.08)
Measurement: Chl-Sqaure/dfratio " 121
Model Goodness of Fit Index -.95.46 (.09)
Adjusted Goodness of Fit Index =.93
Root Mean Square Residual - 04 HIV Sexual
Structural: Chi-SqaurcAf ratio- 1.25
Model Goodness of Fit Index - 94 isk-Takin
Adjusted Goodness of Fit Index - 9:3/ Seuala
Root Mean Square Residual =.05 Orientation
Results: All standardized path coefficients in the structural model reached
statistical significance (p.<.01) and all fit statistics indicated an excellent model
fit (see Figure). Results indicated that: (1) Gay community involvement predicts
social support for and self-acceptance of gay identity; (2) Social support for gay
identity is related to self-acceptance of gay identity and psychological health;

and (3) Self-acceptance of gay identity predicts increased psychological health,
sexual orientation disclosure, and decreased sexual risk behavior.
Self-acceptance of gay identity can be important for reducing sexual risk behavior in US young gay men. Men who accept their sexuality most are also likely to
be more psychologically healthy. Gay community involvement and social support
for gay identity increase self-acceptance of gay identity. These findings suggest
that HIV preventive interventions for young gay men can be more effective if they

facilitate personal and cultural environments that increase self-acceptance of gay
identity.
643*/14136 HAART, attitudes, and risk behavior among
serodiscordant male couples
Robert H. Remien1, G. Wagner, A. Carballo Dieguez, C. Dolezal. HIV Center NY
State Psychiatric Institute 1 Unit 74, Columbia University, 722 West 168th Street,
New York, NY, USA
Background: Advances in the medical management of HIV have raised hope for
many, however, there is concern that the achievement of undectable viral load
and/or the belief that HIV is a manageable, or soon to be "curable," disease may
contribute to increased risk behavior, among couples, where greater intimacy is
desired.
Methods: In a cohort of HIV serodiscordant male couples in NYC, we closely
examined the relationship between beliefs and attitudes about new medical treatments, and sexual risk appraisal and actual risk behavior in the first 61 couples
(122 gay men) to enter a longitudinal intervention study (target N = 120 couples).
Results: Average age was 36 years; 64% were white, 15% Latino, 11% black,
10% mixed or other; median length of relationship was 22 months. Of the 60
HIV+ men, 90% were on combination antiviral therapy; mean CD4+ cells were
344; median viral load was 560. Fourteen couples (24%) reported engaging in
unprotected anal sex in the past 2 months. Half of the entire sample agreed with
the statement "reducing viral load also reduces the risk for HIV transmission."
The HIV- men who agreed with this statement were significantly more likely (p
=.05) to engage in unprotected receptive anal sex with their HIV+ partner. Only
14% agreed with the statement, "the new treatments have made me more willing
to take risks in my sexual behavior with my partner," but the HIV- men who
agreed were, more likely (p =.02) to engage in unprotected insertive anal sex
with their HIV+ partner. Finally, one-third of the sample agreed with the statement,
"new treatments will soon be able to reverse HIV infection and eliminate the virus
from the body." Again, there was a trend (p =.07) for the HIV- men who agreed
with this statement to engage in more unprotected receptive anal sex with their
HIV+ partner. There were no such relationships, between beliefs/attitudes and
risk behavior, for the HIV+ men.
Conclusions: While most of these couples are not engaging in high risk behavior, our data support the concern that beliefs and attitudes about medical
treatment advances may be related to increased sexual risk behavior, for some:
direct causality is not demonstrated. Primary prevention must continue to evolve
as medical treatments progress. Related findings, analyses on a larger sample
size, and implications for prevention will be discussed.
14137 Antiretroviral drugs and sexual behavior in gay and
bisexual men: When optimism enhances risk
Sheila Murphy1, L.C. Miller1, R. Appleby2, G. Marks3, G. Mansergh3. 1102
Annenberg School for Communication USC Los Angeles California 90089-0281;
2Department of Psychology-USC; 3Centers for Disease Control & Preventio,
USA
Objectives: To determine whether optimism regarding antiretroviral drugs containing protease inhibitors is related to increased sexual risk-taking among gay
and bisexual men.
Methods: 503 gay or bisexually identified men between the ages of 18-41 were
approached on the street in West Hollywood, California and agreed to complete
a self-administered questionnaire.
Results: 416 respondents, or 83% of the sample, had heard of protease inhibitors and were eligible to answer questions regarding their impact. Five items,
measuring the extent to which protease inhibitors enhance the quality and length
of life among HIV positive individuals, were averaged to generate an index of
optimism toward antiretroviral drugs. Analyses of 346 respondents whose HIV
status was negative or unknown revealed modest, but consistent, negative correlations between this index and the percent of time respondents used condoms
during anal sex (r = -.20), were monogamous (r = -.16), attempted to determine
partner HIV-status (r = -.22), and limited their number of sex partners (r = -.18).
Interestingly, for the 64 HIV positive respondents, this negative relationship was,
if anything, stronger (e.g., used condoms during anal sex (r = -.30), were monogamous (r = -.22) or limited their number of sex partners (r = -.27)). Further
analysis revealed that the more HIV positive men felt that protease inhibitors
enhanced the quality of life among HIV infected individuals the more men with
whom they had unprotected sex (r =.22), and the more they tended to agree that
protease inhibitors "decrease the fear of transmitting HIV to others" (r =.22) and
"increase the freedom for sex without condoms" (r =.26).
Conclusion: There are at least two possible interpretations of these data. It
may be the case that individuals who engage in risky sex attempt to rationalize
their behavior through optimism in protease inhibitors. If true, this would make
behavior change difficult. Alternately, these data suggest that the introduction
of drugs that enhance the quality of life among HIV positive individuals may
reduce the overall level of concern regarding contracting or transmitting HIV and,

paradoxically, may lead to riskier sexual behavior.