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

212 Abstracts 14147-14152

12th World AIDS Conference

Conclusions: ARV treatments have decreased concerns about infection and
increased willingness to take risks in a substantial minority of couples. While
new medical advances (PEP, VL, viral supressive therapy) may not increase
unprotected sex, they may provide additional rationale for it, particularly for
some uninfected partners. Monitoring their effect on risk perception and risk
taking should continue. These issues should be addressed by providers and in
interventions for HIV(+) and high risk heterosexuals.
14147 1Preaching to the choir: Preference for female-controlled
methods and HIV/STD risk
Sheila Murphy1, L.C. Miller1, L. Clarke2, J. Moore3. 1102A Annenberg School for
Communication USC, Los Angeles, California; 2University of Alabama,
Birmingham, AL; 3Centers for Disease Control & Prevention, Atlanta, GA, US
Objectives: To assess level of interest and characteristics of women most interested in female-controlled methods for HIV/STD prevention.
Method: 170 African-American women, 18 to 32 years old, living in the greater
Los Angeles area who had unprotected sex and at least 3 sexual partners in the
last 2 years were surveyed with regard to their sexual history, recent practices,
and preferences for features of HIV/STD prevention methods.
Results: Out of 44 potential features for HIV/STD prevention methods, the
average rating of "female control" (i.e., a method women control by either wearing
or applying it) was 22nd in importance with concerns regarding adverse physical
side effects, effectiveness, and pregnancy prevention rated as most important.
The distribution of responses to the "female control" item was bimodal with the
majority of Rs either rating female control as highly important to them (a 9 or 10,
42%) or relatively unimportant (a 6 or below, 35%). Comparisons between these
two groups revealed that women for whom female control was important: 1.) had
significantly fewer sex partners in the past year (M = 2.62 vs. 4.64, p <.01), 2.)
had fewer STDs (p <.05) and, 3.) were more likely to use male condoms on a
frequent basis (M = 4.69 vs 3.19 on a 5-point scale). Moreover, women for whom
female control was relatively unimportant were not unaware of their HIV/STD
risk, rather they accurately perceived themselves to be significantly more likely to
contract HIV or other STDs in their lifetime than women who rated female control
as very important.
Conclusion: These data suggest that female control may be of interest to
a substantial percentage of women in their selection of a HIV/STD prevention
method but, ironically, may be of lesser interest to women most at risk for HIV
and other STDs. These data underscore the need to take the priorities and
preferences of at risk women into consideration when developing and marketing
new HIV/STD prevention methods.
14148 Motivations for participation in HIV vaccine trials among
men who have sex with men
Cristiane Silva1, Mary-Jane Spink2, C.G.M. Silva2, M.F. Diogo2, S.E.P. Garcia3,
V.C. Costa4. 1Rua Frei Caneca 1140-3Y Andar, Sao Paulo, CEP 01307-002;
2Pontificia Universidade Catolica-PB. V, Sao Paulo, SP;
3CRT-AIDS/SES-Projecto Bela Vista/PB. V, Sao Paulo, SP; 4 nstituto de
Saude/SES-PB. V., Sao Paulo, SP, Brazil
Objectives: To explore the reasons given by volunteers of the Bela Vista Project
for participating in vaccine trials as well as the reasons for not wanting to
participate
Method: The Bela Vista Project is a cohort study of HIV incidence among
men who have sex with men. Until July 1997, after three years, the study had
recruited 662 volunteers who are seen at the research unit at six months intervals.
Questions regarding reasons for participating and for not participating in vaccine
trials were included in the interview schedule. Positive responses were classified
into: collaboration with science; credibility of research group or product; solidarity;
own benefit and negative responses into: lack of credibility, fear of side effects,
dislike of being a volunteer. The association between responses and level of
education was explored and response stability tested by comparing responses at
second and fourth interviews.
Results: all volunteers who had completed the second (N = 414) and fourth
(N = 175) interviews were included in this study. Only 4.8% of respondents at
second and 10.9% at fourth interviews would not consider participating. The
most frequent reasons for participating were: collaboration with science (20.1%),
solidarity (22%) and own benefit (22.2%). Reasons for participating did not vary
significantly with level of education. Positive reasons were quite stable over time,
specially for those who gave collaboration and solidarity as reasons. The most
frequent reasons for opting out of participating were: fear of side effects (38.2%)
and lack of credibility of vaccine product. The percentage stating they would never
consider not participating increased from 15% to 24%.
Conclusions: the data suggests that the Bela Vista Project volunteers are
willing to participate in vaccine trials, moved by considerations associated with
altruism and with potential benefits to themselves. However, fear of side effects
and lack of knowledge about the product being tested may become powerful
deterrents for enrolling in HIV vaccine trials. (supported by UNAIDS, MS/BR,

SES/SP and FAPESP)

S14149 Social, sexual, and reproductive aspects related to AIDS
prevention among women in Bogota, Colombia
Carolina Garcia-Vargas, H. Ardila. Liga Colombiana de Sida, Bogota, Colombia
Objectives: To assess attitudes, information and risk perception about AIDS/STD,
female condoms, condom negotiation with partner and safe sex behaviour among
women from low socio-economic level in Santafe de Bogota, Colombia
Methods: A qualitative study (n = 100) was developed in order to assess
psycho-social aspects about AIDS-STD prevention. Twelve focus group sessions
and individual open ended (face to face) interviews were held with women.
Complementary, close-ended questionnaries were administered.
Results: Most of the women feel worried about the possibility of acquiring
AIDS with their stable partner. Love and long term relationships are not perceived
as a way of HIV protection during deep discussions. Infidelity is seen as very
probably, especially among men. Nevertheless they do not use condoms in their
sexual relationship. Male dislike, unpleasant feelings with condoms and passivity
to negotiate with partner rejection were named as difficulties. Female condom
was perceived theretically as a practical method to prevent HIV and unwanted
pregnancies. Condoms are mostly used as a contraceptive method, mainly during
periods when it is not possible to use another one for health reasons. In addition,
condoms were perceived as unpleasant during sexual intercourse. After long discussions, they agreed that these feelings could be imaginary and they could be
modified. On the other hand, they stressed the importance of STD-AIDS prevention using condoms. Importance of communication and dialogue was emphasized
as a strategy to negotiate safer sex behaviours with stable partners.
Conclusions: It is necessary to strengthen assertivenness and control over
one's sexuality among women. Additionally, the image of the condom promoted
not only as a STD AIDS prevention tool, but also as a part of eroticism and a
reinforcement of family planning methods. Female Condoms need to be promoted
in light of their potential use.
S14151 Negative partner reactions and sex roles: Influences on
male condom use
Janet Saul1, R.M. Dabrowski2, D. Dixon3, J. Moore4. 1CDC 1600 Clifton Road
Mailstop, Atlanta; 2TRW Inc., Atlanta, GA; 3University of Miami, FL; 4Centers for
Disease Control, Atlanta, USA
Objectives: To determine whether negative partner reactions to requests for
condom use predict lower levels of condom use. To explore whether condom use
among women with traditional beliefs about sex roles is influenced more strongly
by negative partner reactions than among women with nontraditional beliefs.
Methods: 187 Puerto Rican women, aged 18-35, who were at risk for heterosexually transmitted HIV were recruited from comprehensive health clinics in
the Bronx, New York. Women who had asked their male partner to use condoms
(requestors) were asked what partner reactions they experienced. Women who
had not asked their partner to use a condom (nonrequestors) were asked how
they had expected him to react. The hyper-femininity scale was used to measure
beliefs about sex roles.
Results: 58% of the women had requested that their male partner use condoms; of these, 36% experienced some type of negative reaction. 42% had not
asked their partner to use condoms; of these, 43% expected a negative reaction.
The most common negative reactions, experienced or expected, were breech of
trust, embarrassment, and arguments (10%-29%). A small percentage of women
had concerns about physical violence or loss of the relationship in response
to requests for condom use (1%-3%). Women who experienced or expected
negative partner reactions were significantly less likely to report always using
male condoms (requestors: X2 = 7.01, p <.01; nonrequestors: X2 = 8.59, p <.01). Among requestors, negative partner reactions tended to have a stronger
influence on condom use for women with traditional beliefs about sex roles than
for women with nontraditional beliefs (p <.07). There were too few nonrequestors
to test an interaction effect.
Conclusion: These data suggest that negative reactions by male partners,
whether experienced or expected, have a major impact on whether condoms are
actually used in a relationship. However, these partner reactions may play more
of a role in condom use for women who hold traditional beliefs about sex roles.
Women, particularly those who hold traditional beliefs, need assistance in overcoming the negative consequences that they expect, or indeed may experience,
as a result of requesting male condom use.
|14152 Risk management in relationships between HIV positive
people and their partners
Tim Rhodes, L. Cusick. The Centre for Research on Drugs and Health
Behaviour 200 Seagrave Road London SW6 1RQ, England
Objectives: To examine the social relations of risk management in the context of
sexual relationships where at least one partner is HIV positive.
Design: Depth qualitative study, with purposive sampling design to achieve
adequate quotas of: (a) HIV positive drug users; (b) sexual partners of HIV posi
tive drug users; and (c) differences on account of gender, sexuality and drug use
experience.
Methods: Qualitative interviews were undertaken with 61 HIV positive drug
users (12 diagnosed with AIDS) and 12 sexual partners of HIV positive drug
users, and were coded using 'Ethnograph'. Of the total sample (n = 73), 36%
were current drug injectors, 37% defined themselves as gay or bisexual men,
and 32% had never injected drugs and were not gay or bisexual men. Almost