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

216 Abstracts 14167-14171

12th World AIDS Conference

force. Both qualitative and quantitative methods were used to collect the data.
A pre-tested interview schedule was administered on a sample of 500 street
children living at Railway Stations, Bus Terminals, shopping complexes and night
shelters. The children covered were between the age of 5 to 18 years (5-11
years - pre-puberty and 12-18 years - puberty). Convenience sampling method
was followed because the street children were not easily traceable because of
their mobility. Informed consent was taken from each participant. In order to understand the organizational structure and stratification, focus group discussions
were conducted. In addition, case studies were also done to get an insight into
their behavioural problems.
Result: As high as 44% children in the age group of 12-18 years and 17% in
the age group of 5-11 years have bought sex. It was remarkable to note that 23%
of the 5-11 years age group male children sell sex. Although 34% of the children
had heard about AIDS, they had several misconceptions.
The study indicates that the street children both at pre-puberty and puberty
indulge in unsafe sexual activity not only with opposite sex but with same sex.
Elder boys forcibly indulge in anal sex with the younger boys. Drug use is also
common there, which the children learn from their peers.
S14167 | Psychosocial determinants of HIV preventive behavior
among black women in Washington DC
Kevin K. Hylton, R. Delapenha, W. Frederick. Howard University Hospital,
Washington DC, 6805 Riverdale Road #203, Riverdale, MD, USA
Objective: This study examines the impact that violence, interpersonal power,
financial dependence, condom use self-efficacy, and self-esteem have on the
safer sex practices of black women in Washington DC.
Methods: This abstract reports preliminary analysis of personal interviews conducted with thirty women using a questionnaire consisting of: (1) the Rosenberg
Self-Esteem Scale, (2) the Condom Use Self-Efficacy Scale and (3) questions
dealing with interpersonal power, violence and financial dependence. Subjects
were recruited from the Women's Interagency HIV Study (WIHS) at the Metropolitan Washington site. The women in this study were between the ages of 23-46
years old (mean age = 33). Of the 30 women, twenty eight (93%) were seropositive
and two (7%) were seronegative. Risk factors for HIV infection were intravenous
drug use and heterosexual contact.
Results: There is a history of violence among women in this study. Twenty
women (68%) reported that they had been physically abused. Power imbalances
also impacted on women's control over whether or not a condom was used during
intercourse. Six women (19%) reported that they had no control over whether or
not a condom was used, thirteen (43%) reported that they had some control, and
eleven (38%) reported that they had total control. There does not appear to be
any direct effects on the safer sex practices of women in this study as based on
financial dependence, condom use self-efficacy and self esteem.
Conclusion: Black women in Washington DC may have limited control over
their decision to engage in safer sexual practices. HIV prevention interventions
targeting this group should address their experiences with violence, power imbalances and conflict resolution.
S14168 Factors influencing HIV/AIDS partner notification
Thomas L. Hafemeister. 238 Burnett Hall, University of Nebraska, Lincoln NE
68588-0308, USA
Objectives: A widely-accepted and utilized component of public health programs designed to curtail the spread of the HIV/AIDS epidemic is the voluntary
notification of sexual and needle-sharing partners of individuals who test HIV
seropositive. However, little is known about barriers to this notification and factors
that promote or inhibit this notification.
Design: Experimental
Methods: 100 members of the HIV community are being surveyed to determine
what factors influence their decisions to notify or not to notify their partners of
their seropositive status. Partners of these individuals are also being surveyed to
ascertain their views of what facilitates or impedes partner notification. This study
will ascertain 1) factors that promote or discourage such disclosures; 2) the typical
course of this disclosure, including its impact on the individuals involved; and 3)
factors that exacerbate or ameliorate the potential negative impact of disclosure.
Results: Data currently being collected, but to be concluded by May 1, 1998.
Conclusion: A number of factors influence the decision of persons living with
HIV to notify their partners of their seropositive status. This study will identify a
number of these factors.
| 14169 Factors influencing marital stability among HIV
discordant couples in northern Thailand
Arunrat Tangmunkongvorakul1, D.D. Celentano2, J.G. Burke, M.A. deboer2,
P. WongPan1, V. Suriyanon1. 'Research Institute for Health Sciences Chiang
Mai University PO Box 80 CMU, Thailand; 2Johns Hopkins University Baltimore
MD, USA

Objective: To examine social factors influencing marital stability among a cohort
of HIV discordant couples in Northern Thailand.
Methods: From 3/1992 to 6/1996 [n = 292] (male positive/female negative)
discordant couples were identified at 2 northern Thai hospitals. 13 couples identified as having separated following notification of HIV status were contacted by
mail and asked to participate in the study. Six couples agreed to participate. 13

additional couples whose relationships were known to be intact were selected
as controls. Each member of the couple was interviewed separately. The semistructured interviews focused on topics such as premarital background, marital
relationships, and how HIV notification affected their relationship with specific attention to conflict and sexual relationships. Field notes taken during the interviews
were expanded and analyzed using a qualitative data analysis software package.
Result: The data collected suggests that three specific factors directly influence marital stability following HIV notification; 1) the role that the extended family
members play in the relationship. 2) the existence of children from the marriage,
and 3) fear of stigmatization by community members. In addition, regardless of
the couples separation or not, the husbands HIV diagnosis has profound effects
on the dynamics of the relationship and the emotional well being of the family. Condom use is low and the infected husbands are coping with depression
associated with HIV notification.
Conclusions: Little research exists worldwide regarding 1) the affect that a
diagnosis of HIV discordant status can have on a heterosexual relationship and
family and 2) ways to reduce HIV risk between members of stable heterosexual
partnerships. There is a growing need for culturally relevant programs designed
to address the effect of HIV on partnerships and families.
S14170 Safer sex: The use of male and female condoms among
women who use drugs
Kirk W. Elifson', Claire E. Sterk2, D. German2. 1Department of Sociology
Georgia State University; 2Rollins School of Public Emory University Atlanta GA,
USA
Objectives: (1) to examine sociocultural factors impacting the use of condoms;
and (2) to examine evaluations of the male and female condom.
Methods: Structured interviews were conducted with 150 active female drug
users in Atlanta, Georgia. Central topics included the use of male and female
condoms by type of partner (steady versus steady casual and casual partners),
sex act (vaginal and oral) and social context (level of privacy and presence of
drug use). Supplementary in-depth interviews were conducted with a subsample
of 30 women to further investigate the statistical findings. Major themes were the
impact of the social context and the reasons for preferring one type of condom
over the other.
Results: Statistical analyses showed a significant relationship between type of
partner, type of sex act, and the use of male condoms. The analysis failed to capture the impact of the social context. Qualitative data indicated that a main factor
contributing to unsafe sex was the impact of the presence of other persons and not
the type of partner or the women's drug use. In addition, while women preferred
their partners use the male condom, men favored the use of the female condom.
The impression was that some men viewed female condoms as erotic toys.
Conclusions: Accurate assessments of condom use may require a combination of quantitative and qualitative data collection. In addition, intervention
programs should take the social context of sexual encounters as well as the
gender-related evaluation of male or female condoms into consideration.
14171 Behavioral explanations for elevated prevalence of HIV in
St. James Parish, Jamaica
Maxine Wedderburn1, J. Amon2, P. Figueroa3. 1c/o Mary O'Grandy, Impact/FHI,
2101 Wilson Blvd, #700, Arlington, VA 22201; 2/mpact/FHI, Arlington, VA, USA;
3MOH/EPI Unit, Kingston, Jamaica
Objective: To compare results from a KABP survey on HIV/AIDS conducted
nationally with one conducted in St. James parish, which has reported an annual
AIDS case rate more than twice the national average since 1993.
Methods: Cross-sectional surveys on HIV/AIDS KABPs were conducted nationally and in St. James parish in the 3rd quarter of 1996 with population-based
samples using a stratified multi-staged design. The sampling frame consisted
of enumeration districts (from the national census). Districts were grouped into
strata from which a random selection was done. Systematic sampling of dwellings
based on a randomly selected starting point in each district was undertaken. At the
houselhold level, respondents aged 15-49 were selected from a random numbers
grid. For the national survey, the nations capital, Kingston & St. Andrew, and the
main tourist parish, St. James, were purposely selected. A similar methodology
was used to identify the sample for the St. James survey. Results from the 1996
survey, which sampled 1189 individuals, were analyzed and compared with the
St. James survey of 500 individuals.
Results: Although residents of St. James parish were as likely as the national
population to report non-regular partnerships (26% among men, 10% among
women), the number of non-regular partners reported by St. James residents was
significantly higher, especially among women. St. James residents also reported
a higher incidence of multiple regular partners (38% vs. 30% among men, and
9% vs. 5% among women, p <.05). While men reported higher rates of condom
use than the national average, adolescent females (aged 15-19) were less likely
than the national population to use condoms with regular partners (39% vs. 67%,
p =.05). St. James residents reported higher use of marijuana (23% vs. 19%,

p <.05), crack (0.6% vs 0.1%), and alcohol (29% vs. 19% report 5 or more
drinks/month), and were more likely to report unprotected sex after alcohol or
drug use (41% vs. 39%). Thirteen percent of the men and 4 percent of the women
in St. James reported sexual contact with tourists, twice the rate for the national
population (p <.05).
Conclusions: Previous research has shown higher rates of AIDS cases and
HIV prevalence in St. James than the national average. A general population sur