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

12th World AIDS Conference

Abstracts 14172-14176 217

vey explained the elevated rate by showing increased numbers of sexual partners,
increased drug and alcohol use, and sexual contact with tourists. In conjunction
with specific target population studies and infrastructural studies addressing STI
clinic access, migration and economic vulnerability, a greater understanding of
the causes of this increased prevalence, and the means to address it, can be
defined.
S14172 Culturally appropriate persuasive communication
strategies in HIV/AIDS prevention: What works among
Nigerian university students?
Charles Uwakwe', S.O. Agofurel, A.O. Ogundiran2, K.C. Okamgbal. 'Dept
Guidance Counselling Ibadan University Ibadan Nigeria; 2Ministry of Health Oyo
State Ibadan, Nigeria
Background: This study was designed to identify aspects of culturally appropriate content and presentation in persuasive communication that would have
a significant impact on sensitizing young Nigerian adult university students to
cultivate HIV/AIDS preventive attitudes and behaviours.
Methods: the sample consisted of male and female university students (n =
780) in the resident university campus of Ibadan, and the non-resident Ogun
State University, Ago-lwoye, Nigeria. The students responded to a questionnaire
regarding their sexual self efficacy and risk-taking, preferred medium of HIV/AIDS
communication, variants of informational and emotional content of message and
possible effect of the passage of time on changes in attitudes, knowledge and
behaviours resulting from persuasive communication on HIV/AIDS prevention.
Indepth interviews and focus group discussions were also conducted on the
above themes.
Results: The respondents (34.2%) perceive themselves to be at risk of HIV,
but only 28.4% adopt any HIV preventive methods. Preference was for print
(posters and hand bills) and electronic (video) media in the dissemination of
HIV/AIDS information. Respondents ascribed higher persuasive quality to testimonies of HIV/AIDS patients, or direct account of peers who have encountered
such patients as effective in sensitization for sexual behaviour change on campus.
Conclusions: Persuasive communication for sexual risk behaviour modification
among Nigerian University students holds promise for success when testimonies
of HIV/AIDS patients are incorporated in such intervention and supplemented with
appropriate print and video education materials for this vulnerable but oblivious
cohort.
14173 Coping style is associated with mood and sexual risk
behavior in HIV positive patients
Catherine Classen', C. Koopman', M. Gill1, M.A. Chesney2, N.H. Ney1,
D. Spiegel. 'Stanford University School Of Medicine Dept. Off Psychiatry 401
Quarry Road; 2 UCSF Medical School San Francisco, CA, USA
Objectives: To examine the relationship of various coping styles with mood and
sexual risk behavior in HIV positive patients.
Design: Prospective, randomized clinical intervention trial.
Method: The baseline data of 29 women and 73 men who have been recruited
into a support group intervention trial for HIV positive patients are examined
to see whether coping style is associated with mood and sexual risk behavior.
Coping style was assessed using the COPE (Carver et al., 1989) and mood
with the Profile of Mood States (McNair, Lorr & Droppelman, 1971). Sexual risk
behavior was assessed in a structured interview. Subjects were asked to indicate
the number of partners with whom they had sex during the past 3 months, how
many of these partners knew they were HIV positive, and with how many they
had unprotected sex. Baseline coping styles were correlated with baseline mood
disturbance, baseline sexual risk behavior.
Results: Baseline mood disturbance was negatively correlated with active
coping (r =.29, p <.01), acceptance (r =.30, p <.01), and positive reinterpretation and growth (r =.17, p <. 05) and positively correlated with behavioral
disengagement (r =.43, p <.001), denial (r =.27, p <.01), alcohol/drug use (r =.31, p <.01), mental disengagement (r =.19, p <.05), and focus on and venting
of emotions (r =.29, p <.01). Active coping was positively associated with the
number of female sexual partners (r =.21, p =.01). The number of partners
informed about subjects' HIV status was negatively correlated with active coping
(r =.16, p =.05), acceptance (r =.17, p <.05), and religion (r =.16, p <.05).
The number of partners with whom subjects had unprotected sex was positively
associated with seeking emotional support (r =.16, p <.05).
Coping styles are associated with both mood and sexual risk behavior. Coping
styles that are proactive and positively oriented are associated with less mood
disturbance, while denial and giving up are associated with greater mood disturbance. HIV positive patients are less likely to engage in risky sexual behavior if
they use active coping strategies, accept their illness, and are religious.
S14174 A comparison of HIV behavioural risk factors for young
gay men and young immigrant women

Jacqueline Barnett', Lezlie Wagman2, Scott Robertson2, Christopher Buchner3.
'British Columbia Centre for Disease Control, 655 12th Ave, Vancouver, B.C.
V52 4R4; 2British Columbia Centre for Disease Control Society, Vancouver, BC;
3 Youth-Co AIDS Society, Vancouver, BC, Canada
Issue: Numerous HIV prevention programs have based their education materials on lifestyle related risk factors, identifying mutually exclusive behaviour

patterns for each at-risk population. These programs have demonstrated their
effectiveness in teaching about the disease but have had little effect on long-term
behaviour change.
Project: To develop more effective educational interventions two distinct risk
populations were compared. As a first step in exploring this idea two focus groups
were organized one consisting of young gay men of European extraction the
other with young immigrant women from South and East Asia, Africa and Latin
America. People from these regions appear to be at high risk in Western Canada
for HIV. The discussion guides for both focus groups were based on the same
format with attention paid to the following topics: Intimate relationships, Desires
of the young gay/immigrant, man/woman, Safety in relationships, Condoms and
Risky relationships. Both didactic and projective techniques were used in the
focus groups to access information beyond social desireability.
Results: As both groups are marginalized by the dominant culture the risk
issues they share are not surprising. Cultural isolation and alienation were expressed as a need to be accepted by the culture at-large and to be positively
recognized for being different. In practical terms this was demonstrated by a
desperate need to find a boyfriend as refuge from the rest of society. Traditional
male values affected both these groups in slightly different ways. For the gay
men it both affected their sexual risk-taking and an unspoken expectation to be
submissive. This latter issue was reflected by the women as well.
Lessons Learned: It is important to recognize that distinct populations at-risk
have more in-common than initially thought. Their similarities can offer a more
complete picture of mutually related behavioural risk factors. This information
adds to the wealth of information already gleaned in this area and will be used to
develop and test innovative educational interventions which can reach more than
one population at a time.
114175 Sex, rights and roles
Godfrey Woelk', R. Kerkhoven2, C. Todd', M. Bassett', A. Chingono1. 'PO Box
178-A vondale-Harare; Dept of Community Medicine University of Zimbabwe
Harare; 2Safaids Harare, Zimbabwe
The spread of HIV/AIDS/STDs in Southern Africa is predominantly fuelled by
sexual transmission. This reflects inequalities in sexual roles, gender, access to
essential services and basic human rights. Within the SADC region and between
the member states there is no common policy, shared principles and or joint legal
response to reproductive health, HIV/AIDS, gender and human sexuality, although
these issues are linked and closely related. It would appear unlikely to expect the
governments or regional bodies to lead the way in the identification of common
ground and the exploration of interrelations between gender roles, human sexuality, health care and the fight against HIV/AIDS/STDs. NGOs and other civil society
organisations in the region, such as trade unions, professional associations etc,
have played an active and often pioneering role in the development of effective
responses in these 'linked' sectors and issues. However these different categories
of partners have not yet managed to establish common ground of understanding
and action. Consequently joint action and advocacy between these potential
partners seldom occurs. The development of common ground and understanding
of issues between the various categories of actors is a minimal condition for the
development of a sound and ethical framework of policies, principles and norms
against the impact and spread of HIV/AIDS/STDs in Southern Africa. Although this
is a complex and seemingly abstract issue the formulation of a shared vision and
strategy amongst the multitude of partners would appear to be critical. The preliminary results of the first phase of data collection from a limited number of SADC
member tates will be presented. Differences and comparisons of issues and responses between SADC member states will be critically reviewed. Finally details
of a five stage project initiated by organisations from the region will be shared.
The use of rapid assessment techniques to collect data in the field of substance abuse and sexual behaviour offers the opportunity to develop appropriate
responses to the associated risk of HIV transmission in a timely mariner.
S141761 HIV+ MSM in discordant relationships report sexual
risk-taking with primary and non-primary partners
Colleen Hoff, B. Faigles, C. Gomez, R.B. Hays. UCSF Center for AIDS
Prevention Studies, 74 New Montgomery St., San Francisco, CA 94105, USA
Objective: To describe differences in sexual risk-taking behavior with primary
versus non-primary partners among HIV+ men who have sex with men (MSM).
Method: A cross-sectional sample of HIV+ MSM (N = 255) was recruited from
two US urban centers (New York and San Francisco). Participants were recruited
from public sex environments, AIDS service organizations and gay venues. Men
participated in a semi-structured interview and completed a self-administered
survey. The interview included detailed narratives regarding specific sexual encounters. The survey explored a broad spectrum of variables including: sexual
behavior (past 3 months), relationship issues, and health status. Men in primary
relationships (N = 94) were stratified by their primary partners HIV status (+/+, N
= 45 and +/-, N = 49) to describe sexual behavior with primary and non-primary
partners.
Results: HIV+ men in discordant relationships (+/-) were more likely to have

unprotected anal intercourse (UAI) with an HIV- or HIV status unknown (HIV?)
non-primary partner than HIV+ men in concordant relationships. Yet, men in HIV+
concordant relationships were more likely to have unprotected anal sex with their
primary partners (see table).
Guilt free sexual gratification emerged as a theme in the interview data explaining why some men in discordant relationships engaged in UAI with non-primary