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

12th World AIDS Conference

Abstracts 14182-14186 219

its modes of transmission and available preventive options. However, according
to surveillence reports from the AIDS Control Programme, over 80% of new HIV
infections are through sexual coitus.
Project: There is such a large desparity between information and knowledge
about HIV/AIDS and human sexual behaviour. This is because knowledge alone
does not change behaviour. In an effort to do away with this disparity, Lifeskills
have been integrated into our HIV/AIDS preventive initiative for young people and
adolescents to enable them cope with challenges of growing up. The project has
emphasized imparting psycho-social skills like self awareness, self esteem, self
confidence, assertiveness, coping with emotions and stress among adoelscents.
HIV/AIDS preventive projects among young people should never stop at only
giving knowledge. An attempt must be made to address other psycho-social
factors that greatly influence their behaviour.
207*/14182 Power echoes: The impact of gendered power
relations on HIV/AIDS risk and risk reduction as
echoed in survey responses
Teresa Swezey1, C.K. Harris', J. Nantalel, N. Nakyanjo2. 'Dept. of Soc -
Michagan State University East Lansing, Ml, USA; 2lsalamic Medical Assoc of
Uganda, Kampala, Uganda
Objectives: To assess the effects of gender and economic power relations on
HIV/AIDS risk and risk reduction among Muslim community members reached by
an AIDS education and prevention program in rural eastern Uganda.
Design: Household-based survey of a parish located about 90 miles from
the capital city. The only trading center and five villages were selected. In each
location, the entire Muslim population over the age of 15, resident in a household
for at least three months and in the community for at least a year were surveyed.
Methods: A total of 313 people participated. Approximately equal numbers
of females and males were interviewed. The survey was written in Lusoga and
verbally administered by interviewers who speak Lusoga as their first language.
Respondents were matched with interviewers of the same gender. Key concepts
used in the survey were derived from focus groups and key informant interviews.
The survey was pretested twice and appropriate revisions were made. Topics
included: risk perception, behavior, and reduction; HIV/AIDS knowledge; HIV
testing; projective questions about dimensions of power and powerlessness; and
gender and economic relations.
Results: Male and female respondents differed in their answers to the HIV
testing, condom, and risk reduction questions. These differences echoed men's
greater decision-making power and control in these areas. Women expressed
less control over their HIV/AIDS risk. Their answers reflected the ways that gender
relations impact self assessed risk and risk reduction.
Conclusions: Differences in male and female responses to HIV testing, condom, and risk reduction questions reflect the ways that gendered power relations
impact self assessment of risk and risk reduction. Power relations between men
and women influence HIV/AIDS risk and risk reduction.
14183 The relationships between social support and anger on
sexual risk behavior
Cheryl Gore-Felton', C. Koopmani, L. Laguna', C. Classen1, D. Israelski2,
D. Spiegel'. 1Stanford Univ. Dept Psychiatry & Beh Sci Room 2308, Stanford,
CA; 2San Mateo County Hospital, San Mateo, CA, USA
Objectives: This study examined the cross-sectional relationships between social support, mood, and gender on sexual risk behavior among HIV-positive men
and women.
Design: Prospective, randomized, controlled study.
Methods: HIV-positive adults (73 men and 29 women) were recruited through
healthcare providers and newspaper advertisements to participate in a research
protocol evaluating the effects of group psychotherapy for HIV-positive people. All
participants completed self-report measures on social support and relationship
status (UCLA Measure of Social Support), mood (Profile of Mood States) and
completed interviewer-administrated measures on number of sexual partners,
and sexual risk behavior (The Sexual Risk Behavior Assessment Schedule). This
study focused on baseline data collected prior to participants being randomized into treatment conditions. A demographic questionnaire was used to obtain
background information on all participants.
Results: Regression analyses revealed that for men social support from friends
was positively associated with having more unprotected sexual encounters, [F(4,
51) = 1.42 (p <-.05); R2 =.10]. Among women, anger was positively associated
with number of unprotected sexual encounters in past 3 months, [F(4, 18) = 3.44
(p <.01); R2 =.43].
Conclusion: Clinical intervention strategies aimed at increasing safer sex practices may be more effective if they are gender specific. For example, HIV-positive
men may benefit more from interventions which include their social networks
while women may find assistance in coping with anger particularly beneficial.

14184 Gay men, cognitions and risk: Outcomes from
a survey
David Reeves', Richard Harding', J. Bensley', J.E. Dockrell2, M.J.D. Dockrell'.
'Gay Men Fighting AIDS, 42 Eurolink Centre, Effra Rd.; 2Southbank University,
London, UK
Issues: Gay men's sex sexual health promotion has been described as being

dominated by "information and exhortation". Health promoters have struggled to
devise interventions which reflect the complexities of individual's strategies and
lifestyles and the challenges men face in adhering to their strategies.
Project: Our project had three aims:
(1) To gather data on personal strategies, lapses from strategies and cognitions
which feature in such lapses.
(2) To encourage men to identify explicit strategies for avoiding HIV transmission and sensitise them to the cognitions which relate to their non adherence to
those strategies.
(3) To offer detailed group work with a clear theoretical base to achieve
sustained personal change.
A multi disciplinary team including experienced researchers and health promoters designed a bar survey to be conducted in gay commercial venues. 24
volunteers were selected and trained as interviewers.
Results: 501 valid responses were analysed. Men were free to identify more
than one strategy. The most widely favoured strategies were "no unprotected
anal intercourse (UAI)" (68%), "UAI only with my regular partners" (16%), "no Al"
(11%) "UAI, withdrawing before orgasm" (9.6%). Adherence to strategies did not
vary across age groups but varied significantly across.
Lessons learned. (a) Men using "Traditional" safer sex strategies reported
higher levels of adherence than other men. (b) Surveys can be used to sensitise
men to their risk taking. (c) Individual, personalised interviews served as a low
cost, high impact means of recruiting to other interventions.
1141851 Psychosocial and behavioral factors associated with
physical and sexual abuse among HIV-infected women
Ariane Lisann Bedimo', P. Kissinger', J. Dumestre2, R. Clark'. 'Delta AETC,
LSU Medical Center 136 S Roman St, New Orleans, LA 70112; 2HIV Outpatient
Program New Orleans LA, USA
Objective: To describe the correlates of a history of physical and sexual abuse
among HIV-infected women.
Methods: A convenience sample of 60 HIV-infected women attending the HIV
Outpatient Program in New Orleans, Louisiana, were interviewed.
Results: The mean age at diagnosis was 24.7 years, 78% were African American, 82% acquired HIV through heterosexual contact, 43% reported less than
a high school education, 50% reported a current annual income under $6000 a
year, 45% reported a history of non-IV drug use, 17% reported a history of IV drug
use, 55% had undergone sterilization subsequent to HIV diagnosis, 33% reported
using condoms as a method of birth control, 28% reported using no method, 73%
reported having used a condom the last time they had sex, 33% reported that they
had ever lived apart from their children. Sixty percent reported ever experiencing
any type of physical or sexual abuse, 45% reported ever experiencing sexual
abuse, and 47% reported ever experiencing physical violence by a sex partner.
Among those sexually abused, 27% had first experienced it before the age of 17.
Factors associated with a history of physical violence include not using a condom
at last sex (43% vs 13%, p <.01), having lived apart from her children (48% vs
19%, p <.05), being sterilized (68% vs 44%, p <.09), being currently employed
(50% vs 28%, p <.09), being currently in a relationship (68% vs 47%, p <.15)
and having less than a high school education (54% vs 34%, p <.15). Factors
associated with a history of sexual abuse include younger age at diagnosis (22.8
vs. 26.3 years, p <.05), having a history of abortion (33% vs 9%, p <.05), not
using a condom at last sex (37% vs 18%, p <.15), having less than a high school
education (56% vs 33%, p <.15), being currently married (22% vs 6%, p <.15),
and having lived apart from her children (44% vs 24%, p <.15).
Conclusion: This on-going study demonstrates that nearly two-thirds of the
study population has ever experienced a form of physical or sexual abuse. It
suggests that women with these characteristics are at risk for having a history
of physical and/or sexual abuse and should be targeted for appropriate counseling. Moreover, they appear less able to use condoms and may need special
interventions in order to protect themselves and their partners.
|14186 Substance use and HIV risk among low-income
adolescents
Denise Crumble', D.A. Wagstaff', S.D. Pinkerton', K.J. Sikkema', J.A. Kelly',
V.A. Cargill2. 'Medical College of Wisconsin, Milwakee, WI; 2Case Western
Reserve, Cleveland, OH, USA
Background: AIDS has a disproportionate impact on African American youth,
many of whom experiment with tobacco, alcohol, and illicit drug use. According to
Jessor & Jessor's Problem Behavior Theory, experimentation with drugs and sex
often covaries. To explore the relationship of substance use to HIV infection risk,
the present study correlated adolescents' self-reports of substance use during
the past year with an HIV risk index, the cumulative probability of infection, based
on adolescents' sexual behavior (number of partners, acts, and times condoms
were used) during the past year. The present study also considered the relationship between the HIV risk index and psychosocial variables that have previously
been shown to predict safer sex behaviors (peer norms, condom use intentions,

condom use self-efficacy).
Methods: In 1995, anonymous questionnaires were administered to 125 lowincome, predominantly African American youth, aged 12-17, residing in eight
housing developments in four geographically dispersed US cities. A mathematical model of HIV transmission was used to calculate the HIV risk index.
Regression models were used to examine the relationship between substance
use, psychosocial variables, and HIV risk during a 12-month period.