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

220 Abstracts 14187-14191

12th World AIDS Conference

Results: Marijuana use was correlated with HIV risk (r =.43, p =.03). Demographic characteristics (age, gender, minority status) and psychosocial variables
were related to marijuana use but did not account for any additional variability
in HIV risk. Within the overall pattern, the multi-substance associations were
stronger for males than females.
Conclusions: The results of this study were generally consistent with Problem Behavior Theory. The results point to the need to develop interventions for
adolescents that address the association between marijuana use and HIV risk.
Moreover, given the potential of tobacco and alcohol to act as "gateway" drugs,
the observed association of these substances with marijuana use suggests that
interventions should also target these substances.
S14187 A cross-sectional descriptive survey of factors
influencing reproductive decision making in women with
HIV infection
Gillian Rhind1, N.J. James2. 1 The Mortimer Market Centre Off Capper Street
London; 2University of Nottingham Nottingham, UK
Objectives: To examine social, biomedical and psychological factors which may
influence women with HIV infection to either plan or continue a pregnancy to term.
Methods: A cross-sectional descriptive survey of 100 women with HIV infection
(a 92% response rate) was undertaken using a structured interview.
Results: Women whose partners wanted children were significantly more likely
to continue; (x2 = 9.3, df = 1, p = 0.002) or plan a pregnancy (x2 = 16.4, df
= 1, p = < 0.001), than women whose partners did not want children. Women
with partners who also had HIV infection were less likely to plan pregnancy, than
women who had disconcordant relationships (x2 = 5.2, df = 1, p = 0.02). Women
who considered the risks of vertical transmission too great were significantly less
likely to plan, (x2 = 13.5, df = 1, p < 0.001) or continue a pregnancy (x2 = 4.0,
df = 1, p = 0.04), compared to women who did not consider the risks too great. In
contrast, women who agreed they would take drugs to reduce the risks of vertical
transmission were significantly more likely to plan (x2 = 7.4, df = 1, p = 0.007) and
continue a pregnancy (x2 = 10.4, df = 2, p = 0.005), than women who would not
take drugs. Women who had concerns about poor health and their consequent
inability to care for a child, were significantly more likely to feel they would not
plan a pregnancy (x2 = 8.7, df = 1, p = 0.003) compared to those for whom poor
health was not a consideration. Black women were significantly more likely than
White women to feel that they would continue a pregnancy (x2 = 5.6, df = 1, p
= 0.018); that their partners wanted children (X2 = 8.0, df = 2, p = 0.01); and to
report that their partners refused to use condoms (x2 = 7.1, df = 1, p = 0.007).
Conclusions: The reproductive intentions of women were influenced significantly by their perceptions of what their male partners wanted and should be taken
into account when providing counselling services for women with HIV infection.
The option of taking antiretroviral therapy had a significant impact on women's
decision making towards becoming pregnant.
14188 HIV testing, results and attitude of society: Results of a
study in Bouake
Jean-Pierre Amonou. Centre SAS 01 Bp 3812 Bouakeoi, Cote D'lvoire
Objectif: Identify key elements (social, economic, behavioural...) which facilitate
voluntary testing in order to decrease progression of the epidemic related to lack
of knowledge of their serological status by people infected with tile virus.
M6thode: A survey was conducted in a random sample from April to July
1995 in Bouake. A questionnaire had been sent to 595 people, of various socioeconomic and vocational backgrounds. The main items were: socio-economic
information, serological status and involvement (real or possible) in a testing
process, proximity with HIV/AIDS patients or families affected, involvement in the
fight against AIDS, and a special item for medical staff.
Resultats: 55% of the persons are between 15 and 25 years of age. Singles
males represent the most important category and 57.6% of the respondants are
pupils and students. In 85% of the answers, the main difficulty for voluntary testing
seems to be the fear of a positive result. 14% of those interviewed have already
had a test, 41% during a blood donation. 64% of all the interviewed persons
considered that seropositivity should lead to safe or protected intercourse and
consciousness-raising.
For the medical staff (doctors), 52% do not ask for the consent of the person
before testing and disclose to other than the person him or herself. They all
indicate the wish to insure the care of infected patients.
Experience gained in medical and testing councelling since 1995 within a local
NGO (Centre SAS), combined with these results enlighten the current changes
within the general population showing both better acceptance for testing and better social visibility of HIV/AIDS. Since 1995, changes have also occurred in health
staff attitudes towards testing (proposal and disclosure) and this component is
one of the key factors in the fight against the epidemic.

14189 Gay community integration predicts HIV testing among
US young gay men
Greg Rebchook, R.B. Hays, S.B. Kegeles. UCSF/Center for AIDS Prevention
Studies 74 New Montgomery San Francisco, CA 94105, USA
Objectives: To describe the HIV testing behavior of young gay/bisexual men in
a longitudinal cohort study and to identify factors that predict their HIV testing
behavior.

Methods: A prospective cohort study conducted from 1990 to 1995 surveyed
young gay and bisexual men, ages 18-29, in three mid-sized US communities.
548 individuals completed at least one wave of data collection. At each wave,
participants were asked about their HIV testing behavior and results as well as
a wide range of psychosocial variables including measures of gay community
integration (shown in table).
Results: Bivariate logistic regression analyses showed that community integration variables were the most predictive of HIV testing. Odds ratios are presented
in the table.
1990 1991 1992 1993 1994 1995
n = 409 n = 418 n = 410 n = 354 n = 308 n = 278
Out to family members 1.4* 1.5* 1.4* 1.3 1.4 1.30
Community involvement 1.3* 1.3 1.3 1.2@ 1.2+ 1.3+
Number of gay friends 1.7** 1.5" 1.4 1.3@ 1.50 NS
Gay bar attendance 1.3 1.2 1.2* 1.3 NS NS
Knows PWAs 2.5 NA NA 4.2 NA NA
Gay political involvement NA NA NA 1.8 1.6 NA
+ < 0.10; @ < 0.05; < 0.01; < 0.001; < 0.0001; NA: Not asked; NS: Not significant
At baseline, almost two-thirds of the sample had tested. By 1995, over 85% of
participants had tested. Nearly three-quarters of men who completed all waves of
data collection tested multiple times (143/193). Total seroprevalence rates ranged
from 4.3% to 6.1% each year throughout the course of the study.
Conclusion: Advances in early medical intervention and treatment make it
crucial to understand the motivations for HIV testing and to encourage HIV testing
among populations likely to engage in high risk behaviors. Integration into the
gay community may provide valuable information, knowledge of resources, and
social support for HIV testing. Therefore, HIV prevention providers may need to
make special efforts to attract less integrated men to HIV testing services and
support them during the testing process.
S14190 Regular partnerships and perception of risk for HIV
infection among men who have sex with men: An elusive
notion
Cristaiane Siva1, Mary-Jane Spink2, M.A.S. Veras3, M.O. Fonseca4
C.G.M. Silva2, M.F. Diogo2, O.A. Barbosa2. 1Rua Frie Caneca 1140-30 Andar,
Sao Paulo; 2Pontificia Univ. Catolica/SP-PB. V, 3CIP/SES, Projeto Bela
Vista/PB. V; 4lnst. Infectologia Emilio Ribas/SES-PB. V, Sao Paulo, SP Brazil
Objectives: To understand the notion of regular partnerships used by the volunteers of the Bela Vista Project (BVP) and its implications for the perception of risk
for HIV infection.
Method: The BVP 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. Regular partnership is
defined in the research instruments as "someone with whom you have sex and
have a horizon of future encounters, such as boyfriends, lovers and husbands".
In order to explore how this notion is interpreted by the volunteers, quantitative
(number of partners declared in the initial and two follow-up interviews) and
qualitative analysis (response to open question about "what is a regular partner
for you") have been carried out. Relationships between the patterns identified in
the quantitative analysis, socio-demographic data (age and level of education)
and risk perception were also explored.
Results: 279 volunteers who had completed the second return visit by December 1997 were included in this study. Three patterns of relationship were
identified: one regular partner (RP) on all interviews (25.4%); no RP in the period (11.5%); and mixed trends (63.1%). No significant relationship was found
between patterns and age (p = 0.11); lower levels of education were associated
with pattern two (X2 = 13.15, p < 0.05); mixed trends tended not to perceive self
at risk (x2 = 17.29, p < 0.01).With regards to the qualitative study, the definition
of regular partners offered by the volunteers tended to include other dimensions:
duration of the relationship, monogamy, fidelity among them. Love, affection and
sex, however, were the most relevant factor.
Conclusions: regular partnership is a polissemic notion incorporating aspects
as varied as duration of relationship, fidelity, regular sex, living under the same
roof, organised around a nuclear notion of love and affection. This diversity of
definitions is reflected in the reported number of regular partners in the six month
period between interviews. However, volunteers that report regular partners, in
whatever number, consider they are less at risk for HIV infection. (supported by
UNAIDS, MS/BR, SES/SP and FAPESP)
S14191 Behavioural studies and HIV/AIDS prevention policy in
Russia
Tatyana Smolskaya', O.F. Momot2, I.P. Tahkinova3, S.V. Kotova4.
4Epidemiologist, 'Head, North Western Regional AIDS Center; 14 Mira Street,
St. Petersburg Pasteur Institute, St. Petersburg; 2Head, 3Epidemiologist,
Kaliningrad AIDS Centre, Kaliningrad, Russia

Objectives: 1) To follow up the changes of the attitude of Russian society
to behavioural studies (as a base of prevention policy) in the dynamic of the
HIV/AIDS epidemic. 2) To estimate the significance of the behavioural studies in
understanding the causes of dramatic spread of HIV among IVDU communities.
Methods: Analysis of surveillance system and prevention policy in the course
of HIV/AIDS epidemic in Russia since 1987. Assessment and comparison of