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

12th World AIDS Conference

Abstracts 14192-14196 221

the results in the behavioural studies carried out for the last three years in the
North-Western region of Russia within the framework of local AIDS prevention
programmes.
Results: The first response of Russian society to HIV epidemic was the introduction of strict surveillance system. But since 1993 prophylactic approach
including behavioural studies has become a substantial component of the prevention programmes. Behavioural studies had several peculiarities in Russia as
compared to the Western European countries: sexual behaviour and attitude
to drug use were never analysed in context of public health; social aspects of
epidemic were analysed by physicians only; the existence of multifactorial risk
of HIV transmission because HIV epidemic coincided with STD epidemic, drug
use spread and social changes. Good knowledge of HIV transmission routes in
general population associated with very risky personal behaviour. Special studies
of the subpopulation of IVDU in Kaliningrad city that represents the largest outbreak of HIV infection in the Russian Federation have shown many risk factors
that support this epidemic. Every four of five HIV positive female simultaneously
used drugs and were involved in sex trade. All these women continued non-safe
sexual activity in commercial sex industry-because they had no other possibility
to gain money for living. The morbidity rate increased in the Kaliningrad area from
7.3 up to 177.9 per 100.000 during 1.5 years.
Conclusion: Behavioural studies are very important for better understanding
of natural history of HIV epidemic in Russia. It is necessary to standardize the
design of these researches and attract international experience to improve the
quality and comparability of the results. Because negative social factors support
risky behavior effective prevention programmes should be focused not only on
individual behaviour but also on the public policy.
14192 Rates and predictors of HIV risk behaviors among
mid-life and older African American women living in
low-income housing developments
Denise Crumble1, T.G. Heckman1, K.J. Sikkema1, J.A. Kelly1, L. Solomon2,
E. Anderson3, D.A. Wagstaff1. 'Medical College of Wisconsin, Milwakee, WI;
2University of Vermont, Burlington, VT; 3 Virginia Tech, Blacksburg, VA, USA
Background: While a few studies have examined HIV risk behaviors among
African American women little is known about HIV risk characteristics of mid-life
and older African American women (i.e., women 40+ years of age).
Methods: Anonymous surveys were administered in small-group settings in
1994 and 1995 as a part of community-based, multisite HIV prevention intervention for women living in 18 low-income housing developments in five US cities.
The present study focused on 240 African American women, 40 plus years of
age (M = 51.2 years, Range = 40-84).
Results: Most women (95%) had children, and 81% reported annual incomes
less than $12,000. Women's mean education level was 10.7 years. Women
answered correctly only 60% of items comprising a 12-item HIV risk behavior
knowledge scale, and many women showed misconceptions about HIV risk behavior. For example, 23% believed birth control pills protect against the AIDS
virus and 20% though that cleaning injection needles with water kills the AIDS
virus. While few women (3%) reported multiple sexual partners in the past two
months, 36% of women had a primary sexual partner who engaged in high HIV
risk activities. Women were classified as being at higher or lower risk for HIV
infection based on sexual behavior and HIV risk levels of their male sexual partner(s). Eighteen percent of women were determined to be at higher risk for HIV
infection. Logistic regression analysis revealed that high risk women were in their
early-40s, reported weaker risk reduction behavioral intentions, more frequently
talked to their male sexual partner(s) about AIDS, and perceived their housing
development to be unsafe.
Conclusions: A substantial minority of older African American women in
low-income housing developments are at increased risk for HIV infection. HIV
prevention interventions for mid-life and older inner-city women should strengthen
risk reduction behavioral intentions, improve safer sex negotiation skills, and be
conducted through programs that foster community cohesiveness.
|14193 The association of substance use and HIV infection on
mother-child separation
Patricia Kissinger1, D. Gruber2, N. Fuchs2, C. Colston2, C. Croft2. 136 S
Roman ST 3rd Floor New Orleans LA 70112; 2Pediatric AIDS Program New
Orleans LA, USA
Objectives: To determine factors associated with maternal child separation
among HIV-infected and/or substance using high risk women.
Design: Prospective cohort study
Methods: All children. 19 years of age enrolled in a case management
program for at least two months from September 1996 to October 1997 were
included. Children who were not living with their biological mother for at least
one month were compared to children who were living with their mothers for the
entire period. Residential and substance using patterns were tracked by the case
managers.

Results: Of 558 children followed, 30% were <5 years old, 93% were African
American, 54% were girls and 46% were boys. Children had an average of 3.1
siblings, 8.7% were HIV-positive, 62% of their mothers were HIV-positive, 13 of
the mothers had AIDS, 50% of the mothers used substances during an average
follow-up of 8 months. Fifty seven percent (57%) were separated from their biological mother at least once during the follow-up period. In multivariate logistic
regression analysis, factors associated with separation were maternal substance

use (R.R. 3.84, 2.67-5.53, p <.001), and 5-18 year olds compared to <5 years
(R.R. 1.62, 1.09-2.42, p <.01). Maternal HIV/AIDS status was protective for
separation (R.R..58,.38-.90, p <.001). Race, gender, number of siblings and
HIV status of child were not associated with separation.
Conclusion: Results indicate that substance use is more detrimental to the
maternal-child dyad than HIV-infection (either mother's or child's). The protective
effect of maternal HIV-infection may indicate that social services provided to
HIV-infected mothers could reduce the risk of maternal-child separation.
14194 Knowledge, attitude and risk-taking behaviours towards
HIV/AIDS of marginal youth in Hong Kong
Chion Billy Ho. Division of Social Studies City University of Hong Kong Tat Chee
Avenue, Hong Kong
Objectives: To assess and examine the knowledge, attitude and risk behaviours
of marginal youth towards HIV/AIDS in Hong Kong and to identify any significant
psycho-social factors affecting the practices of such risk behaviours.
Design: Exploratory, descriptive research design
Methods: A questionnaire survey is conducted. The active and potential cases
of the 30 Outreaching Soical Work Service Teams are the study population. A self
administered questionnaire is distributed to the study sample randomly. A total of
801 marginal youth aged from 12 to 23 returned the completed questionnaires.
Results: In general, the AIDS knowledge is not low among the marginal youth
with positive attitude though some common misconceptions still existed. It is
found that the sexuality ideology of marginal youth is quite liberal, permissive
and open. They are sexually active. 40% of them have actual sexual experience.
39.5% claim that they have more than one sexual partner. Around 41% of them
report that they use condom at the last intercourse but only 17.1% claim that they
use condom persistently. Intravenous drug use and sharing needle are found to
be not a risk factor for HIV infection. The major risk-taking behaviour among the
marginal youth is having casual sex without safer sex practices. Their perceived
susceptibility to HIV is low and perceived self-efficacy on condom use is also far
from satisfactory.
Conclusion: Marginal youth in Hong Kong has basic understanding on
HIV/AIDS. The main risk factor to HIV infection is casual heterosexual practices with a low sense of self protection. It is found that low perceived self-efficacy
on condom use, undesirable peers influence, ventureness personality trait with
unrealistic optimism are the key psycho-social factors influencing their practices
of safer sex.
14195 Barriers to adopting HIV risk-reduction behaviours in
Malawian youth
Ellish Mcauliffe, Anthony Zingani, P. Ntata. Research Fellow; National AIDS
Control Programme; Lecturer, Malawi
Description: The prevalence of HIV/AIDS in Malawi keeps rising especially
among the youth. Efforts are in place to reduce the rate of infection. Nevertheless
the youth seem not ready to change their risky behaviours.
Objectives: To determine some of the barriers to adopting HIV risk reduction
behaviours
Methodology: A total of 394 primary and secondary school groups of youth
were interviewed. This was a Focus Group Discussion (FGD) with a structured
questionnaire.
Findings: (a) 45.1% of youth believe it is possible for people to change their
behaviour to reduce the risk of contracting HIV
(b) 50.3% believe cannot change behaviour because sex is a habit and they
enjoy and so cannot refrain from intercourse
(c) The most frequently mentioned behaviour change for youth (61.2%) was
abstaining from sex
Discussion: (a) Youth need to corrected on the misconceptions on proper
usage of the condom
(b) Youth ought to differentiate between Love and Sex
(c) Majority of youth say they changed behaviour when they heard about AIDS
S14196 |Risk perception and vulnerability in female adolescents
from Argentina
Laura Pagani1, M. Bianco2, M.I. Re2. Parana 1353ro 131425 Buenos Aires;
2FEIML, Buenos Aires, Argentina
ISSUE: HIV/AIDS infection is increasing among women in Argentina affecting
them at younger ages than men. Young women and girls are specially vulnerable
due to early sexual initiation, cultural and social patterns.
PROJECT: Training voluntary adolescents as peer educators in sexuality and
HIV/AIDS prevention with a gender perspective was initiated by FEIM in 1996
in Buenos Aires City. Adolescents participate in a 24-hour workshop discussing
and developing subjects as sexuality, gender issues, STDs and AIDS through
games, videos and reflection. Main goals: to make teenagers aware about gender

differences and its impact on HIV/AIDS, and to promote and divulge a more equal
gender model to improve HIV sexual prevention through activities they create and
organize.
Results: During a 4 month period in 1997 FEIM trained 253 female adolescents aged 13 to 19 years old. Previous to the workshop 21% female adolescents
expressed having been in risk of HIV infection due to unknown sexual partners.
Condom use in girls is associated to unknown partners (17.5% use condoms