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

222 Abstracts 14197-14201

12th World AIDS Conference

occasionally). Although, after the training female teenagers diminish risk perception because of the belief of "being always exposed to the infection", they no
longer associate it to unknown partners but to the practice of sexual intercourses
without condoms. Women's vulnerability is emphasized and discussed during the
workshops but only 35% girls recognize after the training that women have high
risk in heterosexual intercourses based in biological factors.
LESSONS LEARNED: Gender inequities and differences in sexual relationships are still strongly rooted among young people. Social and cultural patterns
need to be worked out and reflected specifically to promote changes. FEIM is
planning to organize focal groups with young people of both sexes.
14197 Identifying HIV risk factors and information needs of men
at risk in the coastal towns of southern Myanmar
Maung Maung Kyaw1, Rai Mra1, Aung Naing2, U. Myomyint3. 1STD Team; 136
46th Street, Yangon (HIV/AIDS Project), UNDP; 2National AIDS Program,
Yangon; 3World Vision International, Yangon, Myanmar
Objectives: To identify HIV risk behavior patterns of fishermen working in the
coastal towns and the Thai-Myanmar borders and use these data to develop
appropriate HIV prevention programs.
Method: Five focus group discussions (FGD) were held among fishermen in
the coastal towns of Myeik and Kawthoung in Southern Myanmar. Discussion topics included current knowledge of HIV/AIDS and Sexually Transmitted Diseases
(STDs), sexual practices including condom use, recreational activities, mobility
patterns and use of narcotic drugs.
Results: A total of 45 fishermen participated in the focus group discussions.
Their ages ranged from 14 to 44 years. More than half (62%) of the fishermen
were unmarried and majority of them has reached primary school (44%) and
middle school (38%). Most of the men came from neighboring towns such as
Dawei (36%), Myeik (46%) and Kawthoung (8%). The men were familiar with
words like STDs, HIV and AIDS but were not sure what these actually mean. For
most of the men, STD was generally described as the symptoms of gonorrhea.
The men believed that STDs and AIDS are transmitted through sexual intercourse
with "unclean" sex workers and homosexuals. The men knew that AIDS is also
transmitted through injecting drug use and blood transfusions. These information
were mostly received from billboards and television and video shows. The men
admitted having sex with sex workers or their girlfriends while away from home.
Very few admitted having used condoms during sexual intercourse. Some of the
men said they have sex with sex workers in exchange for diesel fuel. There were
two categories of fishermen, those who fish near the coast and those who are
involved in deep-sea fishing. Coastal fishing boats usually go out to sea for 3 to
4 days, come back and stay in Myeik for 3 to 4 days and out to sea again. The
deep-sea fishing vessels go up to Mawlamyaing and as far as Rakhine. Carrier
boats are used to collect fish from both coastal fishing boats and deep-sea vessels
and transport these to Thailand.
Conclusion and Recommendations: Certain factors could increase the risk
of fishermen in southern Myanmar for STDs and HIV infection. An information
campaign needs to be conducted among the fishermen, possibly a workplace
based education program. These programs would need to be institutionalized
within the shipping industry to ensure sustainability.
S14198 Female sex workers in Abidjan, C6te d'lvoire:
Determinants of entry into sex work and perspectives for
leaving
Peter Ghys1, Yao Konan2, G. Mah-bi2, M. Traore2, A. Tiemele3, I.M. Coulibaly3,
S.Z. Wiktor5, M. Laga4. 1Institute of Tropical Medicine, Antwerp, 01 BP 1712
Abidjan 01; 2lnstitut National De sante Publique, Abidjan; 3National
AIDS/STD/TB Control Program, Abidjan, Cote D'lvoire; 4 Institute of Tropical
Medicine, Tiemele, Belgium; 5Centers for Disease Control & Prevention, Atlanta
GA, USA
Objective: To determine socio-economic and cultural factors associated with
entering sex work and to identify factors that could facilitate leaving sex work.
Methods: In October 1997, 6 focus group discussions with 41 female sex
workers were conducted followed by in-depth interviews with 60 randomly selected female sex workers from the 10 districts of Abidjan. A qualitative analysis
of the transcripts of the focus group discussions and of the in-depth interviews
was performed.
Results: Entry into sex work is determined by poverty, and is often precipitated by disruption of the family (e.g. death or divorce of parents, own divorce),
lack of family support, or expropriation (e.g. following divorce or death of the
husband). Individual motives for entering sex work vary, but have in common the
desire to gain social autonomy through financial independence. The mechanism
of entry into sex work tends to vary by nationality; most Ghanaians are contacted
and recruited in their villages by older women who have retired from active sex
work in Abidjan; most Ivorians initiated sex work without external recruitment.
All 10 1 sex workers are acutely aware of the risk of acquiring AIDS and other
sexually-transmitted diseases through sex work. They all experience feelings of

shame, disgust and tiredness about their work, and say they want to leave sex
work. To leave sex work, the majority state they need external assistance, ie from
charitable institutions, the government, the church, a future husband or the family;
while a small number thinks this can be achieved through personal determination.
The majority of women (46/60) envisage having a business when leaving sex
work, while 11 anticipate they will be supported by their husband, and 3 hope to
emigrate and find a better life in Europe.

Conclusion: While women enter sex work for various reasons and through
different mechanisms, they all seek social autonomy through financial independence. The success of projects designed to help sex workers leave sex work
could be facilitated by their desire to leave sex work and their negative feelings
about their work.
S14199 Economic, political, social and cultural determinants of
high risk behaviour amongst groups at heightened risk of
STD/HIV infection
Suman Sengupta, K. Verma1, S. Bhattacharya2, A. Banerjee3. 1Asst. Project
Officer W B.S.H.P; 2Social Dev Officer W.B.S.H.; 3Gay Support Group
Volunteer, 9A Little Russel Street Calcutta 700071, India
Issue: High risk sexual behaviours are determined and governed by a complex of economic, political, social and cultural factors which need to be properly
understood and addresed under sexual health interventions.
Project: One and half years of association with various vulnerable groups
like commercial sex workers (CSW) and their clients, street and working children (SWC), migrant populations, truckers and Males who have Sex with Males
(MSMs) in West Bengal has provided insights into various determinants of high
risk behaviours.
Results: Economic determinants: CSWs with lower incomes are forced to entertain large number of clients, are unable to negotiate condom use and are often
forced into anal sex. Poverty forces SWCs to earn a living on the streets, exposing
them to sexual abuse and rape. Political: Power structures, unbalanced power relations and associated violence are determinants of high risk behaviours amongst
CSWs and SWCs. Social: For SWC, lack of shelter invites rape and promotes
hurried unprotected sex in dark corners. For street boys and truckers, sex with
CSWs is a result of peer pressure and a means of gaining peer esteem. Hurried
sex in dark public places, promotes unsafe sex amongst MSMs. For Migrant
populations and truckers, proximity to peers promotes situational homosexuality.
Cultural determinants: Initiation ceremonies for minor CSWs are associated with
gang rape and violence. Street boys have violent initiation ceremonies for gaining
entry into the street "gangs", wherein they are raped by 4-5 older boys. Myths
like: "forced sex with virgins or young boys increases vigour, strength and power
and cures an adult of STDs", "using condoms lead to emasculation", "anal sex
does not lead to STDs", "discharge of menstrual blood results in cleansing of the
body of STDs", promote high risk behaviour.
Lessons learnt: Since high risk sexual behaviour associated with vulnerable
groups involve two or more individuals, they are essentially social behaviours.
The complex of social, political, economic, and cultural determinants of high
risk behaviour associated with groups like CSW, Street and working children,
MSMs, Migrant populations, Truckers etc. need to be studied, taken into account
and specially addressed through behaviour change communication strategies for
implementing effective sexual health interventions.
14200 Population inquire in Rosario about the general
knowledge in HIV/AIDS infection
Maria Alejandra Acosta1, L. Trape1, A. Troglial, A. Celentano2, R. Kunc1,
E. Virgala1, M. Agostini1. 1Argentina AIDS Society (SAS) Rosario; Rodriguez
1215 2000 Rosario; 2Celentano AIDS Society (SAS) Rosario, Argentina
Introduction: Programs of diffusion and prevention of HIV/AIDS infection have
to be adapted to the population necessities.
Objective: To evaluate the source and the level of information about HIV
infection and its ways of transmission in a general population.
Methods: We made a survey with 373 people from Rosario city, in Argentina,
witch is a representative sample of 22 Police Departments of this city. 176 of them
were men (47%) and 197 (53%) were women with a median age of ys (13-55).
The survey consisted on 22 items in an open and close question system during
June and July 1997.
Results: About basic information on HIV infection: 93% of the people know is
a transmissible disease, 93% know is an STD, 91% a viral infection, 76% believe
there is no cure, 56% believe is possible the progression, 45% that is congenital
and 36% that always progress to AIDS. Source of information: TV (96%), newspaper (75%), radio (80%), friends (72%), family (69%), teachers (47%) and doctors
(29%), miscellaneous (2%). About HIV transmission: sexual intercourse (97%).
IV drug abuse (96%), blood transfusion (87%), vertical transmission (92%). Increase the risk of transmission: multiple partners (92%), homosexuality (71% for
males and 40% for females). Ability to transmit the infection: all HIV patients are
infectives (70%), only drug symptomatic patients (66%). 61% of the population
considered they were properly informed about the infection.
Conclusions: 1) The population surveyed has an acceptable level of information about HIV/AIDS. 2) The information is received mostly from the communication media and then from friends and family menbers. 3) There were a little group
of people on which personal believes seems to influence their information.

i14201 Worries, concerns and experience of AIDS singled
positive women about their children
Mary Alice Awuor, M.N. Kalondu, C.L. Aluoch. Tapwak, PO. Box 30583, Nairobi,
Kenya
Issue: Concerns, worries and fears of singled positive women about the future of
their children upon death by AIDS.