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

12th World AIDS Conference

Abstracts 14202-14207 223

Project: During the evaluation and strategic planning seminar women and AIDS
within TAPWAK we interviewed 25 AIDS singled mothers about their worries and
fears about the future of their children.
Results: The twenty five women said: - (i) 30% had not informed their children
about their serostatus (ii) 10% are taken care of by their own children when indisposed (iii) 65% had their children discriminated against by neighbours, relatives
and other children. (iv) had educated their children about HIV/AIDS. (v) 10% had
their children out of school (vi) 10% had no wills.
Lessons Learned: Many women mothers in Kenya singled by HIV and AIDS
have some information on AIDS but lack avenues and resources of support for
their future orphans.
14202 Vulnerability of women youth which could be news
strategies for NGOS to helps women and youth to have
an effect and sustainable behaviour change
Aimee Mwadi Kadi1.2, Saidi Misangu2, Yav Nguz3. 'Mfumu Lutunu 75 Kinshasa
Gombe; 2SWAA Rep. Democratic of Congo, Kinshasa; 3SWAA Katanga, Likasi,
Congo Democratic
Objectives: - To identify together with women and youth differents factors,
certains women practices.
- To determine the anable environnement for maintaining an effect and sustainable behaviour change.
- To evaluate the impact prevention (I.E.U) on women and youth.
The responsable of group women and the young received a training by the
Swaa/Ngo to let them organize themselves discussions, focus group in their
community.
Results: After organising discussions "Focus Group" with women psychologist,
sociologist, anthropologist, ethnologist on several subjects related to vulnerability
of women youth.
Lesson Learned: The new vision of the struggle against AIDS implies new
approaches which urge the individu as well as his group to participate in the
struggle and change the behaviour.
14203 The detribalisation of the Zambian youth and its
consequences of HIV/AIDS vulnerability
Maria Nkunika', J.B. Kalipenta2, M.C. Chalowandya22, G.T. Mumba3,
J. Munsanje4, A. Liyoba2, W. Nyirenda5. 'Steadfast Action Foundation, PO. Box
32557, Lusaka; 2Anti AIDS Project, Lusaka; 3Society for Women and AIDS in
Zambia, Lusaka; 4Children in Distress Project, Lusaka; 5Teachers Education on
AIDS Project, Monze, Zambia
Introduction: Young people in Zambia today are the victims of rapid urbanisation, an economic environment that is unable to support, sustain or fulfill
their aspirations leading to rising unemployment, high school drop out rates and
homelessness be it urban or rural.
Objectives: To examine the young people's seemingly similar occupations,
perculiar language and culture and using more or less like strategies to try and
solve their problems.
Methods: Field trips, focus group discussions, in-depth interviews, interaction
with the participanting young people out of school, other NGOs and organisations working in similar areas and workshops were used to obtain qualitative
information. This information was analysed using structured questionaires.
Results: From the replies it was established that young people in urban areas
are now largely detribalised, speaking a common language which seems to be a
mixture of a variety of languages including English, perculiar to them. They are a
"new" ethnic group no longer adhering to the norms and values of their original
ethnic groups unlike their rural compatriots.
The common experiences of young people in urban areas has made a lot of
them detatched from their families and created their own cohesive entity. Through
exposure to Western media and different cultures, young people are uncritically
adopting new values, norms concepts and culture, a lot of times out of social and
economic context with adverse consequences to society & themselves.
S14204 | Determinants of changes in patterns of unprotected anal
intercourse (UAI) among men having affective and sexual
relations with men (MASM) in Montreal
Michel Alary', J. Otis2, A. Dufour3, R.S. Remis4, J. Vincelette5, R. Leclerc6,
B. Turmel7. 1CHA - Pavillion ST- Sacrement 1050 Chemin Ste - Foy, Quebec,
G1S 4L8; 2Department of Sexology, UQAM Montreal QC; 3Epidemiology Group,
Laval University Quebec QC; 4Dept. Of Preventive Medicine, U. of Toronto
Toronto ON; 5CHUM - Pavillion St - Luc Montreal QC; 6COCQ - Sida Montreal
QC; 7Direction De La Sante Publique Montreal QC, Canada
Background: The objective of this study was to assess the determinants of
changes in patterns of UAI over time among MASM participating in the Omega
Cohort Study, Montreal, Canada.

Methods: The Omega Cohort is an ongoing study on HIV incidence and
associated psycho-social determinants among MASM in the Montreal area. Enrollment began in October 1996. Men complete a questionnaire (demographics,
behaviours and Likert scales corresponding to the constructs of several theoretical behavioural models) and are tested for HIV every six months. As of October
31, 1997, 774 baseline interviews (To) and 431 first follow-up interviews (Ti) had
been conducted. We used matched analysis to compare the frequency of UAI at

T1 and To among 403 subjects (94%) with complete data on sexual behaviour at
both To and Ti. Logistic regression was used to assess the predictors of UAI at
T, among subjects practising only safer sex at To.
Results: The prevalence of UAI over the preceding six months was similar at
Ti and To (33.7 vs 37.2%; p = 0.23). Among the 253 subjects with safer sex
practices at To, 51 (19.9%) reported UAI at Ti. In the logistic regression analysis,
the following continuous variables from the behavioural models were associated
with recurrence of UAI: a lower perceived behavioural control (p = 0.0001) and
a higher perception of the risk of unprotected receptive oral intercourse with
HIV-seropositive men (p = 0.007). The variables external to the behavioural models that were also significant in this analysis were: having reported at least one
episode of UAI during their life at To [Odds ratio (OR) = 2.3, p = 0.049] and
having been in a couple relationship between To and T, (OR = 6.0, p = 0.0004).
Importantly, among the 51 cases with UAI at T1 but not at To, 39 were with regular
sexual partners and 12 with casual partners. Of the 39 incident cases of UAI with
regular partners, 27 were with partners known to be HIV-seronegative.
Conclusions: These results indicate that: 1) UAI is associated with a lower
perceived behavioural control and with the perception that unprotected oral sex is
risky; 2) previous practice of UAI seems to predict recurrence of UAI in people who
had stopped this practice in the intervening period; 3) UAI is mostly practised with
regular partners who, very often, are known to be HIV-seronegative. Considering
UAI only may thus lead to overestimation of risk-taking among MASM.
114205 Economic factors affecting condon usage among female
commercial sex workers
Lightford Masmon Browning. 72 1/2 Mannings Hill Road Kingston 8, Jaimaca
West Indies, Jaimaca
Issue: To study the frequency of condom use among female Commercial Sex
Workers and Male Clients.
Project: Between August and December 1997 several hours were spent in
each week with female commercial sex workers and male clients who were
interviewed on their work location, with questions related to condom use and
frequency. Frequency of condom use was expressed as number of times of using
condom per 10 sexual contacts.
Results: A total of 86 female commercial sex workers (CSW's) at different work
locations and 42 of their male clients were successfully interviewed voluntarily, a).
No oneinterviewd used condoms for every sexual encounter, b). 4 out of 10 CSW's
used condoms but deviated if paid higher prices. c). 5% of male clients were not
overly interested in using condoms (older men) d). 20% explain that encounters
with CSW's provided opportunities for realization of fantasies not encouraged or
supported with primary partners and not all CSW's are always sick.
Lesson Learned: Frequency of persistent condom use is relatively low for both
female commercial sex workers and their clients especially where determined
by levels of income. Both CSW's and clients need a comprehensive education
program which will translate increase in knowledge into behaviour change.
S14206 Economic and cultural factors leading to risky
behaviours among the Giso community
Allen Jane Bunyasi Opolot. The AIDS Support Organization (TASO), Pallisa
Road PDO. Box 2250, Mbale, Uganda
Objectives: To determine what leads young girls and women to behave in a
manner likely to expose them to HIV/AIDS.
Methods: Random interviews were carried out among young girls and women
in their homes around Mbale town. Many of them were single mothers and others
prostitute. A total of 30 women and girls were interviewed and questions were
asked how they got to be in their present situations.
Result: The main reasons given were economic and cultural. Many young
women opt for rich elderly men to meet their economic needs. They are not self
reliant so they cannot say no to sex when it is the only way they can raise an
income, hence no negotiation for safer sex. Local culture allows a man to marry
as many women as he can pay bride price ofr. Greedy parents force their young
daughters into marriage for the bride price. Widow inheritance is practiced and the
widows have no right to reject the decision made by clan elders. Circumcision and
funeral rites encourage night long revelling during which sexual permissiveness
is the order.
Community and NGOs need to provide loans/grants to women and girls to
enable them become self reliant through Income Generating Activities in order
to alleviate poverty which is the major cause of HIV/AIDS transmission and
the Community should enforce legal procedures to abolish dangerous cultural
activities in order to eradicate HIV/AIDS transmission.
| 14207 1 Fundamental obstacles to behaviour change in
prevention of HIV/AIDS: Case example of Kenya
Sobbie Mulindi. College of Health Sciences, PO Box 19676, Naibori, Kenya

Lack of appropriate strategies to prevent and control HIV/AIDS accounts for the
rapid spread of the epidemic in Africa. Based on health education model, of
IEC (Information Education and Communication) as applied in western countries
where individual psychology of locus of control and self-efficacy enhances behaviour change at individual level, contrasts with Africa where AIDS is not an
individual disease but a society disease requiring group psychology approach
strategies.