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

12th World AIDS Conference

Abstracts 14213-14217 225

heterosexual men, 18 and 25 years old, in 1986 (N = 170), 1988 (N = 178),
1990 (N = 427), and 1995 (N = 365). Overall, 46% were White, 17% Black,
21% Hispanic, and 16% of Asian American background. Respondents indicated
whether or not they had changed their sexual behavior to reduce their risk of
contracting HIV and if they used any of 10 named strategies for risk reduction.
Results: Reported use of strategies for reducing sexual risk varied: 56% limited
their numbers of partners, 53% delayed sex until they knew their partner better,
53% avoided anal sex, 44% asked about sexual histories, 43% insisted on using
condoms, 36% talked about AIDS with partners, 21% asked about I.V. drug use,
20% avoided oral sex, 18% asked about HIV test results, and 7% used celibacy
to reduce risk. Controlling for the effects of age and time, both Black and Hispanic
men were significantly more likely than White men to report having changed their
behavior to reduce sexual risk. Asian American men were less likely than White
men to report changes. In comparison to White men, Black men were more likely
to report avoiding oral and/or anal sex. Hispanic men, in contrast to White men,
were more likely to report that they delayed sex, limited their partners, avoided
oral sex, asked about I.V. drug use, talked about AIDS, and/or were celibate.
Asian American men, in comparison to White men, were more likely to report that
they delayed sex and/or were celibate.
Conclusions: Results of this study indicate that sexual risk reduction strategies vary by ethnic group among young heterosexual men in the United States.
Hispanic and African American men are more likely to report changes than White
men. However, preferred strategies vary in their effectiveness. It is important to
assess young men's beliefs about protective value of strategies they choose and
those strategies offered by HIV interventions targeted to this population in order
to develop successful culturally-specific HIV interventions.
205*/14213 1 Cultural beliefs; barriers to sex discussion among
married couples and its implications in
STD/HIV/AIDS prevention in Malawi
Antony Chaima1, D. Zimba2. 1AIDS Control Programme Health Educator, PO.
Box 30622, Lilongwe 3, Malawi; 2Lilongwe Central Hospital, Lilongwe, Malawi,
Africa
DESCRIPTION
The HIV/AIDS prevalence in Malawi is one of the highest in the sub-Saharan
Africa. The government has put up prevention strategies to slow down the infection rate. However, there are some cultural trends that tend to obstruct these
efforts.
Objectives: (a) To determine and identify barriers towards sex discussion
among couples and sexual partners.
(b) To facilitate communication among sexual partners
(c) To identify and map out means of modifying culture and traditions that bloke
STD/HIV/AIDS prevention efforts.
Methodology: A total of 1,800 respondents were targeted. The study was
conducted in the form of a Focus Group Discussion (FGD) using a questionnaire.
Findings (a) It was observed that males play a dominant role in decision
making in as far as sexual matters in the family are concerned.
(b) 48% of male respondents and 36% of female respondents ever talked to
their partners on issues related to sex and condom use
(c) Culture accepts males to have sexual relationships outside the family. 17%
males having had sexual relationship with a girlfriend against only 4% females
with an extra boyfriend.
Discussion: (a) Communication between sexual partners relating to matters
of sexuality is a vital pre-requisite to effective contraceptive use in general and
condom use in particular
(b) Cultures that pose a threat to STDs/HIV/AIDS prevention efforts need
modifying.
14214 Cognitive frames and cultural responses to AIDS
education
Rodney Jones. Department of English City University of Hong Kong, Tat Chee
Ave, Kowloon Tong, Hong Kong (China)
Objectives: This study explores the effect of linguistic 'frames' and cultural
models of communication on subjects' perceptions of and responses to AIDS
prevention television advertisements.
Design: Controlled interviews with linguistic analysis of responses.
Methods: Two subject groups, one consisting of Hong Kong Chinese university
students and the other of Western university lecturers were asked to view and
then describe a collection of Hong Kong AIDS awareness television commercials.
Two hundred 'retellings' from twenty subjects were collected, transcribed and
then analyzed for the cognitive/linguistic 'frames' subjects' operated within in their
responses using a methodology adapted from Tannen (1979, 1980, 1984).
Results: Analysis revealed important differences in how the two groups approached the commercials. The Chinese students tended to see the commercials
as stories, with most of their responses operating in the narrative frame in which
they described, interpreted and judged the actions of the characters. Commer
cials were evaluated primarily based on the 'feelings' they aroused. The Western
teachers, on the other hand, saw the commercials as lecturers, focusing on
the information they contained, the technical aspects of the presentation, the
possible intentions of the producers and whether or not the ads were effective
in conveying 'facts'. The differences in focus led the two groups to take from the
ads different messages and to apply these messages to themselves in different
ways.

Conclusion: This preliminary study suggests that people from different speech
communities might 'read' AIDS prevention messages in different ways and that
the design of culturally relevant AIDS education must take into account not just
a community's practices and presuppositions regarding sex, drug use, medicine
and disease, but also their practices and presuppositions regarding language
use.
106*/142151 The Afro-Brazilian religions and the reduction of
risk of HIV-AIDS infection
Luiz Mott. Caixa Postal 2552, Brazil-40022-260, Salvador; Bahia, Brazil
Issue: The Afro-Brazilian religions present two principal areas of risk of HIV
infection: the liberality of their sexual morality and the practice of ritual tattooing
with the use of a shared blade.
Project: In the state of Bahia, Brazil, the descendants of Africans represent
80% of the population (8 million). In the capital, Salvador, there are more than
2000 temples of the followers of the cult of the Orixas (deities), where a large
number of priests and the faithful are homosexual and where the practice of
collective scarring rituals with a single shared blade can be observed. A study
carried out in 500 houses (yl/) belonging to the cult demonstrated that 96%
of the priests and priestesses identify blood, sexual secretions and the use of
sharp or cutting objects as the principal means of HIV transmission, and 44%
of them knew someone close who had died of AIDS. The study also revealed
the willingness of the Afro-Brazilian religious leaders to actively participate in HIV
and STD prevention, replacing the shared blade for individual disposable blades,
turning the temple into a place where educational material and condoms are
distributed.
Results: Currently 50 leaders are being prepared to turn the houses of this cult
(which is socially the most influential) into HIV and STD prevention centres. 30%
of the religious heads have already substituted the shared blade with the use of
individual disposable blades.
Lessons Learned: Using pictures, messages and leaders of the Afro-Brazilian
community itself, STD and HIV prevention has become much more effective,
with the passing on of information to the community leaders on how to keep the
prevention programme going on their own with the available public resources.
S14216 1 HIV/AIDS/STIs and gender issues in Tanzania
Mary Mshana1, E.F. Ndyetabura2, F. Mhalu3, R.O. Swai4. National AIDS
Control Programme, Dar-es-Salaam; 2UNDL, Dar-Es-Salaam; 3Muhimbili
Medical Centre, Dar-Es-Salaam; 4NACP, Dar-Es-Salaam, Tanzania
Issue: HIV transmission is predominantly heterosexual, a route with gender dimensions that require great considerations. Women/men blame each other for
being the major avenue for HIV/AIDS/STIs transmission.
Project: Women are biologically more vulnerable to STIs due to their being
passive receivers of potentially infected semen from men. Other factors which
aid women vulnerability: culture/traditional values, lack of social/economic empowerment, poor education, poverty, and marital norms which discriminate and
oppress women. Most epidemiological serosurveys which have been conducted
in the country indicate higher HIV/STIs infection rates in women. Already in 1987
in one such surveys in Bukoba urban in North-Western Tanzania, the rates were
28.6% among women against 16.9% in men. The same has been indicated to
be true with other STIs such as gonorrhoea for which chances of male-to-female
transmission has been reported to be around 50-80% after a single exposure
and female-to-male around 20-25%.
Strategy: Reduction in number of sexual partners, early treatment of STIs,
education of children and youth on gender equality, promoting condom use especially the female condom, and empowerment of women socio-economically are
key components for reduction of HIV/STIs transmission. Female condom use will
have to be accompanied by innovative efforts to empower women.
Results: Women do face a formidable risk of HIV/AIDS/STIs transmission
which puts the individual, the family and the entire survival of the nation at
stake. Much has to be done in linking heterosexual behaviour and HIV/STIs
transmission.
Lessons Learned: Urgent responses to ward-off the looming catastrophe of
HIV/AIDS/STIs are highly required. Researches on microbicides/female condom
intended to empower women to protect themselves are needed.
14217 Predisposing risk factors for methamphetamine use and
HIV infection among men who have sex with other men
(MSM): A community study
Alfred Pach1, E.M. Gorman2, W.J. Sherrell2, E. Borgesen2, S.M. Nicholson2.
1NORC, Suite 500, 1350 Connecticut Avenue, NW Washington, DC; 2University
of Washington, Seattle, WA, USA
MSM who use methamphetamines have elevated risk of HIV infection. This NIDA
community study explores predisposing factors associated with initiation into

methamphetamine use co-occurring with HIV risk behaviors.
Project: A community epidemiological/ethnographic study of methamphetamine use among MSM in the Pacific Northwest. Methods entailed: review of
epidemiological data, in depth interviews (N = 80), unobtrusive observation, focus
groups with MSM. Key domains were identified in transcribed interviews through
content analysis (NUD*IST); descriptive statistics were applied to quantifiable
database aspects.