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

226 Abstracts 14218-14222

12th World AIDS Conference

Results: Patterns of methamphetamine initiation were related to substance
abuse in families of origin, history of childhood sexual and physical sexual abuse,
transience or homelessness, being a street youth, having worked in the sex
industry in California and socialization via gay peers. A majority of respondents
stated initial use of methamphetamine in connection with a sexual experience,
often with an older partner. A majority of subjects reported they were HIV+;
serostatus appeared related to both sexual factors and injection factors High-risk
sexual activities were associated with failing to discuss HIV status prior to sex and
reported disinhibition while using drugs. Injectors reported inadequate information
about needle safety, or poor adherence to safe needle use guidelines; also easing
of vigilance was reported among those who had a regular partner, those were
under 25.
Lessons Learned: HIV prevention and treatment, substance abuse prevention
and treatment should begin with assessment of drug use and sexual histories,
histories of sexual, physical abuse. Outreach and treatment approaches need
to target high-risk sexual behaviors and risk taking co-occurring in the context
of drug use including injection use, with emphasis about young MSM in urban
epicenters of the Western US.
S14218 Anonymous unprotected anal intercourse in London's
gay backrooms and saunas
Peter Keogh, P. Weatherburn, F.C.I. Hickson, P.M. Davies. Sigma Research,
University of Portsmouth Unit 64, 49 Effra Road, London. SW2 1BZ, UK
Background: The last two years have seen a proliferation of gay saunas and
bars advertising backrooms in London (at least 20 now operate in the city). Given
the controversy that such venues often cause, their role in the sexual transmission of HIV remains relatively unexplored. This research examines their use and
makes concrete recommendations regarding the most appropriate models of HIV
prevention in these venues.
Methods: [1] Self complete questionnaires (examining sexual risk behaviour
and patterns of use) completed by users of backrooms and saunas in London
(N = 179). [2] In-depth interviews with 20 users of backrooms and saunas which
examine practical and erotic motivations, symbolic meanings of risk, intimacy,
pleasure etc.
Results: In the last year, 8% of the sample had engaged in unprotected anal
intercourse (UAI) in a sauna, 16% had done so in a backroom and 43% had done
so at home. Qualitative data suggests differences in UAI may be due to differences in symbolic meanings attached to saunas and backrooms and differences
in their organisation. Backrooms are erotically associated with transgressive sexuality. Users perceived themselves and other participants present both as more
sexually experienced and more likely to know their own HIV status. Men willing to
engage in UAI are perceived as knowing or assuming themselves to be infected
whilst those who are not willing to engage in UAI are assumed to know that they
are uninfected. Saunas are associated with relaxation, health and voyeuristic
sex. Substantial sexual experience is not assumed and users were less likely to
make decisions based on assumptions on prospective partner's likely HIV status.
Moreover, unlike saunas, the spatial organisation of most backrooms prohibit free
access to condoms whilst engaging in sex.
Conclusions: The study shows that users of backrooms and saunas engage
in significant amounts of anonymous unprotected anal intercourse (UAI) in circumstances where knowledge of partner's HIV status is unlikely. There are major
differences in erotic motivations and sexual interaction between backrooms and
saunas. The symbolic meanings attached to venues and spatial considerations
are directly related to the occurrence of UAI, and must be considered when
planning interventions in such venues.
14219 Reducing HIV risk: Differences in self-reported strategies
among Asian, Black, Hispanic, and White women, age
18-25 years, 1986-1995
Susan D. Cochran1, V.M. Mays2. 1 UCLA 405 Hilgard Ave. Box 951563, UCLA
Schl. of Public Health Dept. of Epi., Los Angeles, CA; 2Univ. of Calif. Los
Angeles Dept. of Psych., Los Angeles, CA, USA
Background: Ethnic minority US women are at increasing risk for HIV infection.
Although public health interventions tend to recommend similar strategies for
reducing risk, we hypothesized that cultural differences among ethnic groups
in sexual behavior might result in differences in preferred sexual risk reduction
strategies.
Methods: Questionnaires were administered to ethnically diverse samples of
sexually active, unmarried heterosexual women (38% White, 19% Black, 20%
Hispanic, and 23% Asian American), between the ages of 18 and 25 years, in
1986 (N = 173), 1988 (N = 199), 1990 (N = 367), and 1995 (N = 472). Respondents were asked if they had changed their sexual behavior to reduce HIV risk
and whether or not they employed any of 10 methods for doing so. Data were
analyzed for both time-related and ethnic group differences, after controlling for
age.
Results: Over the 4 time points of data collection, women were significantly

more likely to report changing their behavior and showed significant time-related
increases in the following strategies: asking about sexual histories, HIV test results, and/or IV drug use, talking about AIDS with partners, limiting their numbers
of partners, insisting on condoms, and avoiding anal sex. Controlling for both age
and time effects, Black women were significantly more likely and Asian American
women less likely than White women to report having changed their behavior
to reduce risk. Black women, compared to White women, were more likely to

report avoiding oral and/or anal sex. Asian American women, compared to White
women, were more likely to report celibacy as a strategy. Hispanic women, in
contrast to White women, were more likely to report celibacy, asking about IV drug
use and/or talking about AIDS, limiting their numbers of partners, and avoiding
oral sex.
Conclusions: Results of this study indicate both time-related and ethnic differences in sexual risk reduction strategies among young heterosexual women.
Previous HIV efforts have alerted young women to the risk of HIV and overall
self-report suggests positive behavioral changes. However, differences among
ethnic groups suggests differential preferences for strategies that vary in their
effectiveness to reduce HIV infection.
402*/14220 Responding to the needs of Maori gay men and
transsexuals who live in Sydney
Clive Aspin. Wellington School of Medicine, Wellington, New Zealand
Issue: For decades, Maori, the indigenous people of Aotearoa/New Zealand,
have migrated from their homeland to Australia so that now Maori gay men and
transsexuals constitute a significant ethnic minority population within the broader
Sydney gay community. Regular visits home to New Zealand are a feature of the
lives of those who have chosen to reside long-term in Sydney. Understandably,
trans-Tasman migration continues to be an important component of the AIDS
epidemic in both New Zealand and Australia.
Project: Interviews were conducted with a group of long-term Maori residents of
Sydney and a group who had returned from having lived in Sydney. The in-depth
interviews aimed to understand respondents' reasons for taking up residence in
Sydney, reasons for returning to New Zealand, their involvement with the Sydney
gay community and the impact that trans-Tasman migration has on their cultural
and sexual identity.
Results: Analysis of transcripts has indicated that Maori gay men and transsexuals in Aotearoa/New Zealand have a greater degree of attachment to their
cultural origins than those who reside in Sydney. Those who reside in Sydney
tend to be intimately involved in the Sydney gay community but their involvement is often at the expense of their cultural identity. They are often required
to suppress their cultural identity in order to assimilate into the gay community.
Many respondents reported racism, verbal and physical abuse, police brutality
and exclusion from gay venues.
Lessons Learned: Prevention programmes need to acknowledge the cultural
backgrounds of their target audience. This is particularly important in a multi-cultural society such as Australia. In the case of Maori gay men and transsexuals,
it is inappropriate to view them as New Zealanders only. Maori have specific
cultural needs that must be incorporated into HIV prevention programmes aimed
at this vulnerable population.
14221_ 1 The vulnerability of women addressed: An HIV/AIDS
prevention approach
Nhu Trang Nguyen. 91/35 Su Van HANH NOI DAI, District 10, Hochi Minh City;
Care Vietnam, Vietnam
Issue: Too little money and time has been spent on educating women on the risks
of HIV infection they face because of their own partners' practices. Most projects
for women in Vietnam target the minority with multi-partners via commercial sex,
leaving the majority feeling safe.
Project: With AusAID funding, CARE Vietnam embarked on solid research
into the construct of sexuality for Vietnamese women and their levels of power in
relationships. From this an assertiveness training package for sexual negotiation
was developed. Training was given to 1000 women without regard to the number
of sexual partners they had (1997-1998) by trained Women's Union cadres in
three provinces and evaluations of the training and its personal usefulness after
three months were collected and analyzed.
Results: According to the evaluation by the trainees 78% said that for the
first time they could talk to their partners about sexual practices with each other
and outside the relationships. 75% used the skills of negotiation taught within
three months and believed that they were effective. 93% reported a better understanding of their bodies, health and the sexual needs of their partners and
themselves. 25% felt that they were still not good at negotiating with their partners
and need more practice. In follow-up meetings a number of women reported that
their sexual lives were more exciting and satisfying and one province reported a
lower incidence of domestic violence which they attribute to better relationships
because of the training.
Lessons Learned: The skills learned in the training can assist multi-partnered
and monogamous women alike, because it is based on the power relationships
between men and women rather than on their membership of the specific industry.
S14222 Drug use and HIV risk behaviors among Asians in San
Francisco
Tooru Nemoto1, B. Aoki2, K. Huang3, A. Ching3. 1IHPS/UCSF 1388 Sutter St.

11th Fl., San Francisco, CA 94109; 2UARP, Berkeley, CA; 3Asian American
Recovery Services, San Francisco, CA, USA
Background: The objectives of this study were to identify the patterns of drug use
and HIV risk behaviors among Chinese, Filipino, and Vietnamese drug users in
terms of ethnicity, gender and immigrant status and to examine the relationships
between cultural factors and these behaviors.