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

12th World AIDS Conference

Abstracts 14243-14248 231

14243 Masculinities, sexual negotiation and HIV/AIDS
prevention in Puerto Rico
Carlos Vasquez-Rivera, I. Cunningham, D. Perez-Jimenez, J. Coss-Rodriguez,
B. Ortiz-Torres, J. Velasquez-Lopez, M.L. Franco-Ortiz. HIV/AIDS Research
Center University of Puerto Rico, Po Box 23345, Puerto Rico
Objectives: To understand the social construction of masculinity in Puerto Rican
male university students, and its implications for sexual negotiation and HIV/AIDS
prevention.
Methods: As part of a study to identify the contextual variables that influence
and determine the social construction of sexuality and gender roles and their
relationship with sexual negotiation and safer sex practices, we have conducted
4 focus groups with men at the University of Puerto Rico. Questions for all groups
covered topics regarding sex and sexuality, their beliefs about sexuality, sexual
roles, sexual practices, and how sexual negotiation takes place between partners,
among others.
Results: Our findings suggest that men tend to see family, TV, school and
friends as most influential in the formation of gender roles and their notion of sexuality. A frequent comment was that the information they receive about sexuality
is confusing and intimidating and in most cases is something that nobody talks
about. For these men, sexuality is more a means to physical pleasure than emotional intimacy. Many participants criticized some notions about male roles (e,g,
"men don't cry", and "men are supposed be in control") because they feel men
are to behave in socially prescribed ways. Students claim that if a relationship is
casual, condom use is more likely, but is less likely if the relation is a stable one.
Conclusions: HIV/AIDS prevention programs targeting young men, particularly in Puerto Rico, must take into account that many resist suggestions for
behavioral change when engaged in ongoing relationships. Also, a distinction
should be made between casual and steady sexual relationships when they are
being targeted for condom use programs.
S14244 Determinants of condom use in Turkish students and
homosexuals: Culture, gender ideology, and perceived
risk
Diane Sunar1, P.O. Fourreau2. Psychology Dept. Bogazici University PK2
Bebek Istanbul 80815; 2lstanbul, Turkey
Objectives: To identify and compare factors determining condom use among
Turkish respondents.
Design: Questionnaire applied to a purposive sample.
Methods: Respondents were (1) 227 male university students; (2) 42 members of a gay men's group in Istanbul. The questionnaire included items covering
sexual activity and practices; condom use; traditional gender role (TGR) attitudes;
knowledge of HIV/AIDS; attitudes toward people with AIDS; perception of severity
of threat from AIDS; and perception of personal risk.
Results: (1) Condom use was most powerfully predicted by low TGR attitudes,
and secondarily by perceived severity of threat. (2) TGR attitudes were negatively
related to perceived severity, perceived risk, knowledge about AIDS, and attitudes
toward people with AIDS. (3) There was no overall difference between heterosexual and homosexual respondents on TGR attitudes, perceived severity of danger,
or perceived personal risk; however, gay men were more knowledgeable about
AIDS and had more positive attitudes toward people with AIDS. (4) Reported condom use is greater in casual than in long-term relationships. (5) Sexually active
respondents were more knowledgeable about AIDS and had higher perception of
personal risk than non-active respondents.
Conclusion: Factors emphasized by the health belief model, such as perceived
severity of threat and perceived personal risk, were less powerful in predicting
self-protective behavior (condom use) than cultural factors such as attitudes toward traditional gender role ideology. To be effective, preventive interventions
must target cultural attitudes as well as personal perceptions.
S14245 The dilemmas of cultural reforms in the era of HIV/AIDS:
The case of polygamy in the muslim community in
Uganda
Muosa Khalid Nsubuga1, L.I. Ismeal Dungu1, B. Mugerwa2, K.K.Y. Nsugba3,
S.J. Kiberu4, R.H. Nabisuuka5. 1Uganda Muslim Teachers Association, PO. Box
12116, Kampala; 2Rawempe Secondary School, Kampala; 3Uganda AIDS
Commission, Kampala; 4Mende Kalema Secondary School, Kampala; 5Islamic
University in Uganda, Mbale, Uganda
Issue: In Uganda, following the multisectrol approach to the control of HIV/AIDS,
religious institutions among other actors were brought on board specifically to
adress themselves to the religious communities. Whereas there has been an
increase in HIV/AIDS awreness there has been resistance regarding changes of
some religious dogmas. Although there is no emperical evidence regarding any
relationship between polygamy and HIV/AIDS, our prevention efforts have been
directed to it.
Project: The Uganda Muslim Teachers Association started an HIV/AIDS pre
vention programme within the Muslim communities. Among other issues we
adresse is the modification of some practices that increase the vulnrability to HIV
infection of our peolpe.
Results: A few years ago it was not possible to even allow a disscussion
on some of these cardinal and devine doctrines because they are God given.
Through time we have been able to create space for discussion of these matters.
Whereas there is still resistance within some sections of our society, there is a

change in alttitude among certain sections towards such issues like polygamy
and increasingly muslims are apprciating the reality of the situation.
Lessons Learnt: Active involvement of all the sectors in this struggle to combat
HIV/AIDS is a very good strategy. In Uganda the different religious sectors have
been very instrumenal in reaching different communities of our society. Cultural
reforms should be initaited and implimenteed by the very communities affected
by such practices as are found risky to HIV.
1142461 Folk beliefs and women's reproductive health practices
in an urban poor community in the Philippines
Ma. Isabel Melgar12, M.R.A. de los Reyes2, O.T. Monzon2. 139 Mt. Williamson
Filinvest 1, Quezon City; 2Research Ins. for Tropical Medicine, Muntinlupa,
Philippines
Objective: To explore traditional beliefs and superstitions influencing reproductive
health practices among Filipino women; and to identify behaviors that threaten
their reproductive health and protection against HIV.
Design: Descriptive study
Methods: One hundred forty eight women in Pulang Lupa community were
randomly selected to participate in the survey while 30 women and 12 men
participated in the FGDs. Respondents' ages ranged from 18-45 years. The
survey used a 106-item questionnaire which was orally administered by field
interviewers.
Results: One hundred fourteen women or 77% claimed that they followed
certain traditional practices in maintaining personal health and hygiene. A variety
of old beliefs were held by the women particularly during menstruation, child
birth and post-pregnancy periods. A hygiene practices that is most influenced
by traditional beliefs is the frequency and manner of taking their baths. The
differential roles of doctors, quack doctors, midwives, "manghihilot", parents and
peers were also revealed. Out of 148 women, 122 believed that were not at risk
for HIV infection.
Conclusion: The intriguing fusion of old traditional beliefs with modern day
health habits presents a complex picture of women's mind set and behavioral
resistances; and degree of openness to changes as far as physical health is
concerned.
S142471 Exclusion of homosexuals from HIV/AIDS programmes in
Zimbabwe
Siphangilizwe Nyathi. 22 Bristol Court Prince Edward Road Harare, Zimbabwe
Issue: Homophobia in the Zimbabwean government and society excludes gay
people from HIV/AIDS awareness, prevention and treatment programmes. Since
the 1995 book fair, Gays and Lesbians of Zimbabwe (GALZ), has seen an increase in black homosexual membership. It is apparent that homosexuality exists
throughout society, including areas, as evidenced by the local media only when
reporting on paedophilia. Limited statistics available prove the need to seriously
address HIV/AIDS in both the gay community and with men who have sex with
other men but do not identify as gay. Zimbabwe has the second highest HIV/AIDS
statistics in the world; yet, this contributing sector of its society is left unaddressed. GALZ's efforts to advertise services in the media have been thwarted
by government and homophobic individuals.
Project: Since 1996 GALZ has undertaken a study on a small cohort of people
to establish the effects of HIV/AIDS education on gay individual lifestyles. In
the light of the constraints of societal taboos, media inaccessibility and lack of
funding, an attempt was made to cover as wide an ethnical cross-section of
society as possible. We hope to carry out in full a larger study, and embark on a
conscientization programme.
Results: Many gay people are unable to contact GALZ and are therefore
ignorant of counseling and education services offered. These people are entirely
unaware of the risks in which they place themselves and others (including wives).
Many gay men have died silently through ignorance and multiple stigmatization of
homosexuality and seropositivity. There is a growing sense of urgency to extend
services to this wider community.
Lessons Learned: Zimbabwean society will find it difficult to tackle HIV/AIDS
effectively while it excludes homosexuals. Existing legislation urgently needs to
be changed to enable openness and inclusion.
S14248 1 The cultural dimension as a determinant of behaviour
among the Tonga of Southern Province, Zambia
Maria Nkunika1, J.B. Kalipenta2, M.C. Chalowandya2.2, N. Phiri2, J. Munsanje3,
A. Liyoba2, W. Nyirenda4. 1Steadfast Action Foundation, PO. Box 32557,
Lusaka; 2Anti AIDS Project, Lusaka; 3Children in Distress Project, Lusaka;
4 Teachers Education on AIDS Project, Monze, Zambia
Introduction: In this Society virility, well being wealth and prosperity are measured
through, inter alia, polygamy, many children, doweries and other sexual exploits
outside marriage. These practices exists in gender insenstive evironments where

women and girls have very little say in men's behaviour. The women and girls are
therefore exposed to AIDS in situations where they are powerless and vulnerable
sexually.
Objective: To assess how strongly cultural and traditional practices pre-dispose
people to certain behaviour.
Method: Based on field trips, observations and focus group discussions with
peer educators, interviews and testimonies to collect qualitative information.