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

370 Abstracts 23144-23149

12th World AIDS Conference

Results: Peer Educators in turn educated more than 7000 gays and transsexuals, provided them with information about STDs and HIV/AIDS and safer
sexual practices and encouraged the use of condoms, avoiding risk practices like
oral and anal sex. 75% of the identified homosexuals are changing their sexual
behaviour and avoiding risk practices. Among transsexual 117 STD positives
and 31 HIV positives were identified and provided counselling, care and feasible
treatment by the organisation. There is a marked increase in condom usage
among their community and there is a need for stronger condoms. A remarkable
decrease in the number of STDs has been observed.
Lesson learned: There is need of a good health care system to treat STDs of
the gays and transsexuals, and of efficient counsellors by the Govt. and NGOs to
change their sexual behaviour and provide them proper information about STDs
and HIV/AIDS.
S23144 Risky sexual practices amongst MSM in public sex
environment in Dhaka of Bangladesh
Shale Ahmed, M.A.I. Islam Anisul, S.R. Rahman Sohel, Shivananda Khan.
Bandhu Social Welfare Society, Dhaka, Bangladesh
Issue: As a traditional and religiously conservative country it has been assumed
that MSM and anal sex behaviour relatively low and marginal. Is this a valid
assumption.
Risk assesment with technical assistant of Naz Foundation a group of MSM
were recruited from the male sexual network in Dhaka, Bangladesh and were
trained to conduct to risk a need assisment amongst MSM over a period of four
months550 males were interviewed.
The assisment explored sexual stories current sexual practices STD/HIV transmission risk and sexual network.
Conclusion: Despite the general levels of denial and invisiblity, levels of male
to male sexual behaviour including for many female sexual partners and (wives)
and risky practices were significantly high.
There is an urgent need to address these consern though appropriate prvention
and behavioural change support programme.
Follow on: Bandhu Social Welfare Society as the First sexual health agency
working amongs MSM to promote safer sex behaviour in Bangladesh develop as
a consequence of the assesment.
123145 Sexual practices of gay men in third class movie houses
and beauty parlors
Ernesto Gregorio Jr, Celestino R.C.A. Ramirez. 625 Pedro Guil St. Ermita 1000
Manila UP Manila, Reachout AIDS Foundation, Philippines
Objectives: 1) To validate existence of risky behaviors of gay men who frequent
third-class movie houses (covert types) and gay men working and gathering in
beauty parlors (overt types), 2) To compare the risky behaviors between these
two groups.
Methods: A convenience sampling of 100 gay men was done in selected
third-class movie houses (50) and beauty parlors (50) in Manila & Kalookan City.
Using a semi-structured Interview Schedule information on the sexual practices
was gathered through interpersonal in-depth interviewing. For purposes of comparison the respondents were grouped into two, being covert or overt types as
identified by the respondents themselves.
Results: Both groups who admitted to have a regular partner also had sex
with casual partners. Both had multiple casual partners (covert = 6, overt = 7).
The risky behaviors validated included practice of receptive anal intercourse with
regular partner (covert = 12.5%, 17.6% overt); receptive oral sex (covert = 29.2%,
overt = 35.3%); insertive oral sex (covert = 20.8%, overt = 11.8%). The mean age
of casual partnes, covert = 22, overt = 18. The risky behaviors of gay men with
their casual partner included receptive anal intercourse (covert = 8.3%, overt =
29.4%); insertive anal intercourse (covert = 8.3%, overt = 5.9%); receptive oral
(covert = 62.5%, overt = 70.6%); insertive oral (overt = 62.5%, overt = 35.3%),
Inconsistent use of condom (covert = 8.3%, overt = 5.9%); Had gonorrhea (covert
= 12.5%, overt = 11.8%). Had Pubic lice (covert = 8.3%, overt = 0.0%).
Conclusions: The study validated the existence of risky behaviors e.i. multiple
partners, no use or inconsistent condom use, unsafe sex practices, STD experience. However, gay men in beauty parlor engaged more in receptive anal sex
with both partners. This group also had younger casual partner than gay men in
theaters. Therefore the need to educate gaym en about risk of HIV transmission
through anal intercourse and multiple partner and the need to use condom even
during oral sex should be emphasized.
23146 Interferon-a-2B treatment for chronic hepatitis in the
AIDS spectrum: Concomitant interferon-a-2B and
protease inhibitors
Maribel Rodriguez. Condominio De Diego 359, Suite 302, Santurce, Puerto Rico
(USA)

Objective: To measure the efficacy of Intron A-therapy for chronic Hepatitis C in
the AIDS Spectrum defined by CD4 levels, baseline HIV/PCR, and concomitant
treatment with nucleoside analogs and protease inhibitors.
Design: Prospective study.
Methods: 53 patients with AIDS in double therapy with nucleoside analogs or
triple therapy with protease inhibitors and concomitant chronic Hepatitis C were
treated with interferon alpha 2-A treatment 3 million units TIW x 6 months. The

patients had baseline and serial levels of CD4, Hepatitis C viremia by PCR, HIV
viremia by PCR, Hepatic transaminases, thyroid tests, hematological parameters.
Serial examinations and adverse events recorded.
Results: Response was of 35.85% (18.87 partial, HCV-RNA/PCR) 50% baseline reduction, 16.98% total, 100% baseline reduction. ALT response was of
56.6%. Adverse events were mostly mild.
Conclussions: Response correlated with baseline lower HIV, HCV PCR levels, higher CD4 and lower transaminases. When these parameters were given
a score value, baseline score of less than (5) correlated with good prognosis
of response. Score levels over (7) correlated with no response. There was no
difference in response between double or triple therapy groups. There were no
significant adverse effects or added toxicity of interferon therapy.
23147 I Transvestite's potential role as a core community in AIDS
spread
Priyadi Prihaswan1, Maclaren Laurel2. 1JL. Tentara Rakyat Mataram GG. Kapas
JTI/705 Yogyakarta-55231; 2Lentera-PKBI DIY Yogyakarta, Indonesia
Issues: Evaluating strategies to reduce sexual risk of STD and HIV infection
within an outreach program targeting transvestite in Yogyakarta, Indonesia.
Project: The project reaches transvestite through outreach, providing a risk reduction training, condom distribution, and educational and empowerment support
group meeting.
Result: A survey of sexual behavior done in October 1996 showed that more
than 50% of transvestites engaged in anal sex, both receptive (88%) and penetrative (54%). The survey showed that condom use in this community is higher
for receptive anal sex (88%) than for penetrative anal sex (52%), as a result of
Lentera's "protect yourself" message, so they are asking their clients/sex partners
to use condoms. However, the message haven't effectively taken them through
a risk reduction process that helps them understand and take responsibility for
their role in potentially transmitting HIV to others. Barriers to condom use given
included partner rejection, fear of offending partner and not having a condom.
Transvestite have a potential role as a core community in Yogyakarta because
they have so many partners (an avarage 2-5 clients/sex partners per night) and
their partners are extremely difficult to reach with prevention messages because
they are so closeted and our prevention strategy does not seem to be adapted
with the psychology of transvestite.
Lesson Learned: Lentera needs to develop wider reaching messages, aside
from "protect yourself" which can encourage transvestite to help prevent HIV
transmission to clients/sex partners. Also needed is a safe sex campaign, which
supports, for example, non penetrative sex as a method of reducing risk, for both
transvestite and clients. A more neutral campaign also needs to be developed,
which can reach the transvestites clients/sex partners.
23148 1 Risky sexual amongst MSM in public sex environment in
Dhaka of Bangladesh
Anisul (Hero) Islam. Bandhu Social Welfare Society, 106, Kakrail, Dhaka,
Bangladesh
Issue: As a traditional and religiously conservative it has been assumed that MSM
and anal sex behaviour are relatively low and marginal. Is this a valid assumption.
Risk Assessment: With technical assistant of Naz Foundation a group of MSM
were recruited from the male sexual network in Dhaka, Bangladesh and were
trained to conduct to risk and need assessment amongst MSM over a period of
four months, 550 males were interviewed.
The assessment explored sexual histories current sexual practices STD, HIV
transmission risk and sexual network.
Conclusion: Despite the general levels of denial and invisibility, levels of male
to male sexual behaviour including for many female sexual partners (wives) and
risky practices were significantly high.
There is an urgent need to address these concern through appropriate prevention and behavioural change support programmes.
Follow on: Bandhu Social Welfare Society as the first sexual health agency
working amongst MSM to promote safer sex behaviour in Bangladesh was
developed as a consequence of the assessment.
23149 New relationships and HIV discordance rates among
couples requesting HIV counselling and testing in
Uganda
Fulgentius Baryarama, J. Kalule Josephine, M.G. Alwano-Edyego, E. Marum.
AIDS Information Centre PO Box 10446, Kampala, Uganda
Background: In a high HIV prevalence setting where most people HIV+ do not
know their serostatus, there is a great risk of HIV transmission when a person with previously unidentified HIV infection initiates a new sexual relationship.
Preventing this unknowing transmission of HIV to a new partner is a high priority.
Methods: Individuals and couples who come to the AIDS Information Centre

in Uganda for HIV counselling and testing services (CT) are interviewed to obtain
demographic and sexual history data. The data collection tool was revised in May
1997. Data for the period July to December 1997 were merged and analyzed.
Results: Of the 1853 couples, 1425 couples (77%) reported that they had
never had sex together but were intending to marry or to start a sexual relationship. Of these 1425 reported they had not had sex together, 1309 couples (92%)
were both HIV-; 11 couples (0.8%) were both HIV+, and 105 (7%) couples were