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

12th World AIDS Conference

Abstracts 23425-23429 427

to trust and identify with the projects supportive role and this nurtured a cordial
relationship with users of the joints. With this knowledge the project went beyond
counselling for rehabilitation to mobilization of peers within the joints to support
and pursue behaviour change communication. These peers and identified drug
dealers now serve as members of the community anti drug Committee. The
committee identify users, refer them to designated centres for counselling and
education on HIV/AIDS transmission, care and living positively with the virus.
Results: The turn out at the counselling centre by substance abusing youth
and expansion of the antidrug committee/members indicated the success of the
project. Four months after the intervention some drug dealers in the community changed to other forms of business. Six people were identified to be living
with HIV, two have left the project community, two are dead while two are still
being managed by the project in rendering, financial, medical and counselling
assistance on living positively with the virus.
Lesson Learned: The activities so far have shown the importance of designing intervention programmes that are culturally acceptable and appropriate with
positive behavioural change and design strategies to enhance full community
participation for success.
123425 1 Gender differences in sexual risk behaviors associated
with crack cocaine use: Implications for risk reduction
C. Kevin Mallote', M.M. Wood2, M.G. Shedlin3, S.M. Padilla2. 1Center for
Behavioral Research & Srvcs 1090 Atlantic Avenue Long Beach Ca; 2Csulb
Center for Behav Research & Srvcs, Long Beach, Ca; 3Sociomedical Resource
Associates Inc Westport Ct, USA
Background: Crack cocaine users are at risk for HIV due to their sexual behavior, and men and women may be at different levels of risk as a consequence
of their drug use. To develop effective HIV risk-reduction interventions for male
and female crack users, it is important to identify and describe the range of
salient gender-specific behaviors and beliefs as well as the social, cultural, and
subcultural factors influencing them.
Methods: Qualitative data collection methods included in-depth individual interviews with male and female active users and key informants (n = 21) and
focus groups (n = 8; 63 total focus group participants) of active users and recovering addicts. African American, Latino, and White adults ranging in age from
20-56 years were recruited through street outreach in Long Beach, California.
Groups were organized by gender, drug use status (active or former), and self
identification as a sex worker.
Results: Clear gender differences were apparent in reported HIV risk behaviors
and perceived effects of crack use on sex. Men reported being sexually excited
by crack and wanting sex while smoking; however some acknowledged difficulty
maintaining erections or ejaculating. Few men admitted providing sex for drugs
or money. Men described most crack-using women as "strawberries," eager to
have any type of sex for small amounts of crack, typically without using condoms.
Women agreed that men on crack cannot perform sexually, although they persisted in trying. In contrast to the men, women universally reported providing sex
for drugs or money, but stated that they did not like sex with crack, preferred crack
to sex, preferred not using crack in the presence of men, and used condoms
except when they had "hit rock bottom."
Conclusions: Male and female crack users reported different experiences,
perceptions of, and reasons for engaging in sexual behavior, supporting the need
for gender-specific interventions. For example, interventions targetting female
crack users may need to be more intensive, and focus on quitting drugs, on ways
to avoid "hitting bottom," or on avoiding situations where sex and crack use are
combined and where there is a high likelihood of exploitation by male crack users.
S23426 Sexual behavior among gay men attending sauna clubs
in northeast Italy
Massimo Mirandola', G. Zardini2, D. Falchetto3, C. Pasimeni4, R. Bricolo4,
L. Bertinato5, E. Concia'. 137126 Verona-University of Verona, Infect. Diseases
Dept., fzzale Stefani 1.C. Maggiore; 2 "Circolo Pink" Cultural Association for
Gay Initiative, Verona; 3 "Circolo Pink" Cultural Association for Gay Initiative,
Verona; 4Drug Addiction Service (Sert 2-ULSS 16); 5Regional Dept. of Health,
Italy
Background: Back-calculation studies by the Veneto Region Epidemiological
Observatory estimates that the incidence of HIV among gay men is increasing.
Gay men are still one of the main targets for HIV prevention since no significant
stable change of behavior, especially among young persons, has been reached.
Methods: The study design is cross-sectional. The period of subject enrollment
started from mid-January 1998 to present. A questionnaire, including information
on sexual behavior and on social-demographic variables, were distributed to the
subjects by members of the local gay communities, By the and of the study we
estimate to collect 400 questionnaires.
Results: Up to today (end of January) 176 questionnaire have been collected.
The mean age of the subjects is 36.34 years (SD 7.6). Sixty-six percent of the
subjects are residents of the Veneto Region and the remaining 34% come from

neighboring regions Approximately 60% state to spend their free-time in saunas.
Ninety-five percent declare to have had sexual intercourse during the last month.
Thirty-one percent have a stable partner while 15% are bisexual. The median number of male partner over the last month is 3. Twenty-four percent declare alcohol
assumption during their last sexual encounter, 4.5% use cannabis, 5.7% use cocaine and 4.6 use poppers. Thirty percent of the subjects have never had a HIV test
and only 26% have been vaccinated for HBV. On the whole, 78% declare to have

had anal intercourse among which 21% were not protected. One hundred percent
have had oral sex of which 95% were not protected. The logistic model shows
an association between at risk behavior and type of partner, education level, the
number of partner during their last sexual occasion, alcohol assumption and age.
Conclusions: The preliminary results of the study shows that oral sex is not
protected at all, while at risk anal intercourse seems to be associated to sexual
intercourse with a stable male partner. A consistent number of subject have never
had a HIV test and only a few have been vaccinated for HBV. There is the extreme
need for preventive intervention by using HBV and HAV vaccination and a change
in at risk behavior.
S23427 Health promoting and sexual behavior in the aspect of
HIV/AIDS in Poland
Zbigniew Izdebski. Pedagogical University Social Pedagogy Institute, Plac
Slowianrski 25 65-625 Zielona Gdra;, Poland
Design: The main goal of this elaboration is presentation of a survey made
among Poles and concerning health promoting and sexual knowledge, attitudes
and behavior as seen in the aspect of HIV/AIDS. The survey is a part of an
international project initiated by AIDS Program of World Health Organization in
1994. Participation of United Nations Development Program and its Coordinator
in Poland, as well as the Polish Ministry of Health and Social Care was of crucial
significance for the survey.
Methods: The survey was made on the turn of March and April 1997 in a
representative sample of 3209 Poles at the age of 15-59. The survey had a form
of a questionnaire that was filled by the respondents themselves. One person in a
household that met the criteria was selected at random. The questionnaires were
drawn up on the basis of a standard form used by WHO, and supplemented with
questions concerning risk behavior as well as knowledge about HIV/AIDS within
a wider psychological and sociological context.
Results: The survey dealt mainly with social perception of HIV/AIDS and identification of crucial problems concerned. It was also sexual behavior and opinions
concerning condoms and their availability in Poland that was examined.
The essential results of the survey proved the following WHO indices in the
surveyed fields:

P1 1
PI 3
PI 4
PI 5
PI 9

number of persons that knew two acceptable HIV protection means:
number of persons able to receive a condom:
availability of condoms in towns:
availability of condoms in rural areas:
number of persons who claimed to have had at least one irregular
sexual partner during the last 12 months prior to the survey:
- general population:
- population sexually active in the subject period of time:
number of persons claiming they had used a condom during their
latest sexual contact with an irregular partner:
reported incidence of STD's (men):

0.89,
0.93,
0.99,
0.83,
0.18,
0.23,
0.41,
0.04.

23428 1 Risk behaviors of women who have sex with women
Demetrius Porche', A. Martin2. 1931 Independence, New Orleans Louisiana
70117; 2 University of Illinois, USA
Background: Women who have sex with women are considered the lowest risk
category but may engage in behaviors that facilitate sexual transmission of HIV.
Objective: To describe the sexual practices and risk behaviors of women who
have sex with women.
Design: Cross-sectional, descriptive.
Methods: Subjects were recruited from community based agencies, local bars,
and lesbian/gay festival. A purposive sample of 100 women voluntarily consented.
Each subject completed a self-administered survey that requested data on: demographics, sexual practices and injecting drug use, HIV testing and infection
status, and desired safer sex interventions.
Results: Over 75% of the subjects self-identified their sexual orientation as
lesbian. However, all women (100%) reported engaging in sexual activity with
other women. Eighty-two (84.5%) reported vaginal sex with a women but only
4 (5.7%) used a barrier. Over three-fourths (88.1%) engaged in oral sex with
another woman but only 6 (7.6%) used a barrier. Only eighteen (19.1%) engaged
in vaginal sex with a man in the past six months but only one third of these women
used a condom. Five percent of subjects had a history of injecting drugs with
two The top three safer sex interventions desired were safer sex lesbian posters,
safer sex lesbian percent sharing needles.
Conclusions: Women who have sex with women are practicing unsafe sexual
practices. Women who have sex with women engage in risky behaviors that pose
a risk to their sexual partners. Subjects have an intense desire for safer sex
interventions that specifically target women who have sex with women.
S23429 Sexual practice among rural population in Serbia
Dejana Vukovic, V. CuciC, V. Bjegovid, Z. Terzic. School of Medicine Institute of
Social Medicine, Belgrade, Yugoslavia
All of research on sexual behavior published in our country were conducted in
urban areas, this is the first one focused on rural population.
Objective: To analyze sexual practice of rural population in order to identify
level of preventive practice in HIV/AIDS field and the prevalence of high-risk
sexual behavior.