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

12th World AIDS Conference

Abstracts 23466-23470 435

Method:- As a part of ongoing study 200 young males attending counselling
clinic and 120 young intravenous drug users were interviewed for sexual behaviour and visit to a commercial sex-workers. After proper counselling and
consent blood samples were collected for confidential HIV testing. All of these
males were between the age of 16-30. All the young males have visited the clinic
for fear of STD/AIDS. The drug users were contacted through social workers to
monitor needle sharing and sexual behaviour. All the respondents were provided
free one to one information and counselling and blood screening for STD/AIDS.
Follow of the activity was carried for a period of 20 months and respondents were
encourged to drop in the counselling clinic whenever they feel and need any
information or help. All respondents were counselled on risk of HIV infection and
possibility of transmitting to their spouse, girl friend and future wife.
Result:- 32/200(16%) clinic attendants young males and 14/120(12%) drug
users were married. All 200 young males and 56/120(47%) drug users have
visited commercial sex worker on more than one 82/120(68%) drug users have
the record of needle sharing and many men having sex with one commercial sex
worker in one occasion. 16/200(8%) young males and 62/120(52%) drug users
were found HIV positive. In the last follow up after twenty months 14 young males
and 16 drug users have already transmitted HIV infection to their spouse and
newly married bride. Eight of these infected young women are already pregnant
and one new born is HIV positive.
Conclussion- The risk behaviour of young males have contributed to spread
HIV to general population with increased risk to house-wives, newly married girls
and to those girls likely to be married to HIV positive men. Continued monitoring
and follw up through this type of study will provide confidential identification
of person/or group in need of intervention and re-focussing of the preventive
intervention and education activity.
23466 Gender, power and HIV: The impact of partner violence in
the context of poverty on women's risk of infection in the
USA
Brandy M. Britton. 10234 Shirley Meadow Court, Ellicott City, MD 21042;
University of Maryland, Baltimore, MD, USA
Objectives: 1) To examine the impact of the interaction between battering by
an intimate partner and poverty on women's involvement in injection drug use,
crack smoking, condom use, and needle sharing. 2) To determine how battering
impacts the decisions women are able to make about condom use with a partner.
Design: Retrospective Survey
Methods: Quantitative and qualitative interviews were conducted with 280
women Baltimore, Maryland. Multiple and logistic regression were used to test
hypotheses regarding the impact of the interaction between partner violence and
poverty on women's involvement in risky sexual and needle sharing practices and
on their use of intravenous drugs and crack smoking.
Results: The interaction between poverty and battering was a significant predictor of drug use (F = 13.7, p =.0003), needle sharing (Wald = 7.5, p =.02), and
participation in sex work (Wald = 6.4, p =.003) among women. The interaction
term did not predict condom use. However, having been battered in the past year
was significantly related to condom use in the past year (F = 4.6, p =.03). Women
who reported being battered in the past year were significantly more likely to
report that fear of violence (Wald = 6.2, p =.01), concern over accusations of
infidelity (Wald = 8.7, p =.003) and disapproval from their partner for condom use
(Wald = 3.7, p =.05) were reasons for engaging in unprotected sex.
Conclusions: Partner violence in the context of poverty plays a role in shaping
women's exposure to HIV. Services and social policies which address women's
economic power and exposure to partner violence need to be incorporated into
efforts to fight the spread of HIV among.
23467 Physical and sexual abuse as cofactors for HIV
transmission in women
Donna Gallagher, S. Brady. Fuller Mental Health Center, Community Medical
Alliance, 31 St. James Avenue Suite 950, Boston MA, USA
The authors suggest that physical and sexual abuse is most likely pervasive
in the lives of women in the US with AIDS and must be taken into account
when providing care and treatment. A review of the medical records for female
patients in a large clinical practice of Nurse Practitioners providing AIDS care in
the Northeastern US revealed that 95% had a lifetime history of sexual abuse.
More specifically, rape 48%, incest 30%, marital rape 40%, prostitution 37%,
62% listed more than two types of abuse, 21% listed more than three types of
abuse. Since 1992 the Nurse Practitioner group has provided care for over 500
patients, of whom 35% are female, 53% with a history of injection drug use,
and 48% members of minority groups. Almost immediately it became clear that
female patients treated by the group presented with complex mental health and
behavior management needs that were qualitatively different from many of their
male counterparts. These difference pose a challenge to effective care, including
patient adherence to the complex drug therapies widely used in the US to treat
HIV disease. Many of the behaviors associated with these patients had been

characterized by other practitioners as suggestive of Borderline Personality Disorder and include self-injurious acts, exploitative relationships with men, intense
and unstable affective states, and impulse control disorders. Regarding the latter,
female patients in the practice were more likely to have used injection drugs than
their male counterparts. The authors believe many of these women suffer from
some variant of posttraumatic stress disorder and that mental health management
is a key component of effective primary care treatment. A model for the integration

of mental health care into primary care treatment for women with AIDS will be
addressed during this workshop.
The authors suggest that sexual abuse is pervasive in the lives of US women
with AIDS. Consequently, they are more likely to present for treatment with complex mental health and behavior management needs that must be addressed in
their treatment. Failure to address these needs results in non-adherence with
treatment, chaotic and unstable relationships with providers, and we believe
increased mortality and morbidity. The authors address at length a model for
the integration of mental health care into primary care treatment for women with
AIDS.
123468 Gender differences and risk factors for HIV in Belgrade
(how much women differ)
Vesna BjegoviC, D. Vukovid, V. Cucid, M. Santrik Milicevic. School of Medicine
Institute of Social Medicine, Belgrade, Yugoslavia
In our country AIDS prevalence much differ by gender, with three times more
male than female persons with AIDS.
Objectives: The study describes gender differences in HIV/AIDS related knowledge and behavior in Belgrade
Methods: Anonymous questionnaires were administered to 1218 men and
1441 women aged 15-49 in Belgrade
Results: Study shows that as many as three quarters of male respondents and
only a half of the female respondents had sex by age of 19. More women than
men are having regular partner (82.1% of women and 75.8% of men). Involving
in sex with casual partners was twice as common among sexually active male
respondents than among women (X2 = 116.0, p < 0.01). During casual sex more
women (44.0%) than men (35.7%) suggested the use of condoms to their partner.
Also, the reasons cited for not using condoms much differ by gender. Far more
men than women cited dislike and unavailability while more women than men
cited their partners, opposition to using condoms (X2 = 38.5, p < 0.01). Although
a somewhat larger percentage of women claimed they have never heard of AIDS,
a larger percentage of women is familiar with all three major preventive practices
(71.1% off women and 70.4% of men). In our survey larger percentage of men
has some misconceptions of AIDS preventive practices.
Conclusion: In Belgrade women are more aware of main preventive practices
related to HIV/AIDS and fewer among them have misconceptions about the
transmission of HIV. Also, men more often than women engage in high-risk sex.
|23469 Prevalence of HIV among high and low risk pregnant
women in Edinburgh 1993-1997
Louise Shawl, D.J. Goldberg', J.B. Scrimgeaer2, M. Maginnis3, G. Codere1,
F.D. Johnstone4, W. Smyth'. cSCIEH, Clifton House, Clifton Place Glasgow, G3
7LN; 2 Western General Hospital Edinburgh; 3Blood Transfusion Service
Edinburgh; 4 Centre for Reproductive Biology Edinburgh, Scotland
Aim: To determine the prevalence of HIV infection in the Pregnant Female
population in Edinburgh.
Design: Unlinked Anonymous Testing
Method: Those included were women at any stage in pregnancy who attended
Antenatal and Obstetric & Gynaecological clinics and wards in the Edinburgh area
between May '93 and December '97. Following routine anti-D and blood grouping
screening of pregnant women, residual sera were tested anonymously for HIV.
The Abbot Elisa HIV 1-2, 3rd Generation Plus assay was used, and test results
were linked to limited information which included age-group, history of drug use
including that of their sexual partner and pregnancy status.
Results: The 56 month prevalence of HIV among all pregnant women was
0.12%. However women experiencing termination of pregnancy were 3 times
more likely to be infected than those continuing pregnancy (p < 0.01). 45% of
infected women were injecting drug users or their sexual partners.
Patient category All tests Excl. IDU Excl. IDU & IDU part
tested +ve % tested +ve % tested +ve %
Ongoing pregnancy 46,990 33 0.07 46,883 24 0.05 46,724 19 0.04
Terminating pregnancy 18,665 45 0.2 18,589 30 0.16 18,513 24 0.13
Total 65,655 78 0.12 65,587 54 0.08 65,237 43 0.07
Therapeutic termination, miscarriage, ectopic, blighted ovum.
Conclusion: This study demonstrates that when conducting HIV prevalence
studies on pregnant women, rates may be underestimated if those terminating
their pregnancy are not included. Collecting risk information on IDU is essential if
the extent of heterosexual HIV spread is to be determined.
| 23470 Early widowhood as a sustaining and a facilitating factor
in HIV infection and spread
Joseph Kihika Kamara. 'HIV Prevention and AIDS Care, Namirembe Diocese,
PO. Box 14297, Kampala, Uganda

Issue: A human being depends on social, economic, physical, moral and spiritual
needs such as safety, esteem, freedom from all forms of harassment/abuse and
spiritual/moral fulfillment.
Project: A research was carried out in the districts of Kalangala, Mpigi and
Kampala among young widows of 15-35 years. 89% admitted being sexually
active with several reasons such as loneliness, depression and guilt. 5% were