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

12th World AIDS Conference

Abstracts 23486-23491 439

S23486 Women, HIV/AIDS and gender
Marina Laski1, Z. Palma2. 1Defensa 1865, Haedo; 2Mujeres al Oeste, Haedo,
BA, Argentina
Issue: Increasing and continuous growth of women's HIV/AIDS infection basically
in poor and developing countries, needs a deep analysis over causes of women's
greater risk, evaluated from a gender perspective.
Project: For women, unprotected sexual intercourse is the most important gate
to infection. They face greater risk for biological, sociocultural and psychological reasons. Current project analyzes greater vulnerability conditions for women
in metropolitan area of BA city. Women's groups were gathered in workshops
to work out conclusions, additionally, personal interviews were performed with
women living with HIV/AIDS.
Results: Over 17 groups (318 women) and 54 deep personal interviews (ages
16/45) most relevant conclusions were as follows tracks:
* Health Public policies and the relation between women and health institutions
(prevention campaign, diffusion of same and specificity of messages, availability
of health services and access to them, etc.)
* Sexual and Reproductive Rights, in the frame of tough economic politics
(public policies, availability of means to plain pregnancies, abortion question,
support to pregnant women and women with children, access to work sources,
etc.)
* Women sexuality construction features (basically heterosexual) and gender
discrimination (gender social and sexual stereotypes, negotiation skills with men,
dominant sexual myths, empowerment, etc.). All of these according to age and
sociocultural characteristics of each group.
Lessons Learned: Gender standpoint improves the understanding of women
vulnerabilities to HIV/AIDS giving detailed and specific information related to life
conditions in different population groups. In this way it is possible to develop more
effective programs. It is necessary to strengthen the social support network to
women, specially for the ones living with HIV/AIDS as well as to struggle for a
greater involvement and responsibility of public policies.
23487 Women with HIVIAIDS-politicalleconomic impact
Tendaidoreen Chirume. 21A Vanpraagh avenue, Milton Park, Zimbabwe
Issue: Empowerment of women with HIV/AIDS.
Project: Given the problems encountered by women with HIV/AIDS, some form
of programmes have been introduced. Educational & income generating projects
have been started. These enable women to deal with all the dilemmas they come
across as being positive such as stigmatisation from either the family or the
community, stress caused by poverty due to financial constraints, nursing sick
HIV partners and children and also how to fit in a community despite the political
and economic hardships. A lot of advocacy is needed to lobby the Government
so that the political side will also put women with HIV/AIDS into consideration.
Results: Since these programmes were introduced about 90% of the women
who tested positive as from 1986, at least 60% of them have already formed
groups. They have embarked on projects like sewing, poultry, catering, etc. Looking at the progress of these groups about 40% of them are making profits. The
impacts of these programmes on the entire community has showed that women
with HIV/AIDS can also achieve the best, is also starting to be accepted.
Lesson Learned: More programmes are still needed especially those on Advocacy to raise the status of women in society. Women are now making money
from these projects resulting in financial independence to enable them to lead
healthier lives.
23488 Detection of HIV-1 in the female genital tract: Association
with HIV-1 in peripheral blood
Andrea Kovacs1, P. Reichelderfer2, D. Wright3. 1 USC School of Medicine, 1640
Marengo St. #300, Los Angeles, CA 90033; 2Niaid, NIH, Rockville, MD; 3 Westat,
Rockville, MD, USA
Objectives: To determine if the presence and quantity of HIV in the female genital
tract correlates with HIV in blood.
Methods: As part of a cross sectional study sponsored by DATRI nested within
the Women's Interagency HIV Study, paired blood and genital secretion samples
were obtained for 277 women. To date 156 women have completed evaluations.
Virologic evaluations included, HIV cultures and plasma HIV RNA of blood and
genital tract using two collection methodologies (cervical vaginal lavage [CVL]
and cervical swab). HIV-1 RNA was measured by NASBA (blood, CVL) and PCR
(Genital swab). Evaluations for viral co-infections and STDs were also done.
Results: Infectious HIV was detected in the blood of 73% and genital tract
of 12% of the women. HIV RNA was detected in the blood of 71% and genital
tract of 60%. Combining Culture and RNA, 88% of women had detectable HIV
in blood and 70% in the genital tract (combining CVL and swab). HIV was more
likely to be detected in the genital tract of women who had detectable blood RNA
levels (41/102 [40%] of CVL samples and 49/87 [56%] of swab samples) than of
women who had undetectable blood RNA levels (3/42 [7%] of CVL samples and

9/38 [24%] of swab samples). No significant difference was noted in quantity or
presence of RNA by order of genital tract sample collection (CVL collected first
versus swab collected first). The presence of Candida by KOH appears to impact
HIV RNA in CVL even after controlling for CD4.
Conclusions: The majority of HIV+ women have detectable virus in the genital
tract. Genital tract virus is more readily detectable among women with positive
blood cultures or detectable blood RNA.

234891 Sida Info Service: Listening to women
Elisabeth Da Paz. Sida Info Service J90 BD Charonne 75020, Paris, France
The history and the representations of the AIDS epidemic in the Occident have
had serious consequences for women.
Women have shared their needs and anxieties in their testimonies to Sida Info
Service and we have found that our response to their concerns has sometimes
been lacking or completely inadequate. Sida Info Service, with the support of
the European Community, has been engaged in a European-level analysis of
women's specific needs and how they are met. The goal has been to confront
our findings for France with those of other European helplines, by means of
the calls received from women, but beyond that, by giving voice to concerned
professionals who follow their care and provide support.
Our conclusions and proposed responses, shared by professionals, activists
and HIV positive women themselves, are as follows: End women's isolation,
Fight against the discrimination that victimizes women, Reduce inequalities in
the relationships between the sexes, Improve access to treatment and medicalsocial-psychological follow-up, Provide women with means to protect themselves
that are under their control, Encourage scientific research that seeks to expand
knowledge pertaining to women's needs and particularities in the struggle against
HIV infection, promote the health of women throughout the globe, improve access
to information destined to women, along with its quality, sensitize the larger public
to the reality of the epidemic among heterosexuals
Conclusions: Sida Info Service would like to improve the quality of the helpline
response to women by being more attentive to the needs and expections expressed by the women who call the service. We would like to evaluate the need
for a service specifically targeted to women confronted with HIV infection, in a
concerted effort with the other European helplines. Our hope is that this analysis
will enable us, on the one hand, 1) to fight more effectively, with more precise
information, against the discrimination often faced by women with HIV; 2) to
create a resource and service directory listing all the treatment and care structures pertinent to women confronted with HIV infection; 3) to propose themes for
appropriate informational materials directed specifically to women. On a broader
basis, we hope to 1) sensitize and serve as a catalyst encouraging different
actors in the service and activist domains to create new networks of services for
women confronted with and/or infected with HIV and would 2) establish a working
committee at the European level to contemplate this problematic..
23490 Estimate of HIV incidence in women of childbearing age
from population-based seroprevalence data in California
John Mikanda1, R. Sun1, F. Tabnak1, G. Rutherford2. 1Department of Health
Services, Office AIDS, 830 S Street, Sacramento, California; 2UCSF School of
Medicine, San Francisco, CA, USA
Objective: To estimate HIV incidence in women of childbearing age from serial
unlinked Survey of Childbearing Women (SCBW) data in California.
Methods: From 1990 to 1995, the SCBW in California tested 886,129 unlinked neonatal specimens for HIV-1 antibodies. Using these data, we estimated
age-specific HIV incidence among women of childbearing age. As previously
described by V. Batter et al., we used a birth-year cohort analysis to derive
annual incidence, accounting for mortality and fertility rate differentials between
HIV-infected and uninfected women. We used a 3-year moving average scheme
to smooth seroprevalence data. Additionally, assuming a Poisson distribution,
we randomly generated samples of HIV seropositive women apportioned according to the populations in observed 5-year age bands. We applied a Bootstrap
bias-corrected and accelerated method to generate 95% confidence intervals
(Cl).
Results:
Age Smoothed HIV Seroprevalence Estimated Annual HIV Incidence
Group per 10,000 per 10,000 (95% CI)
1991 1992 1993 1994 1992 1993 1994
15-19 5.46 5.74 5.75 5.06 1.69(0.94-2.26) 1.50(1.41-1.68) 0.80(0.06-1.69)
20-24 7.29 7.13 6.60 6.65 4.22(3.92-4.46) 3.76(3.41-3.97) 4.03(3.70-4.40)
25-29 8.41 6.50 7.16 7.00 2.89(2.62-3.17) 4.40(4.13-4.68) 3.98(3.81-4.33)
30-34 7.09 7.15 5.87 5.93 2.54(2.27-3.04) 1.30(0.87-1.51) 2.20(1.78-2.44)
>35 5.21 5.35 5.93 6.56 2.54 (2.14-3.88) 3.11 (2.81-3.92) 3.45 (2.91-3.83)
Total 6.69 6.37 6.26 6.24 2.90 (2.67-3.24) 2.99 (2.50-3.29) 3.03 (2.53-3.37)
Conclusions: In spite of the relatively stable seroprevalence, new infections
may still be occurring in some subgroups. Women aged 20-29 appear to be
consistently at greater risk for HIV infection. These findings underscore the need
for continued efforts in evaluating the dynamics of the HIV epidemic to ensure
sound education and prevention programs.
| 23491 | Utilization of research findings for HIV/AIDS interventions
targeted at women
Jacqueline Makokha1, R. Nduati2, R. Kamau3. 1PO. Box 11771, Nairobi;

2Naresa, Nairobi; 3Ministry of Health, Nyeri, Kenya
Issues: i) Although research findings can be used to impact positively on design
and implementation of HIV/AIDS programs, this is often not the case. ii) There is
need for integration of gender issues into HIV/AIDS policy, program planning and
implementation at the grassroots level
Project: We carried out a baseline survey to assess what programs existed
at the District level for prevention and control of HIV/AIDS in women. We then