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

440 Abstracts 23491-23495

12th World AIDS Conference

called a workshop aimed at providing a forum for a two way exchange between
researchers and district level health managers. Nine months after the workshop
an assessment was done to find out the impact of the workshop on district AIDS
activities.
Results: There was a positive influence on activities at the district level. The
workshop had had a positive impact on target groups for the districts' information
education (IEC) and communication activities. The focus had become more gender sensitive and age specific. Participants had used research findings presented
at the workshop as a guide to re-focus their HIV/AIDS prevention and control
strategies and directly as part of their information and education activities.
Lessons Learned: More concerted and ongoing efforts to target grassroots
program implementors with research findings that can be of use in implementation
of HIV/AIDS activities need to be undertaken.
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
called a workshop aimed at providing a forum for a two way exchange between
researchers and district level health managers. Nine months after the workshop
an assessment was done to find out the impact of the workshop on district AIDS
activities.
Results: There was a positive influence on activities at the district level. The
workshop had had a positive impact on target groups for the districts' information
education (IEC) and communication activities. The focus had become more gender sensitive and age specific. Participants had used research findings presented
at the workshop as a guide to re-focus their HIV/AIDS prevention and control
strategies and directly as part of their information and education activities.
Lessons Learned: More concerted and ongoing efforts to target grassroots
program implementors with research findings that can be of use in implementation
of HIV/AIDS activities need to be undertaken.
23492 Women in contact with the gay and lesbian community:
Sydney Women and Sexual Health Survey 1996 and 1998
Juliet Richters1, S. Bergin2, S. Lubowitz2, G. Prestage1. 'National Centre in HIV
Social Reseach, MacQuiarie University NSW; 2AIDS Council of NSW, Sydney,
NSW; National Centre in HIV Epidemiology, Sydney, NSW, Australia
Background: The AIDS Council of NSW's services for women (including needle
and syringe exchange) are used by many women from the gay and lesbian
community. This study was implemented to describe HIV risk related to sex and
drug use among women in contact with Sydney's gay and lesbian community.
Methods: Self-complete questionnaire distributed to volunteers at gay and
lesbian community functions, venues and health services
Results: In February 1996, 585 women completed the survey. Almost all
had some social contact with gay men. 27 respondents (5%) were transgender.
Most (72%) had post-school education. 58% thought of themselves as lesbian/homosexual, 15% as bisexual, 21% as straight/heterosexual. 159 women
(26%) said they had ever had sex with a gay or bisexual man; 42 women (7%)
had done so in the past 6 months. About 1% of the lesbians said they had had
sex with a gay or bi man in the past 6 months, as had 6% of the heterosexual
women and 29% of the bisexual women; for 20 women this sex was unprotected.
In the past 6 months, 55 women (9%) had done sex work and 71 women (12%)
had injected drugs. Most injectors were under 35. 40 women had injected drugs
with a gay or bi man and 8 had shared equipment; 26 of the 40 women had also
had sex with a gay or bi man.
The survey was repeated with a larger sample and improved questionnaire in
February 1998 and the results will be presented.
Conclusion: Results show high rates of injecting drug use and some unsafe
sex. Reported sexual identity did not exactly correspond to sexual practice; some
lesbians had sex with men. Bisexual women were more likely than heterosexual
women to have had sex with gay or bisexual men. Women in this milieu are at
much greater risk than women in the 'general population'. The men they have
sex with are more likely to be HIV positive. For a case of so-called 'heterosexual'
transmission of HIV to occur, neither person need be heterosexual.
|23493 The social ecology of drug using women's sexual risk in
East Harlem, NYC: An event analysis
Stephanie Turto, J.M. McMahon, R. Hamid, S. Neaigus. National Development &
Research Ins TS., Inc., 2 World Trade Center, 16 fl. NY, NY 10048, USA

Background: The HIV epidemic is a human biological phenomenon fueled by
risk behaviors enacted within personal relationships and diverse social settings.
This study will 1) describe recent sexual events of drug using women in a NYC
community with a high prevalence of drug use, HIV infection, and AIDS; and 2)
identify the determinants of event-specific condom use. "Event analysis" provides
unique information not obtained in standard epidemiological surveys.

Methods: Data from 112 heterosexual events with and without condom use
were obtained in structured interviews with 87 women; all were offered HIV testing/counseling. Women were 52% Latina, 39% Black; 37% drug injectors; 45%
crack users. Drug use was verified by urinalysis. The interview measured 1) relationship-specific factors (e.g., partners' demographics and HIV serostatus; nature
and duration of relationship); and 2) event-specific factors (e.g., time, location,
sexual repertoire, use of injection drugs, crack, and alcohol, perception of intimacy
and control, discussion of condom use, perception of risk). Repeated measures
analyses (ANOVA or McNemar's) identified differences between sexual events
with and without condom use. Multivariate logistic regression analysis identified
significant independent determinants of event-specific condom use.
Results: 1) Differences (p <.05) between events with and without condom use
were found on both relationship-specific and event-specific factors. 2) Determinants (p <.05) of event-specific condom use were: discussing condom use with
partner (OR = 32.0; CI = 18.1-48.7); and women's perceived control of condom
use (OR = 2.8; CI = 1.1-7.3). Cunnilingus during event predicted no condom use
(OR = 4.7; CI = 0.8-26.6).
Conclusions: Interventions to reduce sexual risk among drug using women
in high risk communities should address relationship issues relating to sexual
communication and control in the relationship. Event analysis is a method which
shows promise for identifying contextual factors that may be overlooked when
investigating risk on an individual level.
S23494 Epidemiology of HPV-infected women in Ho Chi Minh City
(Vietnam), 1996-1997
Hoang Anh Dang', D.T.T. Ton2, L.T.T.T. Trinh2, P.T.T. Tieng2, N.T.B.L. Lien1,
C.T.B.N. Nam', N.T.T.V. Van1. '664/109 Nguyen Dinh Chieu 03,
Dermatovenereology Hospital, Ho Chi Minh City; 2University of Medicine, Ho Chi
Minh City, Vietnam
Objectives: To describe the epidemiological characteristics of HPV - infected
women attending the Dermato-Venereology Hospital of Ho Chi Minh City.
Design: Retrospective study.
Methods: Review medical charts of all HPV - infected women attending the
out patient clinic from January 1st 1996 to December 31st 1997. Patients were
screened for HIV (Elisa), Syphilis (VDRL) Gonorrhoea (Culture), Trichomoniasis
(Saline wet mount), Candidiasis (KOH smear) and Bacterial vaginosis (Gramstained smear).
Results: During this period, 685 HPV - infected women were seen. Mean
age was 30 (range 3-72). 577 patients (84.2%) lived in Ho Chi Minh City and
108 (15.8%) in differents provinces. 664 (96.9%) were married and 21 (3.1%)
single. 63 (9.2%) were pregnant, 43 (6.3%) had 1 child, 14 (2%) 2 children,
3 (0.4%) 3 children, 6 (0.9%) 4 children, 1 (0.1%) 8 children and 555 (81%)
no child. 635 (92.7%) were infected by sexual contacts with their husband, 46
(6.7%) with their male partner an 4 children by unknown mode of transmission.
(All these husbands and partners had previous sexual contacts with CSWs). 492
(71.8%) were housewives, 190 (27.7%) had job and 3 (0.4%) were students.
Incidence of associated STDs: 75 cases (10.9%) had Candidiasis, 31 (4.5%)
Trichomoniasis, 9 (1.3%) Gonorrhoea, 9 (1.3%) Syphilis, 5 (0.7%) Bacterial vaginosis, 1 (0.1%) Genital ulcer, 1 (0.1%) Molluscum contagiosium. 684 (99.9%)
were HIV seronegative, 1 (0.1%) had an HIV positive status before getting HPV
infection.
Conclusion: These patients will be exposed to HIV infection if their partner
continue to have unprotected sex with CSWs. Agressive efforts are needed to
increase awareness of HIV/AIDS infection and to promote condom use among
these population.
223495 Women with AIDS: Transmission and prevention
strategies
Leticia Vermelho. Rua Benjamin Constant 55 Apto. 503, Brazil
Objectives: To describe transmission profile, the impact of AIDS on women
and their children lives, health care provided and to point out proper prevention
strategies.
Design: Case stories interviews through semi-structured questions, qualitative
approach.
Methods: Thirty-five issues including age, occupation, partnership, diagnosis
date, and health care provided, previous stories of STD, hepatitis and other
infections, partnership status related to AIDS, intravenous drug use, blood transfusion vertical transmission and analysis categories concerning gender, social
behaviour related to the HIV transmission, imaginary about STD/HIV, sexual negotiation, condom use, economic and emotional dependency, familiar, occupation
and social context were approached through the case stories interviews of twenty
women with AIDS, from the university hospital wards.
Results: The majority encompassed elementary tasks or were housewives,
they were married or widows of HIV/AIDS men. 20% reported previous blood
transfusion or intravenous drug use, 35% reported previous STD and 15% hepatitis. 20% reported vertical transmission, they had never received AZT or any

kind of therapeutic for prevention. Their diagnosis remained late, poverty and
unemployment prevail.
Conclusion: So far epidemiologic, economic, cultural and gender profile of
these women dismystifies the misunderstanding that links the HIV transmission
to the promiscuos and drug users women only. Moreover, It points out to the issue
that sexual transmission prevails and preventive strategies should necesseraly
include the housewives, small tradeswomen and those at low level of literacy. HIV