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

450 Abstracts 23539-23542

12th World AIDS Conference

night (OR = 5.14; 95% CI = 1.65-16.74; p = 0.04); previous treatment for syphilis
(OR = 2.93; 95%CI-1.12-7.8; p = 0.004) and a history of being diagnosed and
treated for salpingitis (OR = 2.31; 95%CI =.93-5.75; p = 0.04). No statistically
significant association was found between HIV infection and marijuana use nor
any sociodemographic variables (age, education, place of work, and duration of
sex work).
Conclusions: We have demonstrated a high prevalence of HIV and syphilis
among the participants of this study. Exposure to syphilis appears to be major risk
factor for HIV. There is an urgent need for an integrated risk reduction programme
focusing on regular STD checkups, safe sex practices and drug abuse prevention
targeting this high risk population.
S23539 Druggies, junkies and sex: Towards an understanding of
the contradictions in young people's practices and
narratives of sex and drugs
Doreen Rosental, Lynne Hillier, L. Narrison, D. Dempsey, L. Matthews. Centre
for the Study of STDs., Latrobe University, Locked Bag 12, Carlton, VIC 3053,
Australia
Objectives: Given that there is Australian evidence that the sharing of injecting
equipment is declining among young homeless injecting drug users (IDUs) while
at the same time the safety levels of their sexual practices are low -: to compare the safety of the drug injecting and sexual practices of a group of
homeless young people.: to examine the drug injecting and sexual narratives of these young people for
potential avenues for sexual health interventions.
Design: Two-stage quantitative/qualitative study.
Method: From a larger sample of homeless youth who completed a survey
about their general and sexual health worries and their sexual and drug using
practices, we selected 178 (24% of the total sample) who reported that they had
injected drugs. from these, 26 were selected for follow-up interviews about their
lives, including their sexual and drug injecting practices.
Results: From the survey data, differences in the safety levels of drug injecting
and sexual practices were immediately evident. Eighty percent of the young people reported never sharing needles when they injected drugs. In contrast only 20%
of these young people reported always using a condom when they had penisvagina intercourse (35% for anal intercourse). Interviews focussed on eliciting the
narratives used by this group to describe their sexual and drug injecting practices
in order to provide an explanation of this apparent contradiction in the safety
of the different practices. Drug use was described in great detail using explicit
language whereas talk about sex was indirect and coy. Drug injecting narratives
contained two strong stereotypes of users -one a good user and one a bad user
- and there was strong evidence that, in these narratives, many of the IDUs were
identifying with the good stereotype and the clusters of behaviours linked with it,
while rejecting the bad stereotype and its attendant behaviours. There were no
stereotypical images of sexually active people in the sexual narratives and no
consistent descriptions of clusters of good and bad behaviours. The language of
the small number of interviewees who did share equipment was more ambiguous
and similar to the ambivalence of the talk around sex.
Conclusion: The absence of a public language for speaking about sex is likely
to be related to the public and private nature of the practices. The identification
of IDUs with types of people and clusters of practices may be a function of
the workings of "community". The implications of these factors for sexual health
intervention are explored.
23540 Risk behavior for AIDS among street children in Sao
Paulo, Brazil
Emily Anna Catapano Ruiz, N.J.S. Santos, R. Munhoz, E.M. Ventura-Felipe,
L.F. Jamal, A. Tayra, R. Barbosa. 1STD/AIDS Reference and Training Centre,
Sao Paulo SF, Brazil
Objectives: To study risk behavior for HIV/AIDS among street children to implement prevention actions
Design: Cross-sectional
Methods: One-hundred and forty-eight questionnaires and interviews were
carried out among 108 boys and 40 girls with ages ranging from 8-18 years
in three different areas of the city of Sao Paulo. Questionnaires and interviews
covered demographic data, data related to living in the streets, drug consumption
and sexual behavior, and knowledge of AIDS transmission and prevention.
Results: Preliminary analysis of questionnaires showed that 70% of children
had at sometime used drugs, 38.5% of which began consumption between 5-10
years of age. The most frequent drugs used were cigarettes (50%), cannabis
(48.5%), crack cocaine (46.5%), solvents (51.5%). Four percent referred injecting
cocaine and 2% admitted having shared needles. Sixty five and a half percent
referred sexual activity, beginning between 10-15 years of age for 56% of the
sample. Seventeen per cent referred always using condom, which in 21.6% of
cases is obtained at a public service. In terms of AIDS transmission the means
mostly frequently mentioned were from man to woman (49.5%), not using a

condom (48%), from man to man (40.5%), from infected needles (31%), and
from woman to man (29.5%). In terms of AIDS prevention 80% of respondents
mentioned using a condom as part of means of AIDS prevention.
Conclusion: There is an important prevalence of risk behavior among street
children in Sao Paulo, considering drag use and mainly sexual activity, but also
a knowledge of means of prevention although not driven into practical action.

Prevention actions in Brazil should target street children in order to make them
put into practice their HIV related knowledge.
|23541 | Intervention strategies in the treatment of HIV+
substance users
Dicxon Valderruten1, Walter Nieves1, Lisa Stern2. 1809 Westchester Ave., Bronx
New York 10455; 20sborne Association, Bronx, NY, USA
Objective: To present and discuss successful intervention strategies implemented
by a multi-service agency, in the treatment of HIV+ men and women with a history
of substance use and under the supervision of the New York State Division of
Parole, in the Bronx.
Design: This is a comparative analysis of two successful groups of clients;
those clients who stop their involvement with the agency upon their completion of
the LIVING-Well Program (Phase I in the continuum of services) add those who
prolong their participation in the agency through the Volunteeer Buddy Program
(Phase II). The methodology used in this analysis is strictly participant observation. Success in this study is measured by weekly samples of clean urine and
clients' recidivism (number of arrests) as they enter Phase I and II. Participants
continuing progress is also measured by weekly attendance at the program, compliance with medical follow-ups after initial referral, adherence to HIV treatment,
and the number of trainings and conferences attended or completed.
Results: This study demonstrates a substantial reduction in criminal behavior
and an increase in participation in life affirming activities, within four to six months
after entering the continuum of services. The study also describes successful
intervention strategies/concepts such as: continuum of services, multiple services
offered in one location, sensitivity to cultural issues as well as issues related to
the criminal justice system, acupuncture treatment, safe space and giving back
to the community.
Conclusion: With the appropriate intervention, HIV+ people involved in the
criminal justice system not only become productive members of society but also
learn how to live successfully with HIV.
235421 Predictors of consistent condom use among secondary
school students in Budapest, Hungary
Vanna Gyarmathy1, J. Mikl2, M. Rockenbauer3, D.L. Morse4, J. Dehovitz5,
E. Uihelyi6, S. Szamado7. 'School of Public Health - Suny at Albany, State
Street, Albany NY;3 Director - Div of INF-NYSD OH, Albany, NY; SUNY Health
Science Center, Brooklyn, USA; 3NTL Institute of Public Health Budapest,
Budapest; 4NTL Institute of Blood Transfusion, Budapest; 5Eotvos Lonard
Univ-Faculty of Sciences, Budapest, Hungary
Objectives: To assess the association of sexual behavior and condom use among
adolescents studying in secondary schools in Budapest, Hungary.
Methods: Between December 1995 and May 1996, students in a random
sample of public secondary schools (predominantly 15 to 18 years of age) were
selected and asked to fill out a self administered questionnaire on demographic
characteristics, sexual knowledge, attitudes and behavior, and condom use. Condom use was assessed as consistent (teenagers using condoms every time they
have sex) and inconsistent (teenagers who do not use condoms every time they
have sex).
Results: Of the 3534 participating students from 28 schools, 2144 (61%)
were male and 1390 (39%) were female; 1974 (56%) had ever had sex. Of the
705 (20%) teenagers who had sex in the previous five weeks, 391 (56%) were
male and 314 (45%) were female; 275 (40%) were consistent condom users.
On univariate analysis male gender, younger age, low frequency of petting in
the previous five weeks, infrequent penetrative intercourse in general and in the
previous five weeks, fewer partners per year, the initiation of condom use by both
rather then only one of the partners, shorter length of current relationship, lack
of depression, nonsmoking, absence of drug use, and being afraid of AIDS were
significantly (p < 0.05) associated with consistent condom use. We also noticed
that students who keep breaking up and getting together with their partners are
less likely to use condoms consistently. Multi variate logistic regression model
revealed male gender (adjusted odds ratio [OR] = 1.5, 95% confidence interval
[95CI] = 1.0, 2.3), younger age (OR = 1.6, 95CI = 1.0, 2.5), infrequent penetrative
intercourse (OR = 2.1, 95CI = 1.4, 3.1), shorter length of current relationship (OR
= 1.5, 95CI = 1.0, 2.2), lack of depression (OR = 1.5, 95CI = 0.9, 2.4), nonsmoking
(OR = 1.5, 95CI = 1.0, 2.2) and being afraid of AIDS (OR = 1.6, 95CI = 1.1, 2.3)
as independent predictors of consistent condom use.
Conclusions: This, one of the first studies in Hungary of secondary students'
sexual knowledge, attitudes and behavior, showed a high rate of risk activities for HIV infection. Alarming is that adolescents who keep breaking up and
getting together with their partners use condoms significantly less consistently.
AIDS education and prevention in Budapest, Hungary should utilize information
on these high risk behaviors to target secondary school population, especially
female students.