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

12th World AIDS Conference

Abstracts 23553-23557 453

Conclusion: Drug injection and needle sharing both in- and outside prison
were very prevalent in a study of nine Swedish regional prisons. In spite of this
only 3% of IDUs were HIV seropositive. One important explanation to the low HIV
seroprevalence could be the high HIV testing frequency and the peer preassure
to be open about HIV status among Swedish IDUs.
235531 HIV knowledge and risk among transgendered people in
Philadelphia
Gretchen Kenagy1, M.O. Marcenko2. 14111 Walnut Street #105, Philadelphia,
PA; 2University of Washington, Seattle, WA, USA
Objectives: To explore the knowledge of HIV/AIDS and risk for HIV infection among two groups of transgendered people (male-to-female, MTF, and
female-to-male, FTM) in Philadelphia, PA, USA.
Design: Needs assessment survey.
Methods: Transgendered people were trained as interviewers to administer
a face-to-face needs assessment survey. People were included in the study if
they agreed to take the survey and if they self identified as transgendered by
responding "yes" to an inclusion question. Knowledge of HIV/AIDS and perceived
risk of HIV infection was explored through standardized questions from the National Health Interview Survey, 1992: AIDS Supplement. Risk of HIV infection was
explored through questions about unprotected sexual practices. Respondents
were considered to be at risk for HIV infection if they engaged in any of a number
of specified sexual practices, either in the last 3 months or in the future, without
a latex barrier.
Results: A total of 70 people were surveyed, MTF (55.7%), FTM (44.3%).
The mean score for AIDS knowledge questions was 9.6 (range 4-11) for MTFs
and 7.8 (range 0-11) for FTMs. The majority of MTFs and FTMs (57.2% and
66.7% respectively) said their chances getting HIV/AIDS were none or low. The
majority of MTFs and FTMs (70.0% and 93.3% respectively) reported engaging
in unprotected sexual practices in the past 3 months and reported they would
(66.7% and 86.2% respectively) engage in unprotected sexual practices in the
future.
Conclusion: The wide range in level of knowledge of HIV/AIDS and unprotected sexual practices of respondents indicate a strong need for HIV prevention
and education services among transgendered people in Philadelphia.
23554 Syphilis, hepatitis and HIV prevalence among low income
female sex workers in the city of Sao Paulo, Brazil
Josefa Laurindo Silva1, I. Silva Carvalho2, E.A.C. Ruiz3, M.C.A. Palhares3,
J.R.P. Marins4, M. Ueda5, M.A. Campagnoni6. 1Rua Frei Caneca, SSao Paulo;
2SSao Paulo State AIDS Programme, Sao Paulo, SP; 3Health Department of
Soo Paulo State, Sao Paulo; 4Socoraba Minicipal STD/AIDS Programme,
Sococaba, SP; 5Institute Adolfo Lutz, Sao Paulo, SP; 6Health and School Center
Barra Funda, Sao Paulo, Brazil
Objectives: To determine the prevalence of syphilis, B and C hepatitis and HIV
infection in a park in the central area of Sao Paulo city.
Methods: Females working as prostitutes during the day in a park were invited
to participate in a one-week health campaign, carried out at a public health
centre. Female sex workers received gynaecologic and medical treatment. They
also answered a questionnaire and those who agreed had a blood sample taken
for HIV, syphilis and hepatitis.
Results: Ninety-six female sex workers attended the one-week health campaign. Of these seventy-three answered the questionnaire and had a blood
sample. Of these 64.5% were between 20-39 years and 47.8% were of elementary school level. Of the 73 sex workers, 97.8% reported always using condoms
for vaginal intercourse with clients, and 33.7% used them with steady partners
and/or known clients. Prevalence of the diseases investigated were: Hepatitis C
- 10.3%; Hepatitis B - 43.6%; Syphilis - 36.9%; HIV infection - 17.8%.
Conclusions: It is fundamental to guarantee female sex workers access to
public health services. It is necessary to establish continuous educational programmes to effectively reach this population.
23555 AIDS in prisons - The history of life in prison as an
indicator of risk from HIV infection
Jose Ricardo Pio Marins1, Marilisa Berti Barros2, R.B. Campos Filho3. 1Rua
Senador Vergueiro, No. 147, COD 18035-400; 2Unicamp DMPS, Campinas;
3Coordenagao Nacional DST/AIDS M. Saude, Brasilia, DF, Brasil
Objectives: To verify the association between HIV infection and male prisoner's
life history and to assess the reliability of the use of such history as an indicator
of risk in Brazilian prisons.
Design: Cross-sectional study.
Methods: This study was carried out in 1995 among 1065 prisoners in Sorocaba, a city in the state of Sao Paulo, Brazil. Prisoners volunteered for interview
and HIV testing. Interview questions regarded: social-demographic variables,

behaviors of risk for HIV infection, risk perception, previous HIV testing and life
in prison (number of detentions, type of crimes committed, overall time of imprisonment in life and of current imprisonment, and time of condemnation for current
crime). Information was obtained from official records and voluntary interviews
with prisoners. Serologic diagnosis was performed using Elisa and IFI (indirect
immunofluorescence). Inconclusive HIV results were excluded.

Results: Of the 1065 inmates, 929 participated in the study. The prevalence
of HIV infection was 12.5%. The factors associated with HIV prevalence were:
number of imprisonment in life (Prevalence Ratio-PR = 3.71 2.18-6.32), time of
imprisonment in life (from 61 to 85 months, PR = 2.62 1.04-6.61), time of current
imprisonment (up to 5 years, PR = 2.26 1.10-4.64). Type of crimes committed
like drug dealing (PR = 1.63 1.04-2.57) and theft (PR = 1.55 1.08-2.24) were
also asssociated with HIV infection. Prisoners with short condemnations periods,
such as theft and drug dealing, presented high HIV prevalence.
Conclusions: Detention history of prisoners allows identification of those with
high chance of infection. Therefore, it is considered a positive risk indicator. Prisoners condemned for drug dealing and/or theft, with several previous detention,
long detentions time periods, and with imprisonment up to 5 years in the current
detention, are the most affected by HIV infection. Therefore, they should be
targeted by prison health services.
23556 | Health and sexuality workshop for psychiatric inpatients
Suelybroxado De Oliveira. Rua Barao De Itapagipe 45/401-A Rio De Janeiro
20261-000, Brazil
Issue: Mentally ill patients run a high risk of contracting and transmitting STD/AIDS
because they have no access to relevant and appropriate preventive education,
they are vulnerable to sexual abuse and, due to lack of reasoning they may
increase reckless behaviour while in hospital.
Project: Considering that some psychiatric disturbances might lead to an
increase of sexual activity during a time of crisis, men and women living together in a psychiatric ward may be the cause to sexual intercourse without
any preparation or protection. Discussing the occurrence of sexual intercourse
is one strategy to avoid risky behaviours. Thus, the programme "Prevention of
transmission of STD/HIV among psychiatric inpatients of the Psychiatry Institute -
Federal University of Rio de Janeiro" was successfully implemented in July 1997.
The programme aims at discussing themes related to the care that should be
taken with health and sexuality, highlightening the importance of prevention of
STD/AIDS, inside and outside the institution. When patients are discharged from
hospital they receive preservatives and are taught and oriented on how to use
them.
Results: O workshop has shown the importance of discussing issues related to
the sexual life of inpatients as a way to preserve their sexual health and prevent
risky behaviour while in hospital. As the work progresses, we can notice that not
only are those inpatients more aware of the risk they run, but they also help to
protect those who have not yet received orientation.
Lessons Learned: Talking freely about sexuality is certainly an effective way
of preventing risky behaviour in a psychiatric ward.
23557 Empowering young women being trafficked/migrating for
sex work across the Bangladesh/India border
Md.Enamul Kabir. Hasab, 83/1 Ring Road BI.-F, Shyamoli, Dhaka-1207,
Bangladesh
Issues: Young women in poor Bangladeshi border communities are highly vulnerable to STDs and HIV - due to being trafficked or migrating for sex work in
India where infection levels are high.
Description of Project: With technical support from HASAB NGO Support
Programme, Association for Community Development (ACD) started with a participatory community needs assessment. It found a large mobile population
dislodged from social, religious and cultural norms exposed to multiple factors
related to high risk behaviour. It found: * Young women being trafficked across
the border - often sold for marriage in India and ending up in brothels, * Women
migrating to India to sell sex, buy goods and then return, * Men refusing to use
condoms, and women unable to negotiate safer sex, * No local STD services. In
response, ACD developed an initial programme to build a close relationship with
both men and women in the community, raising awareness about general and
social issues in group and one-to-one meetings. As the rapport grew, they gradually discussed STDs and HIV/AIDS and promoted safer sex practices, including
condom use. They also mobilised local leaders and trained traditional healers
and birth attendants.
Results: Local peoples' awareness about sexual health has risen, and they
now openly discuss sexuality,' Local leaders are now committed to HIV/AIDS
work, Demand for condoms is increasing, ACD is developing a second programme phase to beyond awareness raising" - to encourage behaviour change,
povide STD services and address contextual issues (Particularly the subordinate
status of women).
Lessons Learned: It is vital to: - Build a close relationship with people in the
community, especially to discuss sensitive issues, - Address the specific selfesteem add health needs of young migrant women, including ways to empower
them through peer involvement, Not just promote condoms, but create enabling
environment

23558 1AIDS Surveilance and education project among RFSW
and MSM
Marian Virgie Gumayan, B.T.P. Polido. Central Phillipine University, Kabalaka
Reproductive Health Center, Iloilo City, Philippines
Issue: There is a need to prevent the incidence of STD/HIV through educa