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

12th World AIDS Conference

Abstracts 24102-24106 461

known about how injection practices may effect viability and new methodological
approaches are needed to examine this question.
Project: Rather than relying upon post-hoc, self-reported descriptions of behavioral processes, we employed direct observational (ethnographic) techniques
to model drug injection processes for use in laboratory studies of viral viability.
Ethnographic research was conducted in NYC and Denver, cities chosen for
their contrasting background seroprevalence, density of IDU's, drug types, and
associated drug injection practices.
Results: Direct observation of drug injection events was used to develop a
quantitative database of drug injection practices (NYC N = 151, Denver N =
100). Data include an inventory of drug paraphernalia, types and forms of drugs,
measures of technical practices of preparing drug solutions (volume, dilution,
source and duration of heat), descriptions of the influence of environment on
injection practices, and mapping the position and role of participants in each step
of the drug acquisition, preparation, and injection process.
Lessons Learned: Ethnographic observational methods are a useful tool in
delineating and measuring the behavioral processes that may effect viability and
transmission of viral infections. These data can be used to improve the validity of
laboratory studies and also to identify specific components of the drug injection
processes which may be amenable to intervention.
24102 Identities and social organisation: An ethnographic study
in the AIDS voluntary sector in Rio de Janeiro, Brazil
Carlos G. 0. Do. Valle. Dep. of Anthropology, University College, Gower St.,
London, NWC 1E6BT, UK
Issues: This study examines issues related to the processes of social formation
and learning experienced by people infected and affected by HIV and the AIDS
epidemic in Rio de Janeiro, Brazil. Identity construction is a personal and social
process that may be complex and plural concerning some variables at stake:
gender, sexuality and illness. A social setting like an AIDS support group can
provide particular conditions for these processes, specially if they are framed
by a specific cultural context as happens with Brazil. Serologic disclosure, AIDS
stigma, sexual expression and forms of embodiment are key themes for these
processes of identity construction.
Project: Grounded in an urban ethnography, I have conducted research in the
Brazilian voluntary sector in Rio de Janeiro. Although some other non-governmental organisations have been visited, I have prioritised fieldwork within one
particular self help organisation: the Grupo Pela Vidda. Participant observation,
in-depth interviews, telephone research, and a small survey are the major chosen
methodologies. A longitudinal perspective has been also used for a historical
understanding of this organisation and the voluntary sector since the eighties.
Results: Informants have stressed that AIDS has caused a huge impact in
their lives. Support groups, like the Pela VIDDA, provide social conditions for the
emergence and the reshaping of social identities and also for the social management of HIV/AIDS. Through joking relationships, humour can be also used by
organised PWA in a distinctive way to express serologic status, gender difference
and sexual orientation.
Lessons Learned: Ethnography can focus on particular aspects of PWA's
social life that are still neglected by social research, such as the relation between
identity and sense of humour. This is particularly important considering the pervasive negative association between death and life with HIV/AIDS in a society
such as Brazil.
24103 The role of migration in the transmission of HIV among
injecting drug users (IDUs) along the US-Mexico border
Joao Ferreira Pinto1, R.L. Ramos2, M.E. Ramos3. 1Lopez Mateos 848, CD
Juarez Chihuahua; 3Programa Companeros AC, CD Juarez, CN, Mexico; 2US
Mexico Border Health Association, El Paso, TX, USA
Issues: While the US-Mexico border has long been associated with injecting drug
users (IDUs), little attention has been focused migrant IDUs social networks and
social worlds.
Project: This study examines how IDUs decisions during the migration process
can be explained by a decision-making model balancing risks and rewards at
three distinct levels: Individual levels by such factors as risk taking, and other
factors influencing the decision to migrate, family and peer group level IDUs by
existing social networks and how during their travels IDUs relate to community
level, at the destination point, by adaptation strategies used to survive in the new
environment in-depht interviews were conducted with 30 IDUs residing USA and
Nexico to elicit information about motivations to migrate, social support before
migration, and upon return.
Results: The studies findings are that migrations undertaken and search of
better economic opportunities and the drugs are not a motivating factor to initiate
migration. Drug taking is continued during the migration as any habit would,
such as smoking. Given the same economic rewards at home, IDUs would not
have taken the risk of being apprehended in the USA. During their migration
they depended on a network of camaradas (acquaintances) who enable them to

travel, to work.
Findings from this research will help guide the development of targeted HIV
prevention strategies which would take into account the migrating IDU special
needs and lifestyles. Drug rehabilitation and treatment initiatives could also use
this information to refocus their efforts on these mobile populations.

24104 The articulation of community in AIDS public policy: HIV
prevention community planning
Liisa Randall. Michigan Dept of Community Health, HAPIS/MDCH PO Box
30195 Lansing Ml 48909, USA
Issue: Through the community-planning process, representatives of infected and
affected communities play a key role in informing HIV prevention policy and
directing decisions about HIV prevention programming and resource allocation.
Project: In 1994, the Centers for Disease Control (CDC) and Prevention mandated that all state health agencies implement community-based planning for HIV
prevention as a condition of continued federal support. Through this process,
infected and affected community representatives share responsibility with state
health agencies for development of a comprehensive approach to HIV prevention. Using qualitative research methods, including participant-observation and
key consultant interviews, this research examines the ways in which conceptions
of "community" both inform the process of planning for HIV prevention and are
articulated through the planning process. HIV prevention community planning as
implemented in Michigan is used as a case study.
Results: Stakeholders in the community planning process express widely differing conceptualizations of "community". Even among affected/infected community
representatives, there is often little agreement on what constitutes "authentic"
representation of a community. Stakeholders also express differing views on the
types of expertise required to inform and guide policy and program decisions. The
variability in ways in which "community" is conceptualized, coupled with differing
views on what constitutes expertise appropriate to craft HIV prevention policy and
program has contributed to a planning process which has often been difficult and
contentious but also tremendously valuable in improving prevention services and
influencing public policy.
Lessons Learned: Representatives of infected and affected communities can
and should participate in development of HIV prevention policy and programming.
Achieving consensus on authentic community representation and needed areas
of expertise is critical to ensuring a productive participatory planning effort.
24105 An ethnographic study of factors associated with HIV
risk behavior among young men who have sex with men
David Wyatt Seal, F.R. Bloom, L.Y. Stevenson, J.A. Kelly, B. Coley, L. Broyles.
CAIR Med College of Wl 1201 N Prospect Ave Milwaukee WI 53202, USA
Background: Young men who have sex with men (YMSM) - and especially
YMSM of Color - continue to contract new HIV infections at a high rate. Yet, little
is known about the patterns of HIV risk behavior among YMSM.
Methods: Extensive ethnographic observations of YMSM (aged 15-25) were
conducted in two US cities (Milwaukee and Detroit) over a 12-month period in
both gay- and non-gay-identified venues (including several targeting MSM of
Color). Detailed field notes were summarized and thematically content coded in
accordance with Principles of Grounded Theory Analyses. We present data on
environmental and socio-sexual venue characteristics associated with HIV risk
behavior.
Results: Venue characteristics associated with increased anonymous or higher
risk sex, included: (a) being a public sex environment (vs. social environment); (b)
increased drug/alcohol use; and (c) low sexual and/or drug use vigilance by venue
staff (e.g., open activity allowed or not allowed). Characteristics associated with
decreased risk, included (a) structural barriers (e.g., well-lit venue; few private
spaces); (b) venue-based norms toward open sexual communication and condom
use; (c) condom availability within or near the venue; and (d) venue attendance
by groups of patrons (vs. attendance as individuals). Characteristics which were
inconsistently associated with HIV risk behavior, included (a) openness of MSM
behavior (covert to overt); and (b) range of patron diversity (e.g., gender, ethnicity,
sexual orientation).
Conclusions: Our findings highlight the importance of both socio-sexual and
environmental influences on HIV risk behavior, and illustrate the need to develop contextualized interventions when developing venue-based HIV prevention
programs. Prevention programs which promote safer sex within the naturally
occurring venue culture are more likely to be successful than standardized programs.
S24106 HIV risk transmission in Mexican injecting drug women
Raul Ortiz Mondragon1, A. Ruiz-Badillo2, C. Magis-Rodriguez2, R. Lozada3,
R. Ramos4, J.B. Ferreira-Pinto4, M.E. Ramos4. 1 Calz. De Tlalpan 4585 2do Piso
Col. Torie, LLO Guerra C.P 14050 Mexico, D.F; 2AIDS National Council, Mexico,
D.F; 3Ministry of Health, Tijuana, Tijuana; 4Programa Companeros, CD. Juarez,
Mexico
Objective: Evaluate the context of HIV risk behavior among female injecting drug
users (IDU's) at two Mexican cities in the border with the United States.
Method: Ethnographic study consisting in the analysis of in depth interview
with females IDU's (3 in a treatment clinic and 4 prisoners); 8 ex-IDUs that work
in NGO's with work in drug prevention and other 6 persons that work in the state

jail (3 physician, 1 lawyer ant 2 customs). The IDUs interviewed are peoples with
mainly high level of dependence to heroin.
Results: Commonly the Mexican female have reduced opportunities of hard
drugs use and frequently are stigmatized for the same male IDUs because of
the practice of sexual commerce, these women with strong addiction have grater
risk of HIV infection than male IDU's. The majority of female UDI's are sexual
partner of IDU's, but this is not the case for male IDU's. For these women is