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

462 Abstracts 24107-24111

12th World AIDS Conference

easier to obtain money through sexual commerce, compared with the males that
are poorer and have an erratic economic. This may be crucial for the gender
difference. IDUs women engage with multiple sexual partners for money or drug,
they also share syringes with partners or other persons. They reported being
intoxicated during most sexual intercourses, and rarely used condom.
Conclusion: The context of HIV risk behavior for female IDU's is associated
with gender differences, those women with a strong drug dependence problem
likely are at a higher sexual risk of acquiring HIV than men.
24107 Variation in patterns of methamphetamine use and HIV
risk in selected populations: Social Impact and
methodological considerations from a 5 site US study
Alfred Pach1, E.M. Gorman2, Z. Sloboda3, R.N. Needle3, E.Y. Lambert3. 1NORC
1350 Connecticut Ave NW Suite 500, Washington DC 2003E; 2University of
Washington, Seattle WA; 3Nida, Rockville MN, USA
Issue: To develop a rapid community assessment process using ethnographic
and epidemiological methods and to assess social impact of methamphetamine
and HIV risk
Project: Methamphetamine is currently the most widely used synthetic drug
in the United States and use has reached epidemic proportions. Research on
the community context, pattern of use, and social impact of the drug in relation
to HIV risk behaviors represents a critical challenge to public health and drug
abuse prevention. Given the stigma attached to the drug and its widespread
use in hidden populations, the National Institute on Drug Abuse commissioned
the University of Washington's Alcohol & Drug Abuse to test a pilot approach
to the problem with the goal of describing sociodemographic characteristics of
users, methamphetamine natural history and current use information about social
and community settings, associated HIV risk behavior, and self-reported and
perceived individual and community consequences.
Results: One hundred interviews were conducted (70 men, 30 women) in 5 US
sites. The ethnographic approach proved especially useful in a range of different
macroenvironmental contexts, from those of high methamphetamine prevalence
and considerable community impact, to those sites only recently impacted by the
drug's diffusion. Social impact, as measured by treatment incidence, lab seizures,
increases in social services caseloads, self-reported HIV risk behavior and selfreported methamphetamine use among HIV positive individuals and those at risk
for HIV, varied across sites, with more pronounced impact in the Western United
States. However, the study provided clear indication of deleterious consequences
of methamphetamine use on all groups.
Lessons learned: This emerging drug epidemic appears to be moving from
West to East in the US in the context of high HIV prevalence. The study demonstrated the utility of targeted ethnographic studies which serve to shed light on
stigmatized and hard to reach populations. In addition, the study documented
the substantial need for additional ethnographic and epidemiological research on
methamphetamine as well as the need for more effective outreach, prevention
and treatment.
S24108 Challenge to prevent HIV/AIDS in the intercultural
context: The Brazilian experience among indigenous
people
Marcos Pellegrine, I.F. Brito, M.C. Pimenta. Brazilian AIDS Program ESPL.
Ministerios BI.G Brasilia DF, Brazilian AIDS and STD Program, Brasilia, DF,
Brazil
Issue: There is about 326.000 indigenous people living in Brazil, comprising 215
indigenous ethnic groups and 170 different languages. This population occupies
about 11.13% of the national territory in 25 states but concentrated in the Amazon
region. They have little access to information and health services. The first case
of AIDS was notified among the Xokleng in 1986. Today we have 22 indigenous
people living with AIDS. The cultural diversity and negative impact of the evolving
society on their culture are the major difficulties to reach and to promote an
effective strategy of HIV/AIDS prevention.
Project: In order to reach this population a strategy was developed with
three major components: 1) Identification of risk factors associated with sexual disease transmission, related to: seasonal mobility, development projects in
the indigenous areas, prostitution, inter ethnic contact, and the use of the psychoactive substance; 2) Promotion of peer education in the primary indigenous
schools and community; 3) Production of educational materials through community participation stimulating the use of native language and culturally appropriate
representation.
Results: 1) data base about sexual disease and risk factors related to social
and cultural context; 2) development of preventive education in the indigenous
schools and training of trainers for indigenous health agent in STD/HIV/AIDS
prevention.
Lessons Learned: The knowledge of intercultural context and risk factors associated with STD/AIDS are very important to identify the vulnerability condition
of the indigenous people and the definition of the prevention strategies.

24109 1 Voices from within: A qualitative study of participants of
an epidemiologic seroprevalence study of intravenous
drug users
Susan Sherman, C. Latkin. Johns Hopkins Univesity, 220 East 31st Street #4
Baltimore MD, USA
Issue: There is little information about how participants of a long-term seroprevalence study of intravenous drug users' view the study in terms of benefits and
reasons for participation.
Project: The purpose of this study is to gain a deeper understanding as to
the motivations for and reactions to participating in a longitudinal epidemiologic
study (LES) of HIV seroprevalence among intravenous drug users. LES is in
its eleventh year, and participants are interviewed and receive HIV and TB test
twice a year. Through 20 interviews with LES participants, this qualitative study,
"Participants Voices," seeks to: identify an emic perspective of research, why
people participate in the study; how their feelings affect their responses to the
study questionnaire; and how the participants feel that the study reflects their lives
as iv drug users. The study is guided by an open ended instrument. Interviews
and anonymous and last one hour in length.
Results: Preliminary analyses have shown that most study participants view
LES as their primary source of health care. As stated by a 36 year old African
American woman, "When people find out that they take the AIDS test, the TB test,
a lot of people want to get in it cause a lot of people just don't have insurance.
"Another finding is that participants are more likely to remain in the study because they are treated like "complete human beings and not just addicts." Lastly,
participants feel that their participation in LES is a way of contributing to their
community. As stated by a 40 year old African man who is HIV infected, "God
has got me here for a reason and if I can share the things that's been happening
to me and the things that I'm going through maybe it will help somebody else,
maybe it will definitely help one of my immediate family. I feel that by bein' in LES,
I'm gettin' the tools that educate my kids."
Lessons Learned: Participants of LES remain in the study because of unanticipated benefits of emotional and instrumental support. LES participants feel they
are aiding their community through their participation. This open ended qualitative
study provides an opportunity to gain insight into the reasons why people continue
to participants in research and the meaning such participation has in their lives.
Epidemiological studies could benefit from the inclusion of qualitative research of
their study participants to inform the ongoing research process.
24110 1 The coming out process among gay youth in the era of
AIDS: A suggestion for a model
Yves Jalbert. Universite De Montreal, 8640 Avenue D'Allonnes Villed'Anjou
Quebec H1J 1W7, Canada
Objectives: To better understand the coming out process of young gays, between
16 and 20 years in the era of AIDS.
Design: From a qualitative research perspective using the grounded theory,
this study puts together the main events associated with the coming out process
among young gays.
Methods: Among 26 gays recruted, 11 have not told their parents about their
sexual orientation. From the personnal trajectory of our participants and a review
of literature on the coming out process, we proposed a model of coming out
for the gays. Our model is composed of four phases: pre-coming out, coming
out, post-coming out and retro-coming out. We documented the first phase, the
second phase is embryonic and the two others are hypothetical.
Results: From the youth interviewed, the coming out process is considered
has a life time presence cycle in the gay milieu where the individual evolve. The
pre-coming out represents the clandestinity of homosexuality. The individual is
aged between 13 to 20. He is in the closet and he is preparing his coming out that
will lead him to told his parents about his sexual orientation. At this stage, he is
trying to demystify homosexuality. The coming out is when the individual is facing
an euphoric moment that will lead him to adopt sexual behaviours that can imply
risky situations. He is aged between 20 to 30. At this stage, he is exploring the
gay culture. The post-coming out is caracterized by the desire of an individual to
be in a relationship. The bars do not satisfy him anymore and he wants to settle
down, to built a couple. He is aged between 30 to 40. The retro-coming out is the
phase where an individual is forced to quit the gay milieu because of his age, his
physical appearance or his involvement in a relationship. He is aged over 40.
Conclusion: Understanding the coming out process provides a lot of informations especially for whom is working in prevention and education. For the gay
youth, the coming out represents the phase where the sexual risky behaviours
are at their climax because they experiment the effects of the euphoric moment.
This study has been supported by grant #6605-5190 47A from NHRDP of Health
Canada.
24111 An analysis of young Quebecers' thoughts on love and
sexuality, STDs and AIDS

Christian Fortin1, Mario Champagne2, Michel Villeneuve3. 12400 Rue
D'Estimauville Beauport; 2CSP Quebec; 3Ministere De L'Education Quebec,
Canada
Objective: To describe teen culture on the basis of a selection of stories written by
participants in the LOVE LIFE! LOVE SMART! contest. The purpose of the contest
was to give young Quebecers between the ages of 14 and 25 the opportunity