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

12th World AIDS Conference

Abstracts 24185-24188 477

Methods: 1600 individuals who aged 15-49 and lived in Shiraz city and three
other urban areas comparted by cluster sampling strategy into 80 clusters. Data
was collected through individual interviews using a somewhat modified Persian
version of standard KAB instrument developed by SBS.GPA/WHO.
Results: The following table shows some selected responses of males (M) and
females (F) who questioned by interviewers:

Questions/Responses
1. Hearing of "AIDS":
Yes
No
2. Causes of AIDS:
Virus
Microbe
Homosexuality
Infected syrings
Sexual intercourse
Addiction
3. Routes of transmission:
Infected syring
Transfusion of infected blood
Sexual intercourse with an infected man or woman
4. Who are at higher risk for HIV infection:
Homosexual man
Immoral people
Persons who do not respect rules of hygiene
Drug addicts
Communication with infected persons
5. Sources of Information on AIDS:
Television
Newspaper & Magazines
Radio
Combination of above
6. Perceived fatality of AIDS:
All will die
Most will die
Some of them will die
7. Perceived threat of AIDS to the local community in
future as a serious threat:
8. Who should look after people with AIDS:
Nurse/hospital
Family/relatives
Doctor
9. Willingness to undergo to share test results with:
Spouse
Family
10. Willingness to undergo HIV testing if necessary:

M (%)
86.0
14.0
12.0
2.6
33.6
2.6
30.4
9.5
79.0
77.0
81.0
27.0
7.7
7.1
4.5
4.9
25.4
18.3
6.3
24.4
29.3
35.0
10.9
49.6
34.9
13.4
6.8
79.2
72.3
82.0

F (%)
71.0
29.0
7.0
4.1
27.8
1.8
3.8
4.1
62.0
58.0
62.0
15.0
5.4
6.5
3.2
4.7
28.4
8.7
8.5
22.0
16.1
30.3
12.5
41.9
39.4
18.9
8.0
75.2
65.9
72.4

Conclusion: Results of the present survey can be used as guides on the existing areas of ignorance, misinformation and prejudice that need to be corrected.
They can also indicate some of the most widely available and popular channels
for reaching different segments of the population. Although the generalizability of
the findings to the total population of Iran cannot be taken for granted, there are
indications that the sample was not in fact too different from the average of the
urban population of the country.
24185 The PCP index: An access and quality of care indicator
for HIV disease
Peter Arno', Ernest Drucker2, Jing Fang3, Robert Padgug3, Marc Gourevitch2.
'Dept Social Medicine Montefiore Med Ctr, 111 East 210 Street Bronx, NY
10467; 2Montefoire Medical Center, Bronx, NY; 3Albert Einstein College of
Medicine, Bronx, NY USA
Objective: To develop a population-based, PCP hospitalization index for persons
with HIV disease which may be useful as a measure of access to and quality of
care.
Design: Small area analysis using hospital discharge and AIDS surveillance
data.
Methods: The PCP index can be defined as the number of persons hospitalized
for PCP by zipcode of residence divided by the number of persons living with
AIDS in each zipcode. Hospital discharge data are used to identify persons with
AIDS who are hospitalized for PCP. AIDS surveillance data is used to establish
population-based, denominator estimates of the affected populations in each
zipcode. The PCP rates are then geo-coded and mapped using GIS software to
pinpoint neighborhoods with excessively high rates.
Results: In preliminary analysis in New York City, we found that among 30,306
persons alive with AIDS in 1996, there were 3,352 hospitalizations for PCP in that
year (11.1%). We found very disparate PCP rates for neighborhoods (defined by
zip code) such as the West Village ( 10%) and the South Bronx (z30%). There
were also some surprising findings. A number of white, working class communities, with low to moderate AIDS prevalence had strikingly high PCP rates such
as on Staten Island (= -30%) and in Bensonhurst in Brooklyn (z25%).
Conclusions: In communities with low to moderate AIDS prevalence, high PCP
rates may be sentinel indicators of pockets of formerly undetected HIV infection.
In more impoverished areas with higher AIDS prevalence, high PCP rates may
indicate poor access to and quality of primary care. The PCP index can be used
to help make decisions regarding the future allocation and targeting of prevention
resources and improving the delivery of HIV-related health care.

24186 Why do they come? Sociodemographic characteristics
that distinguish participants in HIV/AIDS preventive
interventions for women in Puerto Rico
Irma Serrano-Garcia, Damarys Cruz-Gonzalez, Maria Hernandez-Cartagena.
PO Box 23174, University of Puerto Rico, Rio Piedras PR 00931, Puerto Rico
Issue: Participant recruitment and retention (R & R) are barriers to the success
of many HIV/AIDS preventive interventions directed at women in Puerto Rico.
Variables that affect attendance must be identified so as to reach, as many of the
women at risk as possible.
Project: VOCES is a research project that developed an empowering HIV/AIDS
intervention for young sexually active heterosexual women in San Juan, Puerto
Rico. We have developed a diverse set of R & R strategies with varied rates of
success. These have varied according to the means of diffusion incentives, timing
and duration. The most recent effort incorporated social marketing techniques.
Criteria for participation have remained constant and include among others: being
sexually active, reporting not being victims of domestic violence and not being
HIV positive.
Results: VOCES contacted and screened 1,083 women of which 567 fit the
selection criteria. In the screening process we collected data on age, family size,
religion, drug use, risk perception and violent experiences among other variables.
Comparisons between the characteristics of participants and drop-outs will be
presented.
Conclusions/Lessons Learned: Sexual activity and violent relationships were
the two screening criteria hardest to satisfy. Cultural barriers to openly report sexual activity, particularly with an unstable partner, must be surpassed. Other
sociodemographic characteristics and their impact on R & R interventions are
presented.
24187 AIDS in scientific literature: Trends of "epidemiology"
and "control and prevention" related articles - 1987-1997
Gabriela J. Calazans, O.A.A. Valenga, H.C. Salettifilho, J.R.C. Ayres, I. Franga,
Jr.. Medical School-Univ. Sao Paulo, Rua Joao Ramalho, Sao Paulo, SP Brazil
Objectives: To show the tendencies of the scientific production over the last ten
years on "epidemiology" and "control and prevention" of AIDS, aiming at studying
the relative weight of socio-behavioural and socio-structural approaches in this
field.
Design: Metanalysis of indexed bibliography.
Methods: MEDLINE articles on AIDS from 1987 to 1997, indexed under "epidemiology" and "control and prevention" MESH headings, are examined. This
bibliography is analysed in respect to the occurrence of the terms "risk", "risk behaviour", "attitudes", "vulnerability" amongst others, in association with changes
from bevavioural into structural emphasis in their theoretical approaches.
Results: There is an increase in global scientific production on AIDS throughout
the historical series, with the exception of the year 1996. From 1995, a decrease
in the production on "epidemiology" and "control and prevention" can be observed. A growing incorporation of a socio-structural concern to these studies is
noticed, without compromising, nonetheless, the occurrence of studies on "risk
groups", "risk behavior" and " attitudes", wich are commonly associated with the
behavioural approach. The emergence of the concept of "vulnerability" is also
detected.
Conclusion: Studies dealing with prevention issues are declining in AIDS scientific indexed literature, showing, by the other hand, a growing emphasis upon
biomedical research. Among the articles indexed under the headings "epidemiology" and "control and prevention", references to "risk groups" and "risk behaviour"
are still prominents. Notwithstanding, an increase in socio-structural approaches
is witnessed as well.
124188 1 Methodology of HIV-AIDS policy analysis
Jorge SaavedraLopez1, Edgar GonzalezContreras1, E. Gonzalest,
J. Saavedra2. Futures Group International, Ret. 20 G. Garcia # 10 Col. Jardin,
Balbuena 15900 Mexico DF; 2Conasida, Mexico DF Mexico
Issue: There is a great need for a practic methodology to make policy and political
analysis about HIV-AIDS policies and how to influence policy makers, supported
by the traditional analysis on public policies.
Project: To understand public policies like government decision makers take
in front of a problematic social issue, and we are trying analyze the government
strategy about HIV/AIDS issue, we must identify the stakeholders and actors
involve in those processes, their positions, the powers, the network and their
strategies, as well as the government strategies, the obstacles, the implementation's opportunities of the policy. The paper give us a practic methodology of
analysis that starts of the traditional studies of the public policies including the
stages of gestation, formulation and implementation, taking like hilo conductor
of this analysis an example a recent study made in Mexico about the financial
policy's of ARV drugs. the information was processed and analyzed with the
policy maker software as a support tool.

Results: The methodology was successfully used, we achieved to identify the
stakeholders and the position as well as the government strategies about the
ARV financial, the software helped us how to organize the information and gave
us strategy maps of information and that gives us the opportunities to take a clear
view about the situation and try to take a better decision.
Lessons Learned: Because we are talking about a dynamic issue, the position
and the information rapidly changes, and for that reason is very important to have