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

12th World AIDS Conference

Abstracts 33104-33109 613

Conclusions: On these data, the condom is not an exclusively male method.
Both male and female accounts report the female partner putting on the condom
in 1 in 5-6 occasions of last intercourse. Proposal is perceived as having been a
shared or personal act by both men and women. Women claim to have purchased
a quarter to a third of all condoms used at last intercourse.
33104 Low condom slippage and breakage in a clinical trial
Michael Rosenberg. ISIGE Franklin Street, Suite 200, Chapel Hill, NC, USA
Background: Although condoms are the cornerstone of AIDS prevention efforts,
estimates of their clinical efficacy vary quite considerably. Differences in the rates
of breakage and slippage, two key performance measures, may be attributable
to different user groups, study design, and products evaluated.
Method: To address condom reliability, we conducted a clinical trial among
monogamous, heterosexual couples using a single OTC brand, Durex Ramses.
Results: Of 10,480 uses, 8 breaks occurred before intercourse (non-clinical
breakage) and 28 during or immediately following (clinical breakage), resulting in
a non-clinical breakage rate of 0.08% (95% CI, 0.02-0.13), clinical breakage rate
of 0.27% (0.17-0.37) and a total breakage rate of 0.34% (0.23-0.46). The rate
of complete slippage was 0.47% (0.34-0.60), and the rate of total clinical failure
(clinical breaks plus complete slips) was 0.74% (0.57-0.90).
Conclusions: These rates are markedly better than those from other studies and indicate that high quality condoms can, among appropriately motivated
groups, provide excellent protection against STDs.
|33105 Condom use as perceived among the rural set ups
Christine Musumba Kazibwe. Taso Masaka, PO. Box 1679 Masaka, Uganda
Issue: Community Response, Reaction and adoption of condom use requires
continuous and appropriate intervention and awareness.
Project: Given the rapid increase in HIV/AIDS in rural areas an intervention
using a Participatory Rural Appraisal Approach was used in Nakalembe Parish,
Masaka District of Uganda. To this effect Condom Distributors were selected,
trained and distribution centres set up; in 11 villages that make up the Parish. The
project includes TASO Community Trainers, selected Programme Implementors
and Community Leaders. Strategies include, one to one information and counselling in HIV/AIDS, setting up a distribution points and awareness on condom
use.
Results: The community response was satisfactorily positive as evidenced by
selection and training of 18 condom distributors. 56 other programme implementors, namely, Peer Educators, AIDS Community Workers, Community Counselling
Aides were also involved. Within a period of 6 (six) months, 5,987 Condoms had
been distributed to clients from different villages. This shows a safer method of
prevention adopted. However, there has been a keen observation that there are
some antagonistic forces against Condom use.
Lessons Learned: Condom use in rural areas can be successful if it is properly addressed taking in consideration different values with respect to particular
communities.
33106 Consistency of condom use for disease prevention
among unmarried sexually active women - Data from a
national (US) survey of reproductive age women
Robert M. Brackbill, J.B. Greenberg. CDC, 1600 Clifton Rd MS E44 Atlanta GA
30333, USA
Background: Although condoms are an effective barrier method (if used properly) for preventing transmission of sexually transmitted diseases, the proportion
of sexually active women and their sex partners who use condoms consistently
for disease prevention is not known.
Objectives: The objectives of this study are: (1) to update national US estimates of condom use for disease prevention; (2) to characterize consistent
condom us for disease prevention.
Data and Methods: The 1995 National Survey of Family Growth, a nationally
representative survey of reproductive age women, was used. Data on 3,696 unmarried women, who were sexually active in the 12 months before their interview
were analyzed. Methods designed for complex samples were used for making
weighted statistical estimates.
Results: 31.8% (95%, CI, 30.6% to 33.7%) (an estimated 19 million) of women
from ages 14-to-44 were unmarried and sexually active in the 12 months before
the interview. Of these women 11.4% (10.1% (56.0% to 12.7%) reported never
using condoms; 24.7% (23.0% to 26.4%) had ever used condoms for birth control
only; 5.8% (4.9% to 6.7%) for disease prevention only; and 57.9% (56.0% to
59.8%) for both disease prevention and contraception. 19.8%(18.4% to 21.4%)
of sexually active unmarried women reported always using condoms for disease
prevention in the past 12 months before their interview. Younger, black women,
who had more than 2 sex partners in the past year, never been pregnant, and
were not currently using an oral contraceptive were more likely to always use a

condom for disease prevention.
Conclusion: Although a very large percentage of sexually active women report
using condoms for disease prevention and/or contraception, a relatively low proportion of women actually use condoms consistently. Prevention programs should
continue to focus on the large population of sexually active women, promoting
condom use for HIV/STD prevention regardless of contraceptive status.

I33107 Intervention among truck drivers and CSWS along the
National Highway 7 at Hosur, Tamilnadu
Arulraj Louis, Lalitha Kumaramangalam, V.N. Sabapathy, S. Velan. Prakriti,
Chennai TN, India
Issue: Target population vulnerable to HIV/AIDS since they are away from home
from a number of days and highway commercial sex workers are available.
Project: A multi-dimensional intervention using Information, Education, Communication (IEC), condom distribution and an STD referral was developed. A
baseline survey and ethnographic research were conducted to establish indicators for the project. A referral system was developed for both truckers and
sex-workers, through which STD cases were treated to reduce the risk of HIV
infection. The target population was mobilised, peers were identified and trained,
one to one communication and focus group discussions used to promote health
seeking behaviour. 3 counselling booths cum drop-in centres were set up along
the highway at points were truckers assemble. Non-traditional condom outlets
were established close to where sex takes place.
Results: Awareness among truck drivers and highway CSWs increased from
10% to 57% and 47% respectively. More than 600 STD cases were referred and
532 cases received treatment, through affiliated STD care providers. Usage of
condoms increased from 4% to 19%.
Lessons Learned: Targeted intervention programmes can be successful if
they address truckers according to their specific needs, their type of work as men
on the move and the situations they find themselves in.
33108 Condom distribution through lift-off points
Gloria Jere. PO Box 483 Lilongwe, Malawi
Objectives: To Increase accessability of condoms for distant transport workers.
Methods: Identified condom storage points on the highways i. e Petrol bunics,
highway restaurants and transport company offices.
Illuminated hoardings and display boards used to Identify condom lift off points
as well as to focus message on safe sex practices and condom usage.
Results: 30 condom outlet opened on National Highways. Monthly condom
off-take increased to 25,000 from 7,000 pieces per month.
Condom availability ensured round the clock to truckers along NH4, NH5, NH7
and NH 45.
S33109 Potential for an HIV epidemic and prevention among men
who have sex with men (MSM) in the Tokyo Metropolitan
area
Seiichi Ichinawa1, M. Kihara1, H. Ohya3, T. Morio4, Y. Ohyama4, Y. Ikushima5.
1 Kanagawa Cancer Center Research Institute, Yokohama; 2Kanagawa
Prefectural College of Nursing and Medical Technology, Yokohama, 3CAPS
International Program, University of California San Francisco, Yokohama;
4Shin-juku Public Health Center, Tokyo; 5Positive Living and Community
Empowerment (PLACE) Tokyo, Tokyo, Japan
Objectives: In order to get an insight into the magnitude of HIV epidemic among
MSM in Tokyo where 58.1% of all reported Japanese homosexual HIV/AIDS
cases are concentrated, prevalence of HIV antibody were assessed in semen
samples collected from the trash box wastes of bath houses in Tokyo. In an
attempt to develop an effective prevention program, prevalence of used condom
in the trashes was also assessed before and after a half-year preliminary intervention program which provided the bath house clients with free condoms and
jellies as well as education materials for safer sex.
Methods: With the cooperation of the owners of the bath houses, trash box
wastes were sampled in unlinked anonymous fashion from individual rooms
utilized by 1 or 2 people at a time. The sampling was first performed in May
1996, before the programmed safer sex campaign and repeated 6 months later
to evaluate the effect of the intervention program. All samples were checked for
the presence of used condoms, and the semen samples collected from the trash
box wastes were tested for HIV antibody using PA and ELISA and confirmed by
Western blott method. The Intervention program was designed as follows; 1) afer
sex campaign was developed in 4 gay magazines for 3 months. 2) Condoms and
packed lubricant jelly kits were placed in various corners of the bath house within
the easy reach of clients. 3) Colored leaflets specifically developed for safer sex
campaign among MSM were distributed at the reception desk of the facility. 4)
Poster for safer sex promotion were placed on several bulletin boards of each
facility. Effect of this intervention program was evaluated in November 1996 in
terms of the changes in the percentage of the rooms in which at least one used
campaign condom was identified.
Results: Of semen samples in 165 trashes collected from each individual room
utilized by a couple of people at a time, 32 (19.4%) were found to be HIV positive,
of which 6 were from the 21 trashes with used condom and 26 from those (n =
144) without. Intervention trial were found to be effective significantly elevating the
condom prevalence in trash box wastes from 12.3%(23/187) to 30.8%(53/172).
Conclusion: Though to be interpreted with caution since data are only based

on a unit of trash box waste, our results suggested that sexual practice among
bath house clients in Tokyo are potentially at high risk for HIV infection with
insufficient condom use, and that our intervention program could be an potential
model for effective intervention for MSM at least in a bath house setting.