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

674 Abstracts 33422-33427

12th World AIDS Conference

Results: The outreach workers have success fully achieved the IDUs. Their
identification with this group facilitates to talk about prevention. Most of them are
former drug users or still use drugs so they know exactly where to find them.
Lessons Learned: Without outreach workers this project wouldn't have succeed. The outreach is very well accepted by IDUs and the community. They also
believe that their own life has got better after start working for the project. It is
very important enrolled drug uses in the prevention of their own problems.
S33422 STD/HIV/AIDS intervention cum awareness among
intercity truckers in a port based industrial zone
Asish Lahiri. Halvia Vigyan Parisad PO. Haldia Town-Ship Dist Midnapur
WestBengal, India
Issue: - High risk group of Truckers require appropriate need based intervention
programme to reduce STD/HIV/AIDS.
Project: - Inter-city truckers at Haldia, a Port based industrial zone meet
Commercial Sex Workers without having any knowledge of HIV/AIDS and use
of Condoms. Survey revealed high STD rate prevails among them. To reduce
STD/HIV/AIDS and to promote condoms, a clinic has been set up with proper
staff pattern. Counselling and clinical assistance and distribution of condoms are
included in the Project.
Results: - The intervention programme is accepted by the truckers. On average
10 STD treatments, 400 condoms are distributed and 7 counselling are done for
Truckers per day.
STD/HIV/AIDS reduction programme are successful if it is need based and
rapport is made with high risk truckers community.
S33423 | Community based HIV/High transmission area
intervention project in northern Tanzania
Raymos Moses Olomi. PO. Box 8638 Moshi Tanzania, Tanzania
Objective: To educate long distance Truck drivers and their assistants,, and their
Sexual partners about their risk of HIV and other STD Infections and promote
reduction of number of sexual partners and use of condoms.
Method: HIV Infection has continued to spread unabated in Tanzania despite
the current intervention efforts. Sexual Intercourse is by far the the main cause of
STD/HIV transmission. The intervention targeted groups of individuals who are
known to be highly mobile and commonly have large numbers of sexual partners.
Peer Health education through inter personal discussions reinforced by health
learning materials has been the major strategy.
Results: Knowledge about HIV transmission rose from 90% (1993) to 97%
(1996). Truckers had reduced their number of partners from 6 (1993) to 2 (1996).
Two percent of the targe population believed that AIDS could be cured by applying
chemicals (alcohol) or herbs. Condom use remained low 35% (1993) and 40%
(1996).
Conclusion: It is not the high level of knowledge or awareness about HIV
Transmission that counts but the ability to ifluence behaviour change.
33424 An experience on harm reduction in Santos
Neide Gravato1, L. Rodrigues Villarinho2. 1 Prac Rui Barbosa 23 No Andar
Santos Sao Paulo; 2ASPPE Santos SP, Brazil
Issues: The use of injectable drugs is the main HIV transmission cathegory in
Santos (a city located at Sao Pulo seashore), being this cathegory responsable
for 41.0% AIDS registered cases.
Project: The ASPPE and the AIDS Municipal Program, have implemented for
5 months the Harm Reduction Project, with the objective of decreasing STD/HIV
transmission and other blood transmitted diseases among injectable drugs users
(I.D.Us.).
Results: Through trained health agents, 48 drugs users areas were mapped,
176 drug additcs, where 62% are crack addicted; 17.6% are inhaled cocaine
addicteds; 4% are injectable drug addicts, 26.7% are ex IDUs who has changed
the admission drug to crack usage. Through daily visits to the drug addicts area,
the team has deepened confidence joint with the addicts, trying to understand
better this IDUs profile change, through a quantitative and qualitative study, which
was been developed.
Lessons Learned: Based on the Harm Reduction Project experience and other
education intervention programs, it is noted an increasing growth of crack addiction among exclusive DUs. It is importanted evaluate if this change is temporary
or if crack has been used in association with injectable cocaine. Another problem
is the increase sexual transmission risk in the crack usage, speacially among
youngsters who are initialized in prostitution to guarantee financial resources to
drug comsuption.
33425 Bases of a preventive and therapeutic model about the
HIV/AIDS problematical

Erverto Michelli, Fabiana Cantero, Mara Escudero, Silvia Inchaurraga,
Marcelo Marcucci, Maria 1. Mondelli, Dianna Lomonaco. Martin Fierro 575, 2000
Rosario, Argentina
Issue: The "Drug Dependent Assistance Service" is an enterprise of the drug
dependency advance studies center of the National University of Rosario and the
Regional Mental Health Center Agudo Avila (Former Psychiatric Hospital).

Project: The service bases will be exposed, and they are supporting the development advances obtained in the specifical research from the psichoanalitic
model.
Results: 1 - Unbuilding of the clinical symptom "drug-dependency" and formulation of a drugdependents clinic. 2 - Reformulation of the prevention concept in
the joining drug dependency-AIDS. 3 - Intrduction of new intervention devices,
for the judicial patients and positive HIV: "The therapeutical companion". 4 -
Conceptual turn in the interdisciplinarity to the transdisciplinarity: The net Service
in Drugdependency and AIDS. 5 - Work group with work-shops with the approach
of a Damage Reduction Model.
Lessons Learned: Our speciallized service promoved the participation of the
involved parts, analysing the groups own reality so as to promote changes in
the attitudes towards risk conducts, for the benefit of the group inself and the
community
33426 Social marketing of condoms at red-light areas (RLAs)
through community participation and peer promotion
Bhaskar Banerjee1, S. Jana1, A. Banerjee2, S. Mukherjee2. 18/2 Bhawani Dutta
Lane, STD/HIV Intervention Programme, Calcutta; 2Durbar Mahila Samanwaya
Committee, Calcutta, India
Issue: Initial free distribution of condoms, for the purpose of introductory promotion, should be gradually converted into social marketing through a sustainable
outreach approach.
Project: Due to the high prevalence of sexually transmitted diseases (STDs)
and scanty condom use in Sonagachi, the largest red-light area (RLA) of Calcutta,
an intervention implementing clinical service, condom promotion and behaviour
change communication (BCC) was introduced with a strong component of peer
education. Some local sex workers (SWs), trained up for peer education, motivated their community through flip-chart demonstration, verbal discussions and
free condom distribution. In April-May 1992, the rate of condom use at Sonagachi
was 2.7%. Successful peer promotion augmented it to 81.7% in August-September 1995. On an average, about 100.000 condoms were distributed during every
month of 1996. Perceiving the achieved behavioural change, and identifying the
resultant condom demand, the process of replacing free distribution with social
marketing was introduced in 1997. A special group of SWs was trained for door
to door marketing by a registered co-operative of SWs in Calcutta.
Result: Free distribution has been reduced by 50% within June to December,
1997. On the other hand, 300000 condoms have been sold in the same period.
To enforce sustainable behaviour change communication (BCC) among SWs,
initial free distribution of condoms may be gradually replaced by social marketing
through community participation and peer promotion.
33427 Perceptions of condom efficacy in US national samples:
Trends, predictors, and validity
David Alderton, J.L. Jones. Center for Disease Control, MS E-47 1600 Clifton
Rd, Atlanta, GA 30333, USA
Background: To assess the success of HIV prevention messages about condom
effectiveness, people were asked "how effective do you think a condom is" in
preventing HIV transmission through sexual activity. Since the technically correct
answer is that condoms are "very effective," the percentage of people who state
this can be taken as an index of prevention information efficacy and increases
over time index penetration of the message. Social demographic variation in
endorsement rates indicate whether condom efficacy messages are reaching
correct audiences.
Methods: The condom efficacy question was administered in the Behavioral
Risk Factor Surveillance System, an annual probability-based telephone survey
conducted in each American state and the District of Columbia. From 1992 to
1996, the survey was administered to between 78,203 and 98,325 respondents
aged 18 to 64. For each year, data were analyzed adjusting for the sampling
design and selection probability producing estimates approximating US national
values. For logistic regression, item responses were dichotomized into "highly
effective" versus "others" and predicted from marital status, income, education,
age, sex, race, and US region.
Results: In 1992, 27.5% (SE = 0.25%) of the population believed condoms
were very effective in preventing HIV infection. This value rose to 34.6% (SE =
0.24%) by 1996, a 27.0% gain. Regression results were similar across years.
Unmarried people rated condoms more effective (range for significant odds ratios across years was 1.43-2.29) than those married or widowed. Those with
higher incomes (1.16-1.57) and more education (1.21-1.69) rated condoms as
more effective. Males (1.18-1.43) and younger age groups (1.12-1.82) believed
condoms were more effective. Racial groups differed only in 1992 and 1993. US
regions differed annually but all regions increased or were stable except the West,
which had the highest value in 1992 (33.3%) but the lowest in 1996 (30.4%).
Conclusions: While it is encouraging to find a 27.0% increase between 1992
and 1996 in the proportion of the US population rating condoms as "very effective" in preventing HIV transmission, the low 34.6% 1996 estimate is disturbing.

Treating this item as knowledge and not opinion, the endorsement rate should
be higher since condoms are very effective. Clearly, condom effectiveness must
be emphasized in future prevention efforts and some of the messages should be
targeted at those with lower incomes and education.