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

892 Abstracts 43230-43234

12th World AIDS Conference

havioural change and risk perception. On the other hand, on the relation between
the input and output of financial and human resources.
Results: The criteria for evaluation provide a decision model for launching
intervention strategies among clients. Aspects like the selection mechanism on
the basis of which customers are educated or the possibility to establish shared
group standards among clients, are weak points of the intervention strategies.
There is also an imbalance between the financial and human resources involved
and the number of clients reached by the activities. The appreciation on client
education can be very positive assessed. Sex workers find the information given
to clients very supportive for their efforts to keep sex safe. Their knowledge and
experience of client behaviour is endorsed.
Lessons Learned: The results reinforce the argument for the necessity of
safer sex education targeting clients. The endorsement of sex workers' knowledge strengthens trust established between educators and sex workers. This
makes the sex worker more responsive to safer sex messages. However, current
intervention strategies among clients need to be fine-tuned.
544*/43230 Sexual networking and AIDS awareness program
at the workplace: The case of oil locations in
Nigeria
Bode-Law Faleyimu1, O.A. Fagade2, S.O. Ogunniti3, A.I. Faleyimu4,
L.A. Ubuane4.' Cares 9 Swamproad, Chevronclinic, Gra, Warri. PMB 1244 Warri
Delta State, 2Company Medical Practice, Warri; 3University Teaching Hospital,
lie-lie; 4Cares (NGO) Warri, Nigeria
Issue: Field-based Oil Workers are particularly vulnerable to HIV/AIDS in the
face of sexual network with commercial sex workers (CSW) and settlers at Oil
Locations. This interaction requires an innovative, multi-pronged awareness and
intervention programme targeted at both groups.
Project: Workers in the Oil and Gas Exploration and Production sector have
a stable income, have poor access to health information and extremely mobile;
spending long periods away from their usual partner and may therefore be exposed to high-risk sexual behaviour. A pre-program Key informant interviews,
Questionnaire and Focus group discussion amongst Oil workers and CSW at Oil
Locations revealed poor awareness, misconceptions and doubts about HIV/AIDS.
There was a high level of sexual networking (focus and diffuse), multi-partnered
sex with its attended multi-agents STDs. A well-articulated AIDS education programme at the workplace and the surrounding communities was initiated and
directed at these subsets using basic facts about HIV/AIDS; blended with jokes,
cartoons, poetry, drama, music, video shows and moonlight story telling. Comprehensive handouts on STDs/HIV/AIDS, safer sex practices were given and
counselling sessions arranged.
Results: This workplace-based AIDS prevention programme became popular with workers, accepted by management; resulting in the establishment of a
workplace policy on AIDS; an anti AIDS Club, less cases of STDs and 65%
increase in requests for counseling by workers. Condom demand and use have
increased amongst the CSW and the host community has started to respond to
the challenges of HIV transmission.
Lessons Learned: Field-based Oil Workers, like truck CSW, tourists, itinerant
traders may need to be treated as a high-risk group both at the workplace and
in the larger community. AIDS prevention programmes at Oil Locations must also
be targeted at the host communities in order to increase its success and achieve
better company-host community relationships.
43231 An innovative sexuality intervention targeting
African-American women
Beatrice (Bean) E. Robinson, W.O. Bockting, J. Brown-Barber, M.H. Miner,
B.R.S. Rosser, A. Giavasis. Program in Human Sexuality U of MN, 1300 S 2nd
Street, #180, MPL S, MN, USA
Issues: Traditional HIV prevention has focused on promoting safer sex and drug
use behaviors with little attention paid to integration of HIV prevention messages
with comprehensive sexuality education. Focus groups with African-American
women indicated HIV risk associated with limited knowledge about their own
sexual responses and functioning.
Project: WISH (Women's Initiative for Sexual Health) was developed to address this gap. WISH is innovative in that it 1) combines HIV prevention with
comprehensive sexuality education that is culturally specific to the African-American community, 2) is a collaborative effort between a Medical School and three
African-American community-based organizations, and 3) uses an intensive,
stimulating, and sexually-explicit, multi-media format over two consecutive days.
Topics such as culture and sexuality, chemical use, prostitution, spirituality, and
comprehensive sexuality education interspersed with material on safer sex behaviors and attitudes. Large group presentations, videos, exercises, and small
group discussions contribute to an interactive seminar with a positive focus.
Results: This HIV prevention approach is currently being evaluated using a randomized, repeated measures design. Three- and nine-month follow-up interviews
are being conducted with 325 seminar and control group participants.

Lessons Learned: Medical schools can collaborate with communities of color
successfully. Collaborating community agencies were involved in hosting, developing and leading the intervention, as well as recruiting, tracking, and interviewing
participants. Successful collaboration involves cultivating relationships, community-based hiring, fair reimbursement, and finding key community contacts.

S43232 Sisters of Sheba Development Network (SOSDN): HIV
prevention in African-American heterosexual women
Debra Ann Brodie1, K.L. Palmer2. 1Detroit Medical Center, Detroit; 2Henry Ford
Health System, Detroit, MlI, USA
Issue: Many African-American heterosexual females (AAHF) have unprotected
sex with non committed male partners of unknown HIV serostatus. They know
AIDS exists, but still do not see themselves at risk.
Project: Given the rising rate of HIV/AIDS among AAHFs, a 10-month project
was launched to educate Detroit AAHFs about the epidemic and how to prevent
infection. The SOSDN recruited AAHFs inspired by the movie "Waiting to Exhale."
They wanted more power in their relationships with men. They met each month
at a local church. The women heard lectures and talked about the psychology of
romance and gender power dynamics. They also learned about HIV transmission
and safer sex negotiation. Condoms and HIV literature were distributed.
Results: Of the 142 women enrolled, about 30 attended each month. Some
did not like nor complete condom use surveys. Of those who complied, there
were some interesting trends over time. When assessed at a baseline in 9/96,
43% of the 67 women surveyed "almost never" (10%) and "never" (33.8%) use
condoms. In 12/96, 47% of the 17 respondents "almost never" (29%) and "never"
(18%) use condoms: In 4/97, 23.6% of the 13 surveyed "almost never" (15.9%)
and "never" (7.7%) use condoms. In April, all "never" users (100%) were willing
to begin condom use within the next six months and two weeks. This was an
improvement relative to reports made by "never" users in the previous December
(6 months = 75%; 2 weeks = 75%) and September (6 months = 15%; 2 weeks
= 10%). Repeated measures sampling problems precluded statistical analysis
of the data. These positive trends, however, suggest directions for further study
when the project is repeated in 1998-99.
Lessons Learned: Long term programs aimed at teaching African American heterosexual women about the psychology of romance and gender power
dynamics may potentially increase condom acceptance among non condom
users.
43233 High prevalence of HBV infection in young gay men
despite effective vaccine and concurrent HIV risk
Kimberly Page-Shafer1, D. Osmond1, E. Charlesbois2, J. Hahn2. 1 Center for
AIDS Prevention Studies/UCSF 74 New Montgomery Ste 510 San Francisco;
2UCSF Dept. Epidemiology & Biostatistics San Francisco, CA, USA
Objective: To assess prevalence and risk factors for hepatitis B virus (HBV)
infection and HIV co-infection in a population based study of young MSM being
followed for HIV infection in San Francisco, California.
Methods: Data were collected from participants in the San Francisco Young
Men's Health Study (SFYMHS). The SFYMHS includes a probability household
sample (n = 428) of MSM ages 18-29 recruited in 1992 and a referral sample
recruited in 1993 (n = 600). In the 1995/96 follow up, HBV core antibody (HBcAb)
and surface antigen (HBsAg) were measured in 588 men. Logistic regression
was used to analyze risk factors for HBV infection. Logistic regression was used
to asses HBV risk associated with unprotected receptive anal intercourse (URAI)
and receptive oral intercourse (ROI) by constructing two multivariate models:
Model 1 includes all subjects, and Model 2 is restricted to those who reported no
receptive anal intercourse partners.
Results: Prevalence of HBcAb was 22% (n = 132), and of those, 6 (5%) were
HBsAg positive. 93% of those infected with HBV were unaware of their HBV
infection status. Only 27% reported ever being vaccinated for HBV, and of those,
12% were HBcAb positive. HIV and HBV infection were significantly associated
(p < 0.001): 35% (n = 45) of HBV positives were HIV positive. Logistic regression
results are shown below.

Model 1: All participants (n = 575)
Variable OR (95% CI)
URAI (per partner) 1.5 (1.14-2.02)
Age (per year) 1.1 (1.00-1.17)
Education (<12 yrs) 1.9 (1.02-3.40)

Model 2: No RAI partners (n
Variable OR
ROI 0 partners 1.0
1-9 partners 1.7
-10 partners 4.6
Education (-12 yrs) 3.1.

- 173)
(95% CI)
(0.6-5.0)
(1.3-16.7)
(1.02-9.6)

Conclusions: Despite the availability of a safe effective vaccine, a high proportion of MSM are infected, many unknowingly, with HBV. In MSM who do not
report RAI in the prior 12 months, HBV infection is associated with ROI. HBV
infection, and oral transmission of HBV may be overlooked as a significant health
problem among MSM. The high prevalence rate and concurrent HIV risk show
that HBV and HIV prevention could be synchronized to achieve more widespread
disease prevention among MSM.
43234 A multi-institutional street-youth prevention program in
Brazil: Searching for consensus
Marcelo A. Campos, R.F. Martins, A.J.W. van Zeeland, R.J. Costa, T. Almeida,
I.K. Adams. Ammor Clinic Barao De Aiuruoca, 480, Alto Dos Pinheiro
30530090-Belo Horizonte MG, Brazil
Issue: To develop an integrated program for STD/HIV prevention and reproductive health of destitute youth attended by GO and NGO in Belo Horizonte,
Brazil.
Project: A pool of 12 institutions attending Street Kids and other destitute youth
united and obtained European Union funding (ECU$1,000,000.00) to maintaim