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

12th World AIDS Conference

Abstracts 43282-43286 903

43282 "Trust, love condoms": An HIV education campaign
based on survey data on men in relationships with men
in New Zealand
Heather Worth, Tony Ewing. 'Institute for Research on Gender, University of
Auckland, Auckland; 2New Zealand AIDS Foundation, New Zealand
Issue: A high level of unprotected anal intercourse amongst men in relationships
with men in New Zealand, and no previous specific HIV education campaigns
targeting this group.
Project: 'Male Call/Waea Mai, Tane Ma' was a New Zealand-wide telephone
survey of men who have sex with men. Undertaken by the New Zealand AIDS
Foundation research team, it recruited 1852 respondents. Of these 741 men were
in an intimate relationship with another man of at least six months duration. The
data showed that 46% of the men who had anal sex had never used a condom
with their regular partner in six months prior to the survey.
Results: The data on men in relationships indicated a need for a focused HIV
education campaign. After considering other approaches to this problem, such as
"Negotiated Safety", NZAF educators developed a multi-media campaign which
aimed to increase the number of men using condoms with their regular partner.
The strategy was entitled... 'Trust, Love, Condoms'. Strategies employed included
television, radio, a glossy magazine, print advertisements, condom packs and a
web-site. A nation-wide TLC Roadshow reached both gay men in relationships and
health professionals who work with gay men. The TLC Campaign created enormous interest. NZAF was unable to meet unexpectedly high demand for resources.
For example, in the first weekend of the campaign 5,000 magazines and condom
packs were distributed and 500,000 plus viewers saw the television coverage.
Lessons Learned: There is a need for HIV education campaigns to be based
on locally-based research. It is also important to have a close working relationship
with a research team. Targeted, high impact short-term campaigns appear to be
extremely effective.
43283 The whole is greater than the sum of its parts:
An analysis of the intervention components of an HIV
prevention program for young gay men
Susan M. Keegeles, R.B. Hays, C.R. Waldo, L. Pollack. UCSF Center for AIDS
Prevention Studies 74 New Montgomery, San Francisco CA, USA
Background: The Mpowerment Project has been shown to be effective among
US young gay men. This study examines the effectiveness of various program
components on post-intervention sexual risk-taking.
Methods: Independent of the intervention, we recruited a longitudinal cohort of
gay/bi men aged 18-27 in Eugene, OR and Santa Barbara, CA prior to intervention, and resurveyed them post-intervention (N = 172 from the 2 communities).
Data were combined to increase statistical power since we found no significant
differences between the communities on risk behavior, demographics, and psychosexual variables. Scores were computed to indicate how much respondents
participated in each component. Participants self-selected which activities they
participated in. Involvement in one activity did not preclude involvement in other
activities. T-tests were used to compare component scores of men who did vs.
did not engage in unprotected anal intercourse (UAI) with nonprimary partners in
the previous 2 months.
Results: There were no significant differences between men who did vs. did
not engage in UAI at baseline in their subsequent participation in various program
components. However, men who did vs. did not engage in UAI post-intervention
varied significantly in participation in program components (shown below).
% Participated Mean participation among men who
in 1+ component did/did not have UAI post-intervention
activity UAI no UAI t effect size (ES)

as HIV risk reduction supplies (condoms, dental dams, lubricants, and bleach
kits), prevention case management and referrals to drug treatment, health care,
shelter, and public assistance, to female sex workers, since 1991, and sterile
needles since 1995. Women who choose to be tested for HIV are interviewed
about various aspects of their work and personal lives.
Results: During 1997, 3,296 women used our services, for a total of 13,196
contacts. Of these, 503 were tested for HIV, 404 of them sex workers. During
that same period, we distributed >600,000 male condoms and 1,500 female
condoms, as well as dental dams, lubricants, and bleach kits, while our needle exchange distributed 26,278 syringes. In addition, we distributed 9,659 bag
lunches, 39 sleeping bags, 345 toiletries kits, and 367 sets of clothing. Our staff
provided counseling and/or case management to 1,506 women, and referred 541
for additional services.
50/404 (12.4%) of the sex workers tested positive for HIV in 1997, down from
36.2% (242/668) in 1989. In addition to sex and drug use factors, we found that
housing status was significantly associated with infection, with 25/276 women
(9.1%) who were domiciled testing positive, compared with 24/117 women (20.5%)
who were homeless. In addition, 42/183 women (22.9%) who tested with us for
the first time in 1997 tested positive, compared with 8/221 women (3.6%) who
had been tested repeatedly over two or more years since 1989.
Conclusions: As has been observed throughout the world, poverty is a major
risk factor for HIV, and our data suggest that stabilizing the housing of homeless
women would significantly reduce their risk for infection. In addition, our data
suggest that consistently providing a range of supportive services to impoverished women at risk for HIV can reduce the incidence of infection. Governments
should increase funding for programs that not only promote safer sex and drug
use behavior, but meet the survival needs of populations at risk.
43285 A strategy for HIV/AIDS prevention among sexual
workers from Chiapas, Mexico
Patricia Uribe-Zuhiga', M. Brofman-Pertzovsky2, V. Ortiz-Aguirre3,
R. Marchetti-Lamagni3, H. Garcia4, A. Ruiz-Badillo3. 'Tlalpan 4585, 2 DO. Piso
Col. Torrielo Guerra, C.P 14050, Nexico, DF; 2 Public Health National Institute,
Mexico, DF; 3AIDS Nationa Council, Mexico, DF; 4South Border College,
Comitan, Chiapas, Mexico
Objective: To decrease STD's/HIV incidence in commercial sex workers (CSW)
through different workshops
Methods: We selected two groups with similar sex work conditions in Chiapas
based in the situational assessment made previously: a) Group with intervention
in Tuxtla Gutierrez,(IG): Two hour workshops working STD/HIV basic information,
self-esteem, community organization and improvement of economic and work
conditions. Each session was structured in four stages. b) The control group in
Comitan (CG) had two hour sessions with only basic information about STD/HIV. A
pre and post-intervention evaluation was conducted. Posters and stickers for the
public transportation and work setting were used in both areas. Before proceeding
with the study civilian, health authorities and brothel owners were contacted and
sensitized. Quantitative data was analyzed by statistical methods.
Results: There was a condom use increase of 62% to 71% in IG. There were
no differences in both groups in schooling, number of children and socioeconomic
level. The age of the CG was lower than in the IG (61% in the 15-24 range age
vs. 31% in the IG). 31.3% of IG were alcohol consumers and 87.6% in the CG.
There were 0.5% IV drug users in IG and 2.4% in the CG. 7.6% reported problems
in medical attention in Tuxtla Gutierrez and only 4% did so in Comitan. In CG
syphilis decreased from 10.2% to 2.7%, gonorrhea from 24.8% to 8.6%. Two
years after intervention, the conditions of increased self-esteem, and improved
group organization and work conditions remain.
Conclusions: Prevention of STD/HIV among CSW is easier, deeper and longerlasting with the inclusion of psychosocial variables. The participatory methodology
enhanced the population's self-esteem, which is a key factor in the prevention
of STD/HIV, and it is possible improved through the process of "rationality-affectivity-awareness-will-praxis", that we used here. Reflective workshops enhance
organization and improve work conditions.
43286 Sexual behavior change among seropositive adolescents
with hemophilia
Larry Brown', J.R. Schultz2, J.T. Parsons3, R.B. Butler4, A.D. Forsberg5,
S.M. Kocik6, G.K. King7, M. Manco-Johnson8, L. Aledort9. 1Child Psychiatry
Rhode Island Hospital/Brown University School of Medicine; 2Xavier University,
Cincinnati, OH; 3Jersey City State College, Jersey City NJ; 4 The Children's
Hospital of Philadelphia, Philadelphia, PA; 5New England Regional Hemophilia
Treatment Center, Worcester, MA; 6Puget Sound Blood Center, Seattle, WA;
7University of Connecticut Health Center, Farmington, CT; 8 University of
Colorado School of Medicine, Denver, CO; 9Mount Sinai Medical Center, New
York, NY USA; CDC Adolescent HBIEP Study Group; Centers for Disease
Control and Prevention, USA
Objectives: To determine the factors associated with the adoption or mainte
nance of consistent safer sexual behaviors among HIV positive adolescents with
hemophilia.
Design: Comparisons of adolescents based on safer sexual behavior before
and after a one-year intervention.
Methods: One hundred and eleven HIV positive adolescents with hemophilia
were included and participated in a theory-based intervention that spanned one
year. The intervention, carried out in ten hemophilia care sites funded by the

Core Group or volunteer
Small groups
Large social events (safer sex promoted)
Outreach (formal & informal)
Total Mpowerment Project activities

31%
33%
59%
77%
82%

0.38 0.81 2.2
0.12 0.36 3.2
0.88 1.64 2.0
1.92 2.50 1.7'
4.46 6.95 2.5

0.40
0.59
0.51
0.36
0.49

p 0.01, p- 0.05, t 0 0.10
Conclusions: The small groups had a large ES, but reached substantially
fewer men than social events and outreach. Though not as powerful, the social
events and outreach were critical to the effectiveness of the program as sources
of recruitment to the small groups and as a means of reaching men disinclined
to attend small groups. The effectiveness of program components are not independent; the synergy created by the whole program makes the net effect of the
intervention activities greater than the sum of its parts.
43284 1 Give them what they need, and they'll keep coming back
for more, reducing the incidence of HIV among female,
street-based sex workers in New York City
Joyce I. Wallace', P.J. Alexander', S.R. Horn1, A. Weiner2, M. Hidalgo2,
L. Dolphus2. 'FROST'D: Form Our Streets With Dignity, 369 Eight Avenue, New
York, NY; 2 Wurzweiler School of Social Work, Yeshiva Univ, New York, NY, USA
Objective: To reduce the incidence of HIV infection among low-income, female,
streetbased sex workers.
Methods: Using two mobile units working in tandem, FROST'D has provided
counseling and testing for HIV, syphilis, and Hepatitis B, since 1989, as well