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

904 Abstracts 43287-43291

12th World AIDS Conference

Centers for Disease Control and Prevention, was designed to increase safer sexual behavior. Patients attended individual sessions, small group activities, and an
intensive group retreat. Sexual practices, stage of change for safer sexual behavior and other pertinent information were obtained using a 162-item questionnaire
administered to all participants before and after the intervention.
Results: Patients who maintained or improved safer sexual behaviors (79%)
were compared with those who relapsed or failed to improve (21%). Logistic
regression analyses found that improvement and maintenance of safer sexual
behavior was significantly associated with improvement of peer norms for outercourse (OR = 5.47, CI = 1.4-20.8), improvement of peer norms for abstinence
(OR = 5.08, CI = 1.2-20.1), and decreased general emotional distress (OR =
4.65, CI = 1.04-20.6). Outcome was not associated with health status, prior
sexual behavior, or changes in other variables targeted by the intervention, such
as self-efficacy for safer sexual behaviors.
Conclusions: These are the first longitudinal data which indicate that improvement and maintenance of safer sexual behavior during an intervention is strongly
associated with improvement in perceptions of peer norms and lesser degrees of
emotional distress. Programs for seropositive adolescents may require developmentally appropriate social and psychological approches to impact peer norms
and emotional well-being.
43287 "Provincial Project" - Prevention interventions: Outreach
program targeting men who have sex with men
Andre Beaudry1, J. Otis2, R. Bastien3, R. Pelletier4. 1Localillo 59 Monfette
Victoriaville, Quebec Gbp 1J8; 2UQAM University of Quebec in Montreal
Montreal QC; 3Dir. Sante Publique Montreal QC; 4Miels-Quebec Quebec QC,
Canada
Objective: First, to reach men who have sex with men in parks and other public
places then to sensitize them on AIDS/STD, on the other hand we did proceed to
a process evaluation of these interventions.
Project: From nine (9) different regions: the workers often different community
AIDS organisations did met the men who have sex with men directly on the
spot. This did allow a diffusion of preventive information, a reference and a direct
action of sensibility toward men which usally it is difficult to meet by usual means.
Furthermore, we did proceed an evaluation of this project with a search/action
method where all the workers were implicated. This evaluation was done with
some university searchers collaboration and financed by the Health and Social
Services Ministry. The strategy was consisting to capacitate all the community
aids organisation on a process evalution and to increase their capacity to take
their own responsability at that level.
Results: The research/action did permit to collect informations especially on the
intervention's process by the intermediate of 8 different datas sources. According
to one of the sources, like the daily reports completed by each different workers,
over 2000 contacts were realized between may and october 1997. The preliminary
results revealed a large diversity toward those different types of realised interventions (approachs, informations, listening in, sensitize, giving reference and
support) on those just mentioned themes and the distibuted materials. Among
the executed contacts, about 40% do have ana sexual relations. Furthermore,
the datas indicate the proportion of bisexual men who frequent parks, especially
in semi-urban sites, may reach 50% and near one third of those 2000 contacts
do not frequent the usual social gay sites. Incidentally, many intersites variations
where observed, example: the more experimented sites does accomplishe their
interventions much more profound and more rapidly towards men which they met
(listening in, support, reference). Finally the formosts datas does indicate how the
project is very much accepted by the parks clients whereas the majority express
their satisfaction as much toward the intervention than to the park worker's skill.
Conclusion:The fact to couple the outreach program (parks intervention
project) to a search/action did first permit the empowerment to the community aids organisations who did participated and shall facilitate to repeat these
preventions interventions in parks and other exterior sex sites. Also, our analysis
does indicate effectively that the parks and other exterior sites, does target men
whom will not be met otherwise.
43288 Sex mapping of sites where MSM meet in Mumbai Metro
Ashok Row-Kavi. Ashok Row-Kavi, 10 Riviera CHS, 15th. Rod, Santa Cruz (w)
Mumbai-400.OS4, India
Issue: Focussed intervention are possible in the invisible men-who-have-sexwith-men (MSM) community if a comprehensive mapping of sites where they
meet is done using motivated members of the self-identified gay community in
the metro.
Project: Given the well known fact that unprotected homosexual sex is a high
risk activity, it is nevertheless difficult to pin-point this actvity, especially in overcrowded metros like Mumbai where migrant floating populations form significant
segments of the citizenry.
The Humsafar Trust was given government funding to map out Mumbai metro's
sites where MSM activity takes place so that the Trust's outreach workers would

carry out highly focussed interventions to disseminate IEC literature on STDs and
HIV/AIDS.
Results: MSM activity was found to be "high" after the sex mapping was
completed over four months starting from September 1998. Many of these sites,
like public parks and public toilets and slums used for 'quickies', were identified
as sites for focussed interventions in HIV prevention programmes of the NGO.

Lessons Learned: Prevention programmes must first identify sites of "high"
risk activity and only then focus IEC literature there discreetly so that high risk
behaviour can be reduced wherever possible through distribution of condoms.
43289 Keepin' it R.E.A.L! A comparison of two HIV prevention
interventions
Colleen Dilorio, K. Resnicow, B.A. Manteuffel, K.V. Childers. Emory University
School of Public Health 1518 Clifton Rd NE #554 Atlanta Georgia 30322, USA
Issue: Which theoretical approach is most effective when designing an intervention to encourage young teens to delay sexual intercourse and exposure to
HIV?
Project: Two interventions based on different theoretical approaches were developed for use with 11-14 year old teens and their mothers. The two interventions
were implemented at seven centers of a large community organization whose
membership is primarily African-American. One intervention is based on social
cognitive theory and the other on problem behavior theory. Both interventions
emphasize the mother's role in delay of sexual intercourse. The interventions are
comprised of seven 2-hour evening sessions. The social cognitive intervention
promotes delay and abstinence through enhancing self efficacy, positive outcome
expectancies, and mother-adolescent communication about sex. The problem
behavior intervention addresses enhancement of self-concept, ethnic identity, decision-making, future time perspective, stress reduction and parenting. Mothers
of age eligible teens were contacted and recruited into the program. Evaluation
of the program is ongoing with assessments conducted at baseline, 4- 12-, and
24-months post enrollment in the intervention, and a comparison program was
conducted at 4 additional sites.
Results: Both interventions of the "Keepin' it R.E.A.L.!" Program have been
well received by participants. Within 15 months, 150 mother/teen pairs were recruited into the social cognitive program and 135 pairs into the problem behavior
program; a goal of 192 pairs is anticipated by 18 months. While data analysis
will not be completed for some time, anecdotal reports from participants include
positive evaluations of the program and reported positive changes at home.
Lessons Learned: HIV prevention programs for young adolescents and their
mothers meet a need for these families and are well received, particularly when
the curriculum is designed keeping in mind participant characteristics and timing
of the program, and facilitators are well trained.
531 / 43290 Situation analysis of prostitution in Bobo
Dioulasso, Burkina Faso and vulnerability of the
sex workers in the context of the HIV epidemic
Michel Cartoux1, P. Huygens4, M.D. Nikiema2, G. Ido3, A. Dembele2, P. Van De
Perre1. 1Centre Muraz, BP 153; 2Direction Regional dela Sante; 3Service
D'Hygiene, Bobo Dioulasso, Burkina Faso; 4 Universite Libre de Bruxelles,
Bruxelles, Belgium
Introduction and Objective: Prevention addressed to the Commercial Sex Workers (CSWs) are recognised effective to limit the progression of the HIV epidemic.
Before establishing such interventions, a precise knowledge of the different type
of prostitution is necessary.
Method: In-depth interviews were carried out from November 1997 to January
1998 with 14 key-informants and 60 CSWs. All bars, public places, health centres
and places of distribution of condom were listed and located on the map of the
city.
Results: Three major types of prostitution were identified: "bar waitresses",
"sitting prostitutes", "night-walkers". Child prostitution as well as heterosexual and
homosexual male prostitution also exist but on very limited scale. Bar waitresses,
forced by too low wages (<20$ per month), accept sex proposals of customers.
In a context of seduction, and to lead customer into a stable life in couple, they
less often use condoms.
"Sitting prostitutes", are mainly foreigners and await their customers on the step
of their doors in popular, crowded districts. They have much more customers (>2
per day) with very low fees (<1$ per intercourse). The majority of them refuse
sexual intercourses without condom with their customers but seldom with their
regular partner. "Night-walkers" move in the city centre in search of customers
in streets, bars or night clubs. They have wealthier customers and are tried by
sexual relations without condom for higher fees. The majority of CSWs, think that
the HIV transmission is more risky with oral sex than anal sex. Condoms were
well distributed in the city by hawkers.
Conclusion: Precariousness of life, indirect risk related to regular partner,
profit, and ignorance of the practices at risk are to be taken into account in an
education program targeting CSWs.
S43291 Women who trade sex: Results from a community
intervention trial
Philip James Smith1, B. Person1, J. Adams2. 1CDC, Mailstop E37, 1600 Clifton

Road Atlanta, GA; 2Family Health Council Inc., Pittsburg, PA, USA
Objective: To describe the efficacy of a community- level intervention for increasing condom use behaviors among women who trade sex for food, shelter, money,
drugs, or other things of value.
Design: A pre-test/post-test, intervention/comparison experimental design was
used.