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

12th World AIDS Conference

Abstracts 43323-43327 911

wich results should highlight the needs of awareness activities, STD management
training, a training in communication skills for education and provision of STD
medicines to health centers in the sites.
Resultats: On the basis of results of the qualitative study, within 4 months
activities, 5120 CSW and clients and 5200 dirvers (taxis, trucks and buses) were
contacted by educators and peer educators (among CSW) in 1210 awareness
sessions (3-4 persons), 2 paramedics were trained in STD management, 20
educators received the communication skills training.
Lesson Learned: The awareness campaign became more efficient by the
increase of public interest when linked to STD management and cheap STD
medicine availability.
43323 HIV positives commitment in prevention of HIV/AIDS:
The experience of "Club des Amis" (CDA), RCI
Koua Desire Ndah12, Hubert Ngoran Kovadio3, Siko Gbeli2, Adele Oli2,
Rose Dossou2, Edmond Adjobi2, Casmir Grogue4. 159 Boulevard de Marseille,
Treichville 06BP1021, Cidexi Abidjan 06; 2Club des Amis Apvvih, Abijan
Treichvil; 3GAPF PS RIP' Abidjan; 4Nawa Dance Abidjan, Cote D'lvoire
Introduction: Since 1983 that AIDS has been discovered in C6te d'lvoire some
people take it to be a divine sickness and a punishment from God, so most of
them Said it is a price from God, so most of them said it is a price to be paid.
In west AFrica precisely in C6te d'lvoire my country people living with HIV/AIDS
discriminated. AIDS is compared to be a shameful disease. As a friendship
therefore, the neighborhood starts isolation.
Objectives: To change the discrimination attitude of the community towards
people living with HIV/AIDS by their comittment into prevention activities.
Methods: Members of the "club des Amis" are HIV positives who run a support
group by doing counselling and training on the prevention field.
Results: More awareness of the community and more comittment of peers in
taking care of themselves while prevention in the community.
15.000 adults, 500.000 young men: school boys and university students were
sensitized by the "club des Amis".
310 new HIV positives have joined listed 150 attendants of the club.
Conclusion: If more attention is given to the role of HIV positives in the
prevention and care, HIV infection should be considerably reduced. We would
then have more comittment of HIV positives. Three other more associations are
gathered into a network of PLWA to fight against AIDS in C6te d'lvoire.
43324 1 Knowledge and use of safe sex practices among men
having sex with men in the Czech Republic
Ladislav Machala1, M. Stahkova1, J. Mandel2, N. Hearst2. 1AIDS Center
Charles University, Prague, Czech Republic, 2University of California, San
Francisco, USA
Objectives: To evaluate knowledge and use of safe sex practices and adaptation
to the HIV epidemic of homosexual men in the Czech republic.
Design: Descriptive study.
Methods: An anonymous questionnaire was distributed, by volunteers among
male visitors to "gay settings" in Prague. The questions focused on social and
educational characteristics of the respondents, their knowledge about the epidemiology and biology of HIV, information and attitudes about safe sex practices,
type of partnerships and attitudes to HIV testing.
Results: 500 questionnaires wers distributed and 376 (N = 376) correctly completed were collected. 78% of respondents identified themselves as homosexual,
21% were university graduates, 96.3% gave precise answers about HIV epidemiology. In 58% mass media (mainly TV) were the main source of information, 46%
were not afraid of HIV infection, 52% at least sometimes practiced unprotected,
anal intercourse, 3% refused HIV testing.
Conclusions: The level of information about HIV epidemiology and safe sex
practices among homosexual men in the Czech republic is satisfactory but the
acceptance of HIV danger and the use of safe sex practices are low. Campaignes
in mass media must better consider psychosocial factors among homosexual
men in addition to providing information in order to change their sexual behavior
regarding HIV.
43325 HIV prevention education and support services:
A marriage within AIDS service organizations (ASOs)
John Maxwell. 399 Church St. 4th Floor, Toronto Ontario M5B2J6, Canada
Issue: Targeted HIV prevention education programs need to be developed and
delivered in tandem with appropriate support services in recognition of the complex psycho-social needs of different groups of gay men.
Project: Focus group research conducted with HIV negative gay men in Toronto
(Autumn 1996) indicated a need to provide enhanced support services to these
men to address numerous psycho-social issues that were impacting on safer sex
practices. Further research with gay men in relationships (Autumn 1997) and with

HIV positive gay men (Winter 1997) also indicated a need for the development of
targeted HIV education programs that include the provision of support services
to enhance the health of these groups of gay men.
Results: Through the development of inter-departmental working Teams and
the dissemination of research results throughout the agency, the AIDS Committee
of Toronto was able to develop a series of HIV education initiatives that included
the provision of support services, such as counselling and support/discussion

groups, for different groups of gay men. This evolution within HIV education
programming has allowed for greater synergy within the agency.
Lessons Learned: HIV education initiatives have increased effectiveness when
they include (where appropriate) a support component. The historical separation
within ASOs between Education Services (HIV prevention) and Support Services
(Support for people with HIV/AIDS) is artificial in construct, and must be eliminated
to ensure the development of services which adequately respond to community
needs.
S43326 Project GOAL: Prevention intervention in the Mexican
immigrant population in New York City
Elba 1. Montalvo1, Elaine Daniels2, Mary Laouise Lopez3, Sandra Lara4. 1140
West 22nd Street New York, New York State; 2Health and Human Services
Washington DC; 3Young Women's Christian Association USA, New York NY:
4Committe for Hispanic Children and Fam New York NY USA
Issue: New York State Department of Health has identified the Mexican immigrant
population in New York City, especially men who have sex with men, at increased
risk for HIV infection. Awareness and prevention interventions are recommended.
Project: Given the increasing population of Mexican immigrants in New York
City with inadequate social support and exhibiting high risk behaviors, an interactive model to teach HIV/AIDS awareness and promote condom use was
developed through the Mexican soccer leagues, a major means of social interaction within the community. Proyecto GOAL currently works with 14 teams (308
men). Messages are delivered on the soccer field by health professionals who are
members of the Mexican community. These facilitators interact with the players on
a long-term "saturation" basis, urging discussion and asking them for solutions, in
order to internalize knowledge and break through denial barriers. Presentations
often involve the use of low literacy materials, (cards, key chains with condoms
and brochures) the performance of live action skits, and availability of health
professionals for individual consultation. Administrators of the soccer league,
coaches, and soccer team leaders are actively involved in the coordination of the
project.
Results: Proyecto GOAL has been very well received by the Mexican immigrant population. During the second year of operation we distributed 3,500
condoms. Of the 300 players surveyed at the end of the second year, 75% had
carried the condoms and 82% reported using condoms received from Proyecto
GOAL. The soccer league presidents and coaches have invited Proyecto GOAL
to return in 1998 and expand their services to the remaining teams in the soccer
league (greater than 3,000 men).
Prevention interventions among Mexican immigrant males in New York City
are successful if done with emphasis on their established community and social
organizations and their cultural concerns.
43327 HIV risk behavior and a sociocultural study among
female sex workers from a low-income community in Sao
Paulo, Brazil
Josefa Laurindo Silva1, I.C. Silva2, R. Munhos3, J.R.R. Marins4, L.F. Andrade5.
1 Rua Frei Caneca, SSao Paulo; 2SSao Paulo State AIDS Programme, Sao
Paulo, SP; 3Health Department of Sao Paulo State, Sao Paulo; 4Socoraba
Minicipal STD, Sococaba, SP; 5Piracema Association, SSao Paulo; SP Brazil
Objectives: To describe sexual behavior patterns and identify psychosocial and
situational factors of unprotected sex among sex workers to design an educational
prevention AIDS model for this population.
Methods: A total of 125 low socioeconomic class female sex workers were
recruited from one district with high HIV incidence in Sao Paulo City. Trained interviewers administered a structured anonymous questionnaire regarding: sociodemographics; HIV/AIDS knowledge, condom attitudes, frequency of unprotected
sex, frequency of sexual programs and cost, sexual behavior, number of sexual
partners, number of sexual clients, STDs, drug use behavior, HIV testing, and
public health care access. An educational intervention was carried out through
face-to-face counseling and small group discussions. The sex workers suggested
themes of interest to discuss, but all questionnaire items were also discussed.
During the educational intervention condoms were distributed, peer leaders were
selected to maintain the activities when the project finished, and access to public
health care services was guaranteed.
Results: The majority of respondents (69.6%) were 20-35 years, 63% were
migrants from other states, 68% had less than 8 years of schooling, 79%. had
some children, 66% lived in rented rooms, and 7% were homeless. The monthly
mean of sexual programs was 50, each costing U$ 18.00. Unprotected vaginal
and anal intercourse with regular and known partners was reported by 59% and
26% respectively. The main reason for unprotected sex was trusting in their
partners. Concerning drug addiction, 38% were currently drinking, 8.5% used
cannabis, 8% crack cocaine, and 3.5% were injecting drug users. Mostly (70.5%)
reported making use of some public health care services, at least once a year
to prevent illnesses. Regarding HIV testing, 49.5% had already been tested, and
5% were seropositives. However, none of them had sought HIV/AIDS treatment.

Conclusions: It is urgent to develop a systematic AIDS prevention program
for this population and their clients. AIDS prevention discussions need to be integrated with themes such as STDs, safe sex negotiation, self-esteem, and health
care. Educational strategies should also aim at rising issues such as human rights,
empowerment and autonomy to integrate low income communities, specialty in
developing countries where citizens used not to have their fundamental rights
guaranteed by the society.