Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

XIV International AIDS Conference

Abstracts WePeC6165-WePeC6169 123

WePeC6165 Condom use increasing among men in Kampala,
Uganda, but substantial risk continues
M. Kamya1, P. Kajubi1, S. Chen2, W. McFarland3, N. Hearst4. 1Makerere
University, Uganda; 2Johns Hopkins Bloomberg School of Public Health,
Baltimore, United States; 3San Francisco Department of Public Health, San
Francisco, United States; 4University of California, San Francisco, United States
Background: Data on trends in risk behavior can help to guide and monitor the
impact of AIDS prevention programs. We conducted a survey of young men in
poor neighborhoods of Kampala and compared their reported condom use to results of a similar survey eight years earlier.
Methods: Both studies were in low SES, peri-urban communities surrounding
Kampala. The 1993 study has been described previously (Kamya et al. AIDS
1997; 11:S61-6). In brief, it was a household survey of 301 men aged 18 to 49,
65% of whom were under age 30. The 2001 survey recruited 491 men aged 18
to 30 in two communities through a variety of methods including youth groups,
community organizations, and door-to-door. Interviews included detailed questions about types of partners and condom use with each partner over the past six
months.
Results: In the 1993 study, 68% of men reported a casual partner in the past
year and only 31% reported "always" using condoms with such partners. In 2001,
47% reported a casual partner in the past six months. Of these 229 men, 82%
reported always using condoms with such partners. Only 41/491 men (8.4%) reported unprotected sex with a casual partner; 27% reported unprotected sex with
a steady partner and 32% reported unprotected sex with any partner.
Conclusions: Although some of the change between 1993 and 2001 may be due
to differences in sampling strategy, time frame (6 vs. 12 months), and the wording
of condom use questions, there appears to have been a substantial increase in
condom use with casual partners during this period. While this trend is encouraging, the prevalence of sex with casual partners remains high, and not all men
are consistently using condoms. Condom use with steady partners remains much
lower. Continuing prevention efforts are needed to further increase condom use
with all partners.
Presenting author: N Hearst, UCSF Box 0900, San Francisco, CA 94143, United
States, Tel.: [phone], E-mail: [email protected]
WePeC6166I Risky attitude and behaviour in prisons of
Moldova
D. Laticevschil, A. Leorda2, V. Soltan3. 1NGO Health Reforms in Prisons,
Moldova, Republic of; 2Prison Health Service, Chisinau, Moldova, Republic of;
3Soros Foundation Moldova, Chisinau, Moldova, Republic of
Background: Inducing changes towards less risky patterns of attitude and behavior among inmates in prisons of Moldova was an important component of our,
IHRD financed, project.
Objective: To measure the intensity of risky attitude and behavior in different
prisons of Moldova. To evaluate the "baseline" knowledge of general facts about
HIV.
Design: Descriptive study of knowledge, attitude and behavior in 494 inmates
from 8 prison institutions of Moldova.
Material and methods: The participants, have filled-in a questionnaire, with 97
statements. EPINFO was used to computerize the data. A "check file" was written to clean the data base for double entries and spelling errors. Risky lack of
knowledge, risky attitude and risky behavior were defined as positive selection
of the respective statements. Data was analysed with EPINFO/ANALYSIS. The
frequency of the above mentionned variables was determined in the study by program files, which were summing the "risky" statements, and thus offering grades
for every individual.
Results: The study revealed a a relatively high average knowledge of basic facts
about HIV, a moderately risk-taking behavior, and an intensely expressed risky
attitude.
Discussion: The the collective prison culture, marked by a violent and intolerant
folklore is probably influencing the selection of "risk taker" statements.
Conclusion: A high level of expressed risky attitude may not exclude a moderately risky behavior.
Presenting author: Dumitru Laticevschi, bd. mc batrin 32 ap 199 md 2075,
Moldova, Republic at, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeC6167 The contribution of travel to diagnosed HIV and
sexually transmitted infections in the United
Kingdom
C.A. McGarriqle, K.A. Fenton, J.Y. Mortimer, E. Rudd, B.G. Evans. PHLS
Communicable Disease Surveillance Centre, PHLS, CDSC, 61 Colindale Ave,
London NW9 5EQ, United Kingdom

Background: Worldwide travel has increased in the past decade due, in part, to
its increasing accessibility and affordability. In this paper, we examine the contribution of travel to the epidemiology of HIV and sexually transmitted infections
(STI) in the United Kingdom (UK).
Methods: Analysis of national surveillance data of newly diagnosed HIV infections and sentinel surveillance of primary and secondary syphilis, and antibiotic
resistant gonorrhoea was undertaken.

Results: In 2000 probable country of infection was recorded for 65% of newly
diagnosed HIV infections. The likely country of infection was the UK for 31% (691
of 2247) of those diagnosed, while for 56% (1261) it was an African country, for
4.2% (95) it was in Europe and for 5% (106) it was in Asia. This varied by exposure
group with 17% of infections attributed to sex between men acquired outside the
UK and 88% of infections in heterosexuals (p<0.001). GRASP, a national sentinel
surveillance system r monitoring antimicrobial resistant Neisseria gonorrhoea
found that, in 2000, 13% (300 of 2,260) of individuals diagnosed with gonorrhoea
reported having had a sexual contact abroad in the past three months. Eleven
percent (104 of 918) reported a sexual contact in Western Europe, 2% in the Far
East, and 2% in Africa. Enhanced surveillance of primary and secondary syphilis
in London from April to November 2001 found 25% of cases were acquired outside the UK, accounting for 15% (22 of 151) of cases in homosexual men, and
52% (29 of 56) of heterosexuals (p<0.001).
Conclusions: Increases in travel associated STI reflect increases in overseas
leisure and business travel and changing migratory patterns, both within and outside the European Union. Travel health experts should be aware of the risks and
encouraged to actively promote sexual health in their consultations.
Presenting author: Christine A McGarrigle, PHLS, CDSC, 61 Colindale Ave,
London NW9 5EQ, United Kingdom, Tel.: [phone], Fax: +44 (0) 208
200 7868, E-mail: [email protected]
WePeC6168 Increasing incidence of anal intercourse among
Australian gay and bisexual men
P. van de Ven, J. Crawford, P. Rawstorne, T Nakamura, S. Kippax, G. Prestage,
A. Grulich. The University of New South Wales, National Centre in HIV Social
Research, Level 2, Webster Building, The University of New South Wales,
Sydney NSW 2052, Australia
Background: To examine trends in anal intercourse among gay and bisexual
men in Australia.
Methods: Biannual cross-sectional surveys of gay men in Sydney (1996-2001;
n=17026) and four-yearly national cross-sectional surveys of Australian gay and
bisexual men (1992, 1996, 2000; n=2954). Sydney data were annualised. Practices were assessed 'in the previous six months'.
Results: Among those who had regular partners, anal intercourse increased in
Sydney from 85.6% in 1996 to 89.0% in 2001 (trend p<.05) and in the Australiawide sample from 77.2% in 1992 to 88.4% in 2000 (trend p<.001). Among those
who had casual partners, anal intercourse increased in Sydney from 71.5% in
1996 to 81.6% in 2001 (trend p<.001) and in the Australia-wide sample from
58.9% in 1992 to 79.1% in 2000 (trend p<.001). In the Australia-wide sample,
among those who also had sex with women, anal intercourse with female partners increased from 32.6% in 1992 to 57.7% in 2000 (trend p<.001).
% Anal intercourse 1992 1996 1997 1998 1999 2000 2001
Sydney
Regular male partner 85.6 87.8 90.3 87.8 87.8 89.0
Casual male partner 71.5 74.9 74.9 75.7 79.5 81.6
Australia
Regular male partner 77.2 87.2 88.4
Casual male partner 58.9 70.5 79.1
Female partner 32.6 48.8 57.7
Conclusions: In Australia, increasing proportions of gay and bisexual men with
regular and casual male partners are having anal intercourse, and (where applicable) with their female partners. The evidence suggests a changing sex culture
in which anal intercourse has become increasingly normalised.
Presenting author: Paul van de Ven, National Centre in HIV Social Research,
Level 2, Webster Building, The University of New South Wales, Sydney NSW
2052, Australia, Tel.: [phone], Fax: [phone], E-mail: p.vandeven
@ unsw.edu.au
WePeC61 69 Sexual behaviour among female sex workers and
male company workers in western province, Kenya
U. Schwartz1, A. Costigan2, E.N. Ngugi1, J. Kimani1, S. Moses2, J. Price3,
F. Plummer2. 1 nvest of Nairobi, Nairobi, Kenya; 2University of Manitoba,
Manitoba, Canada; 3Family Health International, Nairobi, Kenya
Background and Methods: The Strengthening STD/AIDS Control Project undertook two baseline surveys of 368 female sex workers (FSWs) and 817 male
company workers in four community sites in Western Province, Kenya, prior to implementing a HIV prevention programme under the FHI/USAID-funded IMPACT
Project. All participants responded to a structured questionnaire, and had their
blood and urine specimens screened for syphilis, gonorrhoea and chlamydia trachamatis infections using the rapid plasma reagin and palymerase chain reaction
methods, respectively.

Results: FSWs were significantly younger, less educated and more mobile than
company workers. Twenty-five per cent of company workers had more than one
sexual partner, and 4.2% had been clients of sex workers in the previous year. All
FSWs had clients, and up to four non-paying partners per week. Condom use was
the HIV prevention method favoured by the FSWs, while company workers cited
faithfulness. Consequently, significantly more FSWs had ever used a condom
(81.8% versus 46.5%). However, they were less likely to use them with steady,