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

XIV International AIDS Conference

Abstracts WeOrD1273-WeOrD1l276 147

Conclusions: HAART initiated during pregnancy showed efficacy and favorable
safety profile in mothers and exposed newborns
Presenting author: Pedro Cahn, Angel Peluffo 3932, C1202ABB, Buenos Aires,
Argentina, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WeOrD1273 HIV Prevention among street children in India:
Lessons learned
M.U.B. Mohammed. S. VUniversity, Dept. of Population Studies, Associate
Professor, Dept. of Population Studies, S. VUniversity, TIRUPATI - 517 502,
Chittoor Dt., A.PR, INDIA
India has the largest number of street children in the age group of 8-18 years.
They are exposed to all kinds of risky social environment. They are prone to
drinking alcohol, smoking, begging, pick-pocketing and many other similar vices.
A vast majority of the street children indulge in sex at a very young age (after
crossing 14 years of age). The Government of India felt that there was a potent
danger of the spreading of HIV/AIDS among the street children and from them to
the general public. Indian Government has initiated a few pilot projects through
non-governmental organisations (NGOs) to prevent STD/HIV on an experimental
basis among the street children. One such project is in operation in the Chittoor
district of Andhra Pradesh, where there are about 16,000 street children. This
project was started in 2000-2001.
Peoples Action for Social Services, an NGO has initiated a Street Children Project
not only to ameliorate the street children but also work towards the prevention of
STD/HIV among them. A pre-survey was conducted before the commencement
of the project to know their activities, motivation to engage themselves in different
occupations. Based on the pre-survey results, a broad-based programme was
planned to bring about changes in their daily activities, general behaviour, sexual
behaviour and to prevent STD/HIV among them. The services included general
services and non-institutional services. The general services included non-formal
education, vocational training, placements and sending them back home in some
cases. The non-institutional services included counselling in general, sex education, condom promotion, medical referal services and treatment in case of STDs.
A recent mid-term evaluation conducted by the PASS has shown a great reduction in STD prevalence among the street children. The experiences of this project
can be replicated in all other countries of the world where street children are
abundantly found.
Presenting author: Ubaidullah Mohammed, Associate Professor, Dept. of Population Studies, S.V.University, TIRUPATI - 517 502, Chittoor Dt., A.P., INDIA, India,
Tel.: [phone], E-mail: [email protected]
WeOrD1274 Health improvement measures in a service version
of an effective sex education programme
C.M. Kay1, A.R. Mellanby2, J. Hinde1, J.B. Rees1, T. Hull3, J.H. Tripp1.
1 University of Exeter, Exeter, United Kingdom; 2East London & City Health
Authority London, United Kingdom; 3C.S.N., Essex, United Kingdom
Concern in the UK that sexually transmitted infections amongst the young are
continuing to rise and that the teenage pregnancy rate is the highest in Europe
has been highlighted by The National Strategy for Sexual Health and HIV. Although the need to deal with these issues is recognised, the methodology for
achieving targets is still not clear. While a number of studies have shown that sex
education programmes can be effective, few have been scientifically robust and
many have shown no behavioural change. In its original experimental mode, A
PAUSE, a social influences based sex education programme, which uses both
adult teachers and peer educators, demonstrated changes in knowledge, beliefs
and behaviours. We report here, the evaluation of the dissemination of this programme. This study, carried out from 1995 to 2000, compares questionnaire responses from 22,794 students (mean age 16) who have (n=3953) or have not
(n=18841) received the A PAUSE sex education programme during their secondary school years. Analysis used a General Linear Model (GLM). The effect of
the intervention is estimated from between and within school comparisons, allowing for time trends.
Results: show that students who received the intervention demonstrated higher
levels of correct knowledge concerning contraception and sexually transmitted infections (GLM p<0.001). They viewed their sex education more positively
and were more likely to recall issues directly relating to the intervention, (GLM
p<0.001). Intervention students were less likely to incorrectly believe that most
teenagers under 16 have had sex (GLM p<0.001). The intervention also resulted
in an absolute reduction of 5.8% (a relative reduction of 13.6% of those sexually
active) in the number of students who reported having had sex. (GLM p=0.009).
This is, we believe, the first theoretically based sex education model in Europe to
be disseminated and maintain behavioural effects.
Presenting author: Catherine Kay, Dept Child Health, University of Exeter,

Church Lane, Heavitree, Exeter, Devon, EX2 5SQ, United Kingdom, Tel.: [phone], Fax: [phone], E-mail: [email protected]

WeOrD1275 School programs in Mexico and Thailand increase
condom use
H. Stewart', A. McCauley2, S. Baker3, M. Givaudan4, S. James5, I. Leenen4,
S. Pick4, RP. Reddy6, U. Rewthong3, P. Rumakon7, D. Walker'. 'Population
Council/Horizons, Washington, DC, United States; 2International Center for
Research on Women/Horizons, c/o Ann McCauley, Population Council, 4301
Connecticut Avenue, Ste 280, Washington, DC 20008, United States; 3Program
for Appropriate Technology in Health/Horizons, Bangkok, Thailand; 41nstituto
Mexicano de Investigacion de Familia y Poblacion, Mexico City Mexico; 5Medical
Research Council - Cape Town, based at the School of Public Health and Family
Medicine at University of Natal, Durban, South Africa; 6Medical Research
Council, Cape Town, South Africa; 'Population Council/Horizons, Bangkok,
Thailand
Background: In Mexico and Thailand, local organizations and educators designed school programs to include elements from programs found to successfully
change students' behavior elsewhere, such as interactive teaching methods and
the provision of accurate sexual information.
Methods: About 1880 students at 4 secondary schools in Mexico and 2380 students at 6 colleges in Thailand completed questionnaires before the intervention,
immediately after the intervention, and 4 to 6 months later. In each site half of the
schools received the intervention and half served as controls. Mean age was 16
years in Mexico and 20 years in Thailand.
Results: Sexually active Thai females in the intervention arm increased condom
use at last sex from 26% to 37% post-program. Although still higher than baseline, the increase was not significant by the second followup measure. Mexican
girls reported an increase in condom use at last sex from 48% at baseline to
58% after the program but the number was too small to calculate the statistical
significance of the increase. Females in both sites reported significant increases
in confidence to correctly use a condom in the intervention arm (Mexico:18% to
70% to 59%; Thailand: 54% to 83% to 82%). These data were significantly higher
than the control in both followup measures. In both sites, males reported more
condom use and confidence to use a condom at baseline than females. Although
males showed an increase post-intervention, it was not always significant when
compared to the control arm. In all measures the percentage fell from the second to the third round of data collection but remained significantly higher than
baseline. Among males and females in both countries, there was little change in
confidence to persuade a partner to accept condoms.
Conclusion: School programs can increase condom use and confidence to use
condoms, especially among females. Program refinements are needed to increase confidence to negotiate condoms with a partner.
Presenting author: Holley Stewart, c/o Ann McCauley, Population Council, 4301
Connecticut Avenue, Ste 280, Washington, DC 20008, United States, Tel.: +1 202
237 9401, Fax: [phone], E-mail: [email protected]
WeOrD1276 Outcomes of a community-level intervention
among adolescents in inner-city housing
developments
K.J. Sikkemal, R.G. Hoffmann2, M.J. Brondino2, E.S. Anderson3, C. Gore
Felton2, R.A. Roffman4, J.A. Kelly2, R.A. Winett3, T.G. Heckman2,
L.J. Solomon5, A.M. Somlai2. 1 Yale University School of Medicine, yale school
of medicine, 389 whitney avenue, new haven ct 06511, United States; 2Medical
College of WI, Milwaukee, United States; 3 Virginia Tech, Blacksburg, United
States; 4University of WA, Seattle, United States; 5University of VT Burlington,
United States
Background: A randomized, multisite community-level trial was undertaken with
ethnically-diverse adolescents living in low-income housing in the U.S.
Methods: Developments were randomly assigned to one of three conditions: 1)
a multi-component community intervention of skills training plus social/peer norm
change to reinforce and support risk avoidance; 2) skills training; or, 3) education only. Computer-assisted surveys were administered to 1172 adolescents between the ages of 12 and 17 living in 15 housing developments in 3 urban areas
(85% of all adolescents in the 3 areas were assessed). 74% and 65% of adolescents completed the 3- and 9- month follow-up assessments, respectively. Data
were analyzed using multilevel, general estimating equations, and nonparametric
techniques appropriate for a group-randomized trial.
Results: Average age was 14.5 years and 73% of adolescents had not yet had
sexual intercourse. Among sexually active teens, average age of first intercourse
was 12.5 years, 46% of females and 70% of males reported multiple partners, half
reported inconsistent condom use, 23% had been pregnant, and 9% had an STD.
Delayed onset of first intercourse was the primary outcome variable. The proportion of adolescents reporting initiation of first intercourse at the 9-month follow-up
was 26% in education only, 23% in skills training, and 17% in community intervention developments (p<.05). The effect for delayed onset of first intercourse
was stronger for male adolescents, and was related to age, family structure, and
behavioral intentions and outcome expectations both related to risk avoidance.

Conclusions: A multi-component community-level intervention that included social norm change was shown to be more effective than education or skills training
alone in delaying the onset of first intercourse among adolescents. Higher risk
youth must be identified earlier and may need more intensive intervention.
Presenting author: kathleen sikkema, yale school of medicine, 389 whitney avenue, new haven ct 06511, United States, Tel.: [phone], Fax: +203 562
6355, E-mail: [email protected]