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

XIV International AIDS Conference

Abstracts WePeD6274-WePeD6277 155

Description: Realization epidemiological of surveillance for HIV by an infection
and infectious diseases according to the methodical recommendations UNO in
one city Omsk by a method of a taking blood of a material for the analysis in syringes for injection. For maintenance of reliability of the analyses, each syringe
was marked and was given out outreach. All in the project participated 8 outreach. Suitable for analytical researches there were 188 syringes and 58 bloodtube. The analysis has shown difference of official statistics from a real situation
of businesses on distribution of a HIV-infection 1,5 cases on 100 men (official
statistics - 8,4 cases on 100 000 people), and similar situation on distribution of
infectious illnesses - virus hepatit C- 89% virus hepatit B- 40%. In the project the
opportunity of recurrence of research - was stipulated whereas outreach filled the
special registration forms of the participants of researches including age, name,
etc.
Acquired lessons: The active consumers of drugs in a status on equal with state
scientific institutes to participate in scientific - field researches and to influence a
situation on HIV; IDU's - outreach are interested in the further field researches and
are ready to pass medical rates, which could promote their further professional
growth.
Recommendations: The further stage epidemiological of surveillance for
HIV/AIDS and infectious diseases are planned to July, - August 2002 and as will
be carried out by forces outreach in the same groups IDU's, which participated in
the first investigation phase.
Presenting author: Sergey Katantsyev, Omsk, Prospekt Koroleva, 26, Office
52, Russian Federation, Tel.: [phone], Fax: [phone], E-mail: evnan
@mail.echo.ru
WePeD6274 Learning from the Spanish experience of not
implementing on time a public health policy for the
control of the hiv epidemic in injection drug users
L. De la Fuente', G. Barrio 2, M.J. Bravo2, A. Rodes3, M. Suarez3, F. Parras3.
' Secretaria del Plan Nacional sobre el Sida. Instituto de Salud Carlos Ill/, Madrid,
Spain; 2Centro Universitario de Salud Publica, Madrid, Spain; 3Secretaria del
Plan Nacional sobre el Sida, Centro Nacional de Epidemiologfa, Instituto de
Salud Carlos Ill, C/ Sinesio Delgado 6, 28029 Madrid, Spain
Issues: Some countries that are submitted to a very rapid expansion of the HIV
epidemic are faced with a situation very similar to that of Spain at the beginning of
the eighties: very rapid social changes derived from its evolution from an authoritarian regime to a liberal one, high prevalence of drug injectors (IDU) and social
perception of great insecurity.
Description: Spain set priority on supply control measures against public health
policies. This priority gained a large unanimity. In 1985 access to methadone
was severely restricted (see figure), when the country began to take consciousness of the abrupt rise in the number of AIDS cases among IDUs, as well as
the high HIV infection prevalence. Although it was not possible to know the incidence rates, it was suspected that they were very high; later estimates showed
that during these years the peak of the epidemic was reached. Harm Reduction
policies (methadone programs and syringe exchange programs) were not widely
implemented until ten years later.

WePeD6275 Condonmovil: A strategy to overcome barriers for
promoting public access to, acceptance and use
of condons through direct action among youth in
Mexico
A. G6mez, J.A. Arias-Velasco, J.J. Herndndez - Chavez. Colectivo Sol,
Cuauhnochtli No. 11, Col. Pueblo Quieto, 14040 Mexico, D.F, Mexico
Issue: Prevalent unprotected sexual penetrative practices among young people,
low levels of awareness on the risk of contracting HIV and other STIs, and proactive opposition of churches, conservative media and politicians, facilite the ongoing and increasing spread of HIV infection. The absence of proactive campaigns
promoting sustained and appropriate use of condoms nationwide fuels the HIV
and STI epidemics.
Description: CONDOMOVIL is a the only project of its kind in Mexico: a small vehicle which travels throughout the country promoting visibility of condoms, putting
in place outreach activities in public sites, universities, market places, bars and
discos addressing sexually active young men and women. Educational interactive
events, social marketing and free distribution of condoms and lubricants, public
presentation in relevant fora, media presentations and advocacy responses in
cities and villages where CONDOMOVIL faces visible opposition from churches,
media and decision makers, are some of the key components that have made
CONDOMOVIL a model for outreach activities, social marketing and advocacy
among government officials, NGO and community leaders.
Lessons learned: Proactive and open promotion of condoms and water-based
lubricants in public places along with educational activities, has allowed young
beneficiaries to uninhibitedly discuss difficult issues related to HIV and STIs and
to have direct access to condoms. Swift responses against opposition and attacks from conservative groups have given CONDOMOVIL an added value and
credibility in the cities it visits.
Recommendations: As a unique outreach model, CONDOMOVIL has the potential to stimulate the creation of replicates, as happened in Venezuela. The Health
Ministry in Mexico and other NGOs should replicate the model at state and local
level, given its comparative advantages due to its mobility and low cost.
Presenting author: Apolonio G6mez, Cuauhnochtli No. 11, Col. Pueblo Quieto,
14040 M6xico, D.F, Mexico, Tel.: [phone], Fax: [phone],
E-mail: pologomez@ hotmail.com
WePeD6276 Sustainability of effective STD/HIV prevention
intervention targeting female sex workers and
their clients at five different settings in China
Z. Wu1, K.M. Rou1, F. Li2, W. Liu3, D.H. Liu4, J.H. Guan5, C. Xu6. INational
Center for AIDS Prevention & Control, 27 Nanwei Road, Beijing 100050, China;
2Xinjiang Center for Disease Control, Urumqi, China; 3Guangxi Center for
Diseases Control, Nanning, China; 4Beijing Shijinshan STD Hospital, Beijing,
China; 5 Fujian Health Education Institute, Fuzhou, China; 6 Fuyang Center for
Diseases Control, Fuyang, China
Background: Commercial sex and its related epidemics of sexually transmitted
diseases (STDs) and human immunodeficiency virus (HIV) infection are becoming an increasing problem in China. The objective of study is to evaluate the effectiveness and sustainability of STD/HIV prevention intervention targeting sex workers and their clients in Xinjiang, Guangxi, Beijing, Fujian and Anhui provinces,
China.
Methods: Sex workers in entertainment establishments were selected as target population. A qualitative study of organization of sex work was carried out in
5 study sites first. Educational materials were developed for intervention based
on qualitative study and the baseline survey. Comprehensive interventions were
implemented using several strategies: improved STD care services; promoting
health care seeking behaviors; and promoting condom use. Outreach was taken
for each targeted establishments by project clinic staff. Before versus after study
design was used for evaluation of effectiveness of study Self-sustaining mechanism of intervention is expected from marginal profits generated from improved
paid STD care and from selling of condoms.
Results: Sex work was well organized and coordinated. Five project clinics were
set-up delivering out-reach intervention for sex workers. Clinical based-out reach
was delivered for sex workers at monthly base. Condom use with all last 3 clients
increased from 41% before intervention to 72% after intervention. Average rate of
STDs (gonorrhea and chlamydia) dropped by 17%. Marginal revenues generated
from improved sexual health care and condom promotion were able to maintain
the intervention in 3 sites.
Conclusions: Clinical based out-reach intervention aiming improving sexual
health care seeking and condom use targeting entertainment-based sex workers
are effective and sustainable. Scaling-up the intervention strategies are urgent
needed in order to prevent sexually transmission of epidemics of STD/HIV.
Presenting author: Zunyou Wu, 27 Nanwei Road, Beijing 100050, China, Tel.:
[phone], Fax: [phone], E-mail: wuzy@ public.bta.net.cn

WePeD6277 Methadone therapy: HIV prevention worker
perspectives
J.RP. Egan. University of British Columbia, Vancouver, BC, Canada
Background: Methadone is often suggested for heroin IDUs to achieve abstinence. HIV prevention workers,often the gatekeepers for information regarding

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2000

- Aidscases(hundreds) - - - HIV-positivecases(fivehundreds) --&-patimtsinmethadone (thousands)
Evolution of AIDS cases, estimated HIV-positive cases and number of heroin users in
methadone treatment in Spain, 1982-2000.
Lessons learned: The gap between the moment when public health policies
should have been implemented and when they actually were originated an enormous cost for the country. Due to the high existing HIV infection prevalence, Spain
now needs to achieve much greater reductions in risk behaviours in order to reach
incidence rates similar to those of other occidental countries.
Recommendations: Public health policy makers must show their societies what
differed costs are derived from not implementing public health policies on time.
Presenting author: Luis De la Fuente, Centro Nacional de Epidemiologfa, Instituto de Salud Carlos Ill, C/ Sinesio Delgado 6, 28029 Madrid, Spain, Tel.:
[phone], Fax: [phone], E-mail: [email protected]