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

XIV International AIDS Conference

Abstracts WePeD6310-WePeD6313 163

WePeD6310 Reduction in HIV risk behaviours six months after
enrolment in needle exchange based low
threshold methadone programs
P. Millson1, L. Challacombe1, C. Strike2, P. Villeneuve3, T. Myers1, B. Fischer1,
R. Shore4, S. Hopkins5, M. Pearson6, S. Raftis1. ' University of Toronto, hiv
social, behavioural and epidemiological studies unit, 3rd Floor, 12 Queen's Park
Cres. W, Toronto, Ontario, Canada; 2Center for Addiction and Mental Health,
Toronto, Ontario, Canada; 3University of Ottawa, Ottawa, Ontario, Canada;
4Street Health & KFLA Health Unit, Kingston, Ontario, Canada; 5 The Works,
Toronto Public Health, Toronto, Ontario, Canada; 6Queen's University Kingston,
Ontario, Canada
Background: Changes in drug use and HIV risk behaviors were measured six
months after enrolment in low threshold methadone programs at two Ontario needle exchanges, which follow a harm reduction philosophy, not requiring abstention
from drugs other than methadone.
Methods: All individuals entering the programs are invited to enroll in a 3-year
prospective cohort study, completing interviewer administered questionnaires
at baseline and six monthly follow-ups, including the Addiction Severity Index
(ASI)and an HIV risk questionnaire. Intensive efforts are made to follow all participants, continuing in the program or not. Mean number of days using each drug
in the past month at baseline and 6 month follow-up are compared using paired
t-tests. McNemar's test is used to compare proportions of participants using each
drug and with each risk behavior at baseline and follow-up.
Results: After the first year of study enrolment, 62 participants completed 6
months follow-up, with a 5% loss. In the month prior to program entry, 97% had
used illegal substances, with 40% using heroin,95% another opiate, and 48% cocaine. Most (66%) had injected at least once a day;10% had indirectly shared
injections through frontloading/backloading/splitting, while 32% had shared drug
paraphernalia and 42% had injected in a shooting gallery After 6 months, significantly (p<0.05) fewer individuals had used heroin, other opiates, and cocaine in
the previous month, and mean number of days of drug use had declined significantly (p<0.05) for each, and also for multiple substance use. There was also a
statistically significant drop in the proportion of IDU reporting needle or paraphernalia sharing, indirect sharing, and shooting gallery use in the past month.
Conclusions: Early results indicate a significant drop in HIV risk behaviors and
use of heroin, other opiates, and cocaine six months after enrolment in low threshold methadone programs provided through two Ontario needle exchanges.
Presenting author: peggy millson, hiv social, behavioural and epidemiological
studies unit, 3rd Floor, 12 Queen's Park Cres. W., Toronto, Ontario, Canada, Tel.:
[phone] ext. 1, Fax: [phone], E-mail: [email protected]
WePeD6311 The Internet, sex and gay men
J. Elford1, G. Bolding 2, L. Sherr2. 1City University, City University, 20
Bartholomew Close, London EC1A 7QN, United Kingdom; 2Royal Free & UC
Medical School, London, United Kingdom
Background: To examine the association between seeking sex on the Internet
and sexual risk behaviour among gay men in London.
Methods: In 2000 and 2001 gay men in London were asked to complete selfadministered questionnaires concerning use of the Internet, history of sexually
transmitted disease (STD) and recent unprotected anal intercourse (UAI). Internet sex seekers were compared with other men, also with Internet access, who
did not seek sex in this way.
Results: Of the 1289 gay men included in the analysis (201 HIV positive, 789
HIV negative, 299 never-tested), 83.9% (1082) had access to the Internet. Among
those who had access, 35.1% (380) had used the Internet to find a sexual partner; HIV positive men, 33.4%, HIV negative 30.6%, never-tested 24.1% (p<0.05).
Compared with HIV positive men who did not seek sex on the Internet, those who
did were more likely to report seroconcordant UAI (ie UAI with another positive
man) (29.9% v 11.4%, adjusted odds ratio 4.1, 95% confidence interval (CI) 1.6,
10.6, p<0.01). HIV negative Internet sex seekers were more likely to have had
an STD in the previous 12 months (27.2% v 16.6%, p=0.001) and more likely to
report non-concordant UAI in the previous 3 months (ie UAI with a person of unknown or discordant HIV status) (19.9% v 13.6%, adjusted OR 1.50, 95% CI 0.97,
2.39, p=0.07). For never-tested men there was no association between seeking
sex on the Internet and either STD or sexual behaviour.
Conclusion: Seeking sex on the Internet was associated with recent STD and
high risk sexual behaviour among HIV negative gay men in London. This study
suggests that HIV positive gay men may be using the Internet to meet other positive men for unprotected anal intercourse ("barebacking"). The Internet's potential
for HIV prevention and sexual health promotion merits further and urgent exploration
Presenting author: Jonathan Elford, City University, 20 Bartholomew Close, London EC1A 7QN, United Kingdom, Tel.: [phone], Fax: +44 (0) 20
7040 5717, E-mail: [email protected]

WePeD6312 STD/HIV prevention among heterosexual males
utilizing a participatory action research approach
D.E. Morisky1, T.V. Tiglao2, A. Coly1, A. Ang1, T. Tzai1, T Thomas1. 1UCLA
School of Public Health, UCLA School of Public Health, 650 Charles E. Young
Dr. South, Room 26-070, Los Angeles, CA 90095-1772, United States;
2University of the Philippines, College of Public Health, Manila, Philippines
Background: Heterosexual transmission is the major mode of HIV infection
throughout the world and most particularly in Asia. Research has demonstrated
the importance of peer counseling and participatory research.
Methods: Managers and officers of community-based organizations in the southern
Philippines (military establishments, factories, etc.) were invited to participate in
the study. A total of 3300 males (approximately 200 males in each of the 15 study
group) provided baseline information on STD/HIV knowledge, attitudes and practices.
Approximately 20 males per group were trained as peer counselors to provide
information and knowledge to their co-workers. Peer counselors diagnosed and
assessed baseline data and identified relevant educational materials to assist
in information dissemination. Post-intervention assessment was conducted one
year following training with a one year follow up assessment
Results: Educational materials had a pronounced effect in raising knowledge
and positive attitudes among the various study groups. Knowledge regarding the
modes of STD/HIV transmission was significantly related to condom use attitudes
(r = 0.22) and attitudes were strongly related to behavioral intention to use condoms (r = 0.36). A path analytical model identified a significant main effect of peer
counseling on both behavioral intention and self-reported condom use behavior (r
=- 0.39). Follow-up results identified the importance of long term assessment, as
several outcome measures (e.g. condom use and STD incidence) demonstrated
their importance only after educational interventions had sufficient time to modify
attitudes and beliefs.
Conclusion: The concept of participatory action research is demonstrated in every phase of this educational program. Active involvement of peer counselors in
the planning and decision making activities provides a sense of ownership and
commitment resulting in lasting health benefits.
Presenting author: Donald Morisky, UCLA School of Public Health, 650 Charles
E. Young Dr. South, Room 26-070, Los Angeles, CA 90095-1772, United States,
Tel.: +[phone], Fax: +[phone], E-mail: [email protected]
WePeD631 3 HIV/AIDS knowledge, perceptions and risky
behaviors among patients suspected to have
STDs in Alexandria, Egypt
M.E.S. Mona shama, S.A.S. Sallam, M.A.A. Arafa, A.A.M. Mahfouz. High
institute of Public Health, Alexandria, Egypt
Background: The reported HIV/AIDS cases in Egypt are still few. However, indigenous transmission and spread of the virus has been reported. A key element
in developing a health education program for the primary prevention of HIV infection is the accurate assessment of HIV/AIDS related knowledge and practices.
Methods: A representative sample of 700 patients suspected to have STDs
were recruited from the seven public DV clinics in Alexandria. Data was collected
on socio-demographic characteristics, knowledge, perception of threat and practices related to HIV/AIDS. Stepwise multiple logistic regression analysis was performed, with level of knowledge and level of perceived HIV/AIDS threat as dependent variables.
Results: Majority of patients were males; having less than nine years education
with mean age 29.2 years. Less than 10% of them had good level of HIV/AIDS
related knowledge. Misinformation on issues related to modes of HIV transmission was observed, where over half of them failed to identify breast feeding and
tattooing as proved modes of transmission. On the other hand, 71.0%, 33.0%
and 31.7% accused insect bite, sharing toilet and swimming places as modes of
transmission. To prevent HIV infection, more than half of the sample mentioned
avoiding practicing extramarital sex, while only 39.1% mentioned using condoms.
Regarding perceived susceptibility to HIV infection, only 29.1% of male patients
had low perceived susceptibility compared to more than half the female patients.
Sex, educational level and age were the important predictors for knowledge level,
while the most important determinants for perception of threat was patients' gender followed by patients' level of knowledge.
Conclusion: there was a significant number of persons among this risky group
don't know the basic facts concerning HIV/AIDS with a great variation in the level
of knowledge and perception of HIV/AIDS threat & the role of health personnel as
source of information was very limited.
Presenting author: mostafa arafa, High Institute of Public Health.165 EIHorreya Ave, El Hadara. Alexandria, Egypt, Egypt, Tel.: [phone], Fax:
[phone], E-mail: marafa@ dataxprs.com.eg