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

172 Abstracts WePeD6350-WePeD6353

XIV International AIDS Conference

spondents disclosed. Qualitative data revealed most men adopted a single rule
about disclosure e.g. some 'always' told ("I've always been... up front about it. I
don't wait until we're... in bed."), while others treated casual partners differently
to prospective regular partners ("If I'm not asked directly then I don't always tell.").
76% (455/602) of episodes involved casual partners and in 53% of these men disclosed. However, disclosure depended on social context ("If I go to a sauna... (I)
feel less responsible, because people go there to have sex so they should know.")
In episodes where sex with a casual partner occurred in a public sex environment
less than 12% involved disclosure.
Conclusions: In this study, the quantitative results support the qualitative analysis. They demonstrate a considerable proportion of HIV-positive gay men routinely
disclose to their sex partners, but disclosure remains highly personalised and context based. Efforts to promot disclosure without addressing issues of expectation
will be of little value.
Presenting author: John Imrie, Dept of STD, Royal Free & Univeristy College
Medical School, Mortimer Market Centre, off Capper Street, London WC1E 6AU,
United Kingdom, Tel.: [phone], Fax: [phone], E-mail: jimrie
@gum.ucl.ac.uk
WePeD6350 Educational proyect for the prevention of HIV/AIDS
and promotion healthy habits for teenagers in the
province of A Coruna
J.L. Castro, C. Lage, I. Martinez, M. Calvo, C. Isasi, M. Cendan. Spanish Young
Red Cross, Cruz Roja Espahola s/n, 15002, A Coruha, Spain
Issues: Studies suggest that the prevention programs constitute one of the most
important ways to diminish contagius problems such as the HIV/AIDS. There is
no doubt that teenagers are at an important risk, so that the program of primary
attention are directed toward them.
Description: We consider important to undertake specific programs whose characteristics are related to this problem and that are capable of inform and provide
strategies about the HIV/AIDS. The Spanish Youth Red Cross have developed
this project within its area of education in the province of A Coruna.
The main objective is the promote within the youth the attitude of responsibility
with respect to the HIV/AIDS so that they are more capable of perceiving the risk
of the disease. Another important objective is to sensitize the population and the
young population about HIV/AIDS.
These objective were developed thru two lines of action:
1) Educational workshop (directed to the youth population 12-18 years old):
Trained people (youth) in HIV/AIDS made possible the taking of these actions in
educational centers.
2) Meetings, informative speech and stands of information (directed to the youth
population 12-18 years old and to the general population).
These actions were taken in educational center, associations, guardianship centers of minors and in the street by Youth Mediators in HIV/AIDS.
Lessons learned: We have observed a high participation in the sensitive activities with respect to the general population as well as to the youth population. It is
also observed that people have taken advantage of workshops and the analysis
of the data indicates increase on the knowledge of the HIV/AIDS and about the
risky behavior.
We think that in the long run the actions we are taking will have a positive effect
in the future.
Presenting author: Jose Luis Castro, Cruz Roja Espafola s/n, 15002, A Corufia,
Spain, Tel.: [phone], E-mail: [email protected]
WePeD6351I Preventing HIV: working with the lower income
commnunies in Salvador, Northeast Brazil
I. Dourado, G.M.S. Menezes, M.G. Rabelo, A. Velame, V. Falcao. Instituto de
Saude Coletiva/UFBA, Salvador, Bahia, Brazil
Issues: Salvador, the capital of the State of Bahia, is a city with approximately 2.5
million inhabitants. Its population is roughly 80% black or racially mixed. The State
of Bahia has 5,185 cumulative AIDS cases through June 2001 (35,4 x 10-5) and
Salvador is responsible for 62% (3225) of the reported cases in the State. The
AIDS epidemic in Salvador follows the major national trends, with greater rates of
infection in women, young and poorer individuals.
Description: Given the current profile of AIDS in Bahia, it is important to create new means of informing and communicating with lower income communities/groups about STD's/AIDS, and to articulate these actions to Community
Health Agents. The target groups of this work are community leaders and residents of areas of Salvador with higher AIDS incidence rates. In addition, we have
been working with renowned cultural musical groups. The training sessions use
interactive and participative techniques for the transmission of knowledge. This
approach combines group discussion with lectures on STD's/AIDS, epidemiology, myths, taboos and preconceived notions of sexuality and gender. Furthermore, there is critical discussion of the role of each trainee as a future source of

information for his/her community.
Lessons learned: So far, we have worked with 8 different Community Organizations in Salvador, and each community has elaborated an action plan for
STD/AIDS in their area. The qualitative and quantitative evaluations point to the
incorporation of information on STD's/AIDS and discussion of taboo themes.
Recommendations: The selective process of each group and trainee is a key aspect of this intervention. Beyond the positive aspects of this work, the challenge of

constructing sustained mechanisms for the continuation of prevention strategies
with the Community remains.
Presenting author: In6s Dourado, MD, PhD, Rua Padre Feij6, 29 - 40 andar,
Canela, Salvador, Bahia, 40.110.170, Brazil, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeD6352 Impacts of HAART on perceptions of HIV risk and
sexual behavior of gay and bisexual men in New
York City
H.M. Koegel', H. Yi2, C.J. Godfrey', A. Shidlo3, B.J. Dalit3. 1St Vincent
Catholic Medical Centers of NY/Manhattan, St Vincent Catholic Medical Centers
of NY/Manhattan, 412 Sixth Ave., Suite 401, New York, NY 10011, United States;
2TalkSafe, New York, United States; 3Private Practice, New York, United States
Background: While Highly Active Anti-Retroviral Therapies (HAART) are helping people with HIV maintain their health, they are also influencing the appraisal
of HIV risk and sexual behavior of uninfected gay/bisexual men. Since 1996, the
TalkSafe Program has provided cost-free HIV prevention counseling to uninfected
gay/bisexual men in NYC. A scale was developed to assess their sexual behavior
and perceptions of risk since HAART Differences between a general community
sample and a clinical sample were explored. Changes in perceptions and sexual
behavior in the clinical sample were tracked from 1997 through 2000.
Methods:The community sample consisted of 396 subjects, and the clinical sample 295. The samples were matched on age (mean of 35) and ethnicity, with 60%
White and 40% men of color. Participants were generally college educated. A
set of 14 content valid items was constructed and administered to all subjects to
asses emotional, behavioral, and social aspects of their perceptions of HIV risk
and sexual behavior.
Results:Statistical analyses included ANOVAs, t-tests, and post hoc comparisons. Since HAART, gay/bisexual men seem to be having more unprotected anal
intercourse (UAI), and they appear to be less concerned about HIV infection. The
clinical sample perceived greater risk of HIV, yet engaged in more UAI than the
community sample. In 1998, the perception of HIV risk for the clinical sample
reached its lowest level, their risky sexual behavior reached its highest level, and
their social awareness of HIV was at its lowest point.
Conclusions:Perceptions of HIV risk were often at odds with actual sexual behavior. Though they were aware of risk, the clinical subjects were more likely to
have UAI than the community subjects. Subjects were equivocal about having
UAI with a partner whose viral load is undetectable. HIV prevention counseling
services must include accurate information about HIV prevention and treatment
issues.
Presenting author: Henry Koegel, St. Vincent Catholic Medical Centers of
NY/Manhattan, 412 Sixth Ave., Suite 401, New York, NY 10011, United States,
Tel.: [phone] x249, Fax: [phone], E-mail: [email protected]
WePeD6353 Predictors of condom use with casual partners by
men in Kampala, Uganda
S. Chen', P. Kajubi2, M. Kamya2, W. McFarland3, N. Hearst4. '1Johns Hopkins
Bloomberg School of Public Health, UCSF Box 0900, San Francisco, CA 94143,
United States; 2Makerere University, Kampala, Uganda; 3San Francisco
Department of Public Health, San Francisco, United States; 4 University of
California, San Francisco, San Francisco, United States
Background: Despite some success in stemming the HIV epidemic, Uganda is
still a high prevalence country and sustained, long-term promotion of condom use
remains the cornerstone of prevention. To enhance community-level condom promotion efforts, we examined barriers to condom use among young men in two
low-SES neighborhoods on the outskirts of Kampala.
Methods: In mid-2001, we recruited 491 men aged 18 to 30 in two communities
that were randomly chosen from a list of poor peri-urban communities with similar
characteristics. Men were recruited 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. Predictors of unprotected sex with casual partners among sexually active men were assessed using multiple logistic regression.
Results: Knowledge regarding condoms was generally accurate and attitudes
towards condom use were favorable; however, some misconceptions persisted
(e.g., condoms may have holes in them or may disappear inside a woman). Of
368 men who reported any sex in the past six months, 229 (62%) reported at
least one casual partner. Of these, 82% reported always using condoms. Independent predictors of unprotected sex with casual partners included sex while
drunk (OR=6.1; p=.005), past STI symptoms (OR=3.5; p=.001), history of difficulties using a condom (OR=3.2; p=.004), and not always carrying condoms
(OR=2.3; p=.028).
Conclusions: Interventions to increase condom use with casual partners by low
SES peri-urban men in Kampala should teach technical condom use skills so that

men will not have difficulty with their use and should emphasize the importance
of always carrying condoms and of avoiding unsafe sex while intoxicated.
Presenting author: N Hearst, UCSF Box 0900, San Francisco, CA 94143, United
States, Tel.: [phone], E-mail: [email protected]