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

XIV International AIDS Conference

Abstracts WePeD6372-WePeD6376 177

WePeD6372 Predictors of consistent condom use among HIV+
and HIV- injection drug users in Puerto Rico
C.A. Marrero, R.R. Robles, J.C. Reyes, H.M. Colon, T.D. Matos. Center for
Addiction Studies, School of Medicine, Universidad Central del Caribe, Puerto
Rico, United States Territory
Background: HIV-infected IDUs are at risk of transmitting HIV to other IDUs as
well as to their sexual partners. Sexual transmission of HIV is particularly critical
in Puerto Rico where the prevalence of HIV infection among IDUs is considerably
higher compared to the US mainland. Intervention studies suggest that, among
IDUs, high-risk sexual behaviors are more resistant to change than drug injection
behaviors. This study examined the predictors of consistent condom use among
IDUs who participated in a prevention trial in Puerto Rico.
Methods: A community-based sample of 526 injection drug users was recruited
and randomly assigned to either a standard HIV testing and counseling intervention or to an enhanced intervention using motivational interviewing strategies. Six
months later, 440 (83.7%) of the participants were re-assessed. The following
baseline factors were examined in their capacity to predict consistent condom
use at follow-up: HIV status, history of STDs, psychological status, type of sex
partner, perception of self-efficacy to practice protected sex, drug use patterns
and participation in the enhanced intervention.
Results: At follow-up, 43.4% of the participants reported sexual activity during
the previous six months. Multivariate logistic regression analysis indicated that the
only significant predictor of sexual activity was gender. Females were 2.1 times
more likely to report sexual activity than males. Among the participants who reported sexual activity at follow-up, 33.7% reported using condoms consistently.
Being HIV-positive, having a casual partner and perceiving high self-efficacy to
practice protected sex were each independently associated with consistent condom use (odds ratios of 4.1, 3.7, and 9.0, respectively).
Conclusions: The results suggest that HIV prevention programs targetting IDUs
should include strategies specific to type of sex partner and identify strategies
effective in strengthening perceptions of self-efficacy.
Presenting author: C. Amalia Marrero, Center for Addiction Studies, School of
Medicine, Universidad Central del Caribe, Box 60327, Bayamon, Puerto Rico
00960-6032, United States Territory, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
WePeD6373 Awareness of HAART and of their assumed
consequences in the Swiss general population,
1997-2000
A. Jeannin, F. Dubois-Arber, B. Spencer, G. Meystre-Agustoni. University
Institute of Social and Preventive Medicine, IUMSP Lausanne, Switzerland
Background: To assess changes in awareness of the existence of HAART,
knowledge of their effects, and social representations of consequences of availability of HAART on preventive behaviour for both the respondents themselves
and as perceived for 'people in general'.
Methods: CATI surveys on random samples (n-2800) of the general population
aged 17-45 conducted in 1997 and 2000. Questionnaire items were developed
in an EU concerted action on AIDS and provided data on a) awareness of existence of HAART, b) awareness of effects on treated people, c) consequences
for prevention reported by the respondents for themselves and d) impressions
of consequences for people in general. Indicators of consequences were: level
of concern following possible exposure; whether less use of protection; fear of
becoming infected.
Results: From 1997 to 2000, the proportion of people aware of HAART increased
from 31% to 35%. The increase was confined to the most educated segments
of the population. Overall, knowledge of effects was accurate and slightly improving. Regarding the assumed consequences on preventive behavior, few reported themselves being less careful or concerned (highest % of 3 indicators in
1997:13%, 2000:10%). However, considerably more assumed 'people in general'
would be less careful or concerned (lowest % in 1997:37%, in 2000:39%).
Conclusions: Awareness of existence of HAART, whilst increasing, is still limited.
Knowledge of effects is mostly accurate. There is an increasing gap between the
consequences on prevention as reported by the respondents for themselves and
those they assume to exist for 'people in general'. This gap might be interpreted
in terms of tensions between private and social norms as proposed by social
psychological theory of false consensus effect.
Presenting author: Andre Jeannin, IUMSP, Rue du Bugnon 17, CH 1005 Lausanne, Switzerland, Tel.: [phone], Fax: [phone], E-mail: andre.jeannin @ inst.hospvd.ch
WePeD6374 Determinants of sexual risk behavior among HIV
serodiscordant male couples
R.H. Remien', C. Dolezal', A. Carballo-Dieguez', G.J. Wagner2. 1H/V Center

for Clinical & Behavioral Studies, NY State Psychiatric Institute and Columbia
University, HIV Center - Unit #15, NYSPI, 1051 Riverside Dr., New York, N. Y
10032, United States; 2RAND Corporation, Los Angeles, United States
Background: Across many settings and cultures, HIV sexual risk behavior typically occurs within ongoing relationships. Specific factors must be studied to understand determinants of risk in order to develop behavioral interventions for specific groups.

Methods: As part of an assessment of serodiscordant male couples, recruited
into a behavioral intervention trial, we assessed detailed sex behavior and potential determinants of risk. Couples were recruited via widespread community
outreach in the New York City metropolitan area.
Results: The sample(N=238 men; 119 couples) included predominantly White
(62%), Latino (20%), and Black (11%) men; mean age was 37 yrs.; 80% were
employed; and mean length of relationship was four years. HIV transmission
risk behaviors (within the dyads) included unprotected oral sex (HIV+ partner insertive) (62% of couples), unprotected anal sex (HIV+ partner insertive) (8% of
couples), and unprotected anal sex (HIV- partner insertive) (26% of couples).
Couples who engaged in unprotected anal sex were more likely to be Black
(HIV+ partner)(p<.001), younger (p=.024), have a shorter length of relationship
(p=.008), and there was a trend for the HIV- partner to be unemployed (p=.059)
and for the HIV+ partner to be on disability (p=.096). Psychosocial correlates of
risk behavior included intentions (p<.001), self-efficacy (p<.001), perceived social norms (p<.001), the belief by the HIV- partner that transmission risk is diminished with reduced viral load (p=.008), and agreement with, with the statement
"treatments have made me more willing to take risks with my partner," by the HIVpartner (p=.001).
Conclusions: Sexual risk behavior often occurs in the context of intimate relationships. Behavioral interventions must integrate personal beliefs, attitudes,
emotional factors, and cultural and behavioral norms within the context of medical
treatments to make them relevant and meaningful for couples.
Presenting author: Robert H. Remien, HIV Center - Unit #15, NYSPI, 1051
Riverside Dr., New York, N.Y. 10032, United States, Tel.: [phone], Fax:
[phone], E-mail: rhrl @columbia.edu
WePeD6375 Coping and non-condom use among juvenile
detainees
R.C. Conerly, A.G. Robillard, R.L. Braithwaite, T Woodring. Rollins School of
Public Health, Emory University, 1518 Clifton Rd, NE, Suite 512, Atlanta, GA
30322, United States
Background: Juvenile delinquents are at higher risk for health outcomes associated with risky sexual behavior (RSB) than the general adolescent population
(Robertson & Levin 1999). Few studies of juvenile delinquents have examined
psychosocial factors that contribute to RSB. Coping may be an important psychosocial determinant of RSB. Previous research has demonstrated a relationship between coping and sexual risk behavior in Hispanic women, adolescents,
and homosexual men (Dixon,1998;Cunningham 1995;
Davidson, Dew, Pendower, Becker et al,1992).
Methods: The current study examined youth (n=1775) from two youth development campuses (YDC) in the US. Participant assent was obtained authorizing researchers to contact parents or guardians to request permission for participation.
Trained research staff conducted face-to-face interviews. Coping was measured
using a
7-item scale (Pearlin & Schooler,1978). RSB was assessed using the number of
times vaginal sex without a condom occurred in the last month before entering
the YDC. This variable was recoded to reflect either condom use or non-condom
use.
Results: Logistic regression analyses were conducted to examine demographic
variables (gender, age and ethnicity) and coping as significant predictors of RSB.
Non-condom use during vaginal sex was associated with lower coping scores
(adjusted odds ratio [OR]=1.4; 95% confidence interval [CI]=1.1, 1.8), being a girl
(OR=1.5; 95% CI=1.1, 1.9), and being older (OR=1.3; 95% CI=1.1, 1.4).
Conclusions: Lower coping scores may be indicative of learned helplessness.
Coping may influence sexual communication and condom use self-efficacy. The
relationship between coping and RSB needs further exploration, particularly
within juvenile delinquent populations to determine specific mechanisms for this
outcome.
Presenting author: Rhonda Conerly, 1518 Clifton Rd, NE, Suite 512, Atlanta,
GA 30322, United States, Tel.: [phone], Fax: [phone], E-mail:
[email protected]
WePeD6376 Sexual risk behaviour among primary HIV-1
infected patients included in the French PRIMO
cohort
L. Desquilbet', C. Deveau', C. Goujard2, J.B. Hubert', J. Derouineau3,
L. Meyer', and the PRIMO cohort study group'. 'inserm U292 Hopital de
Bicetre, Inserm u.292, 82 rue du general leclerc, 94 276 le kremlin bicetre cedex,
France; 2Service medecine Hopital de Bicetre, Le Kremlin Bicetre, France;
3Service medecine Hopital Ambroise Pare, Boulogne, France
Background: An increase in sexually transmitted diseases has been recently reported in many developed countries, which would imply that HIV epidemic may
re-increase. The aim of our study was to assess characteristics of HIV-1 infected

patients followed in the French PRIMO cohort reporting Sexual Behaviour at Risk
for HIV-1 transmission (SBR), according to the type of sexual partners and their
own viral load.
Methods: Patients included in the French cohort PRIMO during primary-infection
between 1996 and 2001, with at least 3 months of follow-up (n=179; median
follow-up=19 months). Patients reported at every 6 month-visit use of condom
since last visit according to: gender, steady or casual status, and HIV-1 serolog