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

206 Abstracts WePeE6481-WePeE6484

XIV International AIDS Conference

status, through questions on their ability to carry on the daily life activities. The
study reports the preliminary results on 33 residential services which completed
the survey.
Results: 64% of the residential services are located in Northern Italy, 26% in
Central Italy and 20% in Southern Italy. Half of them (51%) are located in the
cities. In 50% a private car is needed to reach the nearest hospital. 33% have
a bathroom equipped for non self-sufficient persons. 24% have architectonical
barriers inside the house. A large majority (75%) of persons who used these services, had a story of IV drug addition. At the moment of the survey these houses
hosted altogether 131 males and 45 females, with a mean age of 40. 95% of the
guests are diagnosed with AIDS. Among the reasons for the admission, there are
difficulties with the families, lacking of a house and loneliness. A significant part
(8,9%) of the guests themselves chose the residential service as alternative to
detention.
Conclusions: This study seems to confirm the importance of residential services,
that stand alone to offer to people with AIDS some essential services. That is both
for those who come from a weak social situation and for those who have severe
functional impairment and need a continuous assistance.
Presenting author: Giuseppe Liotta, Dept. of Public Health, University of
Tor Vergata, via Montpellier, 1, 00133 Rome, Italy, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeE6481 The European Partneriat between African
Communities and health actors for HIV/AIDS
prevention
P.R. Revault, C.M. Mazars. NGO, GRDR, Montreuil, France
Issues: The Aids epidemiological data amongst the African migrant communities
is increasing in Europe.
There was no identification of community organisations, partners and prevention
actions directed to and led by African communities.
There was a lack of collaboration between these associations and institutions.
Descriptions: of the results:
Seven organisations (NGOs or Health institutions) from 7 different countries gathered to build the Partenariat and developed a 2 years program (1999-2001) which
results are:
Identification of the priorities of African communities and health actors (through
workshops).
Identification of the organisations, partners and actions (database).
A system of communication (website) and prevention tools (video-letters and a
document on myths taboos and beliefs around sexuality).
Greater participation of the community organisations in the definition of the prevention programmes developed by the governmental institutions.
Lessons learned:
- The migration and public health policies and practices are heterogenous in Europe. Since people move within Europe, this heterogeneity is a problem in terms
of equity and efficiency of the struggle against aids.
- It is necessary to involve the people affected by Aids who are socially and economically vulnerable in the definition of politics and to work on the social and
economical determinants of the pandemic.
Recommendations: for next phase
Training for health professionals not only on intercultural issues but mainly on the
way to build program between health actors and CBO.
Strengthening the capacities of associations (managing and mediation skills, targeting the social determinants of health).
Questioning national and European institutions to improve access to health care
and the struggle against discrimination.
Developing research (migration policies in Europe, European epidemiological survey system, North/South co-operation regarding Aids issues).
Presenting author: Pascal Revault, GRDR, 20 rue Voltaire, 93107 Montreuil,
France, Tel.: [phone], Fax: [phone], E-mail: grdrsante@wanadoo.
fr
WePeE6482 Risk Perception Of HIV/AIDS/STDs Among Women
Commercial Sex Workers CSWs in Uganda
L.H.H. Luyombya, E.H. Ekideit Hellen, N.H. Nabukalu Harriet, C.T. Chimuiwa
Teddy. TASO(U)Ltd, P0. Box 11485, Taso Mu/ago, Old Mu/ago Hill, Uganda
Objective: To assess the perception of risk of HIV/AIDS/STDs among CSWs
aged 15 - 35 years in and around Kampala city.
Methods: Focus group discussions, interpersonal communication and social
skills, interviews, visits to social evening places and slums where CSWs reside. A
sample of 200 CSWs around Kampala city were monitored for 2 years from June
1998 - June 2000.
Results: The study revealed that 50% of the CSWs had a high risk perception
of HIV/AIDS/STDs transmission and used condoms with their clients; 30% of the

CSWs reported occasional use of condoms with their clients and sex partners.
20% of CSWs reported minimum use of condoms with their clients and sex partners. Reasons for response: 1. CSWs used condoms with clients who insisted
and provided the condoms. 2. CSWs charged very high prices for clients who
refused to use condoms ranging from US$ 100 - US$ 200 and lower prices for
clients who insisted on condoms for US$ 50 - US$ 100. 3. CSWs reported minimum use of condoms with regular partners (lovers)

Conclusion: There is a relatively low risk perception of HIV/AIDS/STDs among
CSWs and their clients in areas in and around Kampala city.
Recommendations: 1. CSWs should be empowered to gain greater control over
their health and their clients through assertiveness, media messages and drama.
2. CSWs should be counselled to appreciate consistent condom use with all sex
partners. 3. Condoms should be availed to CSWs through the AIDSControl Programme (ACP) 4. Networking should be initiated among CSWs.
Presenting author: Henry Hudson Luyombya, PO. Box 11485, TASO MULAGO,
OLD MULAGO HILL, OLD MULAGO HILL, Uganda, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeE6483 Heterosexual Identity and Male-to-Male Sexual
Activities: Implications for HIV Transmission and
Prevention in India
G. Bhattacharya. Univ of Illinois at Urbana-Champaign, Univ of Illinois at
Urbana-Champaign, School of Social Work, 1207 W Oregon Street, Urbana, IL
61801, United States
Background: This study examined the social and cultural contexts that shape the
expression of sexual identity in India and the ways those contexts attach meaning to sexual behavior, including male-to-male sexual activities in various social
arrangements and situations among heterosexually identified men in India.
Methods: This community-based study included in-depth audiotaped interviews
with sixteen participants in India. A semistructured interview guide was used,
and the text of the interview was transcribed, coded, and organized for descriptive presentation in this study. Empirical and scientific data on HIV infection and
transmission, literature on Asian Indian culture, and theoretical frameworks for
research complemented this study.
Results: Male-to-male sexual activities were reported common for having "fun"
(masti) and or for initiating sexual experiences. Procreation determined the socially prescribed gender identity in heterosexual relationships. Married and heterosexually identified men may practice occasional or regular male-to-male sexual activities for sexual pleasure and satisfaction. Male-to-male sexual activities
were not equated with sexual identity as "gay", "bisexual", or "homosexual". The
Indian Penal Code 377 criminalizes "homosexual" behavior.
Conclusions: For understanding the epidemiology of HIV transmission and for
preventing the risks of the transmission of HIV that an individual may be exposed
to in multiple social arrangements in India, interventions must target unsafe sexual behaviors and risks of HIV transmission, rather than relying on specific and
delineated classification of self based on sexual identity.
Acknowledgements: This study was supported by a grant from the International
Council, University of Illinois at Urbana-Champaign (Gauri Bhattacharya: Principal Investigator, 2000-2001).
Presenting author: Gauri Bhattacharya, Univ. of Illinois at Urbana-Champaign,
School of Social Work, 1207 W. Oregon Street, Urbana, IL 61801, United States,
Tel.: + 217 244 5222, Fax: + 217 244 5220, E-mail: [email protected]
WePeE6484 HIV risk behaviors in Roma (gypsy) social
networks in Bulgaria and Hungary
Y.A. Amirkhanian', J.A. Kelly', P. Csepe2, E. Kabakchieva3, S. Vassileva3
I Center for AIDS Intervention Research, Medical College of Wisconsin,
CAIR/MCW, 2071 N. Summit Avenue, Milwaukee, WI 53202, United States;
Semme/weis University Budapest, Hungary; 3Health and Social Development
Foundation, Sofia, Bulgaria
Background: Roma (Gypsies) are one of the most marginalized ethnic minority
groups in Eastern Europe. Ostracism, widespread discrimination, poverty, cultural
barriers between the Roma and the majority population, and widespread mistrust
of outsiders are common. Culturally-tailored HIV prevention programs that operate within natural indigenous Roma community social networks are needed. Little
is known about the composition and risk characteristics of social networks in the
Roma community.
Methods: Staff trained in ethnography observed social groups in Roma neighborhood venues such as cafes, street corners, and yards in Sofia, Bulgaria and
near Budapest, Hungary. We identified social leaders (n=14) in these groups and
asked each to invite the participation of all members of their close social networks
(n-1 10). Participants completed interviews that assessed their sexual behavior
practices.
Results: Men and women in the sample were young (mean age=25 years. Most
men had multiple partners in the past 3 months, 80% of men had unprotected
intercourse and only 13% used condoms consistently. Males had an average 13
lifetime partners, including both male and female partners. Only 42% of men said
that their last intercourse was condom protected. 33% had paid or been paid for
sex. Most sexually experienced women reported a mean of one male partner and
none reported condom use at last intercourse or in the past 3 months. Women's
risk was usually related to men having outside sexual partnerships. All network

leaders said that they would like to participate in a program to become AIDS
educators to others in the Roma community.
Conclusions: Social network interventions for Roma carry feasibility and advantage. Social network leaders personally known by network members are likely to
be trusted more than outsiders. Programs that teach indigenous network leaders to serve as AIDS prevention advocates may be especially useful in tight-knit
Roma communities.