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

224 Abstracts WePeE6561-WePeE6565

XIV International AIDS Conference

WePeE6561I Rapidly changing sex industry in rural
communities of Hainan and Guangxi, China:
Implications for HIV/STD interventions
S.S. Liao1, Q.Y He2, W. Liu3, J.F Liao4, J. Mandel5, S.L. Liang3, X.C. Wang4,
Y.J. Zhou3. 1Peking Union Medical College, Beijing, China, 1843 tacoma Ave.,
Berkeley, CA 94707, USA;, China; 2Hainan Anti-epidemic Station, Haikou,
Hainan, China; 3Guangxi Center for AIDS Surveillance and Testing, Nanning,
Guangxi, China; 4County Anti-epidemic Station, Chengmai, Hainan, China;
5Center for AIDS Prevention Studies, UCSF, San Francisco, United States
Issues Women from rural areas constitute a major part of the migrant population
in China. Work for many migrant women is limited to the sex industry Sex establishments in three rural towns in Hainan and Guangxi province were studied
between 1997 and 2000; HIV/STDs related risks, vulnerability of the sex workers
and the implications for intervention are discussed.
Descriptions: Data came from 3 cross-sectional surveys as well as interviews
with women in the sex industry at 3 sites from 1997-2000, meanwhile a HIV/STD
intervention was conducted. The sex industry was changing in terms of pervasiveness, format and services provided. Unmarried teenagers and married, middleaged women were engaged in sex work. While 70-90% of them had come from
5-12 provinces in the study site of Guangxi and among women in some type
of establishment in Hainan, more ethnic minorities from neighboring areas had
recently joined other types of sex establishments at sites in Hainan. The proportion of these ethnic minorities increased from 20% in 1997 to more than 50% in
2000. The women turned over frequently. Median time since women first came
to a given site till time of surveys varied from 2 to 8 months. The types of the
services influenced womens' views on self-identity and sex-related risks. While
heroine use has mostly been found in men, 7-13% of the women reported knowing someone personally who used heroine. Around 1% of the women reported
having smoked or injected heroine, and 3% reported having sex with drug users
in the study site of Guangxi, where HIV prevalence among male drug users was
more than 10%.
Lessons Learned: Sex work in rural China has shown recent mutability in terms
of types of establishments and characteristics of the women. This change influenced the risks (e.g. drug-use related issues) and vulnerability (e.g. lack of constant exposure to intervention) of the women. This poses a serious challenge to
intervention in resource-poor community.
Presenting author: susu liao, 1843 tacoma Ave., Berkeley, CA 94707, USA;,
China, Tel.: [phone], Fax: [phone], E-mail: susuliao@hotmail.
com
WePeE6562I HIV/sexual transmited Infections prevention
among women who sell sex
C.S. Raita. ARAS, Str. Micsunele/or 13, B/.8A, Sc.A, Ap. 1, parter, 8700,
Constanta, Romania
Background: ARAS-Constanta has identified a need to provide HIV/STI prevention information, and HIV testing to the sex workers in Constanta. If this need is
not met, the commercial sex workers (CSW) are at high risk to contract HIV and to
spread it. CSW in Constanta have a greater chance of contracting and spreading
HIV and other STIs because of Constanta's role as a Romania's primary seaport
on the Black Sea. The CSW population increases during the 3 months summer
time, because they are drawn by the opportunity to make money. It is very important to say that in Constanta don't exist any services especially for this target
group.
Methods: 1.Out reach work on the street (provide information and answer questions from the sex workers regarding HIV/STIs apply questioners, distribute condoms and personal hygiene products)
2. HIV free testing for commercial sex workers in Constanta.
Results:The results show that the outreach workers team contacts 80 CSW (this
mean a 53% from the total number). Most of the CSW who were contacted are
between 16 and 22 years old and they came from family with social problems
(financial difficulties, domestic problems such as violence and/or sexual abuse).
40% have at least one STI in the past and they "traded" without the medical indication. 40% from the CSW cannot afford to pay for the condoms and they agree
to have unprotected sex if the client wants it. 80% from the CSW cannot afford to
pay for the testing or for the medical treatment because most of the money that
they received is for the pimps. 2 of the girls who were involved in ARAS project
quit this activity.
Conclusions 1. To improve their situation it is very important to keep working the
CSW from the street.
2. It is very important for them to become more conscientious about their situation and to increase their self-stem. At that time they will be more prepare to have
more safer sex intercourse because they will understand the importance of being
healthy.
Presenting author: CAMELIA-SANDA RAITA, Str. Micsunelelor 13, BI.8A, Sc.A,

Ap.1, parter, 8700, Constanta, Romania, Tel.: [phone], Fax: [phone].
665, E-mail: [email protected]

WePeE6563 Effekt of low self-esteem of female sex workers
(FSWs) and societal stigmatization on the spread
of HIV and STDs in Lagos, Nigeria
R.C. Akpan, D.E. Ofobrukweta, R.K. Awosola, B. Adetoro. Life Link Organisation,
Life Link Organisation, 13 Commercial Road Ro. box 2659 Apapa, Lagos,
Nigeria
Issues: From investigation STIs / HIV is higher among FSWs than the general
population. Low self-esteem leads to self-stigmatization which put FSW at risk.
They see themselves as cheap, bleach, drink, smoke, gesticulate for notice, display hostility, quarrel, fight, all these are based on their self perception. They
refuse to mix up and get educated on HIV/AIDS. However the society stigmatizes
them, view them as reservoir of HIV/STIs infection, They are harassed by law enforcement agent and their clients. They do not bother about disease prevention,
eg. they accept clients when they themselves are infected, use one diaphragm in
place of female condom for several sexual partners. They are ashamed to seek
appropriate health facilities.
Description: Focus group discussion and interviews revealed low self-esteem
among majority of FSWs. Apart from empowering in disease prevention, alternative trade and condom negotiation, the following skills were provided: high selfesteem building and assertive training. Also law enforcement agents, FSW clients
and other stakeholders were involved in different intervention programmes.
Lesson learnt: -If FSW develops high self-esteem they will lessen their hostility
sand protect themselves and others from infection.
Recommendation: -Programmes should be evolved to build FSW self-esteem
and discourage societal stigmatization with the aim of disease prevention.
Presenting author: Regina Clement Akpan, Life Link Organisation, 13 Commercial Road PRo. box 2659 Apapa, Lagos, Nigeria, Tel.: [phone], E-mail:
lifelink@ alpha.linkserve.com
WePeE6564I Violence and HIV risk infection among female sex
workers (FSW) in Spain
P. Ramon, M.A. Rodriguez-Arenas, M. Lorenzo Riera, A. Sanchez Manez,
P. Estebanez. Medicos del mundo - Spain, Madrid, Spain
Background: HIV infection is another of the health hazards facing prostitutes,
also they are exposed to a high morbi-mortality related with violence. Suffering
violence is discussed as possible cause or risk factor for psychiatric disorders
related with an increase on HIV vulnerability. The objective is to analyze the association between violence and HIV risk in FSW.
Methods: Data on 1057 FSW were collected through a cross-sectional multicentric study in Spain, from May 2000 to June 2001. Face-to-face interviews were
conducted in STD clinics and mobile units; HIV serostatus was self-informed.
Quantitative results are expressed with mean and standard deviation. Relationships between HIV and various categorical independent variables were assessed
using chi-square contingency table analysis and Odds Ratio (OR) calculation.
Results: Mean age was 29,5 ~ 8,4 years. HIV prevalence was 6.7% (95%Cl:
4.8-8.2%). 69,5% of FSW were migrants. 43.3% worked at street, and 10% were
injecting drug users. The prevalence of variables related with violence were sexual abuse in childhood: 11.3%, have been suffered any kind of aggression last
year: 23.5% and ever raped: 20.8%. The HIV risk was significantly higher if having suffered an aggression (OR: 2.88, Cl: 1.66 - 5.02) and having been raped
(OR: 4.84, CI: 2.74 - 8,54). The stratified analysis revealed that OR for have suffered aggression is higher in specific subgroups (table 1). Another risk factors
described were previous imprisonment, HIV+ partner, working on the street, and
intravenous drug use.
OR 95%CI
No injection drug users 4,5 1,8-11,4
Working indoors 6,3 1,8-21,1
Primary (or less) studies 3,7 1,9-7,2
More 30 Euros per service 6,6 1,9-22,4
Conclusions: This study has confirmed that, nowadays, FSW in Spain have a
high prevalence of HIV infection. Having suffered violence (any kind of aggression
or rape) increase the vulnerability for HIV infection in FSW, specifically among
no injecting drug users, working indoors and low studies level. More studies are
needed to assess the mechanism between suffering aggression and increase
vulnerability for HIV.
Presenting author: Pilar Ramon, C/ Andres Mellado 31, 28015 Madrid, Spain,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeE6565 Profile of sex workers who use a waiting program
for prevention of STD and AIDS

R. Morales Morales, C. De Armas, J. Rodriguez-Franco, A. Gutierrez, J. Martin,
E. Garcia-Ramos, L. Capote, A. Bello, C.T. Pitti, L. Haro. Direccion General de
Salud Publica. SCS, C/ San Sebastian 75, 38005 Santa Cruz de Tenerif, Spain
Background: It was intended to understand the profile and the seroprevalence of
HIV of sex workers who use a program of waiting for prevention of STD and AIDS
in Tenerife. This was based on the education of safer sex, the Counselling prepost test HIV, sanitary attention and the dispensing of condoms. It was proposed