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

256 Abstracts WePeF6684-WePeF6687

XIV International AIDS Conference

Presenting author: Emmanuel Chirebvu, c/o UNIFEM, 304 E.45th Street, New
York, NY, 10017, United States, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
WePeF6684 Gender differences in antiretroviral uptake and
attitude in Australia
K.M. McDonald, J.W. Grierson, M.E. Hurley, J.M. Willis, M.K. Pitts. Australian
Research Centre in Sex, Health & Society, La Trobe University, Melbourne,
Australia
Background: As only 6% of the total number of people living with HIV/AIDS
(PLWHA) in Australia are women, they have often been marginalised in both clinical and social research. Using data from the HIV Futures Survey (1997, 1999,
2001) in Australia, this paper reports on gender differences in attitude and uptake
of antiretroviral treatments (ARV).
Methods: The HIV Futures Surveys were self-administered questionnaires
covering attitudinal and health status issues. The large non-clinical samples
(1997:n=921; 1999:n=925; 2001: n=775) represent over 8% of the total estimated population of PLWHA in Australia. In addition to completing the survey,
119 PLWHA participated in semi-structured interviews.
Results: Over the last five years the quantitative data has shown that women
have been significantly less likely than men to be using ARV and significantly less
optimistic than men about ARV meaning better prospects for most PLWHA. Although this gap appears to be gradually closing, interview data reveal that women
tend to be more unwilling than men to pin their hopes for the future on ARV The
interview data also provides insight into the differences in identities that HIV positive men and women adopt and how ARV is situated within these identities.
Conclusions: Whilst women have been slower to take up these therapies, the difference in attitude between the sexes has reduced as combination antiretroviral
treatment has become the standard of care for PLWHA in Australia. Understanding gender differences in uptake and attitude to ARV is a crucial component to
providing effective and appropriate health care to both men and women living
with HIV/AIDS in Australia.
Presenting author: Karalyn McDonald, Australian Research Centre in Sex,
Health & Society, La Trobe University, 215 Franklin Street, Melbourne, 3000, Australia, Tel.: [phone], Fax: [phone], E-mail: K.McDonald@latrobe.
edu.au
WePeF6685I Discontinuing and switching medications in the
era of HAART: women tell us why
A.H. Kim', M. Santiago', A. Shansky', M. Cohen', L. Kirstein2. 1The Core
Center, Cook County Hospital, Administration Building, 1900 W Polk St, Rm.
1240, Chicago, IL 60612, United States; 2Johns Hopkins University, Baltimore,
MD, United States
Issues: Many women in the Women's Interagency HIV Study (WIHS), the largest
US multi-site longitudinal study of HIV disease women, discontinue or switch their
HAART regimen. There are multiple reasons why women discontinue or switch
therapy. Their personal stories provide insight into these reasons.
Description: Of 2056 HIV positive and 569 HIV negative women enrolled in the
WIHS, 59.4% of women were on a HAART regimen as of September 2000. Of
women on HAART, 37.0% discontinued or switched their regimen in the prior 6
months. In 2000-2001, women who discontinued or switched their regimen were
identified through quarterly Chicago Community Advisory Board workshops of 15
to 30 women. In 2002, a follow-up focus group of 12 women raised specific questions including: 1.) Why did you discontinue or switch medications; 2.) How did
you go about making your decision; and 3.) How did you initially feel about your
decision and have your feelings changed.
Lessons Learned: Women's experiences showed that the following issues may
influence their decision to discontinue or switch medications: 1.) side effects including lypodistrophy, feeling sick and physical discomfort; 2.) mistrust of the benefits of HAART; 3.) perceived lack of improved health; and 4.) desire for improved
health. Some women made their decisions by seeking further information about
the benefits and side effects of HAART. Others did not. As a result of their decisions, women conveyed feelings of guilt, fear, uncertainty and empowerment.
Women also said that their feelings often changed over time.
Conclusions: The experiences of women who have discontinued or switched
therapy may help other women who are making decisions about HAART. Additionally, their experiences may help health care providers to better understand
the impact of HAART on women's everyday lives, especially in relation to improving adherence.
Presenting author: Alice Kim, Administration Building, 1900 W. Polk St., Rm.
1240, Chicago, IL 60612, United States, Tel.: [phone], Fax: [phone]
4912, E-mail: [email protected]

WePeF6686 Housing stability among participants of the british
columbia drug treatment program
I.L. Goldstone', J. Asselin2, K. Chan2, R.S. Hogg2, W. O'Briain3,
M.V. O'Shaughnessy2. 'British Columbia Centre for Excellence in HIV/AIDS,
Vancouver,; 2British Columbia Centre for Excellence in HIV/AIDS, Vancouver,
Canada; 3AIDS Vancouver, 608-1081 Burrard Street, Vancouver, British
Columbia, V6Z 1Y6
Background: Housing has been identified as a key determinant of health for
those living with HIV/AIDS.
Objective: To identify characteristics associated with housing and explore possible gender differences among participants of the BC Drug Treatment Program.
Methods: The Drug Treatment Program is an observational cohort of persons
accessing antiretroviral therapy in BC. Participants answered self-administered
questionnaires between 10/17/96 and 09/10/01. Bivariate methods of analysis
were used. Stable housing was defined as renting or owning an apartment, house
or condominium.
Results: Of 2389 participants, 9% (217) were women and 91% (2172) were men.
At baseline, the median age was 40 years for men and 36 years for women.
The majority of participants were antiretroviral experienced (99.5%) with median
CD4 and viral load of 310 cells/mm3 and 704 copies/mL, respectively Compared
to women, men were more likely to fill out two questionnaires (63% vs. 51%,
p=0.001), live in stable housing (92% vs. 86%, p=0.006), live alone (36% vs. 21%,
p<0.001) and move (36% vs. 28%, p=0.006). Men were less likely than women
to share housing with children (3% vs. 21%, p<0.001). Of those living in stable
housing, 1% moved to unstable housing, 12% predicted they would be unable
to stay in their current housing throughout their illness and 38% were uncertain.
Compared to participants living in stable housing, those in unstable housing were
more likely to predict they would be unable to stay in their current housing throughout their illness (48% vs. 12%, p<0.001). Frequent movers were more likely to live
in unstable housing (p=0.001). Unstable housing was associated with an income
<$10K/year (p<0.001).
Conclusions: Overall, this cohort is well housed, although 8% live in unstable
housing. Research is needed to quantify the housing needs of those not accessing antiretroviral therapy.
Presenting author: Irene Goldstone, 608-1081 Burrard Street, Vancouver,
British Columbia, V6Z 1Y6, Canada, Tel.: [phone], Fax: [phone],
E-mail: igoldstone @ hivnet.ubc.ca
WePeF6687 Strategies developed by the Canadian Women's
HIV Study (CWHS) to maintain the largest cohort
of people living with HIV in Canada
K. Pourreaux', C. Hankins2, N. Labrie3, A. Hankins-Palmer3. 1Direction de la
sante publique de Montreal-Centre, 1301 Sherbrooke East, Montreal, Quebec,
H2L 1M3, Canada; 2Direction sante publique Mt/-Centre, Dpt of
epidemiology/Biostatistics, McGill University nstitut nation de sante publique,
Montreal, Canada; 3Direction de/Ia sante publique, Montreal, Canada
Issues: Exploring the key strategies developed to maintain a nation-wide cohort
study since 1993.
Description: The CWHS co-ordination team works with 42 physicians assisted
by 24 study nurses in 21 clinics of 13 Canadian cities to recruit women living
with HIV. 679 HIV-positive and 324 HIV-negative women followed 6-monthly (total
3586 visits) have participated.
Lessons learned: Maintaining a cohort requires continued recruitment and regular participant follow-up visits. Physicians and study nurses should be motivated to
recruit and participants motivated to return. How do we keep everyone motivated?
Facilitating factors include: financial incentives ($100 for recruiters' time, up to $25
refund for participants' expenses), a sense of being part of the study and acknowledgement of the important role that each plays in its maintenance. Opportunities
are given to each to become more involved in the study Strategies developed by
the CWHS include monthly conference calls for co-investigators/collaborators, including five community co-investigators, which address management decisions
and analysis topics. Regular contact is maintained between the research coordinator and study nurses through direct calls, e-mail or conference calls to share
information and concerns. Biweekly electronic bulletins focus on the latest developments in HIV/AIDS with guest editorials by co-investigators. The study web
site (cwhs.ca) contains study information for clinics and a message board for
study participants. Acknowledging participants' contribution to the study was concretised by creating Facts&Findings, a booklet gathering study results translated
in lay language. In September 2001, a national conference call was organised
inviting participants and community members to discuss research priorities.
Recommendations: The key to effective maintenance of a nation-wide study lies
in communication strategies which enhance the capacity of each to play their critical role in study conduct.
Presenting author: Karina Pourreaux, 1301 Sherbrooke East, Montreal, Quebec, H2L 1M3, Canada, Tel.: [phone] ext 3694, Fax: [phone], E
mail: [email protected]