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

XIV International AIDS Conference

Abstracts WePeG6926-WePeG6930 313

Recommendations: The internationalisation of prostitution can be defined as a
phenomenon with a structural character which will continue to determine and map
the future of the prostitution industry. AIDS/STI prevention must be included in a
broader framework of general health promotion, and the development of such a
framework should be recognized as a present priority A broad spectrum of community based initiatives, directed at empowerment of migrant sex workers, can
have a major impact on primary prevention inasmuch as it allows sex workers
more scope in their contractual position with clients, brothels and pimps
Presenting author: Licia Brussa, Westermark 4, 1016DK Amsterdam, The
Netherlands, Tel.: [phone], Fax: [phone], E-mail: tampep@xs4all.
nl
WePeG6926 Creating a national technical assistance program
for HIV prevention among injection drug users
(IDUs)
T.S. Jones1, A.B. Rodgers2, C.D. Raybon2, S.R. Novey 2 1Centers for Disease
Control and Prevention, Atlanta, GA, United States; 2Academy for Educational
Development, Washington, DC, United States
Issues: About one third of U.S.A. AIDS cases are associated with injection drug
use. However, HIV prevention activities to reduce transmission of HIV and other
bloodborne pathogens among injection drug users (IDUs) can be limited because
of: anti-IDU stigma; narrow focus on a small number of interventions; and challenges of collaboration among the diverse providers working with IDUs, (HIV prevention, substance abuse treatment, criminal justice, and primary care).
Description: Since 1998, the Centers for Disease Control and Prevention (CDC)
and the Academy for Educational Development (AED) have collaborated with
leaders in the field to promote a Comprehensive Approach to HIV Prevention
among IDUs" based on 4 principles (ensure coordination and collaboration; ensure coverage, access, and quality; recognize and overcome stigma; and tailor
services and programs); and 8 strategies (substance abuse treatment; community outreach; access to sterile syringes; services in the criminal justice system;
prevention of sexual transmission; services for IDUs living with HIV/AIDS; primary
drug prevention; and counseling and testing services, partner counseling and referral services, and prevention case management).
Lessons learned: Working with multiple collaborators, CDC and AED have developed both brief and in-depth descriptions of the Comprehensive Approach and
fact sheets on key topics (sterile syringe access, criminal justice system, substance abuse treatment, and viral hepatitis). Some materials have been translated into Spanish. All are available at a dedicated website www.cdc.gov/idu. In
addition, the project has responded to 19 requests for technical assistance in 14
states.
Recommendations: Developing technical assistance services and materials
specific to IDUs, a known high-risk group, can assist health departments,
community-planning groups, and community-based organizations design and
manage their HIV prevention programs.
Presenting author: T Stephen Jones, Centers Disease Control and Prevention,
Mail Stop E-35, Atlanta GA, 30333, United States, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeG6927 The risks linked to drug use in terms of public
health - Analysis and proposals to public bodies
A. Molla, J.F. Bloch-Laine, P Hantzberg, C. Basset, D. Juette,
A. Charles-Nicolas, V. Nahoum-Grappe, J. Pasquet, M. Thevenin, F. Buton.
CNS, Conseil national du sida, 25/27 rue d'Astorg, 75008 Paris, France
Issues: The National Aids Council (NAC) is an independant and pluralist ethical
body, created in 1989 by the French Government to advise public bodies on any
subject concerning AIDS in our society Intravenous drug use can lead to deterioration in the health and to the desocialisation of those indulging in it, and it
can place their lives in danger. In the case of illegal drugs, it exposes users to
social and criminal sanctions. In health terms, one of the best known of the consequences relates to the increased probability of exposure to infection by the HIV,
HCV or HBV.
Description: The NAC adopted proposals on the issue in 1993. After 8 years
of new trends influenced by risk reduction initiatives, it investigated needs for
the actual foundation of a public-health approach to drug use. Resulting from a
large consultation of public authorities, community based associations, unions
and other social groups, the NAC's proposals call for a change in the strategy
adopted by the public bodies and lawmakers.
Lessons learned: During the last decade, we improved dramatically our knowledge about drug use and its implications. These are related to the prevention of
drug abuse, to the risk reduction front line involvment, to the context of medical
and welfare care and to the legal frames. Major changes in intravenous drug consumption practices developed in the late 1990's. Despite this, the decrease in the
prevalence of HIV infection among drug users and of high risk-behaviour reached

a ceiling. Obstacles to risk and harm reduction still remain.
Recommendations: Public action cannot be only oriented by drug consumption
methods and patterns. It must bring together all the bodies capable of changing
the context in which high-risk substance abuse and unprotected sexual activity
occur. Setting out general principles for action, the NAC points out which practical
means should guide the comitment of authorities regarding health problems, and
in particular HIV/AIDS.

Presenting author: Alain Molla, Conseil national du sida, 25/27 rue d'Astorg,
75008 Paris, France, Tel.: [phone], Fax: [phone], E-mail: cnsconseil @ sante.gouv.fr
WePeG6928 Experience of a 51-year-old Ex-Substance User
D. Das, K. Misra, P. Mitra, V. Pavamani, D. Mukherjee, S. Ghosh. The Calcutta
Samaritans, 17, Broad Street, Calcutta - 700019, West Bengal, India
Over the years, huge amount of money have been spent for supply reduction but,
till date, success has been elusive. Had supply reduction agencies like Customs,
Police, etc been really successful, then Heroin or any other drugs would not have
been available. The users have to pay exorbitant amount of money to procure
these drugs and drug dealers are earning unbelievable amount of money. So,
vulnerability to HIV/AIDS is on the rise. All others - Governments, Society, and
users are losing in the bargain.
Many countries tried Alcohol Prohibition but hardly any Alcohol drinker stopped
drinking and the drinkers had to spend exorbitant sums of money. Ultimately, most
of these countries removed Prohibition.
NGOs are trying to reduce demand but without much success.Experience of a
Centre from April 2000 to March 2001 shows:- 764 new users and 346 old users
- 1110 in all. Almost all the families of 1110 were either bankrupt or on the verge
of bankruptcy and almost all the 1110 users were into petty crime, just to use
substances regularly Yet none of those users were petty criminals before they
became users. In fact, quite a few of them were educated. Till Dec. 2001, only 58
were maintaining abstinence - approx. 5%. I was an Injecting Drug User for more
than 20 years - started during April 1970 and though I lost my job in December
1984 and was compelled to live on the streets, I kept on using till I wanted to stop
in May 1991 - before that nobody was able to stop me from using drugs. That
means nobody can stop a person from using drugs till he/she wants to stop.
Attitude of the Society along with oppressive and destructive laws related to drug
use force the users to become reclusive. That makes them more marginalized,
more vulnerable to HIV/AIDS and related disease.
Conclusion: 1) Users should get drugs at reasonable rates from Govt clinics under medical supervision, 2) Law Enforcement Personnel must respect the rights
of drug users.
Presenting author: Debashish Das, 17, Broad Street, Calcutta - 700019, West
Bengal, India, Tel.: [phone], Fax: [phone], E-mail: dasdeebee
@yahoo.com
WePeG6930 Substance use and protective factors of youth in
Bangladesh
K.E.T. Talukder, M.I.K. Khan. Institution of Child and Mother Health, Dhaka,
Bangladesh
Youth health issues and risk behaviour such as smoking, alcohol, drug abuse,
pre-marital sexual activity of youth has increased worldwide in recent years, leading to concerns about the serious health consequences of such behaviour. Recently this concept has been changing so that the emphasis of many studies in
this field is now on protective factors i.e. factors, which protect youth from risk
taking behaviour e.g. "having parents who disapprove of premarital sex". Connection is defined as a positive, stable, emotionally close elationship based on
care, support and attachment with significant others. Regulation is the provision
of structure around behaviour, such as, reasonable rules, regulations, supervision, monitoring, expectations, demands, sanctions and norms.
This study was designed to assess risk behaviour of youth aged between 15 and
24 years in Narayanganj city through both qualitative and quantitative methods.
A quantitative cross-sectional survey was carried out among 1009 youth selected
by conventional random sampling technique.
28% of youth admitted to using tobacco almost half the males and about 8% of the
females smoked tobacco. The harmful nature of smoking was by far the biggest
(73%) reason given for not smoking. Other significant reasons given were that it
is forbidden by religion (8.3%) and that no family member smokes (5.2%). Of the
284 youth who smoked, 44% started doing so of their own volition, 38% began
because their friend(s) smoked and 6% because they were frustrated. Prevalence
of marijuana smoking was about 8% and this was almost exclusively a male activity with 16% of males and only 0.4% of females involved. Drinking alcohol was
reported by 18% of youth. This study points to the need for further intervention research to see which are the effective intervention activities in the reduction of risk
behaviours. This is going to be a difficult task, as this concept is now as therefore
not well established as intervention activities.
Presenting author: manirul khan, programme manager,youth protection
studyfaculty of paediatrics, institute of child and mother health, matuail, dhaka
1362, Bangladesh, Tel.: [phone], Fax: [phone], E-mail: [email protected]