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

XIV International AIDS Conference

Abstracts WePeG6936-WePeG6938 315

their own concerns and role in their community The curriculum used for both parenting and HIV education is flexible for the women's varied literacy levels, cultural
background, parenting role, and HIV status.
Lessons learned: We have collaborated with a nationally-recognized research
organization to obtain baseline and follow-up data. First-year data reveal that the
women comleting the program report a tremendous increase in satisfacation in all
areas of life, including family, relationships, vocational, legal, and health issues.
The non-scientific data also reveals that this program has positive impact on the
women's lives. They demonstrate deep bonding with each other, as well as significant growth in their ability to manage their HIV risk factors or disease progression. By addressing issues such as domestic violence, sex work, and relationship
communication, the women report feeling able to take care of their emotional and
health needs.
Recommendations: HIV service providers and preventionists may benefit from
our lessons to truly address women and families as a whole. HIV prevention
needs to condom use and drug use as pieces of a successful prevention program.
Presenting author: Kenis Williams, Haymarket Center, Health Education Unit,
120 North Sangamon, Chicago, IL 60607, United States, Tel.: [phone]
ext373, Fax: [phone]
WePeG6936 Medicos del Mundo syringes exchange program in
mobile unites, a strategy to harm reduction
A. Sanchez Manez, P. Estebanez Estebanez, M.A. Rodriguez Arenas, J. Rodrigo
Alvaro, A. Bermejo Garcia. Medicos del Mundo, c/Andrds Mellado, 31, Spain
Issues: Spain is one of the countries in the Western World area which has the
higest rates of HIV prevalence among drug users through injections. In 1992,
Medicos del Mundo launched a program under the goal of decreasing the extension of HIV among drug injection users and to harm reduce, by using outside
mobil units. This mobil unit accessed to places of drug selling and consumption
and exchange the syringes.
Description: The following activities are enclosed in the programs of exchanging
syringes: Availability of sterile material for injection; promotion of new ways to administrate drugs; promotion of safe sex and use condoms; promotion of HIV tests;
information about medical asistance; sending people to centres and institutions.
Lesson learned: Strengths: Getting close to the marginal places and neighbourhoods where people with that kind af problems used to live and socialize, so we
could attract them into the program and keep on close contact with them; To contribute to the visibility of a hidden problem and to include in the political agenda
through the information of the community; Geographical and human approach;
Intervention in open places where drugs are common, so we could take advantages of the mobility and quick access to the points of selling and networks and
posobility of introducing them into the institutions.
Recommendations: We have to despite the efficency of the strategy at the beginning of tha 90's there are new needs without new answers such as following
the treatments, safe sex, etc; We have to motivate and interested were clear and
high at the beginning, but afterwards there was a period of lack of motivation and
interest as it is shown in the percentage of syringes returned in recent years: 1998
(97.6%), 1999 (89.9%), 2000 (88.2%), 2001 (86.1). However, that data could be
biased dur to the higher accessibility to syringes; We have to homogeneous criteria and common policies in the area of field work.
Presenting author: Amparo Sanchez M.fiez, c/ Andr6s Mellado, 31, Spain, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
WePeG6937 Main tendencies of injecting drug users feature in
the mobile units of the programs of outreach
seringes exchange programs of Medicos del
Mundo
P. Estebanez Estebanez, M.A. Rodriguez Arenas, A. Sanchez Manez,
J. Rodrigo Alvaro, A. Bermejo Garcia, M.D.M. Working group. Medicos del
Mundo, c/Andrds Mellado, 31 Madrid 28015, Spain
Issues: Spain has the highest rate of AIDS in Europe related with infections. At
the end of 80's and beginning of the 90's seroprevalence was between 4% to 75%.
Since March 1992, it was established in the headquartes in Madrid at outreach
program to exchange syringes, in the main points of selling and consumption of

drugs. The aim was to decrease risk beahvior among drugs users. This program
was very innovative at the national level and it was finaced by the National Drug
Agency. Latter on, in the 90's program was extended in the first age (1994) to the
city of Valencia a Seville, and in 1995 to the city of Las Palmas in the Canary
Island, and to Palma de Mallorca. Finally, in 1998 the program was extended to
Tenerife and Lanzarote Island.
Description: The programs aims were: - to get closer to the main points of selling
drugs with the Mobil Unit and reach the marginal populations. They were provide
with packages of 10 units after collecting the used syringes; Returning of used
syringes, education about new ways of administrating drugs and safe sex; To
inform about health services and centres and to collect information about risk behaviour; HIV test and HIV prevalence; Through all these years, it was observed
a decreased in the habit of sharing syringes from a 11% in 1996 in Madrid to
a 13.7% in 1998 and the tendency is still increasing: The use of condoms has
not going through a significant change. HIV prevalence has decreased from 1993
on, with a 48.6% of seropositives; The use of HIV tests increased from 85.9% to
98.2%.
Leasson learned: Easy access to marginal population and communities usually
outside the health system; The kind of people who usually use this services is on
the margins; without job 85%, without housing 40% and has been in prision 60%;
This programs shows the changes in drug uses population.
Recommendations: We have to adapt the outreach programs to the young populations and new injections users, and especialy to the women.
Presenting author: Pilar Est6banez Est6banez, c/ Andres Mellado, 31 Madrid
28015, Spain, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeG6938 Contextual and environmental aspects of drug
abuse and hiv in rural us: results of a rapid
assessment
K. Nelson1, E.M. Gorman1, J. Topolski2, A.RP. Pach3, A. Scrol4, E. Amato4,
C. Clark4. 1San Jose State Uiversity, College of Social Work, San Jose, CA,
United States; 2Missouri Inst of Mental Health, Washington DC, United States;
3NORC-Univ of Chicago, Washington, DC, United States; 4San Jose State
Uiversity, San Jose, CA, United States
Issues: Between 1991 and 2001 treatment admissions for methamphetamine
in rural Western and Midwestern US states increased 1000%. Women represented fifty percent of new cases, injection use was increasing. Isolation, scarce
resources, cultural and economic disparities constituted significant barriers to assessment, prevention and treatment access. description: The NIDA funded Substance Use Risk Exploration (SURE) project undertook rapid assessment ethnographic and epidemiological projectsin western Washington and southwestern
Missouri between 1998-2001.
Lessons learned: rapid assessment, derived from the US surgeon general's
RARE taskforce recommendations, identified key dynamics: poverty, lack of transportation, need for child care, rural North American cultural values, i.e. selfsufficiency, stigma associated with mental health/drug abuse, conformity, religious beliefs, lack of education, traditional gender roles, closed social familial
networks. Data about initiation, patterns of drug use, sexual behaviors and impact on children and families. Fifty subjects (60% female) ranged from 18-55,
with a mean age of 32; approximately 16 percent were non-white reported using
meth alone or in combination with alcohol or other drugs (marijuana, cocaine,
heroin). Twenty-five percent (25%) reported IDU histories primarily of meth. Subjects reported little awareness of HIV or Hepatitis risk Meth use predisposed to
injection, needlesharing and unsafe sexual practices. Subjects reported serious
mental health and social consequences: loss of children, disintegration of their
families and economic deprivation.
Recommendations: Lessons learned provided insight about a drug epidemic
with significant HIV issues. There is urgent need for additional rapid assessment
initiatives and research into this growing problem. There is need for education,
outreach and prevention efforts linked to adequate treatment and HIV education
and services.
Presenting author: Keith Nelson, college of social work, san jose state university, 1 washington sq, san jose, ca 95192-0124, United States, Tel.: [phone]
5812, Fax: [phone], E-mail: [email protected]

Abstract WePeG6936 - Table
1992 1993 1994 1995 1996 1997 1998 1999 2000
Madrid Madrid Madrid, Madrid, Madrid, Madrid, Madrid, Madrid, Marid,
Valencia Valencia, Valencia, Valencia, Valencia, Valencia, Valencia,
& Andalucia Andalucia, Andalucia, Andalucia, Andalucia, Andalucia, Andalucia,
Canarias, Las Palmas de Las Palmas de Islas Canarias Las Palmas Las Palmas de
Las Palmas Gran Canaria Gran Canaria & Baleares & Baleares Gran Canaria
& Baleares & Baleares & Baleares January - September & Baleares
January - September January - September
Number of drug users 1745 1485 4299 9986 9065 8180 11368 9969 10229
Total number of interventions 7375 9720 31717 62624 69773 25790 30371 55718 58337
Distribution of sterile equipment 58906 106902 460916 366801 337291 229964 242201 547038 556534
Number of syringes collected 20726 91707 382710 341437 350958 223197 236197 491573 489504
Percentage of returning 35% 84.2% 88% 89% 94.33% 91.87% 97.6% 89.86% 88%