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

496 Abstracts ThPeD7622-ThPeD7625

XIV International AIDS Conference

condom use. In contrast, the 18% who had sex exclusively with commercial and/or
casual partners reported high rates (83%) of consistent condom use. Most of the
sexually active IDUs had attempted to reduce their sexual risks by either stopping visits to sex workers (67%), decreasing brothel visits (6%), and/or initiating
condom use (33%). Forty-three percent tested HIV positive; a few recognized
their HIV seropositivity. Condom use was independently correlated with having
received voluntary HIV testing/counseling (VCT) (OR 2.38; CI, 1.05-5.38), nondisclosure of injecting status to sexual partners (OR 9.16; CI, 2.48-37.27), and
perceived moderate/poor health status (OR 2.66; CI, 1.19-5.92).
Conclusions: Unprotected sex with primary partner(s) persists among southern Thai IDUs. HIV-infected individuals may act as a bridge for HIV transmission
to their wives/girlfriends and offspring. AIDS prevention efforts should intensely
focus on promoting consistent condom use with regular sexual partners and providing VCT to IDUs and their partners.
Presenting author: Pajongsil Perngmark, 4 East 32nd Street, Apt. 211, Baltimore, MD, 21218, USA, United States, Tel.: +[phone], Fax: +Same as
above (telephone), E-mail: [email protected]
ThPeD7622I Experiences, obstacles and challenges of health
prevention and care interventions among drug
users in contexts of poverty and social exclusion
R.G.C. Radulich. El Retoito, Wineberg 3450, 1636-La Lucila, Buenos Aires,
Argentina
Issue: According to official statistics, more than 43% of the notified cases of
HIV/AIDS are associated to intravenous drug use. If we consider the group of
drug users in the poorest strata of society, the HIV/AIDS prevalence oscillates
between 48% and 50%.
Description: From 1997 - 2001, ACCRAD/El Retono has carried out three
HIV/AIDS prevention programs with active participation of drug users and their
communities of reference. We will highlight the actions carried out in Buenos Aires
which led to the creation of the first Wholistic Harm Reduction Center in Argentina
and gave impulse to the creation of the Asociacion Somos Ciudadanos ASOCI
uniting drug users and former drug users for the defense of their civil rights.
This organization complements its community interventions with systematic research and specific studies. We will highlight a study on the drug use and poverty
used to design appropriate harm reduction interventions for the demands of the
local context, and a seroprevalence study of HIV, HTLV, HBV and HCV among
intravenous drug users, partners and children. These specific community interventions, the research and the serology studies have been complemented with
massive HIV/AIDS, Hepatitis C & P prevention campaigns. These have been carried out in football stadiums, night clubs and other public places that are highly
frequented by drug users.
Conclusions: This paper will present A) a quantitative and qualitative description of the situation of drug users from poor sectors of urban Argentina. B) a
working methodology that promotes the participation of drug users and the local
community in the diagnosis, planning, execution and evaluation of harm reduction
projects, thereby promoting increased citizenship and civil participation within a
traditionally marginalized and stigmatized population. C) lessons learned, obstacles and challenges for the development of harm reduction interventions among
drug users from the most vulnerable sectors of society.
Presenting author: Graciela Radulich, Wineberg 3450, 1636-La Lucila, Buenos
Aires, Argentina, Tel.: [phone], Fax: [phone], E-mail: gradulich
@arnet.com.ar
ThPeD7623 Readiness to change drug use among
out-of-treatment drug users in Long Beach,
California
Long Beach, CBRS, 1090 Atlantic Avenue, Long Beach, CA, 90813, United
States
Background: This study explored the relationship between drug use and stage
of change among out-of-treatment drug-users enrolled in an HIV prevention program.
Method: 137 clients (76% male; 61% Black, 22% White, 14% Hispanic, 3% Native American, 1% "Other") completed the Readiness to Change Questionnaire
(RCQ) and the Risk Behavior Assessment (RBA). The RCQ is a 12-item instrument designed to classify individuals into one of three stages of change with respect to drug use: Precontemplation, Contemplation, or Action; the RBA collects
client demographics, drug use and arrest history, sexual behavior, and employment information. Clients' mean age was 44.75 years (SD=9.14, Range=18-68).
For drug use, 93% had ever used crack, 52% had ever injected drugs, and 29%
had injected in the last 30 days.
Results: More than half of the clients (57%) were in the Contemplation stage of
change in terms of their drug use; 37% were in the Action stage, and 6% were in

the Precontemplation stage. Drug use stage of change was positively correlated
with age (r=0.24, p=0.005) and use of the following drugs in the last 48 hours:
cocaine (r=0.16, p=0.07), heroin (r=0.14, p=0.09), non-prescription methadone
(r=0.19, p=0.03), other opiates (r=0.17, p=0.05), amphetamines (r=0.17, p=0.05),
"other drugs" (r=0.16, p=0.07). Stage of change was negatively correlated with
the number of days a client used marijuana (r=-0.26, p=0.003) and the number of
days a client used "other drugs" (r=-0.17, p=0.05) in the last 30 days.

Conclusions: Older drug users were more likely to be in a more advanced stage
of change, and may be more receptive to interventions that incorporate drug treatment to reduce their risk for HIV. 63% of clients were in either Precontemplation or
Contemplation, which explains the correlation between stage of change and recent drug use. This has implications for HIV prevention programs, because those
drugs that were used in the last 48 hours were all drugs that can be injected.
Presenting author: Jennifer Klahn, CBRS, 1090 Atlantic Avenue, Long Beach,
CA, 90813, United States, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
ThPeD7624 Day treatment center for prostitutes: An integrated
services model of HIV and substance abuse
G. Lockett, C.D. Smith. CAL-PEP, 405 14th Street #162, Oakland CA 94612,
United States
Issues: The California Prostitutes Education Project (CAL-PEP) founded in 1985
has a missionm of working with African Americans and other people of color at
high risk of contracting HIV. The main foucs of our work is street outreach and
HIV mobile testing. Over the years we have expanded our HIV services to work
with substance users, as many in the population we serve have multi-risk factors.
Description: Last year, CAL-PEP opened a Day Treatment Center for Prostitues,
providing a safe day time drop in center for sex workers and their intimate partners. Services include HIV/STD testing and counseling, case management, and
substance abuse support groups. The center also provides meals, clothing, computer stations, child care, and legal aid services.
Lessons learned: 395 clients have received HIV and substance use services
from October 1, 2000 to September 30, 2001. Of these, 219 people were tested
for HIV, 17 were positive. One of the most challenging issues is addressing substance abuse treatment from a harm reduction modality. We offer two different
groups: one for those in recovery, and one for active users. These groups offer
the skills needed in order to either support those in recovery, and those still using.
As relaspse is a part of recovery, we acknowlege that those that even reduce their
use/habit over time are practicing harm reduction skills.
Recommendations: In order to address HIV prevention with this population, a
harm reduction model vs an abstinence base model is essential. Addressing
psycho-social issues via a licensed therapist, as well as alternative counseling,
such as arts and crafts, are essential. The need to provide services that offer a
stabilizing environment is necessary in order to support these women in their day
to day lives. Housing and job readiness programs are being developed in order to
address these needs.
Presenting author: Gloria Lockett, 405 14th Street #162, Oakland CA 94612,
United States, Tel.: [phone], Fax: [phone], E-mail: calpep
@aol.com
ThPeD7625I Factors related to medication adherence among
illegal drug users
D. Longshore. UCLA, UCLA Integrated Substance Abuse Programs, 1640 South
Sepulveda #200, Los Angeles, California 90025, United States
Background: Studies find that HIV medication adherence is lower among persons involved in illegal drug use. While it is widely believed that drug use undermines maintenance of daily routines and motivation to take medication as
prescribed, little is known about the range of factors affecting adherence among
illegal drug users or their relative importance.
Methods: Focus groups with 35 drug users to identify perceptual and lifestyle
factors underlying adherence problems; psychometric tests of survey data from
60 drug users in Los Angeles. Factors measured: concern about dependence
on meds (DEPEND), mistrust of med effects (MISTRST), interest in alternative
therapies (ALTTX), past habit of hoarding illegal drugs (HOARD), history of ad
hoc med management (MEDMGT), perceived doctor's disapproval of drug users
(BADDOC), having a regular daily routine (SCHEDULE), perceived adverse social consequences of taking meds (SOCIAL), perceived adverse health effects of
taking both meds and illegal drugs (HEALTH), perceived adverse behavioral effects of taking both meds and illegal drugs (BEHAV), and perceived "high" from
taking meds (HIGH).
Results: Internal consistency was adequate to good (a = 0.54 to 0.70). Test/retest
reliability (seven-day interval) was adequate to excellent (r = -.40 to 0.90). As expected, adherence was lower among those more concerned about dependence
on meds (DEPEND), those more interested in alternative therapies (ALTTX),
those lacking a daily routine (SCHEDULE), and those perceiving adverse health
consequences of taking both meds and illegal drugs (HEALTH). Unexpectedly,
adherence was greater among those perceiving adverse social consequences of
taking meds (SOCIAL).
Conclusion: Adherence may be enhanced if factors related to drug user perceptions and lifestyle are targeted for intervention.

Presenting author: Douglas Longshore, UCLA Integrated Substance Abuse
Programs, 1640 South Sepulveda #200, Los Angeles, California 90025, United
States, Tel.: [phone] x231, Fax: [phone], E-mail: dlongsho
@ucla.edu