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

XIV International AIDS Conference

Abstracts ThPeD7635-ThPeD7640 499

Presenting author: Claire Sterk, Emory University, Public Health, 1518 Clifton
Road NE, Atlanta GA 30322, United States, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeD7635 Is the medium the message: A comparison of two
network interventions aimed at drug injectors
A.E. Baron', S.K. Koester2, J. Glanz'. 'University of Colorado Health Sciences
Center, GA, United States; 2University of Colorado at Denver, United States
Background: We report findings of a study emphasizing the drug-using risk network rather than the individual as the unit of intervention to reduce injection risks.
Methods: We compared two interventions: a network-focused, individual intervention and a network-focused group intervention. Qualitative and quantitative
methods were used to collect data and to evaluate the effectiveness of the interventions. We analyzed the changes in injection risks over time, clustered by
network, using linear mixed models. In a series of analyses, we looked at distinct
aspects of the heroin injection process. We will limit the discussion of results to
the interventions' impact on syringe transfer, drug sharing, and drug preparation.
Results: We recruited 357 networks comprising 777 individuals. While there were
no statistically significant differences in reducing injection risks between the two
socially focused interventions, there was a significant overall reduction in drug solution sharing between the baseline and 3-month (p = 0.0053) and baseline and
6-month (p = 0.0006) time periods. Non-significant reductions in syringe transfer
and drug preparation were noted at 3 and 6 months. Unsafe location significantly
increased the frequency of these risk practices, and a small quantity of heroin
injected significantly increased the frequency of drug solution sharing and preparation.
Conclusions: Results show the efficacy of using risk networks as a vehicle for
addressing socially embedded risk behaviors. Sharing and dividing drugs as a
solution is an often-unrecognized injection associated risk that begins with the
social arrangements IDU make to obtain drugs. HIV disease prevention efforts
aimed at IDU should emphasize the process of risk and the social context in
which it occurs. Finally, because injection location is an important determinant
of injection risk, public health policy should recognize the need and advocate for
safe injection locations.
Presenting author: Stephen Koester, 1105 Chatsworth Dr., Avondale Estates,
Georgia, 30002, United States, Tel.: [phone], Fax: [phone], Email: [email protected]
ThPeD7636 Changes in alcohol consumption are linked to
changes in gonorrhea incidence rates in the United
States, 1990-1992
H.W. Chesson', PR Harrison2, R. Stall'. 'Centers for Disease Control and
Prevention, Atlanta GA, United States; 2Federal Reserve Board, Washington,
DC, United States
Background. If alcohol consumption promotes risky sexual behavior, then declines in alcohol consumption may be associated with declines in new STD diagnoses. From 1990 to 1992, both gonorrhea incidence rates and per-capita alcohol
consumption declined dramatically in the
United States. We examined the association between changes in alcohol consumption and changes in gonorrhea incidence at the level of the 50 United States
and the District of Columbia.
Methods. We performed multivariate regression analyses in which the dependent variable was the percentage change in the state's gonorrhea incidence rate
from 1990 to 1992 (as reported by the states to the Centers for Disease Control
and Prevention) and an independent variable was the state's percentage change
in alcohol consumption (based on alcoholic beverage sales data maintained by
the National Institute on Alcohol Abuse and Alcoholism). We included 9 additional
variables to control for changes in other relevant state-level characteristics, such
as the state's age distribution and per-capita income.
Results. From 1990 to 1992, changes in alcohol consumption were highly correlated with changes in gonorrhea incidence rates at the state level, even after controlling for potential confounding factors. Each 1 percent decrease in per-capita
alcohol consumption was associated with about a 2.5 percent decrease in gonorrhea incidence (p<0.01).
Conclusions. Interventions that reduce alcohol consumption among people at
risk for STD and
HIV should be tested for efficacy in reducing risky sexual behavior and STD incidence rates.
Presenting author: Harrell Chesson, CDC E-44, 1600 Clifton Road, Atlanta GA,
30333, United States, Tel.: [phone], Fax: [phone], E-mail: hbc7
@cdc.gov

ThPeD7638 IPopulation-based estimates of drug use among
homosexually active men in the United States:
Implications for HIV prevention
S.D. Cochran', V.M. Mays2, D. Ackerman1. 'UCLA School of Public Health, Los
Angeles, CA, United States; 2University of California, Los Angeles, Los Angeles,
CA, United States
Background: Illicit drug use is viewed as a facilitator of HIV-related sexual risk

taking among gay men. While it is generally assumed that illicit drug use is more
prevalent among gay men than heterosexual men, most studies of use patterns
have been based on samples drawn from the visible gay community which may
be biased toward younger, more socially active men.
Methods: To sidestep community participation sampling bias, we used information available in a population-based household survey (1996 NHSDA) of American adults. Self-reported patterns of recent illicit drug use, abuse, and dependency among men reporting any male sexual partners in the year prior to interview (n= 98) or only female sexual partners (n= 3822) were compared. Analyses
were adjusted for possible age, education and racial/ethnic group confounding.
Results: Homosexually active men reported higher rates of marijuana (14%)
and cocaine (4%) use in the prior month than did exclusively heterosexually active men (8.4%, 1.2%), though not significantly so (marijuana: adj OR = 1.4, CI:
0.6,3.2; cocaine: adj OR = 2.8, CI: 0.9,8.6). Rates of heroin use in the prior month
were highly similar (0.8% vs. 1.4%). Homosexually active men also showed elevation in 1 year prevalence of marijuana abuse (15.0%) and dependency (5.7%)
as compared to exclusively heterosexually active men (6.6%, 2.2%), but not significantly so (abuse: adj OR = 2.0, CI: 0.8,4.9; dependency: adj OR = 2.3, CI:
0.9,5.5). Use of inhalants, sedatives, stimulants, analgesics, and tranquilizers was
uncommon and did not appear to differ significantly between the two groups of
men.
Conclusions: While illicit drug use is an important co-factor in HIV transmission, results suggest that rates of illicit drug use, except possibly marijuana and
cocaine, may not be substantially higher among gay men as compared to men
generally Drug interventions aimed at gay men should be targeted to those in
need.
Presenting author: Susan D. Cochran, Ph.D., MS, UCLA Schl of Public Health,
650 Young Drive, 71-245 Center for Health Sciences, Los Angeles, CA. 90095 -1772, United States, Tel.: [phone], Fax: [phone], E-mail:
cochran @ ucla.edu
ThPeD7639 A snapshot of HIV-related assessment and
treatment services at participating clinical
treatment providers in NIDA's clinical trials network
S. Tross', S. Shoptaw2, M.A. Stephens3, B. Tai3, C.T.N. Nida AIDS
Workgroup3. 'New York State Psychiatric Institute, New York, NY, United States;
2Friends Research Institute/UCLA, New York State Psychiatric Institute, 1, New
York, NY, United States; 3NIDA, Bethesda, MD, United States
Background: In January 2001, the HIV/AIDS Workgroup for NIDA's Clinical Trials Network initiated the task of developing a "snapshot" of the type of HIV- and
hepatitis-related services delivered at the participating Clinical Treatment Provider
sites. A total of 65 of 91 (71.4%) sites representing 12 of the 14 nodes responded
to our survey representing the New England, Eastern, Southeast, Midwest, and
Western U.S. regions. The report provides respondents' descriptions and represents these treatment modalities: drug-free outpatient (84.6%), intensive outpatient, day hospital, or partial hospital (70.8%), inpatient (43.1%) and opiate
agonist therapy (41.5%).
Results: Most (73.8%) respondents conduct a formal assessment for HIV/AIDS
when clients are admitted. Assessments ranged from on-site HIV counseling and
testing to referral to community sites for counseling and testing. Assessments
are conducted by program counselors (35.6%), intake workers (35.6%), nursing/medical staff (35.6%), HIV counselors (5.1%) or the client (3.4%). The majority (82.8%) of respondents provide HIV/AIDS education to their clients upon
admission, although there is a broad range of the format, content, and timing of
the education sessions. Only 28.3% of the respondents conduct outreach to drug
using groups at high-risk for HIV transmission. Over one-half of respondents estimated HIV infection rates in their client population below 5% (53.8%), one-quarter
(25%) between 5 and 10%, and the remainder (21.1%) above 10%. Estimates of
Hepatitis C in the patient population ranged from 38.3% of respondents estimating infection rates at 10% or lower, 31.9% of respondents estimating rates above
50%, and the remainder between 10% and 50%.
Conclusions: This report indicates a wide variation in services specific to HIV
and Hepatitis C within the CTN. Findings provide direction for mounting nationwide trials of interventions that target behavioral risk reduction in treatmentseeking drug users.
Presenting author: Susan Tross, New York State Psychiatric Institute, 1051
Riverside Drive, Unit 15, New York, NY 10032, United States, Tel.: [phone]
4468, Fax: [phone], E-mail: [email protected]
ThPeD7640 Factors affecting revealing of HIV status to the
spouses by infected women attending mother-child
and pediatric AIDS/HIV clinics at old Mulago
I. Kalyesubula', M. Mubiru2, P. Bakaki', K. Kintu', M. Owor', E. Kibuuka',
F. Mmiiro2, K. Olness3. MUJHU, Makerere University, Dept of Paediatrics,
PO.Box 7072, Kampala, Uganda; 2Makerere Univ. Dept of Obs/Gyn, Kampala,

Uganda; 3Case Westerm Reserve University, Cleveland, United States
Introduction: It has been observed that most infected women attending the
Mother-Child and AIDS/HIV pediatric clinics do not share their test results with
their spouses. Consequently, spouses do not cooperate in reducing the risks of
vertical transmission through breast milk and infection among discordant couples.
Objectives: To determine the factors that prevent infected women from revealing