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

504 Abstracts ThPeD7659-ThPeD7662

XIV International AIDS Conference

ThPeD7659I Forgotten stakeholders: the role of non-sex worker
employees in reducing HIVWSTI in the female sex
industry of the Dominican Republic
H. Jerez', B. Gomez', C. Hernandez', L. Moreno2, S. Rosario2, M. Sweat3,
D. Kerrigan3. 1CEPROSH, 615 N Wolfe St E7141, Baltimore MD 21205,
Dominican Republic; 2COIN, Santo Domingo, Dominican Republic; 3Johns
Hopkins SPH, Baltimore, United States
Issue: While it is recognized that sex establishment-based HIV prevention programs should address and involve sex establishment owners and managers, little
attention has been paid to the role of other non-sex worker (SW) employees who
also work in the sex establishment and are potential facilitators and promoters of
HIV-related protective behavior.
Description: This paper details the experience of two NGOs from the Dominican
Republic (DR) who conducted operations research on the inclusion and mobilization of sex-establishment employees in HIV prevention. Formative research documented many key actors, mostly male employees such as: doormen, bouncers,
cashiers, waiters, and disc jockeys. Specialized educational materials and participatory workshops were developed and implemented for these actors. These activities were one component of an adapted 100% condom program that demonstrated significant impact reducing STI and increasing consistent condom use
with all partner types.
Lessons learned: Male employees were eager to participate in HIV prevention
activities such as providing educational messages, social support and/or condoms to SWs and clients alike. For many of these men, their experience in the
program was the first time they were asked to contribute to civil society or a
problem of national importance such as HIV/AIDS. Data from process evaluations showed that the men felt proud to be called upon as leaders and agents of
change.
Recommendations: In addition to SWs and owner/mangers, HIV prevention programs should identify and mobilize the influence of other employees to reduce
HIV-related vulnerability in female sex establishments.
Presenting author: Deanna Kerrigan, 615 N Wolfe St E7141, Baltimore MD
21205, United States, Tel.: [phone], Fax: [phone], E-mail: dkerriga
@jhsph.edu
ThPeD7660 Working with Women in the Sex Industry in Rural
China to Prevent HIV/STDs: Three years later,
where are we?
S.S. Liao', W. Liu2, Q.Y He3, YJ. Zhou2, J. Mandel4, W.L. Pan3, J.F. Liao5,
S.L. Liang6, X.C. Wang5. 'Peking Union Medical College, Beijing, China, 1843
tacoma Ave., Berkeley, CA 94707, USA;, China; 2Guangxi Center for AIDS
Surveillance and Testing, Nanning, Guangxi, China; 3Hainan Anti-epidemic
Station, Haikou, Hainan, China; 4Center for AIDS Prevention Studies, UCSF, San
Francisco, United States; 5County Anti-epidemic Station, Chengmai, Hainan,
China; 6Guangxi Center for AIDS Surveillance and Testing, Nanning, China
Background: China's sex industry has been rapidly expanding in both urban
and rural areas. To reduce women's sex-related health risks in sex industry, we
conducted a two-phase intervention project using outreach as one strategy. The
project was conducted in two towns and one small city in Hainan and Guangxi
from 1997-2000. At each study site, a Women Health Center (WHC) was set up.
We present the evaluation of the intervention.
Methods: Three cross-sectional surveys at baseline, mid- and post-intervention,
as well as interviews and field observations were used for evaluation.
Results: The types of sex establishments, and number and characteristics of
women varied across sites and over time. While the majority of the women had
migrated from rural areas of other provinces to the study site of Guangxi, more local and ethnic minorities had joined the business recently in study sites in Hainan.
Cumulatively, three WHCs completed 600 outreach visits, distributed 20,000
copies of educational materials and 60,000 condoms. The surveys showed that
2/3 of women reported knowing about WHCs, 80% having received educational
materials, and 70% having read them. 40% reported WHC as their primary source
of condoms. Compared with baseline, knowledge increased 42-67% in postintervention surveys. Controlling for age and education, higher knowledge scores
were consistently associated with participation in WHC activities. Reported condom use increased by 30-80%. This use was associated with increases in knowledge. Changes in condom use varied across sites and types of establishments.
Conclusions: The project has achieved the objectives of increasing knowledge
and promoting condom use. Specific settings did interacted with the intervention
and influenced patterns of condom use. To be effective, it is critical to understand
the settings, monitor the intervention and make sure the program remains adaptable.
Presenting author: susu liao, 1843 tacoma Ave., Berkeley, CA 94707, USA;,
China, Tel.: [phone], Fax: [phone], E-mail: susuliao@hotmail.
com

ThPeD7661I Pilot project of 100% condom use programme
(100% CUP) in entertainment establishments in
Wuhan, China
Z.D. Chen', S.B. Wei2, J.G. Shan', W. Zhou3, F.B. Wu2, C.Y Cai4. 1Public
Health and Anti-epidemic Station, No.24, Jianghanbei Road, Wuhan, 430022,
China; 2Health Bureau, Wuhan, China; 3Institute of STI Prevention and Control,
Wuhan, China; Public Health and Anti-epidemic Station, Huangpi District,
Wuhan City China
Background: Reported number of HIV /AIDS has been increasing by 30% in recent years in China, sex especially commercial sex is now playing an important
role progressively in this disastrous pandemic. Because of the large number of
entertainment establishment-based sex workers who are somewhat accessible
and manageable, there is an urgent need to take good interventions targeting
this sub-population.
Issues: 100% CUP is proven one of the most effective ways to prevent HIV
through commercial sex. But in China, commercial sex is illegal and has been
being "crack downed" and thus sex workers are underground and inaccessible
for health workers. Implementation of 100% CUP will face political, juridical, cultural and community opposition. How can 100% CUP be carried out in China?
Description: In November 2000, supported by WHO, Wuhan (a metropolis in
central China with a population of 8 millions) began a three-year pilot project
to explore and work out a feasible model of implementing 100% CUP in entertainment establishments, which will provide evidences for Central Government to
develop national policy on controlling HIV/AIDS/STD among risk groups of entertainment establishments. As of November 2001, the one-year-long preparatory
phase that included the following activities has been completed:
1. Selection of intervention area;
2. Advocacy;
3. tablishment of needed structures;
4. Development of IEC materials;
5. Establishment of system of quality condom
5. Baseline study
As a result, local policy on 100% CUP has been formulated and enacted by the
local Government, and qualified staff, necessary structures, quality condoms and
IEC materials are now available.
Recommendations: It is feasible to conduct 100% Condom Use Programme in
entertainment establishments in China; Advocacy to have a good cooperation
between multi-sectors is crucial for the whole programme;
The owners of entertainment establishments will play a key role in the project.
Presenting author: Zhongdan Chen, No.24, Jianghanbei Road, Wuhan, 430022,
China, Tel.: [phone], Fax: [phone], E-mail: czd21cn@21cn.
com
ThPeD7662I Why are sex workers failing to adhere to regimen in
Zambia border towns with peer education
component?
J. Kamangal, K. Sunkutu2, H. Chama2, Z.T. Sichone3, D.K. Mandal. 'Family
Health International, Family Health International, PO Box 320303, Lusaka,
Zambia; 2 World vision Zambia, Lusaka, Zambia; 3Japanese AID Cooperation,
Lusaka, Zambia
Objective: To reduce STIs by providing STI treatment and promoting condoms
among sex workers (SWs)
Method: SWs were trained as peer educators to provide information, education,
counseling and condoms to other SWs and to refer them to health facilities for STI
treatment by health care providers trained by the project. At their first visit, SWs
undergo physical examinations and receive presumptive STI treatment to cover
syphilis, gonorrhea, chlamydia and trichomonas vaginalis. They are counseled to
return at three-month intervals or if they become symptomatic. At each follow-up
visit, history is obtained; if an STI is present, treatment is given according to syndromic management. If there are no STI signs at each follow-up visit syndromic
treatment for cervicitis is given.
Results: The project has had contact with 2,122 sex workers. Only 20% have
successfully completed the return visit. High mobility and improved sexual health
(not experiencing any STI-related problems) are some of the reasons. While condom use is generally high with paying partners (>75%) it is very low with regular
'permanent partners.' With a 'permanent partner,' 51% said they never used condoms, 31% said they sometimes do, and only 14% said they always used condoms. Of those who returned for clinic revisit, the number of those always using
condoms with their regular partners had not changed (13%). But those who said
they "never" use condoms dropped to 39%, while those who said they "sometimes" use them increased to 41%. Regular sexual partners are often comprised
of mobile populations such as truck drivers who also have other sexual partners.
Conclusion: Ensuring adherence to revisits and use of condoms among sex
workers has been problematic despite the efforts of peer educators, some of
whom are sex workers themselves. Training peer educators in communication
and counseling is needed. The innovative idea of tracking sex workers as they

leave for other sites also must be explored.
Presenting author: Joseph Kamanga, Family Health International, PO Box
320303, Lusaka, Zambia, Tel.: [phone], Fax: [phone], E-mail:
[email protected]