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

506 Abstracts ThPeD7668-ThPeD7671

XIV International AIDS Conference

Methods: In each city, prevention programs developed by NGO, accredited and
financed by the National AIDS Program were selected. We carried out 32 Focus
Groups (FG) with CSW.
Results: Knowledge level is satisfactory. Nevertheless, some specific situations
collaborate for not using condom or not having ability for safe-sex negotiation
(i.e., scarcity of clients; increased prices for unsafe practices, fear of client violence, age of CSW). Police members extort money and exert violence. Another
stressor is related to rivalry for clients among CSW. The type of commercial sex
practice was related to environmental stressors, i.e., such practices indoors, specially among younger CSW, makes possible a greater degree of control over situations. In contrast, older CSW working at the streets are more vulnerable. Consciousness about civil rights was scarce. Policemen, clients and other people
feel that violence is legitimate because of the stigmatization of commercial sex
work although this practice is not illegal in Brazil. Collective support instances
constructed by CSW, irrespective of NGO act ivity, were scarce.
Conclusions: Currently, emphasis of NGO interventions is placed on individual
abilities and knowledge. The same importance must be given to civil rights and
social organization.
Presenting author: Jodo Marcos Andrade, CLN 406, Bloco A, Sala 224, Asa
Norte, Brasilia, DF, CEP 70.847-510, Brazil, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeD7668I The dawn of scaling up 100% condom use program
in China
P.F. Zhao. World Health Organization, 401, Dongwai Diplomatic office Bldg., 23,
Dongzhimenwai Dajie, ChaoYang District, Beijing 100600, China
Background: 100% condom use programme (100 % CUP) has been demonstrated a successful strategy to stop HIV transmission among sex industry in
Thailand and Cambodia. In China, among its 850,000 HIV positives, as of end
2001, less than 10% were officially reported being infected by sex. However, sex
work has been rampant across the country, and in some provinces above 10%
HIV prevalence was documented among sex workers. In order to demonstrate the
effectiveness of the 100% CUP in a Chinese society known for its unique socialcultural milieu, a pilot project was implemented in Jingjiang City with a population
of 667,000 and Wuhan Huangpi District with a population of 1.09 million, since
Feb 2001.
Methods: WHO modules on 100% CUP was adapted to include: program organization & policy; advocacy & IEC; coordinated STI services & outreach activity;
condom logistics; and monitoring indicators.
Results: As of Dec 2001, 252 and 354 entertainment establishments were identified in the project jurisdictions of Huangpi & Jingjiang, respectively Sex work is
mainly identified among barber's shops in Huangpi and bath- houses in Jingjiang.
The number of self-identified sex workers varies widely, from some 1, 000 in the
peak season to 300 in low-business times in Huangpi and from 1,500 to 500 in
Jingjiang. As of Jan 2002, about 90% of them have been targeted by the 100%
CUP in both sites. A recent rapid assessment showed that the rates of condom
use among self-identified sex workers at last sex with clients increased from 18%
in Jun to 78% in Dec 2001 in Huangpi. Preliminary analysis also indicated a sharp
increase in condom use in Jingjiang.
Conclusions: 100% CUP could be an effective option for China to stop HIV/STI
transmission through sex industry It is possible to be implemented and scaled up
even amidst national efforts to crackdown prostitution.
Presenting author: Pengfei Zhao, 401, Dongwai Diplomatic office Bldg., 23,
Dongzhimenwai Dajie, ChaoYang District, Beijing 100600, China, Tel.: +86 10
6532-7189, Fax: [phone], E-mail: [email protected]
ThPeD7669I Evaluation of the effectiveness and sustainability
of STD/HIV interventions with female attendants at
entertainment establishments in Yunnan, China
K.M. Rou1, Z. Wu', Y.S. Xu2, J.F. Ma3. National Center for AIDS Prevention
and Control, 27 Nanwei Road, Beijing 100050, China; 2Kunming Center for
Disease Control, Kunmning, China; 3Kunming Health Department, Kunmning,
China
Background: China has experienced rapid increase of commercial sex work and
epidemic of sexually transmitted diseases (STDs). The two factors played significant roles in spread the epidemic of human immunodeficiency virus (HIV) infection. The objective of study is to explore a sustainable intervention model targeting
sex workers.
Methods: Two sites, namely County seat and Tangchi Township, were selected
from Yiliang County, Kunming City, Yunnan Province for implementation of sustainable STD/HIV interventions with female attendants working at entertainment
establishments. In each of study sites, a "Healthy Women Clinic" was set up near
entertainment establishments. Clinic-based outreach activities, including awareness rising, condom promotion, and sexual health care, were developed and de
livered to sex workers in entertainment establishments.
Results: After about 8 month of implementation intervention activities, the clinic at
the County seat was closed because of most entertainment establishments being
closed. The clinic at Tangchi Township kept running through the entire project period. The number entertainment establishments at Tangchi Township decreased
from 33 at baseline to 18 at the end of project. During the project period, out-reach
teams made 552 visits to target entertainment establishments, approached 2774

female sex workers, and distributed 13498 copies of education material and 1820
packs of condoms. Consistent condom use rate (with all last 3 clients) increased
from 60% at baseline to 75.1% at evaluation survey.
Conclusions: Clinical based out-reach intervention targeting entertainmentbased sex workers are effective. Such strategy should widely used in other part
of China for control sexually transmission of epidemics of STD/HIV.
Presenting author: Keming Rou, 27 Nanwei Road, Beijing 100050, China, Tel.:
[phone], Fax: [phone], E-mail: wuzy@ public.bta.net.cn
ThPeD7670 The sexworkers: are they the culprits?
B.T. Kazi. Research associate, Centre for Social Studies, Research Associate,
Centrte for Social Studies, University Campus, Udhana Magad/la Road, Surat
395 007, India
Issues: Sex workers (SWs) are unscientifically and unfortunately deemed to be
the main source of transmission of HIV/AIDS to the coomunity through sexual
mode. But the knowledge and misconceptions about HIV/AIDS and their behaviour related to HIV/AIDS risk is almost similar to the community they come
from and live in.
Description: There are around 650 sex SWs in around 100 houses (ghar) at
Premnagar, in this city of western India- the only organised colony of SWs in the
province. They work through 14 units headed by a Mousi (house-keeper) each.
The sex work activity at Premnagar continues almost for twenty-four hours but 10
a.m. to 11 p.m. are the rush hours. Majority of the SWs are illiterate while a sizable are drop-outs from school at around std. 7. Age at the first sexual intercourse
for all of the SWs was around 16. Some of them had their first sexual intercourse
at the age of 12.
Results: 35% of the SWs reported that they had at least one unprotected sex
act out of previous five. The proportion of such acts was 14%. All the SWs knew
where to obtain a condom and reportedly insisted condom use on their sex partners. The proportion of those reporting condom use in the most recent act of
sexual act by their partner was 95%. 12% of them never go for regular physical
check up. But 42% do it regularly, i.e. within three months and remaining 46%
go for physical checkup occasionally. Among the SWs 73% reportedly suffer with
at least one of the STD symptoms. Of them 68% of them sought appropriate
treatment. Among these sex workers 96% had heard about AIDS. Though only
1% sex workers reported at least two accurate ways of reducing risk of HIV infections, condom as a way of reducing risk of HIV infection was cited by 96% of
them.
Recommendation: In a sub-continental country like India, with very large migration of labourers from rural areas to cities, there is a need to regualrise sex work,
and make aware the SW, who in turn can make their clients aware and safe.
Presenting author: Babasaheb Kazi, Research Associate, Centrte for Social
Studies, University Campus, Udhana Magadlla Road, Surat 395 007, India, Tel.:
[phone], Fax: [phone], E-mail: karimmomini @sify.com
ThPeD7671I The Bali STD/AIDS Study: Documenting the
mobility of female sex workers
K. Ford', D.N. Wirawan2, B.D. Reed1, P. Muliawan2. 1University of Michigan,
Deprtment of Epidemiology, School of Public Health, University of Michigan, Ann
Arbor, Michigan 48109-2029, United States; 2Kerti Praja Foundation, Denpasar,
Bali, Indonesia
Background: Prostitution has been an important factor in the spread of HIV infection in many parts of the world.
Developing interventions for these populations has been a challenge in many
communities. The objective of this presentation is to document the level of mobility among female sex workers in low price brothels int he Denpasar, Bali area and
to examine the relationship of mobility and program participation on AIDS/STD
knowledge, condom use, and STD infection.
Methods: Four rounds of data collection were conducted at six month intervals in
seven brothel areas. About 600 women, including over 95% of the brothel workers
participated in the study. Each round of data collection included person interviews
and STD exams.
Women were evaluated for Neisseria gonorrhoeae, Chlamydia trachomatis,
syphilis, Trichomatis vaginalis, and HPV. Mixed models were used to assess multivariate relationships.
Results: The sex worker population was very mobile. 63% were new the second
round, 48% the third round, and 46% the fourth round.
Inital levels of STD infection were high: Neisseria gonorrhoeae 60.5%, Chlamydia trachomatis 41.3%, Trichomonas vaginalis 11.3%, syphilis 10.9%, and HPV
infection 37.7%. The mobility of the population was related to increased levels of
Neisseria gonorrhoeae, syphilis, and Trichomonas vaginalis and reduced levels
of AIDS/STD knowldge and condom use.
Conlcusions. This study is unique in documenting the effects of sex worker mobility on STD infection in an area. HIV prevention programs need to consider the

mobility of the sex worker population in program development.
Presenting author: Kathleen Ford, Deprtment of Epidemiology, School of Public
Health, University of Michigan, Ann Arbor, Michigan 48109-2029, United States,
Tel.: [phone], Fax: [phone], E-mail: [email protected]