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

XIV International AIDS Conference

Abstracts ThPeD7730-ThPeD7734 519

ThPeD7730 Community-based trial to prevent drug use among
youth in Yunnan, China
Z. Wu1, R. Detels2, J. Zhang3, V. Li2, J. Li4. 1National Center for A/DS
Prevention and Control, Chinese Academy of Preventive Medicine, Beijing,
China; 2School of Public Health, University of California, Los Angeles, UCLA
Department of Epidemiology School of Public Health, Box 951772, Los Angeles,
CA 90095-1772, United States; I Yunnan Anti-epidemic Station, Kunming,
Yunnan, China; 4 Yunnan Institute on Drug Abuse, Kunming, Yunnan, United
States
Background: The HIV epidemic of injecting drug users in China began in southern Yunnan and has spread to all the provinces. This study was implemented in
Yunnan to evaluate a community-based program to prevent initiation of drug use
in young men.
Methods: Two similar areas of 19 villages each were designated as intervention
or control areas. Village leaders, teachers, women, and youth leaders were recruited to participate in the development of the program. Workshops and regular
meetings for village leaders and others were organized, games and videos with
drug prevention messages were played, and classes to improve literacy and agricultural yield were conducted. School programs including didactic work, visits to
detoxification centers, and participation in drug intervention activities were implemented. Incidence of new drug users was estimated from reported initiation of
drugs prior to the final survey.
Results: There was a 2.7-fold greater reduction in new drug users in the intervention villages: 1.59% (from 3.47% to 1.88%) in the intervention area and 0.60%
(from 2.10% to 1.50%) in the control area, an attributable reduction of 0.99%
(p=0.048). The reduction was highest in young men 15-19 (4.79%, p<0.001),
single men (2.98%, p<0.001), illiterate men (6.16%, p<0.001), and the Jingpo
minority group (3.01%, p<0.001). HIV/AIDS knowledge, attitudes, recognition of
drug problems, and willingness to participate in prevention of drug use were all
significantly better in the intervention area.
Conclusions: Community-based intervention programs to prevent drug use can
be successful in rural areas in China. Longer follow-up studies to address sustainability should be implemented.
Presenting author: Roger Detels, UCLA Department of Epidemiology, School
of Public Health, Box 951772, Los Angeles, CA 90095-1772, United States, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
ThPeD7731 I HIV prevention for persons living with HIV:
Developing a comprehensive community approach
J.C.B. Bailey. Community Based Organization, 1125 N. McCadden P, Los
Angeles, CA 90038, United States
Issues: Historically, HIV prevention programs designed to avert new HIV infections have targeted high-risk HIV-negative individuals. Only recenity new HIV prevention programs have emerged targeting persons living with HIV. The proposed
presentation will provide data about the development of a new HIV prevention
program that targets persons living with HIV in the County of Los Angeles.
Description: Positive Images (PI) is a consortium of 11 agencies that targets
persons living with HIV in the County of Los Angeles. The program provides a
continuum of interventions for persons living with HIV less than two years and
distinct interventions for those living with HIV more than two years.
During the initial year of program development PI embarked upon a variety of
formative research activities to inform the development of interventions. One of
the primary activities during the initial year included a series of focus groups designed to assess the sexual health needs of persons living with HIV, two years or
less.
Lessons learned: Numerous themes and experiences arose from the focus
groups, informing specific prevention strategies. Women expressed a tendency
to stop having sex/loss of sexual pleasure, anger toward sexual partners, and
expressed concerns about pregnancy and childcare; MSM reported unprotected
sex with HIV-positive partners and problems with disclosure; transgenders expressed challenges with substance use; and injection drug users expressed complex associations between substance use and sex.
Recommendations: Persons newly diagnosed with HIV are faced with complex
health issues; however, programs that seek to engage this population in HIV prevention programs can be effective by integrating prevention strategies within the
context of recreational and social activities, traditional emotional and social support groups, and through increased visibility of persons living with HIV as role
models in prevention.
Presenting author: Jeffrey Bailey, 1125 N. McCadden PI, Los Angeles, CA
90038, United States, Tel.: [phone], Fax: [phone], E-mail: Jeffcoleb @ hotmail.com
ThPeD7732 Reaching the slum-dwellers through Community
Health Volunteers (CHV)- an experiences of World

Vision India (WVI) in Kolkata
P Nag1, K. Misra1, W. Alyocis2. 'ADP-Calcutta, 35/1 Moore Avenue, PS.Regent Park, Tollygunge, Kolkata - 40, WB., India; 2World Vision India, Kolkata,
India
Issue: World Vision India is an International humanitarian Christian organisation involved in relief and development activities in more than 100 countries. In

Kolkata, it is working through Area Development Programme - Calcutta (ADPCalcutta), a direct project of WVI among slum dwellers and school children. One
study indicated that syndrome based STD prevalence rate among the slum dweelers In project area was more than 30%. World Vision has started to integrate
STD/HIV/AIDS intervention component with its development programme ensuring community participation.
Description: ADP-Calcutta first sensitize rad its worker and community leaders
about the issue. Then it started to develop appropriate communication strategies
for slum dwellers. Socio-cultural analysis indicated that discussing sex, sexuality
and STD/HIV/AIDS was found to be a taboo in the communities. To overcome the
difficulty, ADP- Calcutta developed the concept of Community Health Volunteers
(CHV), who were chosen from the community and representative of various age,
sex, culture and ethnic subgroups. ADP-Calcutta trained them about HIV/AIDS
issue, sex & sexuality, community care of patients, refferal of STD cases and importance of partner management, counselling and Training of Trainers. They are
now reaching their peers successfully and broke most of their barrier of communication. They already proved successful as a source of information/counselling
at the time of need.They may be used as a social outlet of preventive materials.
Lessons learnt/Recommendation: Integrating intervention programme with ongoing development programme was not only found to be cost-effective but also it
ensure better qualitative intervention.
Presenting author: Pramod Nag, 35/1 Moore Avenue, P.S.- Regent Park, Tollygunge, Kolkata - 40, W.B., India, Tel.: [phone], Fax: [phone],
E-mail: nagpramod21 @readiffmail.com
ThPeD7733 Study of immigrant youths' knowledge of HIV/AIDS
A.M.N. Ndiaye. umtivi/acsar, 2 -l1 a, torras i bages, Cerdanyola del valles, Spain
Background: This study was proposed to design an intervention in sexual and
reproductive health (SRH) and HIV/ AIDS, given the important increase in the
numbers of young immigrants. This study is a first step to describe the knowledge
level and perception about HIV/ AIDS and condom use among young migrants living in Spain for less than two years.
Methods: We combined qualitative and quantitative methods. The qualitative part
consists of focus groups according of sex and community of origin. We formed homogeneous groups of six or ten people. Results were used to generate ideas and
elaborate tools for the second, quantitative, part.
For our quantitative analysis, we distributed an anonymous questionnaire in the
language of each target community. Sample size is ~10% with 95% confidence
level and a power of 80%. This would represent between 79 and 90 people aged
between 15 and 30 years for each community. We stratified by sex, based on
databases provided by the immigrant communities.
Results: Results showed a great disparity in knowledge level and information networks between various communities. Knowledge acquired in the country of origin
is either corrected or confirmed by existing media in Spain. The study reveals
differences that exist between communities in relation with communication channels about HIV/AIDS. Perception about the disease follows very much cultural
differences and beliefs between communities.
Presenting author: Abdou mawa Ndiaye, 2 -1oa, torras i bages, Cerdanyola del
valles, Spain, Tel.: [phone], Fax: [phone], E-mail: mawandiaye
@yahoo.fr
ThPeD7734 Importance of psychosocial factors on adherence
in PWA's taking HAART
A. Bader', H.- I. Erlich-Trungenberger2, R.I. Rojas3, M.A. Lohmann4,
R. Lochmann5. 1Universitit Bochum, Bochum,; 2AIDS- HI/fe Stuttgart,
Uni-Klinikum Bochum, Gudrunstr. 56, 44791 Bochum,; 3Universitat Stuttgart,
Stuttgart, Germany; 4Universitlt TObingen, TObingen, Germany;
5Fachhochschule Esslingen, Esslingen, Germany
Background: Importance of psychosocial factors on different types of adherence
and on quality of life has been evaluated by quantitative and qualitative procedures.
Methods: Quantitative methods: 100 patients (Germany) were enrolled in this
study. Questionnaires: HIV/AIDS Symptom-checklist; TSK (coping strategies),
MOS-HIV (quality of life) and SOC-FART (Social factors of ART). Qualitative
methods: 43 patients participated on semi-structured interviews (Grounded Theory, Strauss 1994).
Results: Structured interviews: the psychological parameter "rumination" was
more often observed on patients with negative psychical well-being (p<0.001).
Patients in good contact with self-aid-groups (NGOs) showed better values on
'search for information' (p=0.05). An adequate quality of life was related with low
medical symptoms of HIV-infection (p<0.01), good "social support" (p<0.01), and
positive "psychical well-being" (p <0.01). Semi-structured interviews: we found
six different subtypes of adherence: critical, faithful, fearful and non-reflected
compliance; critical and non-reflected non-compliance. The "critical compliance"

showed to be the most solid type. Faithful adherence was often unstable in times
of "critical life events". In many cases therapy failures were observed on patients
with faithful adherence.
Conclusions: Our study gives assistance to the WHO target of "autonomous patients". Social support and empowerment against discrimination hereby are main
goals regarding the development of critical adherence and positive quality of life
on PWA's.