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

XIV International AIDS Conference

Abstracts ThPeD7740-ThPeD7743 521

participants have identified a series of cultural barriers to more effective prevention. Among these are stigma associated with public sex, attitudes of prevention
workers toward risky behaviours and a lack of community awareness of prevention programmes and models.
Recommendations: Prevention programmes must work to be more responsive
to the sexual culture of public sex venues. Further anthropological and sociological analyses are needed.
Presenting author: Alan Brown, Department of Sociology, University of Oklahoma, 309 Kaufman Hall, Norman, OK 73019, United States, Tel.: [phone], E-mail: [email protected]
ThPeD7740 National surveyof behavioral risk for STDs and HIV
i among residents in rural growth point villages in
Zimbabwe
D.E. Montaho1, D. Kasprzyk1, G.B. Woelk2, N.I.H. NIMH Collaborative HIV/STD
Prevention Trial3. 1Battelle, Seattle, WA, United States; 2Department of
Community Medicine, Medical School, University of Zimbabwe, Harare,
Zimbabwe; 3National Institute of Mental Health, Washington, DC, United States
Background: A comprehensive national survey of risk behaviors and STD/HIV
was conducted in 32 rural Growth Point Villages in Zimbabwe as part of a cooperative international trial in 5 countries. The trial will use the Community Popular
Opinion Leader Intervention to prevent STD/HIV. To establish risk prior to the intervention trial, residents were assessed for sexual behavior, condom use, and
alcohol-drug use. A computer assisted interview (CAI) assessed the magnitude
of behavioral risk. In addition, gonorrhea, chlamydia, syphilis, trichomonasis, bacterial vaginosis, herpes simplex 2, and HIV were assessed.
Methods: A trained team of nurses randomly selected 70 households each in 32
villages, enumerated them for residents aged 16-30, randomly selected a respondent, gave informed consent, and administered the survey to 50 respondents.
Pre-test counselling was then conducted; blood, urine and self-administered vaginal swabs were collected.
Results: 1601 individuals were assessed: 57% female, 43% male. 46% had a
primary education, 56% secondary or more. 60% were single, divorced, widowed, 40% married. 82% had ever had sex: 76% of males, 87% of females. 22%
had more than one partner, 20% had casual partners, 16% exchanged sex for
money/goods. 33% of men, 6% of women drank at least weekly. 1/3 tried to get
condoms and 79% of them found it easy to do so. 26% reporting regular partners
used condoms consistently; 58% reporting casual partners did so. 63% thought
it unlikely they would get infected with HIV, while 37% thought it likely. 23% selfreported ever having an STD: 19% with ulcers, 28% with abnormal discharge.
Conclusions: These data clearly indicate prevalence of behaviors that put individuals at risk for HIV acquisition. Access to condoms is not perceived to be a
barrier. Biological and behavioral data confirm that these rural communities are
at risk for HIV acquisition. Findings confirm the need to intervene in these communities.
Presenting author: Daniel Montahio, Battelle, 4500 Sand Point Way NE, PO Box
5395, Seattle, WA 98105, United States, Tel.: [phone], Fax: +1 (206)
528-3550, E-mail: [email protected]
ThPeD7741 Beliefs and practices on alcohol and sexual
behaviour among rural Zimbabweans
G.B. Woelk1, D. Kasprzyk2, D.E. MontahIo2, N.I.H. NIMH Collaborative HIV/STD
Prevention Trial3. 1Department of Community Medicine, Medical School,
University of Zimbabwe, Harare, Zimbabwe; 2Battelle, CPHRE, Seattle, WA,
United States; 3National Institute of Mental Health, Washington, DC, United
States
Background: AIDS is devastating Zimbabwe, a country in southern Africa hard
hit by the epidemic. Risk factors for HIV transmission include labor migration,
rapid urbanization, transactional sex and alcohol use. The role of alcohol in generating risk has been examined in studies, but needs to be described in providing information to develop HIV/AIDS prevention programs. Beliefs and practices
regarding alcohol and sexual behavior were assessed in the formative ethnographic component of a multi-country collaborative HIV/STD Prevention Trial on
Community Popular Opinion Leaders in 6 countries. Findings from Zimbabwe are
presented.
Methods: Households containing young people aged 16 to 30 were randomly
surveyed in rural villages around 32 growth points throughout the country. Over
200 semi-structured interviews were conducted with males and females.
Results: Alcohol consumption plays an important part in community life, being associated with ceremonies and rituals. It is also seen as an essential recreational
activity, especially for some men. A variety of alcoholic beverages are drunk, but
beer is most frequently consumed. Opaque beer is often brewed at home and
consumed socially on special occasions. Commercial opaque beer is also available, and along with clear beer and other alcoholic drinks, is consumed in drinking

establishments at growth points. Far more men than women drink alcohol, particularly in drinking establishments. For many, the purpose of drinking is to get
drunk, and there is a high frequency of drunkenness among those who indicate
they drink. Drinking is associated with casual and transactional sex. There is a
belief among men that drinking without the company of women is akin to "eating
meat without salt".
Conclusions: Findings confirm the important role alcohol has in generating sex
ual risk. A challenge will be to develop prevention interventions to reduce this risk,
especially as alcohol consumption is integral to community life.
Presenting author: Godfrey Woelk, Department of Community Medicine, University of Zimbabwe Medical School, P O Box A 178, Avondale, Harare, Harare,
Zimbabwe, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeD7742 Knowledge and perceptions of attitudes and sexual
risk behaviors among rural residents in Zimbabwe
and their implications for interventions
G. Ndimande1, D. Kasprzyk2, G.B. Woelk3, D.E. Montaho2, N.I.H. NIMH
Collaborative HIV/STD Prevention Trial4. 'ZiCHIRe, Harare, Zimbabwe;
2Battelle, CPHRE, Seattle, United States; 3Department of Community Medicine,
Medical School, University of Zimbabwe, Medical School, University of
Zimbabwe, Zimbabwe; 4National Institute of Mental Health, Washington, DC,
United States
Background: A rapid assessment (RAP) formative study was conducted in 32
rural Growth Point Villages in Zimbabwe to prepare for an international trial of the
Community Popular Opinion Leader (CPOL) intervention. RAP study results will
be used to develop intervention strategies.
Methods: 20 households were randomly selected in each village. In-depth interviews with 623 16-30 year olds and 78 key informants; and focus groups with
community leaders and stakeholders were conducted. An ethnography team assessed health and sexual behavior; STD/HIV knowledge, attitudes, norms regarding behavior; social venues; leadership characteristics of popular leaders. Focus
groups and interviews were translated, transcribed, and coded into a qualitative
database.
Results: Knowledge about transmission of HIV and condoms affording protection is high. Individuals feel access to condoms is fine, yet few use condoms
especially with main partners. Condom use is perceived to prevent infections but
also seen as "not nice (sweet) thing". Married couples who "know each other, they
do not fear a lot of things", don't need condoms. Delay of sex is seen as difficult
when "one feels ready for sex". It is hard to "control one's feelings" regarding sex.
Monogamy is viewed as something that can't be discussed with partners because
of trust, even when one believes that a partner has other partners. Normative influence exists regarding sexual behavior; "People who sleep around can be a bad
influence", and all people "can be influenced by what others are doing".
Conclusions: A knowledge-based intervention is unnecessary in Zimbabwe, as
the government sponsored AIDS knowledge campaign has been successful.
Changing attitudes towards monogamy, delaying sexual intercourse, and condom use should be the focus of interventions. In addition, the CPOL intervention
should be considered a good intervention methodology, as normative influence
regarding sexual behavior was documented via interviews.
Presenting author: Gugulethu Ndimande, ZiCHIRe Programme Office, 28 Van
Praagh, Milton Park, Harare, Zimbabwe, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeD7743 Intervention with migrant worker's spouses for HIV
prevention
N. D' Costa, S.M.M. Hassan, B. Khatun. NGO, Dhaka, Bangladesh
Background: The HIV prevention program in Bangladesh has been addressed
the high risk behavior group but the spouses of the high risk group like migrant
spouses had never received due attention. SHISUK- CARAM Bangladesh has
been implementing a pilot project supported by CARAM Asia since July 1999 in
a concentrated overseas migrant workers community at Shirajgonj, Bangladesh.
Methods: The program has undertaken based on the findings of a participatory
need assessment of the spouses of migrant workers using PRA tools. Following
methods has been useda) Spouses were organized in-groups. Each group is organizing weekly meeting
to discuss their problems, experience. The community organizer facilitates information of sexual health, HIV, safer sex and development issue. The interested
members received free condom. b) Health care consultations to understand the
STI and reproductive health related problems existing in the community. The program is followed by diagnosis and treatment support. c) An income-generating
program has been undertaken based on their skills.
Results: The spouse program creates good interest and new members are joining the program and participating in group discussion. The consultation was very
useful to aware the spouses about their reproductive health and STIs problem.
Many spouses were suffering form STIs and reproductive health problem without knowing the disease and treatment, like white discharge for long time and
prolapsed womb. The group members are aware of their HIV vulnerability. More
and more spouses of the returnee migrants are taking condoms from community
office.
Conclusions: The income-generating program is helping institutionalization of

group activities and will support their livelihood for economic empowerment. Usually non working female have to deal with many things to go out or join in a meeting but the earning opportunity can make it easy.
Presenting author: Nilima D' Costa, 7/1 Block-A, Lalmatia, Dhaka-1207,
Bangladesh, Tel.: [phone], Fax: [phone], E-mail: shisuk@bangla.
net