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

XIV International AIDS Conference

Abstracts ThPeE7785-ThPeE7789 537

ThPeE7785 Gender and relationship differences in condom use
in Angola
N. Prata, A.E. Fraser. BIG, UC Berkeley, 1213 To/man Hall, UC Berkeley,
Berkeley, CA, 94720, United States
Background: This study identifies factors affecting condom use among adolescents and young adults in Angola depending on gender and type of relationship.
Our analysis focuses on three types of relationships: spousal, regular, and casual.
Methods: We use data from a Knowledge Attitudes and Practices survey of 2400
randomly selected male and female 15-24 year olds, conducted in Angola in
January 2001. For each relationship type we use logistic regression analysis to
test condom use at last sex. For each gender we test consistency in condom
use. Independent variables are classified as socio-demographic; sexual behavior; general knowledge of condoms and HIV; self-efficacy and attitudes towards
condoms; and access and affordability We examine which classifications are significantly associated with condom use in each relationship type, and within categories which variables play a significant role.
Results: By relationship type, condom use at last sex was 43% for casual, 39%
for regular, and 20% for spousal relationships. The factors affecting condom use
at last sex among spouses were in the self-efficacy and access/affordability categories. For regular partners, all independant variable classifications were significantly associated with condom use except sexual behavior, meanwhile for casual
partners socio-demographic, self efficacy and affordability were significantly associated. By gender, factors affecting consistency of condom use were similar
for men and women with significant differences only for variables in the sexual
behavior and self-efficacy categories.
Conclusions: Improving sexual education and knowledge of reproductive health
risks may be the most effective way to encourage safe sex practices among adolescents and young adults in Angola. Access and affordability are also important
impediments to condom use for this cohort. Promoting safe sex and increasing
condoms affordability should be at the forefront of a comprehensive AIDS prevention campaign.
Presenting author: ndola prata, 1213 Tolman Hall, UC Berkeley, Berkeley, CA,
94720, United States, Tel.: [phone], Fax: [phone], E-mail: ndola
@uclink.berkeley.edu
ThPeE7786 Multi-country study on trusted partners among
youth
K. Longfield, M. Klein. Population Services International, 1120 19th Street, NW
Suite 600, Washington, DC, 20036, United States
Background: This study examines the issue of trust in relationships and its role
in sexual decision-making and risk perception for STDs and HIV. Quantitative
studies demonstrate that trusting a partner is a major reason that youth do not
use condoms during intercourse. Focus group results from four countries enrich
survey data and explore meanings of trust and its influence on risk perception.
Methods: A total of 33 focus groups with youth aged 15-24 years were conducted in Eritrea, Tanzania, Zambia and Zimbabwe. Discussion topics included
definitions of trust, criteria for trustworthiness, risk perception for STDs and HIV,
and expectations of trusted partners. Data analysis highlighted common and divergent themes on trust and its role in risk perception.
Results: According to study participants, trusted partners are sexually faithful
and concerned about one's emotional and financial needs. Youth said they employ emissaries to make introductions and rely on family and friends to inform
them of partners' trustworthiness. Participants revealed many indicators of trust:
appearance, emotional cues, social conduct, and a relationship's seriousness.
Youth said they were reluctant to learn about partners' sexual histories and assume partners are HIV negative until suspected otherwise. Compounding risk for
STDs and HIV is early sexual activity with confirmation of trust in a partner coming later. Condom use is abandoned once trust is established and betrayal of trust
usually results in ending a relationship, not reducing risk.
Conclusions: Many youth assume they are not at risk for STDs and HIV because
they trust their sexual partners. Study findings indicate that although youth use
criteria to establish partners' trustworthiness, they fail to explore partners' sexual
history or consider the consequences of not using condoms. In addition, sexual
satisfaction, emotional fulfillment, and fear of relationships' end override youth's
risk perception for STDs and HIV.
Presenting author: Kim Longfield, 1120 19th Street, NW, Suite 600, Washington,
DC, 20036, United States, Tel.: [phone], Fax: [phone], E-mail:
klongfield@ psi.org
ThPeE7787 An AIDS Free You depends on You!' Or does it?
High school girls in Dominica, West Indies, muse
on sexual issues *popular local advertisment
C. George1, M. Alary2, J. Otis3. 1 Universite Lava, Unite de recherche en Sante

des populations, Hopital du Saint Sacrement du CHA, 1050 Chemin Sainte -
Foy Quebec, Quebec G 1S 4L8, Canada; 2 Centre hospitalier affilie universitaire
de Quebec and Institut national de Sante Publique du Quebec, Quebec,
Canada; 3Universite de Quebec a Montreal and Coalition des Organismes
Communautaire Quebecois de lutte contre le sida, Montreal, Canada
Background: As the prevalence of HIV is increasing among young Caribbean
women, it is imperative to find out their sexual practices and what sexual be
haviour they valorize in order to design or manage risk reduction programs, and
to study high-risk behaviours for long-term HIV prevention.
Methods: A qualitative question was added to a cross-sectional quantitative survey done at five high schools in Dominica, in November 2000. Participants were
asked to write comments on issues relating to sexual relationship, sexuality or
to comment on sexual behaviour. Only 2 boys(n=38) and 43% (n=87/204) of the
girls responded to this section. The analysis focuses on the information that these
girls provided.
Results: Sexual coercion by boys was predominant. A majority also experienced
pressure from other girls to conform to the norm of sexual behaviour. Physical
and psychological abuses were important followed by relationships of trust and
boyfriends polygamy. This theme was reflected in the quantitative analysis where
23% of all girls reported that they were coerced and 38% reported unwanted
sexual touching. 51% (38/74) of the sexually active group had >2 and 14% > 6
sexual partners. Girls needed information on alternative forms of non-coital relations, oral sex, modes of STI/HIV transmission - one asked, "Can I catch an STI if I
sex in the sea?" There was a general morality disapproval of sexual practices outside of marriage and condom use, although many of these girls were themselves
sexually active (53% in this analysis and 40% of all girls in entire survey).
Conclusion: Communication is often lacking between girls, their partners and
advisers. Sexual counselling and empowerment issues need focusing on to help
them negotiate sexual safety A preventive strategy on HIV should concern parents and include as a social indicator, sexual pressure, machismo, multiple partnerships and construction of identity at adolescence.
Presenting author: Clemon George, Unite de recherche en Sante des populations, Hopital du Saint Sacrement du CHA, 1050 Chemin Sainte - Foy, Quebec,
Quebec G1S 4L8, Canada, Tel.: [phone], Fax: [phone], E-mail:
cgeorge@ uresp.ulaval.ca
ThPeE7788 More young men are in favour of women's
reproductive rights than young women:paradoxical
findings from Mali and the implications for
programme design.
L. Cisse. Save the Children, Save The Children (UK) B.R 166, Motpi, Mali
Background: Research in Mali indicated that young people's sexual health
knowledge about HIV/AIDS is high but few take preventive measures to protect
themselves from infection. Thus, simply providing information or appropriate services may not be sufficient to induce behaviour change. Save the Children UK
has developed an intervention in 14 localities in the Mopti region that seeks to increase adolescents' psychological skills and social support for their reproductive
rights to improve sexual health.
Methods: The program will develop life skills and reproductive rights through peer
education with young people and societal gatekeepers. Qualitative research was
carried out to inform curriculum design and was followed by a baseline study of
3237 adolescents to elicit knowledge, attitudes and behaviour pertaining to reproductive health and rights.
Results: The baseline study showed that more young women than young men
opposed women's basic rights. Fewer young women than young men strongly
agreed that a married woman can refuse sex with her husband (16%and 27%
respectively). More males than females strongly agreed that a woman can use
contraception regardless of whether her husband accepts (60% and 44% respectively). A greater percentage of males said that a man must use a condom if
asked by his partner than females (78% and 60% respectively). These findings
are supported by the qualitative research which also found that young women
were expected to be submissive to a greater extent than was expected of them
by the young men.
Conclusions: This study shows that paradoxically more young men were in
favour of women's reproductive rigths than were the women themselves. More
specfically there appears to be a distinction between the perspectives of married
and unmarried women. This implies that reproductive health programmes need
to differentiate between these three groups (young men, married and unmarried
women) and tailor their interventions accordingly.
Presenting author: Lalla Cisse, Save The Children (UK) B.P 166, Motpi, Tel.:
[phone], Fax: [phone], E-mail: [phone]
ThPeE7789 Older male sex partners present increased HIV risk
for low-income female adolescents: economic,
social, and cultural influences
G.W. Harper1, A.K. Bangi1, M. Doll1, M.M. Dolcini2, R. Contreras1,
A. Pedraza3. 1DePaul University, Department of Psychology, Chicago, IL, United
States; 2University of Caifornia San Francisco, San Francisco, United States;
3Project VIDA, Chicago, United States
Background: To investigate the HIV risk experienced by low-income female adolescents who have older male sex partners and to explore factors that reinforce

sexual relationships between female adolescents and older men.
Methods: Data for this presentation come from two studies (one quantitative and
one qualitative) of low-income African-American and Latina urban youth.
Results: Quantitative data revealed that female adolescents who reported sexual activity with older male partners participated in higher rates of HIV sexual risk
behaviors than those who had partners who were not older. Qualitative data revealed that female adolescents view emotional and tangible benefits to relation