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

XIV International AIDS Conference

Abstracts ThPeE7822-ThPeE7826 545

600 036, India, Tel.: [phone], Fax: [phone], E-mail: mdurai
@hotmail.com
ThPeE7822 Prevalence of negative male partner reactions to
requests for condom use and the association to
condom use practices among women living with
HIV
G.M. Wingood', R.J. DiClemente', I.S. Mikhail2, D. Hubbard McCree',
S. Davies2. 1Emory University Emory University Rollins School of Public
Health/Center for AIDS Research, 1518 Clifton Rd., Rm #556, Atlanta, GA,
30324, United States; 2University of Alabama, Birmingham, United States
Background: Globally, although women living with HIV represent a substantial
proportion of the infected population, they remain an underserved and understudied population. In particular, there is scant empirical data describing the prevalence and the impact of male sex partner's influence on the sexual health of
women living with HIV This study has two objectives: (1) to examine the male
partners' reactions to a woman's request to use condoms, and, (2) to examine
the association between the male partner's reactions to a woman's request for
condom use and condom use practices.
Methods: Sexually active women living with HIV (N=175) were recruited from
medical clinics in the southern US. Women completed an in-depth personal interview that assessed their condom use practices and their partner's reactions when
they were asked to use condoms.
Results: Nearly a quarter (24.3%) of women experienced negative reactions to
their requests for condom use; with many experiencing multiple negative reactions. Of women experiencing negative reactions, 20.7% were verbally abuse,
8.9% received threats of physical abuse, 8.9% were physically abused, 12.4% received threats of abandonment and 8.3% were abandoned. Furthermore, using
logistic regression analysis, controlling for relationship length, women who experienced negative partner reactions were more likely to use condoms inconsistently
in the past 30 days (OR = 4.2; p=.006); more likely to never use condoms in the
past 30 days (OR = 3.2; p = 0.05) and in the past 6 months (OR = 2.8; p = 0.04),
and were less likely to use a condom at last sexual intercourse (OR = 2.7; p =
0.04).
Conclusion: Sexual health promotion programs that address empowerment, promote feelings of gender pride, and discuss relational factors such as healthy and
unhealthy relationships, women's abuse histories and enhance sexual communication skills are needed for women living with HIV.
Presenting author: Gina Wingood, Emory University Rollins School of Public Health/Center for AIDS Research, 1518 Clifton Rd., Rm #556, Atlanta, GA,
30324, United States, Tel.: [phone], Fax: [phone], E-mail:
gwingoo@ sph.emory.edu
ThPeE7823 Factors influencing disclosure of HIV infection
amongst black African HIV positive women living in
London
J. Anderson', L. Doyal2. 1St Bartholomew's hospital, andrewes unit, st
bartholomew's hospital london, ecla 7be, United Kingdom; 2University of
Bristol, Bristol, United Kingdom
Method: A qualitative investigation was conducted into the health and social experiences of hiv positive black African women living in london. 62 subjects completed a demographic questionnaire and participated in a semi - structured interview. interviews were audiotaped, transcribed and analysed.
Results: Disclosure of information about hiv serostatus emerged as a major
theme. many shared their diagnosis only with the clinical team or with a limited group of people. Reasons cited were fear of rejection by family, partners
and friends, fear of stigmatisation and shielding others from anxiety. Disclosure
was easier to other HIV positive people, especially in the context of peer support
groups. disclosure to infected and affected children was identified as particularly
difficult. Information control was central to their lives, leading to secrecy and lies,
which many found hard to sustain, for a minority secrecy from others allowed them
to persist in denial of their diagnosis to themselves. Many women curtailed their
activities. This was either lest their hiv positive status should become known or
because of the complexities of sustaining secrets and lies. Disclosure of hiv status
was seen as a barrier to the establishment of sexual relationships. For those who
wished to share their diagnosis with family members remaining in africa there was
reluctance to discuss this by telephone. anxiety that family in africa might acquire
the information via a third party made women averse either to discuss their diagnosis with others from their home country or to attend support groups for fear of
meeting people that they knew. This was especially so for women without travel
documents awaiting immigration decisions.
Conclusion: Fears surrounding disclosure are important in limiting the social and
emotional lives of black african women with hiv in london. support from voluntary
and statutory sectors and from informal family and social networks is compromised

Presenting author: jane anderson, andrewes unit, st bartholomew's hospital,
london, ecla 7be, United Kingdom, Tel.: [phone], Fax: +44(0)20
7354 2045, E-mail: jane.anderson @ qmul.ac.uk

ThPeE7824 Listening to situations of sexual risk among
women: the approach of SIDA info service-France
S.RP Parmentier, H.F. Freundlich, M.L. Lefranc. SIDA info service, Paris, France
BackfroundThis paper presents an analysis of sexual risk-taking reported by
women.It will point out the particularities of this population in terms of age, situation when confronted with the disease, and behaviour in relation to prevention
and screening.
Methods: The tool that was chosen to collect the data is the Sida Info Service
hotline, which has collected for more than 10 years the stories of thousands of
women who called the line. This analysis is carried out using computerized reports of the calls taken, filled out by the listeners during exchanges with the
callers.First, the quantitative data is processed as a multi-variable analysis.A qualitative process, via a thematic analysis of information, enables these links to be
more refined and precise.
Results: Of 217,705 interviews which took place from 2001, situations of risk are
mentioned in 22,396 exchanges (10%).The notion of a sexual risk situation has
two different meanings here:
- "Voluntary/intentional" risks: represent 8% of exchanges.It includes nonprotected intercourse and sexual relations in the context of prostitution.
- "Involuntary" sexual risks: represent 2% of interviews.They take into account
rapes, undesired intercourses and condom failures. 76,716 women called. 6,483
of them mentioned a risk situation (8%).The women who mentioned a 'voluntary"
risk situation during an interview were mostly less than 29 of age whereas those
who having reported an "involuntary" risk situation were mainly between the ages
of 30 and 39.
Conclusions: These first results show that there exists a difference of profile
among the callers depending on whether they report "voluntary" or "involuntary"
sexual risk.These differences lead one to wonder about the social, cultural, and
religious factors that can have an influence on the difficulty for women to protect
themselves.To point out the determining elements in these situations at risk is to
contribute to the improvement of knowledge about behaviours of women.
Presenting author: MARIE LEFRANC, 190 BD DE CHARONNE, 75 020 PARIS,
France, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeE7825 Wean it in maes HIV+ in the municipal district of
Ribeirao PRETO-SP
F. Neves. Av. Presidente Kennedy, 2634, Lagoinha, Ribeirdo Preto, Sdo Paulo,
Brazil
Introduction: In Brazil the non breast-feeding is recommended as one of
the strategies to prevent the vertical transmission. The municipal Program of
DST/AIDS follows this recommendation and supplies it with artificial milk for the
mothers of HIV+'s babies. The point of this study is to verify if the HIV+'s motheres
are being well oriented and how they react to the situation of non breast-feeding.
Methods: Interviews were realized with HIV+ mothers registered in this program,
in March-April of 2000. They contained: characterization, previous experience in
breast-feeding, if there had been orientation for not breastfeeding, and what's the
feeling related to the weans.
Results: The usualy mothers is the medium age of 28,6 years; 78,9% are illiterate
or with incompleted high school; 73,6% breastfeeded previously. Most was guided
not to breastfeed, 50% in the prenatal and 50% in the childbirth. Even though,
26,3% of the mothers offered some suckled to the child. About the feelings for
the nonbreastfeed, 94,7% expressed sadness, faulness, enguer and depression.
They expressed the importance of the breast-feeding in the child's protection. A
contradiction is evident: to breastfeed is important, but it is not recommended for
those who are in a fragilit situation and still threatened by a stigmatized disease.
Conclusions: The professionals' actions cannot just resume in passing information about weans. There is the necessit to promote a relationship where can be
verbalized and respected. Because they carry factors related to loss,what contributes for the depression, low esteem, the feeling of fault and social isolation.
Presenting author: Fatima Neves, Av.Presidente Kennedy, 2634, Lagoinha,
Ribeirio Preto, Sho Paulo, Brazil, Tel.: [phone], Fax: [phone],
E-mail: progaids.saude @coderp.com.br
ThPeE7826 A multimedia educational tool addressing care and
support needs of women with HIV living in limited
resource settings
J.R. Anderson', N. Maier2, T. Norton2, E. Piwoz3, D. Lwanga3, N. Mcintosh2,
W. Fleming4. ' Johns Hopkins University Baltimore, MD, United States;
2jHPIEGO, Baltimore, United States; 3Academy for Educational Development,
Washington, DC, United States; 4HRSA, Washington, DC, United States
Issue: Women comprise approximately one-half of global HIV/AIDS infections

and may be more vulnerable to becoming infected for anatomic and physiologic
reasons; because of sociocultural beliefs and practices; and when trying to become pregnant. Women with HIV also have special needs for care and support in
relation to reproductive health and childbearing.
Description: Based on the manual, A Guide to the Clinical Care of Women with
HIV, a series of CD-ROM and web-based multimedia tutorials have been developed to address issues related to the care and support of women living with HIV
in limited resource settings.