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

556 Abstracts ThPeE7872-ThPeE7875

XIV International AIDS Conference

rare and overdoses are highly prevalent among those who use heroin. Sexual risk
behaviors are common and condom use is limited. Although sterile equipment is
highly available there is an absence of policies and actions targeting IDUs, health
risks, discouraging injection or preventing transitions to injecting.
Conclusions: There is a need to develop actions targeting at-risk populations
(discouraging transitions and promoting less harmful drug use), to develop policies and strategies that promote creation, continuity and impact of interventions,
to develop infrastructure to properly face a potential spread of IDU and opiate
dependence. There is also a need to expand the current knowledge given that
the lack of accurate information concerning IDU leads to ignore the real extent of
the practice, undermining the options to include IDUs as priority in HIV/AIDS and
drug use fields.
Presenting author: INES ELVIRA MEJIA, Calle 100 No. 39-98, ED 4 EN 1 (AP
301), Bogota, Colombia, Tel.: [phone], Fax: [phone], E-mail: imejia
@ uniandes.edu.co
ThPeE7872 WHO IDU-RAR Phase II Study and its implication
for implementation of harm reduction strategies in
Beijing, China
Z. Wul, L. Yap', M.Y. Zhang', K.M. Rou', Y Liu2. 1National Center for AIDS
Prevention and Control, 27 Nanwei Road, Beijing 100050, China; 2Beijing AIDS
Association, Beijing, China
Background: Injecting drug use (IDU) and its related HIV epidemic are becoming an increasing problem in Beijing. Information for policy making to address the
issues is limited. The objective of WHO IDU-RAR Phase II Study is to carry out
a rapid assessment of IDU issues and to make suggestions for rapid response to
the problem.
Methods: In-depth interviews were carried out among stakeholders including officials from health and policemen departments, health workers working at the
Detoxification Center and voluntary treatment clinics, and drug users in the Detoxification Center, voluntary treatment clinics and in the community. Existing data
were collected from varies sources. Mapping was carried out for facilities providing services and for reported drug users in communities. Anonymous selfadministered surveys were implemented among drug users in one Detoxification
Center and in 12 voluntary treatment clinics. Serological survey of HIV and HCV
infection were carried in injecting drug users recruited from clinics and from communities.
Results: Drug users are unevenly distributed in community with most in Haidian
District. Heroin is the most common drug used by drug users (90% for female and
97% for male). The proportion of injecting use ranged from 57% to 85%. Sharing
of needle and syringes were 11.5% to 12.3% among injectors. Among first 100
drug users surveyed, HCV infection were 47.6% among injecting drug users but
25% among non-injecting users, no HIV infection was detected. Knowledge of
sharing needles causing HIV transmission was 67% to 81.3%. Self-reported STD
rate was 6.8% to 7.3%.
Conclusions: The results highlight the risk of epidemic of HIV infection among
injecting drug users in Beijing. Current strategies of using detoxification and shortcourse voluntary treatment programs are not sufficient to prevent the epidemic.
Community-based methadone maintenance program should be implemented as
soon as possible.
Presenting author: Zunyou Wu, 27 Nanwei Road, Beijing 100050, China, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
ThPeE7873I Etic vs. emic conceptions of newness: perceptions
Background: In Hartford, Connecticut, 64% (2,366) of 3,697 total reported AIDS
cases resulted from transmission through injection drug use. According to our
community-based research in Hartford, HIV infection among IDUs is the direct
outcome of barriers to safely acquiring, using and discardingrn syringes. In response to the demand for greater accessibility to workable, clean syringes, the
black market syringe seller role emerged. One goal of this study was to examine
the process of acquiring new syringes.
Methods: We collected data with 300+ IDUs, using multiple instruments including injection observations and syringe acquisition interviews. We also conducted
laboratory bioassays for DNA on syringes purchased from syringe sellers. We
coded and analyzed the qualitative data using NUD*IST 4.0, a content analysis
software package.
Results: Laboratory assays of syringes purchased from street sellers revealed
an extremely low incidence of DNA. Yet, the qualitative data exposed that the
IDUs' beliefs about how to determine the status of syringes (new, clean, or used)

and what constitutes a "Clean" syringe might lead to the use of "Dirty" syringes.
We discovered that the seemingly universal terms, "New" and "Clean", are part
of a complex network of meanings. For example, at times, the term "New" meant
a syringe that had been cleaned (with water or bleach); the term "Clean" meant
a syringe that looked "Clean." As a result, an IDU might buy a syringe that was
said to be "New" but had been previously used, without any intentional deception
on the part of the syringe seller.

Conclusions: While our study shows that syringe sellers in Hartford are generally selling un-used syringes, the nature of the interpretation of what constitutes
a "Clean" syringe is cause for alarm. These results demonstrate the importance
of choice of language in research instrument design as well as in risk reduction
education.
Presenting author: Julie Eiserman, 129 Whitney Street, 3rd floor, Hartford, Connecticut, 6105, United States, Tel.: [phone], Fax: [phone], Email: [email protected]
ThPeE7874 Gay and bisexual men who use injection and
non-injection drugs: preferences, experience and
role of drugs in unsafe sex
IT Myers', J. Aguinaldo', S. Bullock2, C. Leaver', D. Dakers', L. Calzavaral,
P. Millson', B. Fischer3. 1HIV Social, Behavioural and Epidemiological Studies
Unit, Faculty of Medicine, University of Toronto, HIV Social, Behavioural and
Epidemiological Studies Unit, Faculty of Medicine, University of Toronto, 12
Queen's Park Cres. W Rm#325, Toronto, ON, M5S 1A8, Canada; 2SORAD,
Stockholms Universitet, Stockholm, Sweden; 3Dept of Public Health Science,
Faculty of Medicine, University of Toronto, Toronto, Canada
Background: While HIV surveillance reports distinguish between MSM-IDU's
and non-IDU's, little is known about the differences in use and role of drugs in
HIV transmission for these risk-groups. This analysis compares the experiences
of drugs in sexual risk-taking in a diverse group of MSM who inject and use other
drugs.
Method:This qualitative phase of a 3-part study considered men eligible if they
reported both drug use and sex with men 2-3 times/mo. Questions were asked on
drug-use career, meaning of drug use, drug-use scenes, and drug use with sex.
Interviews were audio taped, transcribed and analysed for themes and interpretive meaning.
Results: 28 men from varied drug-use scenes participated. Mean age was 32.9
yrs (range 20 - 52). 52% only had high school or less and 41% were unemployed.
52% self-identified as gay and 37% as bisexual. 67% used drugs >twice/week
(37% used daily). Current injection was reported by 14% of eligible and 23% of
ineligible (because of lack of sexual activity). Other drugs used included: marijuana (96%), cocaine (74%), ecstasy (63%), crack (56%), poppers (56%) and
psychedelics (44%). In previous 3 months 78% participated in anal sex. With few
exceptions and regardless of drug preference, participants did not relate unsafe
sex with drug use. Unsafe sex was explained by 'maturity, laziness, and personal
beliefs' and not attributed to drug use. The analysis suggests a continuum of the
drug-sex association from use of drugs for sex to use of sex to obtain drugs.
Constructions/ meanings of drug use and sex differ across the spectrum.
Conclusion: This unique sample of gay men from different drug-use scenes ascribe various meanings to sex and drugs. Understanding the absence of any attribution of unsafe sex to drugs, and the different roles that drugs are assumed to
have in relation to sex are important for HIV prevention.
Presenting author: Ted Myers, HIV Social, Behavioural and Epidemiological
Studies Unit, Faculty of Medicine, University of Toronto, 12 Queen's Park Cres.
W, Rm#325, Toronto, ON, M5S 1A8, Canada, Tel.: [phone], Fax: [phone], E-mail: ted.myers @ utoronto.ca
ThPeE7875I HIV Infection and Drug Abuse: Consolidation of
New Memory
M. Kumar, D. Waldrop, A.M. Kumar, C. Eisdorfer. University of Miami School of
Medicine, University of Miami School of Medicine, Dept of Psychiatry &
Behavioral Sciences, PO Box 016960 (M817), Miami, FL 33131, United States
Background: Injecting drug use (IDU) is a major risk factor for contracting HIV.
Since, the hippocampus has been shown to have the highest concentration of HIV
viral load among infected individuals, it has been proposed that HPA axis activity
and cognition will be compromised in infected individuals. This study investigated
consolidation of new learning in HIV-1+ IDUs
Methodology: Three groups of participants (N = 65), HIV-1+ IDUs, HIV-1- IDUs,
and HIV-1- nonlDU controls were given the Rey Auditory Verbal Learning Test
(RAVLT) as part of a larger study investigating neuroendocrine functions.
Results: A repeated measures multivariate analysis of covariance revealed significant differences in performances between the three study groups across all
five learning trials, F (2, 60) = 7.007, p < 0.002. HIV-1- nonlDU controls showed
significantly better performance than HIV-1+ IDUs (p < 0.000) or HIV-1- IDUs (p
< 003). A significant interaction effect was found indicating that the groups also
differed in their rate of learning (p < 0.033).
Conclusions: Our findings confirm that consolidation of new learning is compromised among HIV-1+IDUs, however, their biological mediators are not understood
as yet. Thus, these findings add to the cascade of cognitive dysfunctions that have
been reported to occur among seropositive individuals.(Supported by NIH grants
# NS 41205, DA 12792 and DA 13550)

Presenting author: Mahendra Kumar, University of Miami School of Medicine,
Dept of Psychiatry & Behavioral Sciences, PO Box 016960 (M817), Miami, FL
33131, United States, Tel.: [phone], Fax: [phone], E-mail: [email protected]