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

XIV International AIDS Conference

Abstracts ThPeE7876-ThPeE7880 557

ThPeE7876 Factors affecting low risk behavior and self-care
among injecting drug users in Catalunya
A.S. Qureshi1, R. Torra2, L. Conejos3, M. Capdevila3, B. De La Torre3, J. Pi1,
J. Colom1. Direccid General de Drogodependencies i Sida, Direccid General
de Drogodependencies i Sida, Generalitat de Catalunya, Travessera de les
Corts, 131-159, Pavell6 Ave Maria, 08028 Barcelona, Spain; 2Servei de Salut
Piblica. Ajuntament de Manresa, Manresa, Spain; 3Servei de
Drogodependencies. Ajuntament de Lleida, Lleida, Spain
Background: This presentation examines the conditions of injecting drug users
in Catalunya. Although social and medical services exist for IDUs and people with
HIV, some do not make use of these services, which provide both treatment and
prevention. It would appear that service use is important not only as a response
to ill-health, but also as a source of risk-reduction strategies and necessities. The
purpose of this study is to gain insight into consequences and causes of low
service use. Specifically, the hypothesis is that service use, living situation, and
engaged social relations will predict greater self-care and lower risk behavior. A
final objective is to assess HIV status and treatment.
Methods: A total of 233 IDUs in three parts of Catalunia participate in the study
Questionaires designed to assess life situation and treatment needs are administered by trained personel in service centers close to areas where IDUs buy and/or
inject. The study will provide frequency data as well as correlations, drawing upon
the appropriate statistical analyses, in order to respond to study hypothesis.
Results:The study will provide information regarding the incidence of HIV, service
utilization and evaluation, risk reduction awareness and behaviors, life problem areas, and basic need coverage. The results will provide data on the relationships
between the different elements, and demonstrate whether or not the hypothesis
must be accepted or rejected.
Conclusions: Insufficient data is presently available. Conclusions will discuss the
hypothesis and propose recommendations.
Presenting author: Xavier Major, Direcci6 General de Drogodependencies i
Sida, Generalitat de Catalunya, Travessera de les Corts, 131-159, Pavell6 Ave
Maria, 08028 Barcelona, Spain, Tel.: [phone], E-mail: [email protected].
es
ThPeE7877 Social-cognitive factors associated with sexual risk
behavior of female injecting drug users
M. Matter, J. Brodbeck, F Moggi. Unversitary Hospital of Clinical Psychiatry
Berne, Universithre Psychiatrische Dienste Bern, Bolligenstrasse 111, 3000
Bern 60, Switzerland
Background: The purpose of the study was to develop theoretically and empirically founded intervention to prevent HIV infection of female injecting drug users.
Method: A total of 146 heroin and cocaine using women living in Swiss cities
completed an interview about sexual risk behavior (SRB) and its antecedent social cognition such as self-efficacy in self-protection of HIV infection, outcome
expectancies, perceived vulnerability and severity of HIV/AIDS, knowledge about
HIV/AIDS and importance of personal health.
Results: In a period of six months, 47 of 146 women (32%) had SRB: 24
women who only had SRB with a boyfriend or partner, 18 women who had SRB
with chance acquaintance and 18 women who had prostituted themselves. Selfefficacy, outcome expectancies, perceived vulnerability and importance of personal health were associated with SRB frequency. A logistic regression including
age, education, kind of sexual relationship and all social cognition yielded that
self-efficacy and perceived importance of personal health were the most important predictors of SRB, followed by sexual intercourse with chance acquaintance.
Reported reasons of SRB were related to the kind of relationship: Women having
a boyfriend or partner trusted in partner's fidelity and health or they mentioned
that feelings of love were more important than the risk to get infected with HIV.
SRB with chance acquaintance was predominantly explained by excessive alcohol and/or drug use. In the context of prostitution, SRB was blamed on clients who
refused to use condoms or paid much more money for having sexual intercourse
without condoms.
Conclusion: Prevention interventions should be aimed at awareness of selfefficacy and personal health in sexual risk situations. Kind of intimate relationship
should also be considered. Based on these results, two group interventions that
improve motivation and social skills for self-protection have been proposed and
are currently evaluated in an ongoing study.
Presenting author: Monika Matter, Universithre Psychiatrische Dienste Bern,
Bolligenstrasse 111, 3000 Bern 60, Switzerland, Tel.: [phone], Fax: +41
31 930 94 04, E-mail: [email protected]
ThPeE7878 Innovative measures to stem the spread of HIV
among people who inject drugs in Central Sydney
C. Aspin. Central Sydney Area Health Service, 192 Barcom Avenue,

Darlinghurst, NSW2010, Australia
Issues: Health education programs for people who inject drugs are a key plank
in Australia's response to the HIV epidemic. In New South Wales alone there are
over 800 outlets which have received official approval to distribute sterile injecting equipment for the purpose of injecting drugs. The first of these programs was
established in 1985 and today, Australia enjoys an international reputation for its
success in stemming the transmission of HIV among people who inject drugs.

Few studies, however, have described the complexities of the services that these
programs have provided throughout the course of the epidemic. This paper describes one of the largest needle and syringe programs in Australia and identifies
the factors that have led to its success in stemming the transmission of HIV among
people who inject drugs.
Description: The Resource and Education Program for Injecting Drug Users
(REPIDU) caters to the diverse needs of people who live in inner Sydney. These
include people from many different language and cultural backgrounds as well
as a significant proportion of indigenous Australians. Currently, this latter group
makes up to 12% of REPIDU's clients whereas they make up less than 2% of the
overall population of the country. Accordingly, REPIDU programs need to be culturally appropriate and must pay particular attention to the needs of indigenous
clients.
REPIDU provides education and resources in a variety of innovative ways. These
include two primary outlets, ten secondary outlets, two outreach programs and
a home delivery service which operates during the day and after hours. As well,
REPIDU operates a health clinic and a referral service to treatment programs and
other health services.
Lessons learned: A measure of the success of this program is gained from the
low HIV prevalence among clients (less than 2%), a significant decline in the rates
of sharing and reusing of syringes and a high rate of referrals to other health programs.
Presenting author: Clive Aspin, 192 Barcom Avenue, Darlinghurst, NSW 2010,
Australia, Tel.: [phone], Fax: [phone], E-mail: caspin@email.
cs.nsw.gov.au
ThPeE7879I Harm reduction programs in Pervouralsk, Russian
Federation
S.B.K. Kozyakov. Institution, UL Vatutina, 10/26, Pervouralsk, Sverdlovskaya
oblast, 623100, Russian Federation
Issue: Cooperation between NGOs and Municipal Health Organizations in small
cities provides large opportunities, activates public opinion and responsibility of
community and municipal authorities in terms of HIV prevention.
Setting: Pervouralsk (164000 population) is a large industrial city, 40 km from
Ekaterinburg -a large transportation knot. Increased problem of drug addiction in
the last 6 years is caused by social-economic instability and large size of illegal
drug circulation. Rapid increase of drug addiction, risky drug-taking practices led
to wide spread of HIV: from 0 in the beginning of 1999 to 926 registered cases to
01.01.2002, 99% of which are IDUs. Project: Pervouralsk is one of the first cities in
the oblast where a HR project has been implemented (February, 2000). Cooperation and joint financing of NGO and city Health institutions helped to start 2 fixed
and 2 mobile needle exchange outlets, street and shooting-galleries outreach,
psychological counseling and HIV testing. A sociological research indicated that
prior to the program start 66% have never been in contact with health specialists,
were little informed about HIV and other infections. Now IDUs wish to contact with
specialists, every one of ten tests for HIV, viral hepatitis and syphilis; start to care
about their health and change behavior to less risky, almost 100% wish to get rid
of dependence; nearly 10% are motivated to stop drug use, there are also cases
when people stopped using.
Outcome: The project opened opportunities of interagency cooperation on the
city and oblast level in HIV prevention among IDUs and drug rehabilitation. Same
joint efforts are taken also towards commercial sex workers and inmates. From
October, 15 - 2001 a rehabilitation program for IDUs was started.
Presenting author: Sergey Kozykov, UI.Vatutina, 10/26, Pervouralsk,
Sverdlovskaya oblast, 623100, Russian Federation, Tel.: [phone], Email: nodrug @prvtel.uralnet.ru
ThPeE7880 Safe injecting rooms as a strategy for risk and
harm reduction among socially excluded IDUs
C. Roman, C. Tapies, B. Kistenich, A. Qureshi. Medecins Sans FrontieresSpain, Las Ramblas 64, 08001, Spain
Issues:Socially excluded IDUs constitute a particularly vulnerable population,
whose health and HIV status is particularly at-risk, and whose access to basic
social and health services is minimal. Lack of housing and hygiene combined
with difficult access to health and social services renders IDUs more vulnerable
to injecting related health problems such as HIV infection, overdose, etc. A safe
injecting room complemented by social and health services is a possible response
which is gaining support amongst profesionals engaged with risk-reduction programs.
Description: This poster will explore the pertinence of a safe injecting room
based on social, health, legal, and humanitarian criteria. We draw from health
and social data collected from IDUs in Barcelona, as a part of MSF-Spain's risk
reduction program in the slum of Can Tunis, along with a review of relevant literature and interactions with existing safe injecting room programs. Furthermore, we

examined the legal viability of safe injecting rooms within the context of Spanish
law.
Lessons learned: Safe injecting rooms are supported by social, health, legal and
humanitarian criteria, however, only if responsive to the social and health needs
of the target population. Safe injecting rooms are particularly needed close to the
areas of excluded IDUs and to drug markets; practices and attitudes concerning
intravenous drug consumption must as well be taken into account.