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

564 Abstracts ThPeE7908-ThPeE7911

XIV International AIDS Conference

Presenting author: Regina Lacerda, Rua Paraguacu, 42, Boqueirao - Santos, Sao Paulo, CEP 11050-020, Brazil, Tel.: [phone], Fax: +55 13
32243947, E-mail: [email protected]
I ThPeE7908 Homophobia in childhood predicts childhood
sexual abuse among Latino gay men
S.G. Arreola1, R.M. Diaz2. 'University of California San Francisco, Center for
AIDS Prevention Studies, University of California San Francisco, Center for AIDS
Prevention Studies, 74 New Montgomery, Suite 600, San Francisco, California
94105, United States; 2lnstitute on Sexuality Inequity and Health, San Francisco
State University, San Francisco, United States
Background: Childhood sexual abuse (CSA) is strongly linked to risky sexual behaviors that increase risk for HIV. Latino gay men (LGM) are twice as likely to have
experienced CSA as non-LGM and have a higher prevalence of HIV than White
non-LGM. This study assessed whether experiences of homophobia in childhood
predict CSA.
Methods: Data were collected from a probability sample of 912 men, self identified as Latino and non-heterosexual, recruited from 35 Latino gay bars in Los
Angeles, Miami, and New York. Structured interviews collected information about
CSA, defined as those who reported sex that was against their will before age 16
with someone 5 or more years older; and homophobia in childhood including how
often the they: experienced 1) mocking, or 2) non-sexual violence; were told 3)
gays "grow old alone", or 4) gays are "not normal"; and 5) feel they "embarrass
family".
Results: Higher proportions of homophobia in childhood (never compared to
ever) were found among LGM who reported CSA than those who did not as
indicated by 1) mocking: 76% of CSA and 58% of non-CSA, (p<.000); 2) nonsexual violence: 36% of CSA and 15% of non-CSA (p<.000); and 3) embarrass
family 78% of CSA and 63% of non-CSA (p<0.002). In multivariate analyses,
mocking and non-sexual violence were independent predictors of CSA especially when it occurred many times: Mocking-many times (OR=2.2, 95% CI=1.2 -3.8); mocking-a few times (OR=1.7, 95% CI=1.0-2.9); non-sexual violencemany times (OR=3.2, 95% CI=1.5-6.5); and non-sexual violence-once or twice
(OR=2.4, 95% CI=1.2-4.8).
Conclusions: Homophobia is a strong predictor of CSA among LGM. Young
Latino boys who are gay or effeminate may be at greater risk for CSA than those
who are not. CSA must be grounded and understood in the larger context of gender and sexual discrimination. Given the importance of CSA in HIV risk, both
homophobia and CSA should be the target of research and prevention efforts in
the Latino community
Presenting author: Sonya Arreola, University of California San Francisco, Center for AIDS Prevention Studies, 74 New Montgomery, Suite 600, San Francisco,
California 94105, United States, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
ThPeE7909I Acceptance of AIDS orphans: A case study in the
upper north of Thailand
M. Sunpuwan. Institute for Population and Social Research, Mahidol university,
Institute for Population and Social Research, Mahidol University, Salaya,
Phutthamonthon, Nakhon Pathom 73170, Thailand
Thailand is one of many countries that have been affected by AIDS. As the epidemic develops, children orphaned by AIDS are becoming an important problem
in society. Therefore, the objectives of this study are to describe the attitude of
people in the community toward orphans, the meanings of acceptance of AIDS
orphans, the reasons for acceptance and the process of acceptance of AIDS orphans. The population of the study was AIDS orphans who had lost their parents,
their families' members and the people surrounding them. The area of study was
a community in the Upper North of Thailand. The research methodology combined qualitative and quantitative components. The study was conducted over a
period of 10 months. The sample size was 265.
It was found that the number of AIDS orphans was three fourths of all orphans
in the community. Most people felt compassion for the orphans, but there was
a difference between non-AIDS orphans and AIDS orphans in the way they felt,
particularly in the acceptance from the community. The extent of discrimination
against AIDS orphans has been declining but remains in some situations such
as eating, sleeping and play. The two dimensions of acceptance of AIDS orphans
are; 1) no rejection / no discrimination and no refusal to join activities and 2) caring/ help and not abandon. The factors that affected acceptance were child health
status, appropriate behavior of orphans, causes or opportunities of infection, love
and bonds, good model of behavior, social status and authority, and knowledge
and understanding of AIDS. The process of acceptance of AIDS orphans is associated with increasing acceptance of PWAs.
The findings of this research may be used to establish strategies to address issues related to AIDS orphans. In particular, to encourage the family and community to help orphans. By these strategies, AIDS orphans will have a future.

Presenting author: Malee Sunpuwan, Institute for Population and Social Research, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170,
Thailand, Tel.: [phone], Fax: [phone], E-mail: g4036514@yahoo.
com

ThPeE7910 Over-emphasizing HIV/AIDS risk in anti-trafficking
programs can contribute to increasing stigma and
discrimination- Lessons from Nepal
V. Sharma Mahendral, P. Bhattarai2, C. Evans3, C. Costello Daly3. 1Population
Council/Horizons Program, Population Council/Horizons Program, 53 Lodi
Estate, New Delhi, 110 003, India; 2The Asia Foundation, Kathmandu, Nepal;
3Consultant, Population Council/Horizons Program, New Delhi, India
Background: HIV/AIDS and trafficking control programs work with disempowered and vulnerable populations. Unlike most HIV/AIDS programs, though, many
anti-trafficking programs have not developed program, policy, and communication
approaches that are sensitive to the human rights of trafficked women and girls.
Methods: Review of project documents of 10 NGOs active in anti-trafficking interventions and interviews with key representatives of national and international
agencies in Nepal were conducted. Participatory Learning and Action (PLA) exercises, 43 focus group discussions with community members and a survey of
1269 adolescent girls (14-19 years) were conducted.
Results: Most anti-trafficking interventions use fear-based messages that emphasize links between trafficking, prostitution, and HIV infection. Similarly, communities associate trafficking with prostitution (91.3%) and condemn trafficked
women and girls for disgracing their families as well as for bringing HIV/AIDS into
their communities when they return. 94.0% of adolescent girls report that communities regard returnees with hate. Community members suggest mandatory HIV
testing (without consent) and segregation and isolation of trafficked returnees and
HIV-positive persons from the community as a means of controlling the spread of
the epidemic.
Conclusions: Fear-based messages overemphasizing the risk of HIV infection
lead to increased stigma for both trafficked returnees and PLHA living within communities. Better collaboration between anti-trafficking and HIV/AIDS programs
could lead to a consistent approach that respects human rights. Addressing
stigma and discrimination by empowering communities and promoting human
rights may serve as a starting point for collaboration.
Presenting author: Vaishali Sharma Mahendra, Population Council/Horizons
Program, 53 Lodi Estate, New Delhi, 110003, India, Tel.: [phone],
Fax: [phone], E-mail: [email protected]
ThPeE7911 Stigma, HIV/AIDS and the prevention of
mother-to-child transmission
V. Bond1, S. Maitra2, I. Ouedraogo3, A. Golubov4, E. Chase5, B. Sleap6.
London School of Hygiene and Tropical Medicine, ZAMBART Project, Lusaka,
Zambia; 2Tata Institute of Social Sciences, Mumbai, India; 3Consultant,
Ouagadougou, Burkina Faso; I Ukrainian Family Planning Association, Kiev,
Ukraine; 5 Thomas Coram Research Unit, London, United Kingdom; I The Panos
Institute, The Panos Insitute, 9 White Lion Street, London, N1 9PD, United
Kingdom
Issues: It is widely agreed amongst those living with HIV/AIDS and those working
in HIV/AIDS, that HIV-realted stigma is both widespread and a significant obstacle to the provision of effective care and prevention measures, including working
effectively with pregnant women in reducing mother-to-child transmission. However, little is certain about how pervasive HIV-related stigma is, what its causes
are, what forms it takes and what steps can be taken to reduce or eliminate it in
the different settings in which it occurs.
Description: This research took place in India, Ukraine, Burkina Faso and Zambia, consisting of focus group discussions with health care providers, health care
users and interviews with key informants. It examined HIV-related stigma surrounding MTCT against the background of HIV-related stigma, both perceived
and enacted, in the family, in the community, in the workplace and in health care
settings.
Lessons learned: Women throughout the research were subjected to stigma as
women, as pregnant women assumed to be HIV-positive, as HIV-positive women
and as HIV-positive women who are pregnant/or have children. Whilst there were
similarities in the causes and manifestations of stigma across the research sites,
there were also clear contextual differences. In some cases discriminatory behaviour and negative attitudes that might be assumed to be due to stigma were
reported to have other causes, such as fatigue or lack of economic resources.
Recommendations: The research recommends a systematic analysis of stigma
within each context as a vital part of HIV/AIDS programming. MTCT programmes
should be part of an integrated approach that addresses broader issues surrounding HIV including fears and misconceptions that reinforce stigma. MTCT prevention programmes should focus on the parents of the infant, not only on the infants
themselves and should take into account health care providers' limited access to
training and professional support.
Presenting author: Bridget Sleap, The Panos Insitute, 9 White Lion Street, London, N1 9PD, United Kingdom, Tel.: [phone], Fax: [phone],
E-mail: [email protected]

ThPeE7912 HIV/AIDS stigma and disclosure in South Africa
J. Pulerwitz', R. Stewart2, E. Esu-Williams3, G. Mgilane3. 'Population Council,
4301 Connecticut Ave. NW Suite 280, Washington, DC, 20008, United States;
2DRA, Durban, South Africa; 3ESKOM, Johannesburg, South Africa
Background: How is HIV-related stigma and disclosure manifested differently