Abstract Book Vol. 1 [International Conference on AIDS (16th: 2006: Toronto, Canada)]

TUPDEO4
Reaching youth from vulnerable populations in
Jamaica: an innovative pilot programme for young
MSM
R. Carrl, I. Mcknight2. 'Caribbean Institute of Media and Communication,
Graduate Studies, Mona, Jamaica, 2Jamaica AIDS Support, Kingston, Jamaica
Issues: Prevention among impoverished youth in Jamaica is undermined by the
many vulnerabilities youth face. Jamaica AIDS Support, a non-governmental
agency, found this especially true when it considered youth among the
populations it serves: MSM, sex workers, persons living with HIV, the hearing
impaired, and incarcerated populations. Stigma complicates behavioural
interventions with these groups, especially for youth from these populations.
Description: Jamaica AIDS Support initiated a specialised program for youth
MSM as a pilot for other socially excluded youth groups. Focus groups revealed
young people face extreme exclusion, including verbal and physical abuse
from their families, communities, the police and schools, finding no means of
redress. Many lived on the streets, and as a result engaged in transactional
sex. There were high rates of infection among them, so secondary prevention
was a focus of programming. The HIV-negative participants reported the VCT
experience cemented earlier risk-reduction messages and so this was used as a
core strategy. Very low CD4 counts among the HIV+ group suggested infection
as young as 12 or 13. Young MSM were included in a range of activities in a
day-camp setting, including activities drawing on their resiliency skills and riskreduction commitment. The program also deliberately included activities not
directly addressing sex but focussing on self-esteem and play.
Lessons learned: Youth from marginalised groups face additional vulnerabilities
and risks. Programs must face these realities and address the needs of these
young people despite external pressures not to provide services that affirm
their right to make life choices.
Recommendations: Programming must be youth-friendly and based on
youth realities, especially for youth at high risk presenting with high rates of
infection. Secondary and primary prevention programmes must be developed
with provision of accurate and non-discriminatory information and modes of
delivery, but also allow for healthy identity formation.
TUPDEO5
Youth-focused HIV prevention: doing gender the
"rights" way
F. Castafilo, L. Atkin', B. Betances2. 'Margaret Sanger Center International
- Planned Parenthood of New York City, New York, United States, 2Margaret
Sanger Center International - RD, Santo Domingo, Dominican Republic
Issues: This abstract describes innovative approaches that help organizations
address gender equity and gender-based violence within HIV prevention
programs.
Description: Through global initiatives such as "Safe Youth Worldwide" (SYW)
and "Safe Men, Safe Women", Margaret Sanger Center International (MSCI) has
worked with organizations in five countries in southern Africa and the Caribbean
to integrate gender equity (GE) and gender-based violence prevention (GBVP)
within HIV programs. Ample evidence suggests that integrating gender into
HIV programs leads to significant behavior change to transform traditional
gender roles and reduce gender-based violence (GBV) that facilitate the
spread of HIV. However, even when programs are aware of the importance
of integrating GE and GBVP they may not know how to do it. In response,
MSCI developed a model, tools, and training so organizations understand the
degree of gender equity in their programs. This ranges from reinforcing gender
stereotypes (gender negative) to achieving greater equity and equality (gender
equity promotion). The model has helped more than 30 organizations design
and implement prevention programs for youth that integrate gender, rights,
and sexuality and address the links between GBV and HIV and AIDS. MSCI
is working with these organizations to reduce violence through empowering
girls and women and involving boys and men to re-define gender roles. In the
Dominican Republic and Jamaica, MSCI and partners have developed media
and advocacy campaigns to address GBV and its links to HIV.
Lessons learned: The model has helped organizations understand different
approaches to gender equity and become more consistent in integrating gender
into HIV programs and GBVP.
Recommendations: A resource guide and a training course on GE promotion
for program planners, funding agencies, and policymakers will help build
organizations' capacity to expand HIV prevention programs that will empower
women and help men to change harmful behaviors that perpetuate HIV.
TUPDEO6
Haath Se Haath Milaa: reality TV and celebrity
spread HIV/AIDS awareness
Y. MacPherson. BBC World Service Trust, Development Communications,
Delhi, India

Issues: Over 5 million people are estimated to be living with HIV/AIDS in
India. Those in the economically productive and sexually active age group of
18-49 are considered especially vulnerable to HIV/AIDS. The BBC World Service
Trust, in partnership with India's National AIDS Control Organisation and
Doordarshan, the state broadcaster, is currently running the country's largest
HIV/AIDS-awareness mass media campaign. One challenge is to attract new
audiences among the most vulnerable groups - youth and young adults.
Description: The Trust produces a weekly, youth focused, reality television

show Haath Se Haath Milaa (HSHM), or "Let's Join Hands". HSHM is in its
third season, in an innovative new format. The show uses the appeal of the
Indian film industry to raise awareness. Each story features a Yuva Star'Young
Achiever' who has made an outstanding contribution to raising awareness about
HIV/AIDS. Through the show the Yuva Star meets his/her favorite film star,
sharing experiences and setting each other challenges. The viewer is informed,
entertained and inspired by this interaction.
Lessons learned: HSHM aims to create effective Behaviour Change
Communication about HIV/AIDS within a mainstream entertainment format.
The show allows insight and discussion on youth issues. The marriage between
entertainment and education weaves HIV/AIDS messaging into the show.
Results of field-based research of the format reinforce that the show is meeting
the intended goals. There is high recall observed of the Yuva Star and film star's
HIV/AIDS related activities.
Recommendations: Celebrity has a key role in addressing stigma around HIV/
AIDS. Creative new formats can reach new audiences, even in a crowded media
market. The first episode of the new series was seen by 12 million viewers.
Key Challenges
TUKCI01
Evaluation of microbicide applicators to determine
vaginal use in the Carraguard phase 3 clinical trial
S. Govender', S. Skoler2, R. Maguire2, L. Guichard2, P. Lahteenmaki',
H. Vilakazi3, F.S. Mapula4, J. Rossier5. 1Population Council, Johannesburg
Office, Johannesburg, South Africa, 2Population Council, Center for Biomedical
Research, New York, United States, 'Medical Research Council, South Africa,
HIV Prevention Research Unit, Durban, South Africa, 4University of Limpopo/
Medunsa Campus, Setshaba Research Center, Soshanguve, South Africa,
5University of Cape Town, Empilisweni Clinic, Cape Town, South Africa
Background: Women represent an increasing burden of the HIV/AIDS
pandemic, making safe and effective, vaginal microbicides an urgent necessity.
Ideally, microbicides will be used before each sex act. Determining product
usage in clinical trials to ensure accurate evaluation of safety and efficacy
is challenging because 1) typical products are not absorbed, impeding
pharmacokinetic assessment and 2) self-reported gel use during the trial is
likely to carry a social desirability bias. A sensitive, specific biological marker
was developed by the Population Council to determine if participants in the
Phase 3 microbicide trial of Carraguard use the gel.
Methods: The test procedure consisted of spraying Trypan blue, (later
changed to FD&C Blue No. 1 Granular Food Dye Powder) on the single use,
prefilled Micralax~ applicators. Vaginal mucous on used applicators stain in
a characteristic pattern when exposed to the dye (staining patterns do not
vary between the two dyes). Lab staff from the 3 Carraguard study sites were
trained, and tested to validate accurate test conduct and interpretation. Kits for
validation consisted of 100 applicators (both inserted and not inserted). Inserted
applicators were those used at participant enrolment visits for demonstration.
Results: Original validation was conducted with the Trypan blue stain at 2 sites
and with the Food Dye at the third (their training and evaluation occurred after
the assay changed). At the 3 sites, 98%, 93% and 95% of the applicators were
read correctly, respectively. Following these successful validations, all sites
implemented the test within the Phase 3 trial, spraying and reading applicator
that is returned opened (participants are asked to return used and unused
applicators at each visit). Re-validations are conducted every 6 months.
Conclusions: This is the first biomarker with which to measure gel usage
in clinical microbicide trials. It is inexpensive, easy and reliable and can be
implemented in any research setting.
TUKCI02
Surveillance of HIV-1 subtypes informs risk for local
spread of infection in Hong Kong
K. Lee1, W. Yu2, T. Leung', X. Hui2, X.J. Fan2, K.H. Wong', Y.M. Shao2,
W. Lim'. 'Special Preventive Programme, Department of Health, Hong Kong,
China, 'Chinese Centre for Disease Control and Prevention, China, China,
'Public Health Laboratory Services Branch, Department of Health, Hong Kong,
China
Background: To understand the HIV molecular epidemiology and assess the
potential of local spread of HIV in Hong Kong, a study to determine the subtypes
of reported HIV-1 infections was started in late 2000.
Methods: Left over samples of diagnostic sera were genotyped at the
government virology laboratory using a sequence based methodology on env
v3-v4 and gag p17 genes. Phylogenetic analysis was performed to examine
sequence variation and relationships. Results are incorporated into the HIV
voluntary reporting system.
Results: As of June 2005, blood samples from 949 patients newly diagnosed to
have HIV infection were successfully subtyped. More than 90% are infections

reported since 2000. 79% of these were male and 71% Chinese. 51% have HIV
risk 'heterosexual', 29% 'MSM' (men having sex with men), 6% 'IDU' (injecting
drug use) and 14% did not have risk factor reported.
The commonest subtypes identified are CRF01_AE (492, 49%) and B (346,
36%). Subtype C, CRF07 BC and CRF08_BC each occurred in 5%, 3% and
2% of total cases respectively. Nine other subtypes or CRFs accounted for the
remaining 5%. Distribution of the subtypes differs by gender, ethnicity and risk
for HIV transmission. CRF01 AE is more common in heterosexual transmitted

XVI INTERNATIONAL AIDS CONFERENCE * 13-18 AUGUST 2006 * TORONTO CANADA * ABSTRACT BOOK VOLUME 1