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

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initiated penetrative sex practices before the age of 15 yrs. of age, 39% started
working in commercial sex at the age of 15-19 yrs., and 6% before 25 yrs of
age. 76% of respondent women reported consistent condom use. Main reasons
for not using condom were confidence to stable partner (79%), and having sex
with a regular client (9%).
Conclusions: The high HIV prevalence and the low level of adequate HIV/Aids
related knowledge found in this study evidences the need for strengthening
specific actions oriented towards reducing vulnerability of FCSWs in Colombia,
particularly in the Caribbean region. False beliefs regarding low condom
protection might be related to the media messages sent by Catholic Church.
This worrying issue should be faced through dialogue and advocay actions with
national religious authorities.
TUPEO533
Knowledge relate to risky behaviors and condom
use among MDMA arrestees
E.Y.-C. Peng', S.-S. Cheng2, S.-Y. Lyu3, P.-T. Yu4. 'Taipei City Hospital, Taipei,
Taiwan, Republic of China, 2Department of Health, Executive Yuan, Taiwan,
Bureau of Medical Affairs, Taipei, Taiwan, Republic of China, 3Taipei Medical
University, School of Public Health, Taipei, Taiwan, Republic of China,
4Department of Health, Executive Yuan, Taiwan, Bureau of Health Promotion,
Taipei, Taiwan, Republic of China
Background: Illicit drug user is one of the high-risk groups for HIV infection.
The main purpose of this study was to investigate knowledge related to risky
behaviors of HIV infection and condom use among MDMA arrestees in Taiwan.
Methods: This survey was conducted between July 2002 and February 2003
among MDMA arrestees from police stations in Taipei, the metropolitan city
in northern Taiwan. A total of 326 subjects were recruited through the selfadministered, anonymous questionnaire survey.
Results: Results of this study revealed that the average correct answer rate
for HIV related knowledge was 73.3%. Only 3.8% of the respondents perceived
that they have risk of contracting HIV, and 43.6% of the respondents realized
where to have HIV screening. Roughly 58.4% of the subjects reported to have
used condom while having sex. The educational level (x2=15.44, p<.01) and
employment status (x2=18.90, p<.01) were significantly associated with
condom use among the subjects. Subjects who had higher scores for HIV
related knowledge used condom more often than their counterparts while
having sex (t=3.00, p<.01). Interestingly, subjects' knowledge of MDMA use
was also associated with condom use (t=7.62, p<.01).
Conclusions: Subjects' HIV related knowledge was associated with their
condom use behavior. In recognizing that the drug users are a hard-to-reach
population, the criminal justice systems should enhance the arrestees' and
inmates' HIV/AIDS prevention education to facilitate condom use.
TUPEO534
Participatory community appraisal
L. Liu, P. Lu. HAPAC Sichuan, Beijing, China
Issues: Information on female commercial sex workers (CSWs) and the
community at large was collected by volunteers using six types of diagrams
through one-on-one and group activities under the funding of the International
HIV/AIDS Alliance.
Description: Volunteers among CSWs employed several community
assessment tools--including timelines, relationship charts, and problem trees--
in order to conduct eleven one-on-one activities and twenty-five group activities
in the small Chinese township of Shuangliu County from June to August, 2004.
Thirty-four original diagrams, nine integrated diagrams and three types of
chart records were then analysed in order to provide a better understanding
of community background, CSW needs and problems and community gaps and
shortfalls, result:
1. Community background: CSWs were affected by several factors in commercial
sex with a wide geographic distribution and a regular time distribution.
2. Needs and problems of CSWs: Needs included conducive policies, personal
safety, favourable working environment, good health, high income, no
discrimination and happy family. Problems included the risk of STI/HIV/AIDS,
crackdown, economic constraints, social discrimination, privacy, fertile activity,
violence, rude clients and poor relationship with bosses.
3. Community gaps and shortfalls: bad relationship between CSWs and bosses,
poor working and living environment, poor quality of medical services and low
satisfaction, limited condoms with poor quality and lack of respect for privacy
and confidentiality.
Recommendations:
1) Strengthen multi-sectoral cooperation;
2) provide condoms of different brands as needed;
3) standardise STI services;
4) build up confidence of CSWs; and
5) coordinate the relationship between CSWs and bosses.

TUPEO535
Who makes the decisions? Implications of social
and community dynamics for the success of PMTCT
services in South Africa
C. Varga', H. Brookes2. 'Nozizwe Consulting, Durban, South Africa, 2Human
Sciences Research Council, Pretoria, South Africa
Issues: Evidence from the U.S. suggests that if properly adhered to prevention
of mother-to-child HIV transmission (PMTCT) guidelines are highly effective.
Nonetheless, sub-Saharan Africa remains the source of the vast majority
of such infections. We assert that a major reason for the ineffectiveness of
PMTCT initiatives on the continent is a clash between health system models of
service delivery and social and community influences over pregnant women's
behavior.
Description: This paper draws on socio-behavioral data from three provincial
studies in South Africa. Data show how factors such as health decision-making
models, gender roles, cultural norms surrounding maternal-child health, and
women's economic and social position influence hoped-for behavioural outcomes
as a result of participation in PMTCT. Using narrative research techniques (key
informant workshops, questionnaires (n=900), focus group discussions, indepth interviews) case studies were developed to explore pregnant women's
PMTCT experiences. Data were analyzed by geography (rural vs. urban) and
age (adolescent vs. adult women).
Lessons learned: The single most important finding from this work is that
while PMTCT-related voluntary counselling and testing (VCT) is grounded in
an individual decision-making framework, pregnant women are subject to a
complex decision-making hierarchy influenced by status, age, family dynamics
and gender. This affects behavioural aspects of PMTCT such as the likelihood of
safe infant feeding practices, disclosure, condom use in the post-partum period,
and infant testing. Other important factors include provider-client interactions,
cultural beliefs concerning proper infant care, and HIV-related stigma.
Recommendations: Consideration of social and community factors is vital
to ensuring accessibility and effectiveness of PMTCT. Our studies provide a
compelling argument for restructuring PMTCT programs to ensure a better "fit"
between health systems and needs of communities they serve. Explicit mention
of social and community issues in PMTCT policy recommendations is timely
given that many countries are currently drafting PMTCT-related guidelines and
legislation.
TUPE0536
Extent of sexual coercion and risk of contracting
from STIs and HIV/AIDS among young migrant
workers in Nepal
M. Puri. CREHPA, Research, Kathmandu, Nepal
Background: Seeking employment, young people in Nepal often migrate from
villages to cities. The Kathmandu valley of Nepal is the favoured destination
because economic opportunities are greater. Most migrants obtain jobs in
carpet and garment factories, brick factories, construction works and tea stalls.
Alongside economic migration, young people experience significant shifts in life
style due to changes in their living arrangements and exposure to a wide range
of new social networks, ideas and behaviours. This paper explores the problem
of sexual coercion and risks of contracting from STIs and HIV/AIDS.
Methods: Information is drawn from a sample survey of 550 respondents aged
14-19 years and 23 in-depth case histories in Kathmandu Valley. Bivariate
analysis is carried out.
Results: The survey found that one in ten young girls had ever experienced
sexual assault and coercion in their lifetime. Two percent of the girls were
victims of rape. Sexual coercion varied from verbal abuse, assault, and threats
to unwanted kissing or touching. Extreme examples of sexual coercion included
forced exposure to pornographic movies, forced drinking of alcohol, incest, rape
and forced abortion. Perpetrators included co-workers, boy friends, factory
owners, parents and relatives. One in seven respondents were experiencing
signs and symptoms of STIs and an overwhelming majority of them did not
seek any treatment for these problems indicating high vulnerability to HIV/
AIDS. In-depth interviews revealed that the inability of young working girls to
communicate effectively with their peers and sex partners, lack of self esteem,
job insecurity and other socio-cultural problems made them vulnerable to these
abuses.
Conclusions: The results indicate that young factory workers in Nepal are
in high vulnerable for sexual abuses and STIs including HIV/AIDS. Factory
based interventions are urgently needed required to protect these subgroup
population from sexual abuses and HIV/AIDS.
TUPE0537
Sexual networks and condom use of migrant
workers in Thailand
K. Ford', A. Chamrathrithirong2. 1University of Michigan, Epidemiology, School

of Public Health, Ann Arbor, MI, United States, 2Institute for Population and
Social Research, Mahidol University, Salaya, Phattamonthon. Nakhon Pathom,
Thailand
Background: Due to the vulnerability of migrant groups to HIV infection, data
are needed to understand their prevention needs. The objectives of this paper
were to 1) identify the sexual networks of migrant workers, 2) identity factors
related to visiting sex workers, and 3) to identify factors related to condom use
with sex workers and other partners.

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