                   AIDS INFORMATION NEWSLETTER
                   Michael Howe, MSLS, Editor
                     AIDS Information Center
                VA Medical Center, San Francisco
                     (415) 221-4810 ext 3305
                        January 13, 1995

               Women and HIV Infection (Part XVII)

 Abstracts from the XTH International Conference of AIDS - 1994

AU  - Marlink R ; Traore I ; Thior I ; Ndoye I ; Essex M ; Mboup
S ; Kanki P
TI  - Natural history of HIV-1 & HIV-2 in cohort of W. African
females.
AB  - OBJECTIVE: A large cohort of female sex workers has been
followed since 1985 in Dakar, Senegal, to determine the clinical
and immunologic outcome of HIV-1 and HIV-2 disease. METHODS: Women
enrolling in an outpatient clinic in Dakar were screened for HIV
status after informed consent. Prevalent seropositives and known
seroconverters, along with a stratified seronegative group, were
asked to enroll in a clinical follow-up study if asymptomatic.
RESULTS: Incidence of AIDS according to person-years observed
(PYO): TABULAR DATA, SEE ABSTRACT VOLUME. Kaplanmeir analysis shows
that the HIV-2 seroprevalent and seroconverters have a
significantly longer disease-free time to AIDS or CDCIV disease
than the HIV-1 seroprevalent or seroconverters (Wilcoxon-Gehantest,
p < .05). DISCUSSION AND CONCLUSIONS: The rate of disease
development with HIV-2 is significantly less than that of HIV-1 in
the same region and population. This difference in clinical latency
has important implications for the individual patient and modeling
the epidemic for this area. 
SO  - Int Conf AIDS. 1994 Aug 7-12;10(1):147 (abstract no. PB0015).

AU  - Perelis L ; Perez P
TI  - Imprisoned women, a positive change.
AB  - PRINCIPALS: Since the work of Argentine Networh of Women
living with HIV/AIDS, women under detention have being identified
as the more affected. Added to this difficulties, prison conditions
restrict better way of living for these women. Caractheristics: 1.
her own care; 2. as an imprisoned mother living without her
children; 3. Care of the positive or negative children; 4.
relationship with family outside the prison. OBJECTIVES: 1.
Research on the women living with HIV/AIDS in Argentine prisons.
2. Workshops in: a. knowledge and care of concerned women
illnesses, b. Therapeutic work with children of imprisoned mothers:
(1. if children live inside prison, 2. outside, 3. if they are
HIV+, 4. if negatives.), c. Therapeutic work with rest of the
family: (1. while deteined, 2. ready to freed, 3. care in freedom),
d. selfcare conscience devellopment. METHODS: 1. Programmed work
with prison authorities. 2. Count quantity of women HIV+ and 
identification of those who want to be involved, 3. inclusion of
prison staff, 4. workshops supervised by coordination, 5. self work
started by trainers, 6. Form multipliers in or outside the prison.
RESULTS: 1. Count of large groups inside prison, 2. Objective
evaluation of the relationship with children and others after one
year of work, 3. better condicion for children of imprisoned women,
4. Publish of a newsletter about experiences, 5. create a
solidarity network for freed women living with HIV/AIDS.
SO  - Int Conf AIDS. 1994 Aug 7-12;10(2):53 (abstract no. 487D).

AU  - Policek N ; McKenzie M
TI  - Positive women relating their experiences of service
provision within Edinburgh.
AB  - OBJECTIVE: In Edinburgh 282 women are diagnosed HIV positive
(at 31/1/94), approximately 100 are in touch with service
providers. This paper, presented by two HIV positive women, looks
at the response to the needs of positive women in Edinburgh,
Scotland from the service users viewpoint. METHOD: The study used
a questionnaire for HIV positive women in touch with hospital based
or voluntary services asking what agencies are used and pinpointing
gaps in service provision. RESULTS: Women have been affected by HIV
and AIDS from the beginning--as carer, mother, partner and friend.
Results showed that services are still male dominated and rarely
geared towards the needs of women. CONCLUSION: There is a need for
continued research into this area to assist more women to access
services sooner rather than in times of crisis.
SO  - Int Conf AIDS. 1994 Aug 7-12;10(1):404 (abstract no. PD0225).

AU  - Purohit A ; Chakraborty J ; Danner R ; Hein D ; Anderson C;
Kiessling A
TI  - Pre- and post-test counseling to a diverse group of HIV
infected population.
AB  - OBJECTIVE: To develop model protocols for pre- and post-test
counseling for diverse groups of population, based on ethnicity,
age, gender preference and cultural beliefs. METHODS: In Boston
City Hospital, the protocols for pre- and post-test counseling were
revised and specific protocols were developed for Haitian, Latino,
African American (black women and gay black men), injecting drug
users, women, transsexuals and adolescents. After three months of
training the counselors were allowed to use this new protocol.
RESULTS: With improved skills and modification of the pre- and
post-test counseling protocols, the counselors felt more
comfortable and confident in the management of their patients. In
1994, an increase of 3% to 7% in seropositivity was recorded as a
result of better recruitment of different ethnic groups at high
risk infection. As a result of this modified protocol we observed
i) an increased rate of patient participation, risk reduction and
relapse prevention; ii) about 85% of these patients who tested HIV
positive were engaged directly in primary care. This is an increase
of 35% over the previous year. CONCLUSION: Design and
implementation of culturally specific pre- and post-test counseling
protocols is essential when dealing with a diverse group of
population. Personal preference and beliefs must be dealt with in
order to implement effective counseling.
SO  - Int Conf AIDS. 1994 Aug 7-12;10(2):394 (abstract no. PD0759).

AU  - Roitstein F ; Becker J
TI  - Reaching women in Latin America and the Caribbean: an
integrated approach to safer sex.
AB  - Most HIV/STD prevention programs have focused on populations
practicing high risk behaviors such as gay men, injection drug
users and commercial sex workers. However, of the estimated 14
million HIV-infected adults worldwide, 6 million are women. In
Latin America and the Caribbean (LAC), the incidence of infection
among women is increasing at an alarming rate. Since the early
90's, heterosexual intercourse has become the dominant mode of
transmission in LAC, and now it accounts for 75% of all new
infections. These data suggest a deficiency in such approaches to
HIV/STD prevention and highlight the need to reach all sexually
active people, especially women. To shift this trend, IPPF/WHR and
its affiliated Family Planning Associations (FPAs) have taken
advantage of their ability to reach large numbers of sexually
active people, especially women, by integrating HIV/STD prevention
into existing programs and services through the promotion of safe
sex practices. This integration process necessitates rethinking of
traditional approaches to family planning requiring a shift from
a narrowly defined medical and vertical family planning model to
a broader sexual health model. Comparative advantages of the
IPPF/WHR affiliates and potential barriers to implementation will
be discussed. This presentation will also describe the sexual
health model used in these projects, and will illustrate how it is
being applied and evaluated through a comprehensive plan. 
SO  - Int Conf AIDS. 1994 Aug 7-12;10(2):397 (abstract no. PD0768).

AU  - Sanchez S ; Woolcott D ; Mejia A ; Rouillon M ; Blume E ;
Mazzotti G ; Sanchez J
TI  - STD/HIV prevention program for women of low socioeconomic
status in Lima, Peru.
AB  - OBJECTIVE: To develop and evaluate educational material for
women of low socioeconomic status (SES) organized in clubs de
madres (mothers' clubs), community-based organizations settled in
Lima, Peru. METHODS: Eighteen focus groups among women from
mothers' clubs, and 7 focus groups and 7 in-deep interviews among
men of low SES were performed to obtain information at 2 levels:
a) sexuality, machismo, STD/HIV, condom use; b) Information and
communication network. A set of educational material (poster,
brochure, manuals and flipcharts) was developed and pre-tested
using in-deep interviews. Health promoters (120) from the community
were trained to use the educational material; changes on knowledge
and attitudes among the promoters were measured among the
promoters. After pre-test, a sample of 600 women from mothers'
clubs not previously interviewed entered into an educational
intervention made by the trained promoters. A post-test will be
performed after 6 month. RESULTS: Educational materials were
develop using messages to improve perception of risk for STD/HIV
and health seeking behavior; to give information on STD/HIV
prevention and family planning; to change attitudes and beliefs
towards sexuality; and to empower women's decision making in health
behavior. Among community health promoters, a significant
improvement was found between pre and post-test regarding knowledge
about STD/HIV and attitudes towards sexuality. In the pre-test
evaluation, women from mothers' clubs were found to have low
perception of risk for STD/HIV, poor health seeking behavior, low
or no power in the family decisions, low or no power in
contraceptive use decisions, and poor knowledge regarding STD/HIV
prevention. CONCLUSIONS: This program develop educational materials
for women of low SES using information from qualitative assessment
and perform a successful intervention to encourage STD/HIV
prevention. 
SO  - Int Conf AIDS. 1994 Aug 7-12;10(2):68 (abstract no. 548D).

AU  - Schilling RF ; Ivanoff A ; el-Bassel N ; Borne D ; Kabas F
TI  - HIV-related risk reduction among women offenders in jail and
in the community.
AB  - OBJECTIVE: Women drug users account for a growing proportion
in jails and prisons, and HIV seroprevalence rates of incarcerated 
women are higher than those of their male counterparts. This study
tests the efficacy of a group intervention, combining
skills-building and social support, and designed to reduce HIV risk
behavior among drug-abusing female offenders. METHOD: Derived from
socio-behavioral theories and from developmental work with the
target population, the intervention consists of 8 group sessions
in prison and 8 individual post-release sessions in the community.
Women with recent drug abuse, approaching release from a 3-12 month
sentence, are recruited in Rikers Island jail, New York City.
RESULT: More than 300 women have thus far been randomly assigned
to the skills-building/social support intervention or to a single
AIDS information session. Measurement includes baseline, and
follow-up at 1, 3, 6, and 12 months. In a logistic regression model
controlling for demographic variables and number of sessions
attended, preliminary findings (N = 159) favor skill/social support
participants on indicators of condom use improvement (OR = 3.92,
p < .07) coping skills improvement (OR = 2.14, p < .1), and
emotional support improvement (OR = 2.42, p < .05), but not sex
trading. CONCLUSION: Early results lend some support to group
skills-building interventions to reduce HIV risk behavior among
female offenders.
SO  - Int Conf AIDS. 1994 Aug 7-12;10(2):43 (abstract no. 464C).

AU  - Ssentongo R ; Sharpe U ; Nanteza C
TI  - Women as caretakers.
AB  - OBJECTIVE: To study the achievements/problems as experienced
by women caring for AIDS patients/orphans in their homes. According
to your experience as a carer, how do you explain care? METHODS:
The Mobile program cares for AIDS patients in their homes supports
7500 orphans in school and helps families to cope during this hard
period. A number of questions were discussed with women under this
program individually and in groups. RESULTS: Women have played a
big role in caring for people infected and affected with AIDS. The
whole process is stressful. Despite the social, economic and
emotional problems women have shown great concern. CONCLUSIONS:
Home care for AIDS infected and affected people is necessary and
very important in our society. There is a need to offer more
support to women.
SO  - Int Conf AIDS. 1994 Aug 7-12;10(2):238 (abstract no. PB0965).

AU  - Sushma S ; Mathur R ; Yadav N ; Sarin E ; Sahi R ; Rao B
TI  - STD prevention in low-risk poor women of Delhi.
AB  - The study is based on 12 months work: OBJECTIVES--1. To
assess the prevalence rate of STDs: 2. To Demonstrate the need for
providing STD services: 3. To provide counselling to women with
STDs. 4. To make women aware of STDS/HIV infection. METHODS--*Five
STD centres established in collaboration with Family Welfare
Programmes of the hospitals. *Individual counselling to STD+ive
women. *IEC strategies. RESULTS--8276 cases secreened, 521+ive for
STDs, (prevalence rate 6.6%), 550 random sample tested for HIV
none+ive, 4028 women and men contacted in interactive awareness
programmes, 428 individual counsellings. CONCLUSIONS--*STD services
should be supported by consistent areness programmes on STDs/HIV
and vice-versa, in the corresponding population. *The incidence of
STDs/HIV infection is strongly linked with other problems resulting
from over population, poverty, disease, illiteracy and gender bias.
*Majority of men and many women (housewive and girls) of these
communities indulge in very very high risk behaviour. *Religion
used as vehicle to spread the message may be more acceptable to
these people.
SO  - Int Conf AIDS. 1994 Aug 7-12;10(2):68 (abstract no. 549D).

AU  - Vorakitphokatorn S
TI  - Sexual behavior of young Japanese women tourists in southern
Thailand and risk for HIV infection.
AB  - OBJECTIVE: To study the sexual behavior of young Japanese
women tourists in Phuket, Thailand. This group was seen as
particularly at high risk for contracting the HIV infection.
METHODS: In-depth interviews were conducted in Phuket (southern
Thailand) with managers of Japanese tour agencies tour guides,
beachboys, Japanese women tourists and tourist policemen.
Interviews were transcribed, coded, and entered. RESULTS: Following
aggressive promotional activities in Japan for FIT Phuket vacation
package, there has been a significant increase in visits of young
Japanese women tourists to the island, with estimates of over
30,000 Japanese tourists of which 65-70 percent were women in the
past 9 months. These young women tourists are seen as culturally,
and socially naive and yet willing to take risks by the local
service boys; beachboys, guides, hotel personnel, etc. who quickly
develop casual sexual relationship with them. Condom use is
sometimes requested by the women but the place and the frequency
of sex acts does not lend itself to any effective preventive
behavior. DISCUSSION AND CONCLUSIONS: The liberating and exotic
environment of a vacation community outside of Japan and certain
personality traits involving the risk taking behavior associated
with young people of both sexes have created situations where cases
of sexual permissiveness, exploitation and unprotected sexual
intercourse are common. Young Japanese women tourists are generally
unfamiliar with aspects of travelling safely as well as with the
risks of various STD's given the very low rate in their own
country. The young, especially should be well informed and well
rehearsed of proper protective measures to use in situations
requiring cautions before embarking on foreign vacation
communities. Package tour operators and health authorities should
take this on as their responsibility.
SO - Int Conf AIDS. 1994 Aug 7-12;10(1):23 (abstract no. 066D).

AU  - Weiss E ; Rao GG
TI  - The need for female-controlled HIV prevention.
AB  - OBJECTIVE: Women currently constitute approximately 40% of
the global total of adult HIV infections worldwide. Current
HIV/AIDS risk-reduction strategies (sexual partner reduction,
mutual monogamy, consistent condom use, and appropriate treatment
for STDs) do not address the broader economic and sociocultural
factors within which sexual behavior takes place. In order to
provide a more comprehensive understanding of how these factors
influence women's risk of HIV infection, findings from 17 studies
conducted by the Women and AIDS Research Program of the
International Center for Research on Women will be presented.
METHODS: In order to provide insights into the realities of women's
and men's sexual lives, the studies supported through the Women and
AIDS Research Program utilized a variety of qualitative methods,
including focus group discussions, individual interviews, sexual
life histories, and participant observation. RESULTS: Data from the
studies show that women in a variety of life circumstances are at
risk of HIV infection, and face numerous constraints in adopting
HIV risk-reduction behaviors. Cultural norms which encourage men
to have multiple partner relationships also expect women to be
ignorant and passive in sexual interactions. Economic vulnerability
not only contributes to women exchanging sex for goods and
services, but also prevents them from leaving high-risk sexual
relationships. DISCUSSION AND CONCLUSIONS: Policy and program
recommendations which emerged from the studies--including the need
to develop female-controlled technologies--will be presented.
SO   - Int Conf AIDS. 1994 Aug 7-12;10(2):46 (abstract no. SS9).

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