identify and determine the number of fisher folk in every fish landing beach on the ... blanc5, Len Tooley3, James Wilton3, Shayna Buhler6, Kim. Thomas7, Greg ...
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Kenya Medical Research Institute, Nairobi, Kenya, 2Kenya Medical Research Institute, Kisumu, Kenya Background: HIV prevalence in Kenya dropped from 7.4% in 2007 to 5.6% in 2012. Despite this decrease, the HIV prevalence in Nyanza region remains the same, 15.1%. This high prevalence may be driven by the highly migratory ‘‘high risk’’ fishing communities residing along the shores of Lake Victoria in Nyanza, with HIV prevalence at 25.6%. We examined the association between mobility patterns and perceived sexual practices of the fisher folk. Methods: Beach management units’ registers were used to identify and determine the number of fisher folk in every fish landing beach on the shores of Lake Victoria in Kenya. Probability proportionate to size sampling was used to draw a random sample of 2638 across 308 beaches for participation in a crosssectional survey. Data was collected on sociodemographics, mobility patterns and reported sexual concurrency. Descriptive statistics and logistic regressions were used for data analysis. Results: In 2013 mobility was mainly to Homabay and Siaya counties which are high HIV prevalent areas, *36% and 31% respectively. Mobility was highest between April and December, 167 (33.3%) and 119 (23.7%) in Homa Bay and Siaya respectively. Approximately 36% suspected their partners had concurrent partners and 566 (46.1%) of the respondents reported that they were currently in a concurrent relationships. Mobility was significantly associated with reported sexual concurrency (OR 1.423 95% CI 1.09-1.85 p = 0.009). After controlling for age, gender, education level, income, reported condom use, age of last born child, marital status, alcohol use and duration of relationship with the most recent sexual partner, mobility was significantly associated with concurrency (AOR 1.74 95% CI 1.01-2.98 p = 0.046). Conclusions: Mobility and concurrent sexual practices among fisher folk may contribute the sustained high HIV prevalence in Nyanza and calls for targeted HIV prevention and care services.
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1) their HIV prevention messages and interventions; and 2) in the case of service providers who are gay men, their own sexual practices.
Some of the latter service providers experienced challenges in reconciling their own sexual practices with the advice they give to gay men in their communities, vis-a`-vis their emerging biomedical knowledge of HIV risk and prevention. Conclusions: Service providers play a critical role in implementing HIV prevention interventions that are reflective of gay men’s lives and new biomedical understandings of HIV. Special attention is required to recognize and mobilize the dual position of service providers who are gay men in shaping prevention responses.
P48.06 Risk Disinhibition: The Effect of Microbicide Communication Materials on Future Prevention Behavior Elizabeth E. Tolley1, Allison P. Pack1, Sam Field2, Elizabeth Ryan3, Bockh Emily4, Caroline Mackenzie5, Alice Olawo5, George Githuka6
P48.05 How Canadian Service Providers Understand, and Incorporate, Biomedical Knowledge of HIV into their Prevention Work and their Own Sexual Practices 1,2
Research, seeking to understand how biomedical HIV knowledge is entering the discourses, prevention strategies and folk wisdom of gay men and their service providers. Methods: We conducted 3 semi-structured focus groups with 22 service providers who work with gay men in Montreal, Toronto and Vancouver. This was followed by 20 one-on-one interviews with service providers, 10 of which were with service providers who identify as gay men. Topics we explored included: the challenges of conveying biomedical information to gay men; the organizational supports and constraints faced by service providers; and, the complex dual professional/personal position of service providers who are gay men. The audio recordings were transcribed, coded, and analyzed using Interpretive Description (Thorne, 2008). Results: Service providers reflected a wide variety of attitudes, level of understanding, degree of comfort and willingness to incorporate biomedical aspects of HIV prevention into:
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San Patten , Ed Jackson , Barry Adam , Marc-Andre Leblanc5, Len Tooley3, James Wilton3, Shayna Buhler6, Kim Thomas7, Greg Penney8, Wayne Robert9, Jody Jollimore9, Joshun Dulai9, Owen Mcewen10, Daniel Pugh10, Robert Rousseau11, Gabriel Girard11, Alexandre Dumont-Blais11 1 San Patten and Associates, Inc, Halifax, NS, Canada, 2Resonance Project, Halifax, NS, Canada, 3CATIE, Toronto, ON, Canada, 4University of Windsor, Windsor, ON, Canada, 5Resonance Project, Gatineau, QC, Canada, 6Interagency Coalition on AIDS and Development, Ottawa, ON, Canada, 7Canadian AIDS Society, Ottawa, ON, Canada, 8Canadian Public Health Association, Ottawa, ON, Canada, 9Health Initiative for Men, Vancouver, BC, Canada, 10Gay Men’s Sexual Health Alliance, Toronto, ON, Canada, 11REZO, Montreal, QC, Canada
Background: In the last 10 years, our biomedical knowledge of HIV prevention has grown tremendously and several new prevention tools are now at our disposal. Historically, gay men have been early adopters of risk reduction strategies, such as condoms. The Resonance Project is a 3-year community-based research project, funded by the Canadian Institutes of Health
FHI 360, Social & Behavioral Health Sciences, Durham, NC, United States, 2FHI 360, Quantitative Sciences, Durham, NC, United States, 3FHI 360, Social Marketing and Communication, Washington, DC, United States, 4FHI 360, Global Health, Population & Nutrition, Washington, DC, United States, 5FHI 360, Country Office, Nairobi, Kenya, 6National AIDS & STI Control Programme, Nairobi, Kenya Background: Vaginal gel use may provide a new HIV prevention tool for women who cannot negotiate condom use. Yet, current microbicide formulations are less effective than consistent condom use. Before introducing such options, it is essential to develop and test communication materials that encourage gel use in the absence of condom use, while promoting condoms-only or gel + condoms among those already using condoms to avoid reduced protection. In Kenya, we developed and assessed the effect of a minimum package of materials on preferences for future HIV prevention and possible risk disinhibition. Methods: We compared participants’ reports of ‘‘ever condom use with a current/recent partner’’ to future HIV prevention preferences (no product, gel-only, condoms-only, or gel + condom) among 746 sexually-active women and men in two Kenyan cities,
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