Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Track C: Epidemiology & Public Health
Mo.C.1430
PREVALENCE OF ANTI-HIV-I AND RISK FACTORS FOR HIV INFECTION IN
PATIENTS AND HEALTH CARE WORKERS OF A HOSPITAL IN A POOR QUARTER
IN BOGOTA, COLOMBIA, DETECTED IN SERUM & SALIVA
Angerer, Richard*, Ramirez, G.**, Dathe, O.***, Frosner, G.*. *Max-von-Pettenkofer-Institut,
University of Munich; **Hospital de Kennedy, Bogota; ***1. Frauenklinik, University of Munich
Objective: 398 patients (264 m; 134 f) and 95 health care workers (HCWs) were investigated to obtain information on prevalence and risk factors for HIV infection in the general
population of a poor quarter in the capital of Colombia. As often as possible, both saliva
and serum samples were taken to get more information about practical experience and
reliability of saliva as a tool for epidemiological studies.
Methods: Between August and November 1993, 398 mainly surgical patients and 95
HCWs were randomly selected.They agreed to give a targeted history concerning risk factors of HIV infection and samples of saliva and/or serum. Saliva was taken with the Omnisal device (Saliva Diagnostic Systems, Inc.,Vancouver, WA, USA) and tested by Wellcozyme
GACELISA. Reactive samples were confirmed by Western blot. Serum was tested by
Abbott Recombinant HIV- I/HIV-2 3rd ELISA and reactive samples were also confirmed by
Western blot.
Results: 59 of 398 (14.8%) patients and 9 of 95 (9.5%) HCWs had received blood transfusions. 45 (I 1.3%) patients (44 m; I f) and I (I.1 %) HCW gave a history of previous STD.
34 (8.6%) patients (28 m; 6 f) and 8 (8.4%) HCWs (5 m; 3 f) admitted often changing sex
partners. Of the male patients, 5 (2. 1%) admitted homosexual contact. 8I (85.5%) HCWs
had needle stick injuries. No anti-HIV-positive HCW was found. 3 of 264 (I.3%) male
patients were found anti-HIV-positive.Total prevalence: 0.75%. Anti-HIV was found in I
(20%) homosexual man. GACELISA showed positive results even when the indicator of the
Omni-sal device did not change color because of lack of saliva (2 cases). Of all saliva samples regarded as anti-HIV-reactive in the screening test, only 47.4% could be confirmed by
Western blot in saliva, which means 100% sensitivity but only 47.4% specificity for the saliva
test. ELISA and Western blot showed identical results when using serum samples.
Conclusions: The 0.75% prevalence of anti-HIV- I in a randomly selected population of a
poor quarter in the capital of Colombia is higher than i official organizations estimate.
Although no anti-HIV- I infected HCW was found, personnel in this area should be considered to have a risk of infection due to working conditions. Although there are many practical advantages of using saliva as an epidemiological tool, screening tests can only be trusted
when confirmed by Western blot.
R. Angerer, Riesserseestr. I I, 86163 Augsburg, Germany Telephone: [phone]
Fax: [phone]
Mo.C.1431
SIMILAR HIV AND HTLV-I INCIDENCE RATES AMONG STD CLINIC ATTENDERS IN
KINGSTON, JAMAICA
Figueroa,. Peter*,Ward, E.*, Morris, J.**, Brathwaite, A. R.*, Peruga, A.***, BlattnerW.****,
Vermund, S.H.*****, Hayes, R.**. * Min. of Health, Kingston; **LSH & TM, UK; ***PAHO
Wash. D.C.; ****NCI; & *****NIAID, Bethesda, Maryland USA
Objective; To compare the incidence of HIV and HTLV-I infections and to identify risk factors for incident infection among STD clinic attenders in Kingston, Jamaica.
Methods: Of 970 heterosexual STD clinic patients enrolled in January 1991,7 10 (73%, 333
men and 377 women) were re-examined between January 1992 and July 1993. Of these,
20% were recruited passively when they returned to the clinic of their own accord, and
80% were recruited actively through home visits.
Results: HIV prevalences at baseline were 3.7% in men and 1.9% in women. 7 men and I
woman became HIV positive during follow-up, giving an overall incidence of 0.7/100py (CI
0.3- I.4). HIV incidence was significantly higher in men (I.4) than women (0.2). HTLV-I
prevalences at baseline were 7.0% in men and 7.9% in women. 4/270 men and 4/318
women became HTLV-I positive during follow-up, giving an overall incidence of 0.9/ 100py
(Men: 1.0, Women: 0.8).
Incident HIV infection in men was significantly associated with drinking alcohol before sex,
cocaine use, total number of sex partners and sex with a prostitute since enrollment,
accepting money for sex, bruising during sex and genital ulcers at follow-up.
Conclusions: The presumed lower transmission rate of HTLV-I may combine with a higher
initial prevalence of HTLV-I in partners to produce similar overall incidence rates for these
two infections. Incidence rates may have been underestimated since those lost to follow-up
may have been at somewhat higher risk.
Figueroa, J. Peter, Ministry of Health, 30-34 Half Way Tree Road, Kingston 5, Jamaica W. I.
Tel.: [phone]; Fax: [phone]
Mo.C.1432
STD'S AND HIV PREVALENCE IN FEMALE SEX WORKERS (FSW) IN MEXICO CITY
Cruz C, Hern~indez-Tepichin.Griselda, Silva A, Uribe Z.PTeran X, del Rio CH.C. CONASIDA
(National AIDS Council), Mdxico.
Objective;To determine STD and HIV prevalence among FSW and determine the more
frequent associations and risk factors.
Methods; Prospective study among 1,389 FSW seen at an HIV/STLD clinic in Mexico City
between July and Dec 1995. A questionnaire with demographic data, sexual practices and
other high risk behavior as well as a clinical history and gynecological exam were performed. Blood samples were taken for; HIV detection (ELISA/W~b), syphilis (VORU/FTA-Abs)
and Hepatitis B (HBsAg).Vaginal samples were obtained for Gram stain and wet mount and,,wabs were obtained for N. gonorrhoeae (TM culture) and C.trachomatis (IF). Statistical
analysis was done with Epi-lnfo 6.02 and SPSS.
Results; Median age was 27.9 years (range I16 to 60); 76.4% were single. educational level
res low (only a few has completed elementary school). Risk flactors associated by multivariate analysis with acquisition of STD's were; more than 100 different sexual partners per
week, age older" than 27 years, and being engaged in commercial sex at a very young age
(< 13 years-old).Vaginal candidiasis was presentin 14.5% (202/1 389). bacterial vaginosis in
42.6% (592/1389) and trichomoniasis in 10% (I139/I1389). Hepatitis B (HBsAg) was positive

in 0,07% (1/1389) and HIV in 0.14% (2/I 389). I. 15% (I 6/I 389) were culture positive for
gonorrhea, 1% (14/1389) had serological evidence of syphilis, 8% had Chlamydia (27/1389).

Mo.C.1430 - Mo.C.1435
Conclusions: HIV seroprevalence among FSW in Mexico City remains low in contrast to
other STD's which suggests that consistent condom use is still low among FSW and their
partners.This emphasizes the importance of integrating STD's detection in existing
HIV/AIDS clinics in order to perform an adequate diagnosis and treatment of STDs present
and thus decrease its potential as a cofactor in HIV infection.
Griselda HenindezTepichin, Calz, deTlalpan 4585 2do Piso. Col.Toriello Guerra, Deleg.
Tlalpan Mexico City MEXICO (5-25) 528.4086/528.4848 FAX [phone]
Mo.C.1433
HEPATITIS B MARKERS IN MEN HAVING HIGH RISK SEXUAL PRACTICES IN
MEXICO CITY
Juirez-Figueroa L*, Uribe F*, Conde C*, Del Rio C*, Hernandez M*. * National Institute
for Public Health, Mexico; ** CONASIDA, Mexico.
Objective: To estimate the prevalence and associated risk factors of Hepatitis B virus (HBV)
serological markers,"s" antigen (HBsAg) and antibodies for "c" antigen (anti-HBc) in men
with high risk sexual practices.
Methods: Between January, 1992 and February, 1993, we interviewed and obtained a blood
sample from 1378 men who voluntarily seeked HIV testing at one information center for
the Control and Prevention of AIDS, in Mexico City(CONASIDA).The sample selected for
this study represents a population with high risk practices which is self-selected as being at
risk for acquiring HIV infection.
All study participants responded to a standardized questionnaire designed to collect information about risk factors associated with sexually transmitted disease transmission, as well
as other relevant factors related to the socio-economic and educational level of the participants. After filling out the questionnaire, the participants received counselling in relation to
the HIV and hepatitis tests and about the risk factors identified in the questionnaire.
In order to determine HBV carrier prevalence, HBsAg was detected.To determine the
prevalence of individuals who had been exposed to the virus in the past, antibodies to "c'
antigen (anti-HBc) were detected. For syphilis, RPR test was done and confirmed with the
FTA Abs test. Results of HIV antibody analysis were provided by CONASIDA. Laboratory
and questionnaire results were data entered in DBase, and bivariate analysis and logistic
regression multivariate analysis was performed.
Results: We found that 1.8% of the population were HBsAg carriers.There was a large difference between the prevalences of HBsAg among HIV negative individuals (0.8%) as compared to HIV positive individuals (7.9%). Likewise, only 0.3% of men with exclusively female
sexual partners were HBsAg carriers, as compared to 4.8% of men with exclusively masculine sexual partners.
General anti-HBc prevalence in the study population was 15.4%. However, among men with
exclusively female partners,. we found 4.6% prevalence, while for men with exclusively male
partners we found a prevalence of 30.4%.
Logistic regression showed an association with age, sexual preference and being seropositive for HIVT pallidum
Conclusions: In HIV positive Mexican men, co-infection with the hepatitis B virus is quite
common.The high prevalence of anti-HBc found among men with male sexual partners
indicates the need to intensify safe sex education campaigns, as well as recommending vaccination among these groups.
Luis Juarez-Figueroa, INSP- Av. Universidad 655 Cuernavaca, Mot C.P 62508 Mexico
Fax: [phone]
Mo.C.1434
TRENDS IN THE AIDS EPIDEMIC IN MEXICAN WOMEN
Vandale Susan*, Rico B**, Magis C**. National Public Health Institute, Cuernavaca, Mor
Mexico. **CONASIDA (National AIDS Council) D.F. Mexico
Objective: To describe the trends in female AIDS cases in Mexico according to exposure
categories, age groups, and geographical regions.
Methods: We used notified cases reported in the government AIDS bulletin for the period
from 1988 to 1995; the data base of the National AIDS Surveillance System; census data
for 1990, and official estimates of the national population for 1995.We calculated the
cumulative AIDS case rates per 105 and the case doubling times (linear model) for exposure categories, age groups and geographical regions.
Results: Total national cumulative AIDS case rates in 1990 and 1995 were 20.2 and 77.8
respectively.The doubling time in 1995 was 2.0 yrs. For heterosexual route these values
were 26.4, and 1.8; for blood transfusion 25.9, and 2.7; for perinatal route 3.2, and 1.8; for
the other exposure categories together (drug use, occupation and paid blood donors) 1.5,
and 2.2. For age groups the same calculations were: 0-14 yrs: 14.7, and 2.2; I 5-24 yrs: 52.4.
and 2.2; 25-44 yrs: 174.6, and 2.0; 45+ yrs: 85.6, and 2.0.We found interesting geographical
variations which we present in a graph using the AIDS profile method outlined by R.P
Bernard (AJPH 1994;84:175).
Conclusions: Our results show the acceleration in the AIDS epidemic in women which is
apparent in this decade.The two important AIDS sub-epidemics in Mexican women are:
contaminated blood transfusions (important up to 199 I) and heterosexual activity which
increasingly dominates.The trend for vertical transmission paralleled that of the heterosexual sub-epidemic.There were important differences in the cummulative AIDS case rates by
age, with those from 25-45 years most affected, representing more than twice the average
rate. Doubling times for all age groups were quite similar Other groups accounted for a
very small fraction of the epidemic.The center of the country and two Northwestern
states represent most of the epidemic at this time.
S.Vandale. Instituto Nacional de Salud Publica Av. Universidad 655 Col. Sta. Ma. Ahuacatitlan
Cuernavaca, MorTel.: (5273) I I 23 43
Mo.C. 1435
PREVALENCE OF HIV, HBV AND SYPHILIS IN A RURAL MEXICAN POPULATION
Virente Hugo E*, Murillo G**, Mismas G* Hernandez S**c Snodgrass 0. ICorvin, Inc.,
Hamden, CT USA; **Univ. Autonoma de Guadalajara. Mexico; ***Centro de Investigacron y

Analisis, Guadalajara, Mexico.
Objective: To determine the HIV- I, HBV and syphilis prevalence in a rural population of
North-Central Mexico.

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