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

Track C: Epidemiology & Public Health
(HIV-related or not) and hospital status (in-patient vs. out patient).Testing was done in
pools following WHO HIV testing strategy II.
Results: HIV testing was done in 9524 specimens. Overall period prevalence was 1.60%
(95% CI:1.3/ -1.88). It increased from 0.7% in the 15-19 age group to 3.1% in the 25-29
rioup. Prevalence of HIV infection was higher in men (2.3%) than in women (I.1 %)
(p<0.00 i), and in out-patients and in patients with HIV-related diagnoses than in their compa~r SOn r,l4)s
Conclusions: The pattern of HIV infection seen in this first survey might be representative
o that in the general population. Continuous monitoring of HIV should enable to target
intention i against the spread of HIV
Jor dt Casaon i iRirbani. CEESCAT Hospital Universitari Germans Trias i Pujol" 08916
Badalorna (Spain) Te1:343 4568858 Fax: [phone]
Mo.C. 1466
SEROINCIDENCE OF HIV INFECTION IN A SANITARY AREA OF SOUTH SPAIN
Pu ol E, Martin I, Galisteo L*, Aguayo DM, Gimeno A*, Cane R, Cuesta FAlcoucer R.
Inteiar Medicine Department. Clinical Tests Department* Juan Ramon Jimenez Hospital
Huelva. Sparin
Objective: The seroincidence studies of HIV infection, apart from being useful tools for
knowing the breakthrough of the infection in some collectives or witness groups, provide
irnformation about the temporary change in the epidemic. Ideally it would be wished to
detect the cases of seroconversions, but this involves ethical and practical problems.
Therefore in its defect, the cases of new diagnostic attended in wide areas of population
throughout a large period of time can be analyzed. In Spain, the HIV infection epidemic
began affecting male intravenous drugs users (IDU), differing from other western countries,
and with a progressive increase of the number of new infections. However, because the
change of the parenteral administered drugs by the inhaled ones, the progressive increase
of the number of infected women and heterosexual transmission of the retrovirus, it has
changed the profile of the epidemic in the last years.We wish to know the annual seroincidence (defined as new diagnosed cases of HIV infection confirmed by ELISA/ WB) in our
sanitar y area, analyzing the temporary behavior of the epidemic in the last eight years.
Method: The Clinical Test Departent
at our tHospital is the referring cen,r....o.............
tre for the determination of anti- _bodies against HIV (ELISA.,WB) of zo.
an important sanitary area (226.948 ~
habitants) of the province of Huelva -
(South Spain). It includes 2 Health ~- e".. os es
Primary Atention Districts (HPAD), "" Cummultedseroind
the General Hospital and the Drugs -.. 6A5/uosh57iants
Dependence Provincial Center
(DDPC). Since 1987, we collected
multiple epOdemiological data in the HIV serology petitions, that we analyzed in a simple
descriptive way. In order to find any difference, we compare gender and principal risk factor
oy serodiagnostic year (Cfhi squared analysis). In the patients with several determinations, it
was included only the first positye.
Results: in the 1987 994 period we detected 3.279 positive serologies for HIV, being diagnosed 1.373 new cases of infect on (81 % were males and 19% females). It is represented
in the F gure.The cumulated annual incidence and the values for the two most important
risk p ractices (IDU and heteriosexua l transmission) are given.
We find significant differen.es rin the gender and principal risk factor depending on the serodiagnostic ye ar Acco di g to the requesting Department, most of the cases were diagnosed
by Inter na Medicine Department (Infectious Diseases Unit) (35%), HPAD (General
Practitioner) (34%o) and DDPC (21,5%).This study showed in a secondary way after crossing the data with our series of infected patients followed in the Infectious Diseases Unit,
that only 6% of cases detected by DDPC and 30% of the diagnosed in HAPD were
known in our clinics.
Conclusions: I.-The number of new cases of HIV infection detected by serodiagnostic
methods, seems to have stabilized in the last three years and even with certain trend to
reduce in the described Sanitary Area. 2. As in other series. It is noticed a progressive
incease of the rcases diagnosed in women and due to to heterosexual transmission.
Emilio Pulol De La Llave. Servicio De Medicina Interna Hospital Juan Ramon Jimenez. Ronda
Norte SN. 21005 Huelva, Spain Fax: [phone]
Mo.C. 1467
AIDS AND INFECTION WITH HIV AMONG ADOLESCENTS IN EUROPE
Elford, onathan*,Weerasuia M*, Noone A**.* Royal Free Hospital School of Medicine
ird * PHLS Communicable Disease Surveillance Centre, London, DK
Objective: To examire the epidemiological featuies of AIDS & infection with HIV among
adolescents in Euiope
Methods: Ar annalysis of AIDS suiveillance data based on all canes of AIDS among adolescents
iged T 19 yeairs d young idults iged 20-29 years reported by 44 European countries to
the Euiopenn C entie for the Epidemiological Monitoring of AIDS to 30 September- 1994.
Results: 8y 30 Septembei I 994, I 22, 321I cases of AIDS had been reported in Europe (I105,
978 mmlis.21,1343 femiles). COf these, 854I (0.7V) were among adolescents aged I13-19 years
(684 isale, I170 lemiles). A fuirthei 36,269 (28.9% ) cases of AIDS cases were diagnosed in
young iduilts iged 20-29 yesirs (28.138 males, 8,631 females) many of whom would have
beer irfortod wills HIV ir adolesceince, given the piolonged period between infection with
DIV isnd the developsenit of nmajor symptoms. Df all females with AIDS, 41I.2% were diagniosed betweer 13-29 yeiis of ige compared with 27.2% of males (p <0.00l). Among
eljecting Iirug useirs minI AIDS, 45.7% of males (I 6,706/36,531I) and 54.9% of females
(5,591/1(1), 18 I) weire diagn osed between 13-29 years of age. In no other behaviour-related
exposure sategoiry wai the piropoction seemingly infected in adolescence no high. Of those
people a,esd 13-29 yeais it AIDS diagnosi who icquired HIV through heterosexail contact,
femes n (- 26.32( outsnuimbered males (n - 1430) by almost 2 to I. Over the ago of 3 0

years this pattern was r eversed (p<0.00I). Males diagnosed with AIDS at age 13-29 years
who acquired HIV through sexual contact (n 10,155) were more likely to report having
had sex with another man (n= 8725; 85.9%) than with a woman only (n - 1430; 14. 1%).

Mo.C.1466 - Mo.C.1470
Conclusion: In Europe, females with AIDS were more likely to have been infected during
adolescence than males. Half the injecting drug users with AIDS appear to have been infected in adolescence.These findings have important policy implications for HIV prevention
among adolescents.
J Elford, Dept. Primary Care and Population Sences, Royal Free Hospita School of
Medicine, London NW3 2PF, UK.Tel [phone]; Fax [phone]! 224; e-mal
[email protected]
Mo.C. 1468
TRENDS IN THE PREVALENCE AND MORTALITY RATE OF HIV IN THE
STOCKHOLM AREA
Christenson B5, Lundbergh P*. *Dept of Communicable Diseases, Karolinska Hospital,
Stockholm, Sweden
Objective: In Sweden, HIV has been almost exclusively spread in three subpopulations:
homosexual men, intravenous drug abusers and immigrants fiom areas of high endemicity
This is an analysis of the epidemiology of HIV regarding incidence, prevalence and mortality
in these three subpopulations.
Methods: The incidence of HIV within a specified subpopulation was calculated as the number of persons reported, for the first time, per year.This figure was related (percentage) to
the estimated number of members of the subpopulation at the end of the year.The prevalence of HIV within a certain subpopulation was calculated as the accumulated difference
between the reported cases and the number leaving the system because of emigration or
death.This figure was related (percentage) to the number of persons belonging to the same
subpopulation. Mortality was observed as the number of deaths per year within the subpopulation.The relative increase of HIV infection within a subpopulation was calculated as
the quotient of the increase in reports per year of new cases and the number of known
cases within the subpopulation.
Results:Through January 1996, 2 700 HIV infected persons have been reported in the
Stockholm area which is 65% of all HIV cases in Sweden. A total of I 300 homosexual men
have been reported in the Stockholm area of whom 800 are alive.This makes a prevalence
of 6%.The relative increase of HIV cases within the subpopulations during 1990-1994 was
approximately 10%, and in 1995 6%.Through January 1996, the prevalence among the drug
abusers was about 1I0%.The relative increase was in 1990 9% compared with 3% in 1995.
The heterosexual mode of transmission increased from 15% of all HIV cases in 1992 to
50% since 1992. Before 1992 67% of the cases were of foreign extraction. After 1992, this
figure increased to 85%. Observed mortality rate exceeded that of the number of new
cases reported for the homosexual men and the drug abusers. For the heterosexual group
due to immigration to Sweden no decrease was observed.
Conclusion: There has been no spread of HIV in the general population. Since 1994 the
relative increase has been less than 10% for the homosexual men and the drug abusers.
B Christenson, Dept of Communicable Diseases, Karolinska Hospital, S 17 I 76 Sweden,
Telephone: + 46 8 729 30 09, Fax: + 46 8 31 57 67
Mo.C. 1469
HIV INFECTION EPIDEMIC SITUATION IN UKRAINE
Scherbinskaya Alla, I Kobyshcha y,2 Kruglov Y Bochkova L.2 I National AIDS Centre:
2National AIDS Committee, Kiev, Ukraine
Issue: HIV infection spread in Ukraine is acquiring epidemic pattern.
Project:The results of routine epidemiological surveillance of HIV infection in Ukraine since
1987 and till I December 1995 were analysed.
Results: During 1987-1994 183 Ukrainian citizens were found to be HIV infected in the
country. In 1995, 1078 new cases were reported to the Ukrainian AIDS Centre. Most of
them (70%) were injecting drug users. HIV infections in local population have been detected in 24 out of 27 administrative regions of Ukraine, and ninety percent of HIV infected
persons have been identified in southern parts of the country. In 1995 there has been a
rapid increase of HIV positive injeecting drug users. (oIDUs).The proportion of sexually transmitted cases decreased from 70% in 1994 to 30% in 1995, and those through injectng
equipment increased from 10% to 64.4% in the same years respectivelyThe basic feature of
HIV spread in 1995 was rapid emerging of HIV infections in prisons (more than 200, all of
them are IDUs), and among male military recruits (10 persons).
Lessons Learned: The above mentioned changes in epidemic situation in Ukraine require to
immediately initiate effective preventive measures among vulnerable groups of the population instead of the old prophylactic approaches.
A Shcherbinskaya, 4 Protasiv Yar Uzviz, Kiev, 252038 Ukraine.Tel: [phone]- II;
Fax: [phone]
Mo.C. 1470
DIVERSITY OF HIV-IM IN FRENCH BLOOD DONORS:A RETROSPECTIVE STUDY
(1985- 1993).
Buzelay Laurence, Ban Fn Courouce AM and the Retrovirus Study Group of the
French Society of Blood Transfusion. 5ttnivernite F KRnbclaisTours, France: *Slnstitut
National de Tansfusion Sanguine, Paris, Fiance.
Objective: To study the HIV I M diversity in French sublects detected as HIV I seroposte
through a blood donation.
Methods: A retrospective study on blood samples collected in I12 blood centes nof continental France between 1985-1993 and identihied as positive fos antibody 1o DIV-I M.This
study was not exhaustive since only samples still available were included. Serologicaml subtypmeg (A to 6) was done using a r ecently developed subtypc-speciftc enzyme immuinnssy
(SSEIA) whose value fos predicting the genotype of the infecting strain has been evaluated
(submitted).
Results: 4t43 samples were seactive and typsable with the assay. 4t01 (91 I), 21 (5 a(, 14
(3%), 3 and I were subtyped is B. CA 0 nd F, nespectnvelyThree samples were cqcnally
reactive to 2 subtypes. Anthough most of tee doonrs wese reactive io subtype B in this
assay, approxim at nely 10 %wesrc exposed to viansts considered as <non Funropeain n, cven

in the early period (1985-1987).
Conclusion: The results ndicate that, is expected, most of these French subects have been
exposed to subtype B variants. However they also show that HIV-I seroposinive French
blood donors have been already exposed to the other malor variants (A, C, D and E).These

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