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

Track C: Epidemiology & Public Health

Mo.C.1478 - Mo.C.1481

respectively Higher prevalence rates were found in those: who were single, divorced and
separated, who had extramarital sex partners (both subject and spouse), whose partners
were not circumcised, who had had many lifetime sex partners, and those who had been
paid for sex. Ethnic, occupational and contraceptive method differences were also noted.
Conclusion: High prevalence of both the classic STD and HIV infection was found in this
"low risk" population.The factors associated with these diseases seem to be related to both
male and female sexual behavior and to cultural practices which need to be further studied
in order to design appropriate interventions.
Diana Menya, PRO. Box 4606 Eldoret, Kenya.Tel.: [phone] Fax: [phone]
Mo.C. 1478
AIDS IN MOROCCO, UPTO SEPTEMBER 30TH 1995
Dr Mahjour J., Dr Chami Y, Dr Filali Baba A., Dr Khattabi H

greater vigour and commitment. In the same breath, rural areas should attract more attention than they presently receive.The need to utilize where appropriate, results from national surveys of this sort, for programmatic, as well as for diagnostic, prophylactic and therapeutic interventions cannot be overemphasized and should be encouraged.
J.A. Nnorom, USAID/Lagos, Global House, I 60 I Adeola Hopewell StreetVictoria Island,
Box 554 Lagos, Nigeria.Tel: [phone]I Fax: [phone] e-mail: jnnorom cfusaid.gov
Mo.C. 1480
TRENDS OF INCIDENCE AND PREVALENCE OF HIV-I IN GUINEA-BISSAU,WEST
AFRICA,AND PRELIMINARY DATA ON SUBTYPES
Andersson Soren, Albert J, Norrgren H. Dias F, Naucler A, Biberfeld G. Swedish Institute
for Infectious Disease Control, Sweden, and the *National Public Health Laboratory,
Guinea-Bissau
Background: Guinea-Bissau has the highest prevalence of HIV-2 in the world and has previously been an almost exclusively HIV-2 prevalent area. Recent findings indicate an increased
spread of HIV- I in various population groups.
Objectives: a) To study the HIV incidence in an occupational cohort, b) To study the trend
of the seroprevalence of HIV among pregnant women. c) To subtype strains of HIV- I in
Guinea-Bissau.
Methods: Prospective study of a cohort of police officers in Guinea-Bissau. Annual screening of pregnant women at a maternity clinic in Bissau. HIV-testing with ELISA and Western
blot. Direct DNA sequencing of the V3 domain of the HIV- I envelope.
Results:

*CUMULATIVE NUMBER OF AIDS CASES
*AGE DISTRIBUTION:
15 A 29 YEARS OF AGE: 25%
30 A 39 YEARS OF AGE: 43%
40 A 49 YEARS OF AGE: 1%
*TRANSMISSION ROUTE:
DE 1986
- HETEROSEXUAL MODEL
- HOMOSEXUAL MODEL
-IV DROGUE USE
- TRANSFUSION
- MULTIRISK 9 % 8 %

290.

a 1989
20%
25 %
23 %
11%

DE 1990 1995
57%
12%
9%
4%

Pregnant women in Bissau
HIV-2

a",
ai)
C)
U
cr
C)
a)
U
(a)
C)
(c)
C)
a)
_.o

* 70 % OF CASES ARE MOROCCAN WHO ARE LIVING IN MOROCCO.
* 82 % OF CASES ARE LIVING IN URBAN AREAS.
MOST OF CASES ARE REPORTED IN THE LARGE CITIES OFTHE COUNTRY:
CASABLANCA,TANGER, RABAT AGADIR, MARRAKECH AND OUJDA.
* HIV Seroprevalence is around I% among:
+ Sexually transmitted diseases patients.
+ Tuberculosis patients.
+ pregnant women.
* Seroprevalence in blood donors.
-+VIH: 0,007%
+ Syphilis: I%
+ Hepatitis B: 3 %
+ Hepatitis C: 1,3 %
Conclusion: The number of AIDS cases have remained limited in Morocco in comparison
to some Asian and African countries. However since few years, the sexually transmitted diseases have continued to be a public health problem in Morocco. Besides, STD control
throughout the country must be implemented as soon as possible to reduce the transmission of sexually acquired infections and to reduce the risk of HIV infection.
Dr H. Khattabi, 55 Oukaimeden Street, I 0.000-Rabat-Agdal-Maroc.Tel: 2 I 2.7. 67.29.50.
Fax: 2 I 2.7. 67.0 1.57.
Mo.C. 1479
HIV,TUBERCULOSIS AND SYPHILIS IN NIGERIA:A DESCRIPTIVE STUDY
Nnorom, oseph A*, Esu-Williams, E.**,Tilley-Gyado A***. *USAID/Lagos, Nigeria; **AIDSCAP/Nigeria; ***NASCP Nigeria
Objectives:
a) To determine the distribution by age group, of tuberculosis (TB), syphilis and HIV in
Nigeria and to establish any association between these disease conditions.
b) To estimate the male to female ratio of HIV and syphilis infections in Nigeria.
c) To estimate the urban to rural ratio of HIV and syphilis infections in Nigeria.
Methods: The data used for this presentation was generated from the results of the 1993/94
national HIV/Syphilis sentinel serosurveyThe survey was carried out in seventeen of the thirty states in Nigeria, spread across the four health zones in the country Seropositivity to an
ELISA and a rapid/simple assay of different antigen preparation was considered positive for
HIV, while positive test results to both RPR and MHTPA was considered positive for syphilis.
A total of 14,796 samples from ante-natal patients, 1,937 from commercial sex workers,
2,502 from STD patients and 2,031 fromTB patients were analyzed.
Results: The distribution ofTB, HIV and syphilis show identical patterns with 70%-90% of
each infection distributed between the ages of I 6-45. Each of these conditions (HIV,
syphilis and TB), recorded its highest disease prevalence in (adolescents and young adults)
in the 16-30 age group. A direct relationship between syphilis and HIV prevalence on one
hand and HIV and TB prevalence on the other hand, was established and demonstrated
by the observed (graphically presented) distribution pattern typical for sexually transmitted diseases.
The overall asverage oIre for HIV prevalence for urban communities was 4.2%, while 2.4% was
recorded for the rural communities, reflecting an urban-rural ratio of 2:1. Urban-rural ratio
for syphilis prevalence was I:1 (fl-om prevalence rates of 3.0% and 3.8% respectively for
urban and rural areas).
Of the four groups studied, the TB sentinel group is the most suitable for the estimation of
the male female ratio of HIV infections. A male-female ratie of 3:2 was established.
Interestingly a similar (3:2) male-female ratio was established for syphilis infections in the
same group.
Conclusion: TB prevalence increases as HIV prevalence increases. HIV epidemic therefore
has grave implications for the control of tuberculosis. Cases of TB within the age bracket of
16-30 should be strongly considered for HIV screening and vice versa. Whereas the HIV
prevalence rate for urban dwellers is twice that for rural communities, the syphilis rates for
the urban and rural areas remain the same. Although estimates fl-om the TB sentinel group
show that the male-female of HIV prevalence is 3:2, the same ratio for syphilis prevalence,
there is a need to further confirm this result using a "healthy" population.
HIV/STD interventions targeting adolescents and young adults should be pursued with

Prevalence
1987
1988
1989-91
1992
1993
1994

%0
0 -0.1
0.4
0.8
0.9
1.4

HIV-I

No. % No.
(0/707) 8.3 (59/707)
(3/2539) 6.0 (152/2539)
(6/1514) 5.5 (84/1514)
(12/1485) 6.0 (79/1485)
(10/1078) 4.1 (44/1078)
(16/1059) 6.7 (71/1059)
P[HIV-1 1988 - 92] <0.05

Police officers
HIV-2

HIV- I

1990-92
1990-95

P
0.3
0.7

I P I
0.7 12.9 1.6
0.9 10.9 1.0
P=prevalence 1=incidence
Double=HIV- I/HIV-2 double reactive

Double
P
0.2
0.2

Four strains of HIV- I have been characterized by sequencing, all belong to subtype A.
Conclusions: HIV- I is increasing rapidly in Guinea-Bissau. Although the prevalence of HIV- I
is still low, the incidences of HIV- I and HIV-2 are almost equal.The four HIV- I strains characterized so far, all belong to subtype A.
Soren Andersson, Dept. of Immunology, Swedish Institute for Infectious Disease Control,
S-1052 I Stockholm, Sweden.Telephone: [phone] I Fax: [phone]
email: [email protected]
Mo.C. 1481
HIV INFECTION IN TUNISIA (1986-1995) VARIATIONS OF PRINCIPAL
EPIDEMIOLOGIC INDICATORS
Sidhom M.*, Fekih Z**. * PHC Director; **National Aids Program Manager, Ministry of
Public Health,Tunis, Tunisia
Objectives: To describe HIV situation in Tunisia, explain evolution of epidemiologic factors
along a decade and propose an appropriate strategy for prevention and control.
Methods: HIV data are centralized at the Ministry of Health (AA Unit) from different
sources as: Declaration of Infection cases, Epidemiologic notifications by
Hospital/Consultations, Seroepidemiologic studies on Risk groups or by sentinel sites, Data
from blood banks screening for HIV.
Results:To date, 650 HIV infection cases were reported. I/3 has developed Aids (75%
died). Annual incidence rised from 50 to 85 new cases by the middle of the decade, Aids
incidence in the last years is stable around 40-50 cases. 75% are male, majority of cases
aged between 20-39 years.Transmission modes are more precise: Intra venous drug is
exclusively reported from abroad livingTunisians (emigrates)altough heterosexuality is now
the predominant factor inside Tunisia livings. In parallel, vertical transmission soared (I 6
cases to date). Blood transmission of HIV was cut in fall 1987 after instauration of blood
screening. 2/3 of cases are from the "bigTunis", 10% from Sousse (center east), others are
distributed in remaining regions. In the last 3 years, inside country contamination prevailed.
Conclusions: HIV surveillance and control from 1987 have fixed "Tunisian profile" exposed
to Aids risk. In Tunisia, it is now admitted that heterosexuality is the major risk other ways
are scarse. In fine, social problems (stigmatisation, reject) become to rise. Aids strategy for
prevention and control is consequently managed: Reinforcement of blood screenings, Sexual
transmission claimedTryings to take care of infected community. National consensus was
obtained from 1993 to realize this plan.
Dr Moncef Sidhom, Direction des Soins de Santd de Base -31, Rue Khartoum -Tunis /
Tel: 789 148 / Fax: 789679.

Double
% No.
0 0
0 0
0 0
0 0
0.3 (3/1078)
0.3 (3/1059)

138