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

Track C: Epidemiology & Public Health
analyses indicated that men who had relatively large numbers of CSW contacts were also
likely to have other high risk partners, earlier age of I st sex, and;es fear of HIV infection.
Condom use was more frequent and consistent with CSWs than with other partner types.
Conclusions: Self-perceived risk appears low as does knowledge relevant to partner
selection, especially in comparison to regions characterized by greater IIV prevalence.
Condom use has become associated with CSW contacts, but n -ed to Ie e ncouraged
with other partners.
COL Kalyanee Torugsa, AFRIMS, 315/6 Rajvithi Road, Bangkok, 104100 Thidiand
Phone: [phone] I Fax: [phone] Email: [email protected]
Mo.C.1512
ENROLLMENT AND BASELINE CHARACTERISTICS OF PERSONS IN A STUDY OF
HIV INCIDENCE IN THAILAND
Lauri Markowitz*, Sirisopana N*, Chitwarakorn A**, Siraprapasiri F', Juivaniclhpong W**,
Charonwatanachokchai A**, Palanuvej T**, Siriwongrangsun P**. laon, *AFRIMS,
**MOPHThailand.
Objectives: I) To determine the feasibility of enrolling subjects from STD clinics into a
prospective cohort study to evaluate HIV incidence, and 2) To dlec be the characterisitics
of persons who agree to participate.
Methods: Subjects attending STD clinics at three sites (Bangkok, Chonburi, Lampang) were
screened to determine if they were eligible and willing to participate in a one year prospective study of HIV incidence. Subjects who enrolled had a PE, a STD evaluation, baseline
behavioural questionnaire, and a blood test for HIV.
Results: Between September 1995 and January 1996, 1592 eligible persons were asked to
participate.Twenty-five percent of eligible men (270/1094) and women (1I37/544) agreed
and were enrolled into the study Data available on 326 persons enrolled indicate that
55% were 1 8-29 years of age; 54% of the men and 92% of the women were married. Of
the men, 93% had visited CSWs and I 6% had had sex with men. Within the past 6
months, 46% of men had visited a CSW and only 48% reported using a condom everytime. Almost all women were married and few used condoms regoularl,, At the time of
enrollment, the most common diagnosis among the men was NGU (28%) and among
women was candida vaginitis (28%). Overall, 21 (6%) had herpes sinmplex, and 2 1 (6%) had
gonorrhoea. Both men (88%) and women (84%) perceived that they were at moderate or
high risk of HIV infection.
Conclusions: It is feasible to enroll high risk men and women from STD clinics in Thailand
into a prospective study of HIV incidence.
Lauri Markowitz. AFRIMS, 3 I 5/6 Rajvithi Road, Bangkok, I 0400, -hailand. lei: 662 245-2966;
Fax:[phone]; email: [email protected]
Mo.C.1513
IMPACT OF AIDS EPIDEMIC IN LAMPANG PROVINCE,THAILAND (EIGHT YEARS
EXPERIENCES)
Yingseree Pipat, Siraprapasiri T Wongwichai Y, Wongsakul M. Lampang Provincial Health
Office, Ministry of Public Health, Lampang,Thailand
Objective: To describe the extent and impact of AIDS epidemi, on morbidity and mortality
in Lampang, a province in the northern part ofThailand.
Methods: Patients who meet the definition of AIDS and symptomatic HI V are required to
be reported to the Provincial Health Office. Death certificates with I IIV/AIDS s a cause of
death were obtained.
Results:The first HIV positive person and AIDS case were identl ied in 1988, and 1990,
respectively The number of AIDS and symptomatic HIV cases increased fron 2 to 29, 205.,
399,803, and 781 from 1990 to 1995, respectively Ninety percent of patients contracted
HIV through heterosexual transmission. Seventy five percent were age I 5-39 years. Male to
female sex ratio was 5. I: I. Pneumocystic carinii pneumonia was the most common opportunistic infection followed by cryptococcosis, and tuberculosis. here were 912 deaths related to HIV/AIDS (113 per 100,000 population) in 1995. AIDS was the leding cause of
death in 1995. Eighteen percent of all infant deaths were attributed to AIDS in 1995.
Conclusion: AIDS became the leading cause of death in Lampang 8 years after the introduction of HIV.
PipatYingseree 3 Pakham Street, Muang district, Lampang 52000 Thailand
Telephone (66) (54) 227-526 Fax (66) (54) 227-524
Mo.C.1514
WHAT IS KNOWN ABOUT HIV/AIDS AND ITS RISK FACTORS IN TWO MUSLIM
COUNTRIES: PAKISTAN AND BANGLADESH
Khawaja, Zahid A*, Gibney L*,Vermund, S.*. *University of Alabama at Birmningham,
Birmingham, Alabama, USA
Issue: HIV Prevalence and Risk Factors for HIV transmission in Pakistan and Bangladesh.
Project: A literature review was done of published and unpubls ed litenature on HIV/AIDS
and on other factors that influence the transmission of HIV/AIDS: exually transmitted diseases, sexual behaviors, drug use and injection needle use prari cc
Results:There is an extreme paucity of epidemiological and behavi.aerieseach on
HIV/AIDS, STDs, and high risk behaviors, and no active surveillance,stem or HIV/AIDS in
either country Most information comes from point prevalent si eys coruated on (i)
small numbers of individuals engaged in high risk behaviot and (i) blood donors at hospitals.These studies suggest that foreign nationals and Pakistanis and haigladeshis who have
worked abroad in the Gulf states or elsewhere, or have been se iarers, mae nip a sizeable
portion of the HIV/AIDS cases. Cases of HIV have also been found among sexually promiscuous individuals, blood recipients, and prisoners.
Lesson Learned: Pakistan and Bangladesh are presently low HI"/ prevalence but high risk
countries. Lifestyle risk factors and geographic proximity to Inda i country experiencing an
HIV/AIDS epidemic, make Pakistan and Bangladesh high risk o, ions for ie if-usion of
HIV.The lifestyle factors that put people at risk include internal and e'te-nd m-o ration,
engaging in commercial sex, failure to use condoms, having mal-,, a l encounters,

and reusing contaminated needles in medical therapeutic settings. s welT a i the context
of illicit drug use. Insufficient public and governmental recognition Cf the threat of an HIV

Mo.C.1512 - Mo.C.1517
epidemic, a lack of blood screening, and a failure to implement prevention programs may all
contribute to the spread of HIV in these countries.
ZA Khawaja, 106 Tidwell Hall, 720 S. 20th St., Birmingham, AL 35294-0008 Telephone: (205)
934-0447 Fax [phone], email: [email protected]
Mo.C.1515
THE INCREASE OF HIV INFECTION IN VIETNAM: DESCRIBING THE EPIDEMIC FOR
PROGRAM PLANNING.
SarrelMatthew*, Kloser, P*, Correll, P*, Bean Mayberry, B.' * University of Medicine &
Dentistry of New Jersey, Newark, New Jersey USA
Issue: The increase of HIV infection in Vietnam over the past five years has resulted in the
need for AIDS education and prevention programs, as well ais a centralized computer based
surveillance program.
Project: The first case of HIV infection, detected late in 1990, occurred in Hochininh City
(HCMC) and, although most cases are in the south and west regions of Vietnam, all areas of
the country are affected. By the end of 1995, over 3400 cases of HIV have been identified.
Over recent years, an AIDS education and training project has been established in HCMC
to address this problem and preliminary attempts are being made in the area of computer
based tracking of HIV cases for surveillance.
Results: Of the approximately 20,000 intravenous drug users in HCMC, 45% are HIV positive, while 2 n% of prostitutes are HIV positive.The number of gay men in Vietnam is
unknown, as is their percent of seropositivityThe population affected by HIV is young - seventy one percent are under the age of 40 years. AIDS education and prevention tactics
have bee undertaken by the AIDS Committee in Vietnam, as well as non government
organiz aticns, in an attempt to curb the explosion of AIDS. Training programs involving
physicians, nurses and outreach workers are ongoing in HCMC in cooperation with the
University of M edicine & Dentistry of New Jersey and other groups.The profile of HIV
infection in Vietnam is not felt to be accurate due to the lack of an infrastructure to support a centralized computer based surveillance program for reporting purposes.
Lessons Learned: Vietnam is an area of HIV explosion in Southeast Asia. Aggressive efforts
are needed to increase AIDS awareness and prevention. Financial support is desperately
needed for these efforts and to establish a data collection system for surveillance and
description of the HIV epidemic in Vietnam.
Matthew Sarrel, 46 Michael Drive, Westfield, New Jersey, 07090, USA;
telephone: /20 i) 982-7410; Fax: [phone]
Mo.C.1516
STD AND HIV TRENDS IN MONGOLIA FROM 1983 TO 1993
Purevdawa E*, Moon TD**, Davaajav K*, Itsinkhorloo G*, Smith, MaIria L*,Vermund SH**.
*National (enter for Hygiene, Epidemiology and Microbiology Ministry of Health,
Ulaanbaatar, Mongolia; **The University of Alabama at Birmingham, USA
Objective: To review HIV surveillance data since 1987 and to map STD trends in Mongolia
from 1983-1993.
Methods: ELISA is used for HIV screening and Western blot for HIV confirmation. Both
active and passive surveillance are used for syphils, gonorrhea, and trichomonas with VDRL,
gramn staiin, and wet prep diagnosis respectively Since 1990, less active case finding and contact tracing has been conducted, compared to prior years, due to fiscal constraints.
Results: Since 1987 more than 132,834 HIV tests have been done with only one confirmed positive result. Data for syphilis show a decreasing trend from 1983 1993 with a
decline in cases from 7.0 to 1.8/10,000.This national trend is mirrored for Ulaanbaatar.the
capital city. Data suggest a 2-3 fold higher rate of syphilis for- ages 15 24 than for any other
group with a peak of 898/100,000 in 1983. Distributions by gender show approximate
equality in the percentages of cases in Mongolia, though among residents of Ulaanbaatar, a
10-20% higlrer rate is noted for women. Data for gonorrhea from 1983-1993 show an
upward trend in the rate of cases with peaks in 1989 and 1993.The majority of cases are
age 15-44 with a peak in 1993 reaching 293/100,000 for ages 15-24 and 271/100,000 for
ages 25 44.The distributions by gender show a consistent 20% higher rate for men.
Trichomonas rates from 1983-1987 fluctuate between 1.0 and I 1.0/10,000 for
Ulaanbaatar and between 1.0 and 4.0/10,000 nationally Peaks of 20.0/10,000 are observed
in 1989 for Ulaanbaatar and 18.0/10,000 in 1990 for Mongolia as a whole.The peak trichomonas rate was noted in I 990 with rates of 400/ 100,000 in persons age 25-44 and
325/i00,000 in the 15-24 age group.
Conclusion: Deterioration in STD services and reduced active surveillance masks a severe
STD problem i, Mongolia. Rising rates of gonorrhea are observed even with less active surveillance programs. Changes in business and social cirumstances result in increasing
HIV/STD) risk behavior.
Maria L. Smlh, UAB SOPH, 211 Tidwell Hall, 720 S. 20th St.. Birmingham. Alabama USATele:
205 975 5793 Fx: 205 934-8665 Email: [email protected]
Mo.C.1517
ACTIVITIES OF A HIV SURVEILLANCE CENTRE AT MIZORAM, INDIA
Puroitab,2 Zohmingthanga j,3 Ra~u PSKP3 Zomawia E,3 Chakraborty J. I Medical
College of Ohio,Toledo, OH, USA, -Harvard-Deaconess Surgical Service, Harvard Medical
Scool, Boston, MA, USA, 3HIV Surveillance Centre, Civil Hospital, Aizawl, Mizoram, India.
Objective: To obtain data on HIV infection in the town of Aizawl of Mizoram, India.
Methods: Phase I. October 1990 January 199 I: A limited survey was conducted in collaboration with inestigators in Calcutta, India by collecting blood samples from high risk groups
and testing far HIV. Phase II. February 1991 -December 1992: Screening was done on blood
donorc from 1ilood banks, patients from civil hospitals and STD clinics, and volunteers. Phase
Itl. lanuary 1993-September. 1993: A maximur number of hig risk groups came for testing
as a resuit o counseling and efforts of the Salvation Army. Phase IV October. 1993 -Septembe, 1994: Mandatory blood screening before tranfusion was strictly maintained.
Phase V Octobe. 1994-Septembe 1995: Due to active IEC programs conducted by

NAClOv'.WIO I nd foreign agencies like WAF and Medii iCollege of Ohio, more awareness has been created in public and more individuals with risky behavior are participating in
voluntary testing.
Results: Following numbers of blood samples were tested HIV positive during this five
phase study:in Phase 1:9 of 164; in Phase II:. 15 of 3,294; in Phase II:7 of 3.066; in Phase

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