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

Tu.C.201 -Tu.C.210

Tuesday, July 9. 1996

infection in comparable grotips of the population. I-he. information fiom itli cornponeint of
HIV surveillance is essential for planning, implemenlting, and monitoirin pii.rc t oi,nd
control efforts.
I. Klats, Institute of Public I ellt,liubarieva 2, 61000 LIjubljana, Sloveni,
Telephone: + 386 61 1323245; Fax: f 386 6 1 323940; email: rena Klati. v i.
Tu.C.20 I
THE STUDY OF CONDOMS ACCESSIBILITY FOR BUYERS IN MOSCOW
Flena V. Lyubaeva,VadimV. Pokrovsky. Russia AID)S Centre
Objective: estimate the ease of condoms purchasing in Moscow.
Methods: were explored availability, the time of selling and prices of co Odis in 3f8 drug
stores, 17 pharmacy kiosks of subway, 20 commercial kiosks, 5 supermarkets, 22 kioks in
Moscow hotels in November 1995.
Results: established, that condoms were sold in 37 (97%) pharmacies, in 15 (88%) pliarnacy kiosks of subway, in four (20%) commercial kiosks, in one (20%) supermarket and in four
18%) hotels.The price of one condom in pharmacies and in pharmacy kiosks of subway
staggered from 280 up to 2900 roubles, in commercial kiosks from 1000 up to 6600 ro -
bles (40% higher than in pharmacies), in hotels from 550 up to 7200 roubles. In the most
sites condoms were sold in packings flom three uip to twelve pieces that increased the
value of one purchase up to 17120 roubles.The pharmacies, pharmacy kiosks of subway
and kiosks in hotels are open from 8 till 20 hours. After 20 hours condoms may be only
obtained in commercial kiosks and pharmacies on duty.
Conclusion: The condoms are not quite accessiblec in MoscowN for the followig reasons: I)
price of condoms is too high with reference to the minimum salary in Rt ssi, (57000 rou
bles); 2) condoms are sold in the limited number of sites; 3) the time of selling is restricted.
Special steps from municipal are necessary
Elent V. Lyubaeva, Russia AIDS Center Ib.2, 15, 8 ya ulltsa Sokolinoy Gory, PlMoscov, 105275,
Russia Telephone: [phone] Fax: [phone]
Tu.C.202
SOME EPIDEMIOLOGICALASPECTS OF HIV-INFECTION REVEALED IN THE
REPUBLIC OF BELARUS
Pimenoy Alexander, Senior Specialist fEpidemiologist, National Centre for AI/DS Pi,.tition
of Belarus/WHO Liaison Officer in Belarus! Membet of UNAIS Coarr fnttryti ire iroup
Republic of Belarus is situated in the centre of Europe,tnd taking into accc,rt,,o.- of ill
the most important communiation routes lieteen the East and the West. It was one of
the first in the former Soviet Ulnion to face in 1987 the problem of HIV-infection al first
there were foreign citizens on different occasions coming to the reptiblic, but sice 1991 one
can speak about virus inculcation in Belarus population. Due to the geographical situation
which is being actively used recently for illegal transit of narcotics in the r epctic for the first
time among the former USSR countrics HIVinfection was revealed among drat users.
Among 1 13 HIV positive revealed as of 01/01/1996 (rate I. 1%), 22 have diagnosed ARC
(AIDS-related complex) and 15 - AIDS. I I patients died, tincluding one child, only in 1995 -4
patients died.
Having gained independence in 1991 Belarusi according to W -O 10recommrendatin, revised
its approaches to obligatory testing and since 1993 gradually reduced it to the iiinimum - at
present only blood and tissue donors and STD patients are being obligatory tlsted.T-he
principle of strict confidentiality is observed at all stages of the work starting from corning of
those who wish to be tested to a testing site.To observe it we worked out a multiple stage
system of enciphering the samples and the results of their testing, as well as the diagnoses.
In 1991 we managed to get changes in legislation having abolished the existing in the formner USSR punishment for homosexuals, the punishment for hormnosexual violence and
seduction being preserved. At the same time with our participation punishlient for drugs
addiction was abolished with lougheninrig it for drugs spread. Since 1992 Belarus strictly
observing Human Rights does not carry out deportations of HIV-infected foreign citizens.
As a result of such approach and benevolent attitude to anyone who is looking for HIIV
counselling, we managed during the post-testing counselling not only to find out with a
large degree of trustworthiness that in the republic sextual transrission prevaitt,- 78.2%,
including homosexual transmission -- 12.4%; transmision by drug injecting 7. t%; children,
born to HIV infected mothers, con;titute 4.4%; but to reveail more than I.,2% of HI infected
by contact tracing.
Dr A. Pinmenov, Belarus, 220001 Mins k, u I. Fabricius 228, room 401, WtC Liais on Office,
elephone: + 375 172 220419/220445 Fax: - 3/5 1/2 262165, email: alex(cdtt'holoninskby
Tu.C.203
HIVI INFECTION EPIDEMIC IN NORTHEAST ROMANIA. PRESENT STATUS AND
FURTHER POSSIBLE EVOLUTION. Apetrel*, M. Duca-. "Virus L aboratory, )niverity of Medic ine of lsi,P ori ani d
BACKGROUND:The IIV I infection epidemic in Rornanian of nto,-sed, horizontally infected
children reached the sixth year of evolution.The present data reveals that nowadaiys, almost
55% of European AIDS paediatric patients were reported ftorn Romania.
Objective: To reveal the main characteristics of this unique epidemic in orde t cl.1 rrst
efficient prevention strategies and to better characterize the circumstancis of thei outtcome.
Method: The review of our laboratory 5 years research activity arnd of the concermed titerature.
Results: FThe Romanian paediatric HIV I infection epidemic has several distinct features that
should be emphasized: I. the nosocomial aspec., revealed by (a) the reduced irmtortance
of vertical transmission (6.04%); (b) a signiLcant association between the acquiring -tIV
infection risk and living in nursing units (5 I% of cases) and an increased risk related to the
duration of living in nursing units; (c) the parenteral virus transmrission, revealed by the
strong association of HIV I infection with HBV infection (53%); epidermtological evidence
showing the improper use of non sterile needles and syringes; rnolecular features showing
high and dispersed values of viral load, thus permitting viral transmission by needle stick
injuries and also evidencing the existence of some "viral spreaders" - those children having
the highest viral charge. (d) molecular virology data, which demonstrates the circulation in
nursing units all over the country of an unique HIV I viral subtype F, presumed to perform
a 'founder effect' in this risk group, thus becoming the main subtype in Romania. 2. The
recent aspect, stressed by: (a) the absence of HIV I seropositivity following testing 854 sera
collected between 1977- 1988; (b) the age distribution of cases (70.68% cases aged less than

4 years):; (c) the pt ientr'l rtural history during the last 6 years (only 45% of HIV infected
children c vlo A'll)S, the rate of mortality being up to now less than 50%); (d) the low
degre e of diver 'n:c vween the isolated HIVI strains (less than 4%). 3. The bmodal
pect of Rcrni: i!' tH epidemic evolution between nursed children ("risk group"- pattern
I) and adui pop liopii ti,t' 'om III, with heterosexual contacts as main transmission mode -
45%). 4. Intru r,, _, cases of HIV I infection in children with no "classical" risk factors: (.) cases of unknovtwn transrission models from children to mother or to nursing personnel 5 Pec ut itiro tnu iologcal a s,.lpects, probably related to HIV I subtype F; 6
Pui,Oaitic. a..:_ the Rotri in particular situation underlying the importance and efficacy
of measures ai d t iopevent nosocomial HIV transmission even when a large proportion
of the poptu!atio are aifeady Ifff-]seropostive, and living among uninfected subjects.
Conclusion: The absence of new case appearance in paeditric nursed patients, correlated
with an increasirg niunbcr of heterosexually transmitted cascs, reveals that the Romanian
AIDS epidemic has r ea(hed a breaking point.Virological studies are required in order to
establish the circulating IHIV I subtype(s) in the adult population.
C. Apetrei,Virus I aforatory, Univ. of Medicine, 16 Universitatii Str, 6600 last, Romania
Tel: [phone]; Fax: [phone]
Tu.C.204
HIV INFECTION AMONG DRUG USERS IN UKRAINE-BEGINNING OFTHE EPIDEMIC
Kobyshcha, Yuri Shcherbinskaya A**, Khodakevich L ***, Andrushchak L*, Kruglov Y***.
*National AIDS Comomrittee; ttNational AIDS Centre; **GPA Intercountry Advisor,
Kiev, Ukraine
Issue: Injecting -u iiuer-, hae become the most vulnerable to HIV high risk group of
population in Ukrt aine.
Project: Results of a special investigation on the current HIV situation among IDUs in
Uraine are piaesented.
Results: A radical chan. e of the I IV situation in Ukraine has been observed during 1995.
More than /00 HI/ infected dru2 users were registered in 9 regions of Ukraine, mnost of
themn (94%)1 in (Odessa and Mykolayiv regions in the south of Ukraine.The current surveillance data show that HIV preva i lence amont g IDUs has increased over Itenold just in I I
roonths: froi\,it hiattly zero in 1995 it reached 30./x in Odessa and 17.7% in Mykolayiv by
tDecerr utI996 In ()dcssi IIV infected IDUs inject mainly locally produced opi ates from
poppyu stfSc', tu Irsed ftoa ygypsties. In Mykolayiv region, ephedrine derivatives
(Ephedrone) at ' more populai: Only 35% of IDUs were registered in the special clinics for
di tig abuse treatneent.
Lessons Learned: TI IV prealence among injecting d trug users in Odessa and Mykolayiv
is incr easing i tan epidemic fomouto, and these cities are likely to r epeat the epidemics
observed earlier in, itk, Etdinburgh, Bangkok, Rangoo roand mor e recently in Poland.
Inurnedite poeven tiv intervientions are urged to slow down the epideminc development.
Yuri Koby, hch, 3 llel oa St, Kiev 252023, Ukraine. tel.: [phone];
Fax: [phone] I I;Ernl: kobisha pnaids.freenet.kiev.ui
Tu.C.205
EPIDEMIOLOGICAL TRENDS OF AIDS AND OTHER SEXUALLY TRANSMITTED
DISEASES IN THE EASTERN PART OF EUROPE
D A C, rovyo. AIDS ST D ProgrammeWHO Regional Office for Europe,
Copenhagen, De'nmark
the fir t cases of AIDS in theo eastern part of Europe appeared mostly in 1986-87, i.e. several years later than int the couti cntries of the western part of Europe. It was a common
understanding it that ti etat trhe disease would start to proceed with the same pace as
in lthe other countries of Western Europe. However; the predicted growth has not
occurred. At present, n 26 countries of central and eastern Europe where half of the
European population 0ivs, only 5400 AIDS cases have been observed while in countries of
Western Europe i 50000 AIDS cases have been reported since the begining of the epidemic. Diue to the inteonsive efforts undertaken by the national programmes on HIV/AIDS prevention, changes in legislation, involvroent of NGOs, and a multisectorial approach to
HIV/AIDS presentic n, the disease remains at the low endemic level at that part of the world.
Significant cont-i ution to thu occurrence of this phenomenon was made by extensive assistance provided y the WHO Global Programme on AIDS of the WHO Regional Office for
Europe to 2ie ounutries of central anrd eastern Europe duroing the last years and particularly
du ring the bienniuiao 19u94-1995. But th epideiolorsgca situation s stiffvoin te and the
recentt outbeak of I-f1tamong drug users in Ukraine and the growth in number of HIV
infectec people' n Polatot reflect the very unstable situation with regard to this infection in
Estern Europe. At th e same time mao ny countries of Eastern Europe have observed an
explosive rise ot other 'ex ally trasnitted diseases particularly in the Newly Independent
Stlates of ex-. SS the fusstian Federatio onle during only 1995 more than 255 000
syphi is cases hat e e'nen reported with a cumulative incidence rate per 100 000 of population equal to 172. I, a level wh t icl has never been so high dunrng at least the last 50 years. In
Belaris, the Repfhc of Moldova, Ukraineand the central-asian countries the incidence rate
of sypl is ha ao nreed to levels Irve observed for at least the last yeas. In almost
aft Westetrn tuu c'san cousntr irs the unrudence rate of syphilis us below 2 per 100 000. Such
ltgh inocidt'nce I tes of Irn at sexuaify tuansmutted dusetses rn Eastern Europe require an
inowediate action to conroloa thus epudenmic. Details of trends of I-IV/AIDS and other sexually
transnmitted diseases umo co'usi'tins of central and erstern Europe, tioc Nqewly Independent
Stares and tfue Btttic States nfuring thec fast S years wih be pr-esenoted ira more details.
F/u. A.LGrsotny to, V~o~ Rc"'ionaif Office for Europe, Sheufugsvey 8, DK-21tOO, Copenhagen,
Elconnit: tel 15?,9 17-15-61 Fax [phone]-/S or 15-39-17-18-18 E-matf: agn[_,svho.dk
Tu.C.210
BASIS FOR EFFECTIVE EDUCATION:A COMBINATION OF A MASS MEDIA
CAMPAIGN AND SPECIFIC TARGET GROUP INTERVENTIONS
Koller: Iiara. Di th Founudation for STO Control, Utrecht,-the Nether ands.
Issue: Nov flout tire generali puic in s welt aware of the importance of 1-fIV/STD prevention, it us crucial that noationml policy us established whereby noass-media and fote individually targeted puevention activities complement arud support each othen.The points of
departure are preventtion wvhuch influences behaviour and the determiunamuts which affect
tuun)safe behavuc.