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

Track C: Epidemiology and Public Health
Tu.C.24 15
SEXUALLY TRANSMITTED DISEASES (STD) AND HIV INFECTION INCIDENCE
AMONG MEN WHO HAVE SEX WITH MEN (MSM).THE BELA VISTA COHORT
STUDY, SAO PAULO, BRAZIL
Luna, E.J.A.*, Figueiredo, G.M.*, Mirim, L.YL.*. *Institute of Health, Sao Paulo, Brazil
Objectives: To determine the incidence of HIV infection and olher STDs a io ng the participants of the Bela Vista Cohort Study.
Methods: The Bela Vista is an open cohort study. Eligibility criteria include: I) men who have
sex with men; 2) aged 18-59 years; 3) non intravenous drug user at least for 6 months
before entering the study; 4) having HIV negative serology; and 5) agreement to participate
according to the terms of the Informed Consent Form.Volunteers are invited to return
every 6 months for interview, blood samples collection and clinical evaluation. In order to
determine the incidence of STDs and HIV infection, only the volunteers who had returned
for the second wave were included in the present analysis.
Results: A total of 113 volunteers had completed the 2nd wave pr ocedureis until Nov.30,
1995. Mean follow up time was 203.04 days.There was one sei ocorinvesion for HIV (0.9%)
and two for hepatitis B (2.9% of the ones that had tested negative for hepatitis B antibodies
and antigens in the Ist wave), and 17 (15.6%) have had other STDs during the follow up
time. Five of them presented genital ulcers, which were diagnosed as Ierpes simplex, but
only one of those was a recent infection.Two of them had gonorrhea (I.8%) and three
(2.7%) non-gonococcal urethritis. Nine of them presented genital or anal warts (8.0%). ST[)
cases did not show statistical association with the use of condoms for anal intercourse.The
only HIV seroconversion case reported unprotected anal sex both in the 6 months previous to the I st wave and during the 6 months follow up. No syphilis cases were observed.
Conclusions: Such high STD incidence among the study participants is particularly worrying
given: a) the well described association between STD and HIV infection, and b) the lack of
association between condom use and STD. However it must be noted that condom use
was limited, in most of the reports, to anal intercourse, whilst many STDs can be transmitted by other forms of close contact, suggesting the need to review counselling procedures
concerning safer sex and STDs prevention.
(Supported by WHO, MS/BR, SES/SP and FAPESP)
Expedito Luna, Rua Santo Antonio, 590, 5~ andai, 01 314-000, Sao Paulo, SR Brazil,lel: 55- II -
6069643, Fax: 55-I I-6502772.
Tu.C.2416
CHANGES IN HIV RISK RELATED BEHAVIOUR AMONG GAY MEN IN BARCELONA,
SPAIN.
Rodes A*, Maguire A*,Vall M*,Tort X**, Rabella N***, Casabona J.*. *CEESCAT. Generalitat
de Catalunya. ** Associacio Stop-Sida. ***Hosp. Sant Pau, Barcelona, Spain.
Objective:To monitor changes in the prevalence of HIV infection and patterns of HIV risk
related behaviours among homosexual men in Catalonia, NE Spain.
Methods:Two surveys have been carried out, in 1993 and 1995, on thle sexual behaviour of
homosexual men recruited in saunas, sex-shops and through a gay community based organisation. Demographic and behavioural data were collected by nieans of an anonymous self
administered questionnaire. Also, in 1995 saliva was collected and tested for HIV to estimate prevalence of infection.
Results:The results for the 1995 survey are preliminary, although checks do reveal that they
will be accurate. A total of 745 questionnaires were completed in the 1995 survey (questionnaire return rate "QRR"=29%) and 55I in 1993 survey (QRR=28%). Also, 303 saliva
samples were collected as part of the 1995 survey. For both surveys, respondents were
similar in terms of age (mean -33 years) and other socio-demagraphic variables. No
changes in the number of male sexual partners were observed. However, significant differences were found in the proportion of men who engaged in anal intercou se (70.5% vs
59.5%) and oral sex with ejaculation (13.6% vs 6.8%) with occasional partners, in the
month prior to the questionnaire. Whilst the proportion of men who never used condoms
for anal intercourse remained similar (6.2% vs 7.5%), the proportion of tlose who always
used them was significantly higher in 1995 than in 1993 (80,1% vs 62.8%). Alcohol consumption before and during sexual practices was similar in both samples but the proportion of men who used inhaled nitrites (poppers) had decreased significantly, being 34,1 % in
the previous 6 months in 1993 and 28,5% in the previous 12 months in 1995. A growing
number of men had been tested for HIV (67% in 1995; 61% in 1993), providing a self-noti--
fred prevalence of HIV infection of 21% for 1993 and I16% for I1995. Prevalence of HIV
infection in the saliva sample was 14%.
Conclusions: Observed changes in the sexual behaviour of homosexual rmen in Catalonia
provide support of the positive results achieved by the preventive measures undertaken to
tackle the AIDS epidemic. However, the prevalence of HIV infection among homosexual
men remains worryingly high, indicating the need to keep up or increase such interventions.
ARodes. CEESCAT Hospital Universitari "GermansTrinas i Pujol" Ctra. de Canyet, s/n, 08916
Badalona (Spain). Phone:[phone] Fax [phone]
Tu.C.241 7
METHAMPHETAMINE USE AMONG GAY MALE DRUG USERS:AN ETHNOGRAPHIC
STUDY
Eggan, Ferd, Reback C*, Ditmas D*. AIDS Coordinator's Office, Los Angeles, CA,
USA; **Van Ness Recovery House, Los Angeles, CA, USA
Issue: On the west coast of the United States, the stimulant nnethasmphetamitne,"crystal" is
rapidly becoming the most frequently used dirug in gay male coiinnirnities.l Ir eno Angeles,
CA, approximately 10,000 gay men use "crystal" on a regular basis.The dint nine places
them at extremely high risk of HIV infection through both needle shiririg psractices anrd sexsal activities associated wish the drug.
Project: An ethnographic study targeting self-identified gay men who use methamphetamine at least once a week was implemented in hen Angeles. CA t)bseivatronal ield work
was conducted is identified high-risk drug and sexual areas including, but not lumited to, baii
and sex clubs, hotels, and streets and alleys.Thirty (30) is-depth unstiructured inter'views
were conducted as well asS5 focus groups with members of the targyet popu lation, encome

passing several class and ethnic strata.

Tu.C.2415 -Tu.C.2424
Results: Gay men who use crystal methamphetamine exhibit social behaviors and develop
social networks that intersect both their gay identity and drug using practices. Unlilke heterosexually identified drug users, metlhamphetamnine use in certain gay comnmunities is
specifically associated with sexual functioning. On the west coast, it is estimated that 65% of
gay male crystal users are HIV infected.
Lessons Learned: HIV prevention efforts targeting gay male drug users nust design cultur
ally appropriate intervention programs that focus on both gay identity and drug using
behavior s, specifically the high risl< sexual activities associated with crystal use.
Ferd Eggan, Los Angeles City AIDS Coordinator 215 W. 6th Street 3rd Floor I os Angeles,
CA 900 14 tel. (2 I 3) 485-6320 - fax [phone]
Tu.C.2418
HIGH PREVALENCE OF STDs AND HIGH-RISK BEHAVIOR AMONG MEN WHO
HAVE SEX WITH MEN IN AN HIV SEROINCIDENCE STUDY IN BRAZIL.
Harrison, lee t.", Ferro R.F.a ", Friedman, R.K. iC, Quinn i.t., Rodrigues J."*, Schechter
M."*. lJohns Hopkins University, Baltimore, MD; *^Universidade Federal do Rio de Janeiro,
Brazil.
Objective: Ve recently initiated Projeto Praa Onze, a IIVNE fsponsor ed IHIV ser oincidence study among men who have sex with men (MSM) in Rio de Janeiro. Although no
data are yet available on seroincidence, we determined the prevalence of high risk behav
iors and sexually transmitted diseases in our cohort.
Methods: Ninety eight potentially eligible 18 50 years old MSl had serology performned for
HIV, syphilis, hepatitis B, and HTILV I/Il, as well as urine PCR for Chlamrydia treihomtinis. A
detailed questionnaire on risk behaviors during the previous six month period was administered. Pre- and post test I IV counselling were given and attendance at workshops on the
preventicmn of HIV infection were offered.
Results: Of the 98 subjects, 9 (9'%). including I with an evolving Western blot, were HIV
seropositive and excluded friom further analyses. Of the remaining 89 subjects, 43 (48%)
reported having sexual relations with someone at first encounter, 9 (10%) having an HIV
seropositive sexual partne, 59 (66%) having at least I casual partner (mean =- 7, range 1I
40), and 19 (21 i) having unprotected receptive anal intercourse.Thirty-four (38%) were
positive for hepatitis B core antibody II (I 2%) had serologic evidence of syphilis, 3 (3%)
had a positive PCR for C. trachoratis, and none hadF I HTLV1I/11 infection.
Conclusions: A high proportion of the subjects in our cohort reported behaviors that
place them at high risk for HIV inflection, a notion that is supported by the high prevalence
of serologic evidence for syphilis and hepatitis B.This cohort represents an excellent population for studying interventions to decrease the transmission of -11IV.
I_.H. tarrison, Room 5515, Johns Hoplkins Univ., 615 N.Wolfe Streel, Baltimnore, MD 21205
Telephone: [phone] Fax [phone] E-mail: Iharriso(0phnet.sph.jhu.edu
Tu.C.242 I
HIV AND AIDS PREVENTION AMONG GAY MEN IN AFRICA- A BURNING ISSUE:
Willam O'DuorTorn A. Ochieng', Andrew M. )nani, Care y Bwana Fopogap. Kenya.
Objective: To determiane the likely numbers of gaymen and thie pr evalence rate of HIV
infection among ther in three nmajor cities of East Aftica namely; Dar Esalaam, Mombasa
and Kampala.
Methods: An independent study by four FOPOGAP members vo luntarily carried out a
study in the above mentioned cities of Est Africa.1he interview and information gathering
took place where the male sex workers usually canp for clients, who are usually tourists
from abroad and local inen who have sex with men.-I hin points acted as entry point for
the study.
Results: The study revealed that hoeosexualism iis now common in almost every country
in Africa, this is high especially to areas which host higher number of tourists. The age
groups who are being attracted to the practice are mainly young men as ged between 20 35.
These are tire nodeni generation who have adopted diverse lifestyles.
Conclusion and Discussion: IV/AIDS among gaymen irn African Contrinent is real. There is
a strong need for a more detailed research about this subject to come up with a pro
grarnnue to plan prevention programmes to target and save gaynsen fiom contracting HIV.
\Williami Odou, RO. Box 2404Tel.: 254,35,40091 Fax: 254,35,40797
Tu.C.2424
HETEROSEXUAL TRANSMISSION OF HIV IN RIO DE JANEIRO, BRAZIL.
Sion,Fernando Samuel, Morals de Sa, C. A, Signorini,D. H.P, HubemPV., Pestana,N.H.,
Rubini,N.P, Moura,S.M., ArabeJ. Gaffrce and Guinle University Flospital -University of Rio
de Janeiro, Rio de Janeiro, Brazil.
Objectives: Determine the efficiency and associated risk factors in heterosexual transmis
so of HIV/ fuons male to-fennale anud tfenale-tao-nale.
Methods: Fronr 1988 to 1995 robott of 62 hete exual couples (bisexual men and thneir
ten male partners),ages 21-47 yrs, and 42 stable, monogamous heterosexumal couples,ages 25.
55 yrs, whose men were partners of HIV infected women (29 index women infected by
bloh tiansfiusson and 13 IV+infected by ether male partners burt who sibsequently
acquire nova partiters) have boost stuadied. Mo'st index eanensn ee asyunpneomatrr. Beth
rnember s of ie coupies were irterv mwed face toface rdinaly and donacts who were
HIV -foliowed up evaery nix mnontnhs. -hn cocuples were counselled about the iik oh FIIV
infections and safer sex pm rcties. Qcuestions explorecd rnumedr of sexii l par tens, rink faetenrs, hr equmenry of sexual contact pen- weee, knowna or esttnsated chine of infection, regular
sexual praetices anad use oh condoens. Other r'sk trector s suceh us, penis lesro,laeck of cicurineusren, disease stage, antigeanri has hueie valutedh. In 2C18 idivituals, (uges finer 22 -Sil yr s), heternosexual mnale behavior have bees stiudied.
Results: In mate to hemale study 177 (26 7%) wornen reused to nio r. 149 (50.3%) of 296
fl-male onlants engigung only in vagunal intercouur'se were UIVi- rind I 19 (63%) of 189
female contacts engaging us moth annul ammd vaginal were f-IV+I. Flablea eutnate encude transnmussueon r ute mrs 54,6%. Founain ru to turansnmssion dud nuat occrrn us cohnert 5uf 42 stahale
mu iiiogaurnoa 1 hunter osexa coules. CII 208 fueleroexual maem, I129 (62%) stern I IV- mmmd

79 (38%) CIV+. As level of confidence enhanced along with subsequent peg sonal interviews, II (I 3,9%) I\/V+ admitted other risk behavior;7 (53,9%) were bisexuals, 3 (23%)
homosexuals and I (7,7%) IVDU.

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