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

Tu.C.2610 - Tu.C.2619

Tuesday July 9, 1996

by the Ministry of Health.This kind of program, if correctly completed, could provide useful
information for prophylaxis and prevention.
Pietro Crovari, Institute of Hygiene and preventive medicine, University of Genoa, ItalyVia
Pastore I -161132 Genova Tel: [phone], Fax: [phone]
Tu.C.261 0
ATTITUDE OF HEALTH CARE WORKERS (HCW) AFTER OCCUPATIONAL
EXPOSURE TO BLOOD (OEB).
Ch. Rabaud-I, M.C.Vignaud2, F. Brel3,Th. May3, Ph. Canton3, Ph. Harteman I. I Service
d'Hygiene Hospitaliere, 2Service de Maladies Infectieuses, 3Medecine du Travail, CHU de
Nancy, FRANCE
Objective: to investigate attitude of HCW after OEB, self-administred anonymous questionnaires were placed at HCW disposal.
Results: in February 1994, 89 responses of HCW with history of OEB were collected (sex
ratio: I man for 3 female). Immediate decontamination of exposure sites was correctly performed in 98% of the cases. Other results are reported in following table:
Nurses Aide Nurses Physicians Others
I l-W wth history of OEB 52 I 5 10 12
OFB reported by HCW to pibhic health authorities (%) 60 54 50 92
Initial HIV serological testing of HCW (%) 73 66,7 40 92
HItV serological testing of HCW after 3 months (%) 63 66.7 30 92
HIV serological testing of lCW after 6 months (%) 54 60 30 92
These injuries were reported to the public health authorities only in 62% of the cases, and
HIV serological testing of HCW wazs not correctly performed in 38% of the cases.
Although I18 HCW reported OEB of known HIV infected patients, 4 HCW did not report
this injury to public health authorities and did not perform HIV serological testing for themselves. Among the 50 HCW who did not usc condom during their sexual intercourse, only
2 I HCW modified their sexual behaviour after OEB.
Conclusion: Although 27 HIV infections were suspected and 10 were proved consecutively
to OEB in France, several HCW failed to report OEB to public health authorities and to
realize HIV serological survey for them-selves.This study established that HCW did not
protect their sexual intercourse after OEB.
Christian Rabaud, Service d'Hygiene Hospitaliere, CHU de Nancy H6pitaux de Brabois,
545 I Vandoeuvre les Nancy France.Tel: [phone], Fax: [phone]
Tu.C.2615
EUROPAP: EUROPEAN PROJECT FOR AIDS PREVENTION IN PROSTITUTION'
Mak Rudolf P*, Day 5"r,Ward H**,Visser J***, Covre P****, Czajka M****. *EUROPAP
Coordinating Center, University of Ghent, Belgium, **St. Marys Medical School, London, UK,
***De Graafstichting, Amsterdam,The Netherlands, ****Comitato per i Diritti Civili Delle
Prostitute, Pordenone, Italy *****Madonna, Bochum, Germany
Objectives:To support, develop and extend preventive interventions for prostitutes, in
order to reduce the risk of HIV and other sexually transmitted diseases (STD), to evaluate
these interventions using a common methodology to develop a protocol for setting standards of such interventions and to develop proposals for establishing a network of participating centres in Europe.
Methods: In each of eleven participating Member States of the EU, a local coordinator (LC)
was appointed to build a national network of intervention projects.The LCs worked
together to develop a list of indicators to describe and evaluate all projects. After the first
year of work they reported back to the Coordinating Center, which drafted general conclusions from the experiences in the participating countries.The conclusions were then discussed and fnalised at a further meeting of all LCs.
Results: EUROPAP has produced an overview of 156 intervention projects for prostitutes
in eleven European countries (http://allserv.rug.ac.be/-rmak/europap/).We have identified
various barriers to safe sex in prostitution. In a number of European countries repressive
legislation makes it difficult for prostitutes to work safely For example, where soliciting is a
criminal offence, this may reduce the time prostitutes have for negotiation with their clients.
Intensive policing may lead to prostitutes working in remote areas where they are vulnerable, and more hidden fr-om intervention prolects.We have found that existing health and
social services in Europe do not cover the needs of all sex workers. Some prostitutes are
not allowed to use such services, others are reluctant to use them because of the negative
attitude many health care workers have towards them.
Conclusions: There should be a review of the laws regarding prostitution specifically considenring their impact on safe sex conditions for prostitutes. Health and social services should
be accessible to prostitutes through meeting their needs more directly I (supported by EU
DGV in its programnme:'Europe against AIDS')
RP Mak, Dep. Public Health, University of Ghent, De Pintelaan I 85. 9000 Gent, Belgium
Telephone: -32-9-2403616 Fax: -32-9-2404994 email: [email protected]
Tu.C.26 16
SAFER SEX STRATEGIES AMONG BELGIAN U.N. BLUE HELMETS ON A PEACE
KEEPING MISSION IN A HIGH HIV/AIDS PREVALENCE AREA.
Buysse An*, Van Renterghem H*, Drieghe L*, Wouters R**. (*University at Ghent,
reInstitute for Hygiene and Epidemiology Brussels, **Belgian Army)
Objective: Assessment of safer sex strategies adopted by armed forces stationed in a high
HIV/AIDS prevalence area (Kigali/Rwanda) in order to evaluate the AIDS prevention programme of the Belgian ar-my.
Methods: Prevention activities consisted of transmitting information about AIDS, group discussions, condom use demonstrations and free availability of condoms before and during
the mission. Information on sexual practices of militaries involved (N-379) was collected by
ereans of ar written anonymous questionnaire immeadiately after- the mission. In order to
obtain more in-depth information, semi-structured interviews, developed upon the findings
of the written questionnaire, were conducted.Thirty-three subjects volunteered to participate. Results of the latter are presented.

Results:Twenty out of the 33 respondents (61%) reported to have had sex during the mis
sion.All subjects, except one, reported to have used condoms on all occasions.The only
exception involved a c.s- where condom use was stopped after both partners passed an
HIV-test.The subects vvhi, abstained from sex did so mainly because of fear and to remain
faithful to their partner at home. For those who had sex, reasons for having sex included:
they needed to have sex (I 6/20), the partner asked for it (8/20), to relax (6/20), for adventure (5/20), because they were drunk (4/20) or because they were in love (3/20).The effec
tiveness of condom use promotion is illustrated by the fact that the sublects reported that
always having a condom on you was considered to be the most effective safer sex strategy. Although the soldiers did not like condoms (13/20), they always used them. Occasional
abstention from sex was reported by 8/20, mainly when condoms were not available (5/8).
Considered knowledge of HIV-serostatus of sex partners was frequent (I 2'20): because the
girls told them so spontaneously, showed them their HIV-test result certificates or because
the subjects asked for it. If serostatus was unknown this was mainly due to not being interested because irrelevant in combination with condom use. Additional to this, partner selection based upon subjective criteria seems not to have interfered with condom use. Most
subjects reported their partners looked healthy (18/20) and did not present themselves as
prostitutes (19/20).
Conclusions: Findings suggest that a well-developed AIDS prevention programme and the
availability of condoms on a UN peace keeping mission in a high HIV/AIDS prevalence area
result in a high degree of risk avoiding practices such as abstention and/or condom use,
even in combination with partner selection and/or knowledge of HIV-test results.
HenkVan Renterghem, 14 J.Wytsmanstraat, Brussels, Belgium Tel: [phone] Fax: [phone] email: [email protected]
Tu.C.2617
FEMALE SEX WORKERS IN BELIZE - EARLY SOCIALIZATION, CURRENT PRACTICES
AND RISK OF ACQUIRING SEXUALLY TRANSMITTED DISEASES
Andrewin-Jenkins V E *, Bain BC *. * Ministry of Health, Belize City Belize, Central
America; ** Department of Social and Preventive Medicine, University of the West Indies,
Mona, Kingston 7, Jamaica.
Objectives: To investigate (a) aspects of early socialization, and (b) current knowledge, attitudes and behaviours related to sexuality and sexually transmitted diseases (STDs), among
two groups of female sex workers.
Methods: A pre-tested, structured questionnaire was administered with prior consent by
trained interviewers in three districts in Belize over a two-week period in early 1994. Quots
samples of 45 brothel workers (BWs) and 35 free-lance sex workers (FLWs) were selected
from lists obtained by health workers in each district.
Results: Forty-two of 45 BWs were born in neighbouring countries, while 31/35 FLWs
were born in Belize.Their approximate median ages in years were: BWs 23; FLWs 26,
respectively; more FLWs were above age 30 years (p<0.008). Only 23% of the women had
attended school beyond primary level.The reported rate of childhood sexual abuse was
67.5%, p not significant between the groups). Eighteen of 45 BWs compared to 3/35 FLWs
claimed that they had check-ups weekly or fortnightly". Forty one of 45 BWs said that
they ask their clients to use condoms at least sometimes or always, compared to I12/35
FLWs (p < 0.0001). Sixteen of 45 BWs (36%) and 15/35 FLWs (43%) reported having had
at least one STD ( p not significant). Fifty-four of the 80 women said that they had been
tested for HIV; of the 47 who knew their test results one, a FLW was HIV-positive.
Unbeknown to them, the women's reported repertoire of sexual behaviours appeared to
exclude activities of which their parents disapproved during their childhood.
Conclusions: In Belize and neighbouring countries, the authors recommend that attention
be paid to the following with respect to girls: appropriate carly sexual socialization; encouragement to remain in high school; child sexual abuse; unnecessary or unsupervised migration.The researchers believe that the success of this study shows that effective and empathetic communication with sex workers is possible.
Valerie E Andrewin-Jenkins. R.N., M.PH. 62 Amara Avenue, Belize City Belize.Tel.:
77170/77176/72234 Fax: [phone]
Tu.C.2618
HUMAN PAPILLOMAVIRUS INFECTION AND CERVICAL INTRA-EPITHELIAL
NEOPLASIA: INFLUENCE OF HIV AND OTHER CLINIC-EPIDEMIOLOGICAL DATA.
Andrade, Neto. Jos L*, Carvalho NS*, Hanel RA*, Rossi S*, Machado MC*, Maia M*,
Salvalaggio PRO.*. *Federal University Curitiba, Paranai, Brazil.
Objectives: To evaluate the incidence of Pap smears indicating human papillomavirus (HPV)
infection and cervical intraepithelial neoplasia (CIN) in sex workers (women) as well as to
determinate the influence of HIV including clinics and epidemiological data of this group.
Methods: The authors studied 105 Pap smears of sex workers from Paranagu,- Parani -
Brazil and another group of 105 Pap smears of non-sex workers f-om Curitiba - Parani -
Brazil (comparative group).The group of sex workers had also answered questions about
their habits and they were submitted to HIV-test (ELISA).
Results: There was a higher incidence of HPV in the group of sex workers (24.7% against
1.9% in the comparative group - p<0.0 I).The incidence of HPV was more often in those
who had a HIV test positive (33.3% against 16.2%).There was an incidence of 6.6% of CIN
in the group of sex workers (I 6.7% in positive HIV test and 6. I% in negative one).There
were no cases of CIN in the control group.
Other data such as age, time and beginning of prostitution life, the number of partners per
week, other sexual transmitted diseases, smoking, the number of pregnancies, the use of
condom (and contraceptive methods), and previous Pap smears were also analyzed.
Conclusion: There was a higher incidence of HPV in the group of sex workers, especially in
the positive HIV test and there was a higher tendency of CIN in the sex workers group.
Jose L Andrade NetoTravessa joo Turim, 28 ap 402, Curitiba-PR, Brazil Telephone:
(04 1)244-942 I. Fax: [phone] I
Tu.C.26 19
THE HIV EPIDEMIC IN BRAZIL: DIFFERENTIAL DISTRIBUTION AND TRENDS
Dhalia Carmen BC, Lauria Lilian, Rodrigues Lair GM. Gomes Maria RO. Chequer Pedro JN,
Loures Luis AM. National STD/AIDS Program, Ministry of Health, Brasilia, Brazil.
Objective: To examine the distribution and trends of HIV in Brazil

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