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

Track C: Epidemiology and Public Health

Tu.C.2620 -Tu.C.2625

Methods: In May 1992 the National STD/AIDS Program established the HIV sentinel surveillance in STD clinics and maternities nationwide. Residual blood o irnlv collected for
VDRL is used for HIV assay by unlinked anonymous method. Sarn, lie ts nperiod is
limited to a maximum of 8 weeks.We have analyzed data from I-i,,,..;-, ned out in
representative cities from the different Brazilian regions.
HIV SENTINEL SURVEILLANCE SUMMARY RESULTS, PREGNANT
WOMEN - ITAJAi - BRAZIL- 1994
Results: (I) I ",, 1,, r. Porto,. Alegre (Sout r i IV I'prevaR 1* ALL AGES lence for all -:,,., nii c s inchanged
VL GEover time, th, ci ', i increased
L =--from 3.70% i i ".', 6'0% in 1994,
c jJ for those aged i r A's A similar
~ trend was obs ived tn Belo Horizonte
(Southeast). In Sao Paulo (Southeast), it was observed a differential i cri- en ii FI-V prevalence among females (2) Pregnant women: in Itajai (South), where preiociriate IIV transmission is associated with injecting drug use, and in Porto Alegre wh -', the trarnsmission
pattern is mixed, prevalences of 2.0% have been detected. Prevalerc rateis lower than I%
were detected in 5 other cities (including cities in the North and Nor tei ie-ns!,n regions),
where the transmission pattern is also mixed.
Conclusions: These results reflect the special impact of the HIV epldem;c fo youth and
women in Brazil and have assisted the NSAP in directing its prey:,rr srofo ts.
Carmen B. C. Dhalia Ministerio da Saude, Bloco G, sobreloja, sala i i i,rzil
70.058-900 Tel: [phone] Fax: 55-6 I -315.25 19
Tu.C.2620
NATIVE AMERICANS OF BRAZIL NEED A SPECIFIC PREVENTION PROGRAMME ON
STD/AIDS
Tanaka, Nair, Bellucci, Silvia B., Heringe, E., Loures,L.A.M., Gomes, 1. Riod.uesi_,ur G.M.
National STD/AIDS Program, Ministry of Health, Brasilia, Brazil.
Issue: Native Americans of Brazil (NAB) - 205 societies, 586 nativ land,;dU,(i0 NAB -
are at high risk for STD/HIV/AIDS and do not have access to preveston t-in irmnition.
Project: To assist in preventing HIV/STD transmission among NABP, ithe Iliriistrv of Health
initiated a large-scale project with the following first phase objectiv sn (1 to determine the
epidemiological interaction of HIV infection and others STD; (2) to pI, e>,i, oinseling and
on site treatments for STD; (3) to define anthropologic and sociolyic varIlc-s related to
risk for HIV/STD. Objectives I and 2 have been achieved througih iipid,s s ent based
on individual medical consultation offered to all NAB present in th e t he at 1he time of
survey Objective 3 have been achieved through field observation aiid,ontact with key persons and native liderances. As of December 1995, 150/586 nativ' lands h,,ve been visited.
Results: High STD prevalence has been detected. From 69 male i.eio nitive, 10 (58%)
presented at least one clinical sign of STD; among 106 women, 7., (d? Pa hve been diagnoses with STD.Treatment was conducted based on WHO fluxorr: nis for SI[D/HIV information and counseling were provided with the participation of a traiined Kapo educator.
The following variables were identified of predictors of HIV/STD travel sto nearby city (odds
ratio: 3,64), forest exploitation, mining, native land delimitation, estheticai ippsea ance, roads,
exogenous disease knowledge and others.
Lessons learned: Prevention of dissemination of HIV and others ST D.,riii rtive
Americans of Brazil should include strategies to deal with risk fact(: s delertmined by inadequate social and economic development.
Silvia Bellucci // Ministerio da Saude, Bloco G, sobreloja, sala 100 - 1 alia, Brscil 70.058-900
Phone: [phone] //Fax: [phone]
Tu.C.262 I
TRENDS ON THE AIDS EPIDEMICS AMONG ADOLESCENTS IN RIO DE JANEIRO
STATE - BRAZIL
Sanches, Katiar*, Matida A.*, Pires D.*. *AIDS Department - Health S'cs ei-y of Rio de
Janeiro State, Brazil.
Objectives: To analyse trends on the profile of the AIDS epidemi c anini- adclcescents in
Rio de Janeiro state. 2- To provide information for future prevention pr1,1as.
Methods: We selected all AIDS cases aged between 13 and 25 resporte,.t to the AIDS
Department of Rio de Janeiro State -from 1982 to 1995.The group elected included 25 y.o
and younger considering that HIV infection had occurred during their,dole, en ce. Cases
were distributed by age, sex, transmission categories, place of residence an, I,c iof diagnosis.
Results: The cumulative number of AIDS cases by December 199; w I I.69
(98.33/100,000 inhabitants). From this total, 996 (8.5%) were bet,-cen I 3-25 y:o.-The proportion Male/Female was 3:1. In 56 I (73.6%) cases HIV were traritted cIthrough sexual
intercourse and 88 (I I.5%) were Intravenous Drugs Users.The pcioci of diaineosis of the
cases in the study group was highly associated (X2= 124; df=4; P 10 ),,th place of residence:

Objective: To establish strategies and Educational and Prevention Policies in STD/AIDS, for
the female prostitution population of the State of Sao Paulo
Methods: Based on studies carried out in STD/AIDS and female prostitution of governmental organizations, leaders of Prostitution Groups, NGOs State of Sao Paulo and an
organization from RJ, an eight hour seminar was organized in order to define the most
effective intervention strategies with the target populations. One hundred and forty persons took part in the seminar, sharing their experiences and elaborating proposals.
Results: Health workers that deal with STD/AIDS were involved to assist the target populations in health services and carry out prevention activities to train "health agents" among
prostitutes, ongoing meetings with health professionals, NGOs and prostitutes to educational intervention in SDT/AIDS in this specific group were also carried out.To elaborate, one
seminar weitr sex professionals" was aimed at discussing with wider questions related to
prostitution such as: violence, self-esteem, etc; also importantly prevention issues related to.
Conclusion: For effective educational intervention work in STD/AIDS with this specific
group, partnership with regional governmental and non governmental organizations is
important and must include target population.This is the most effective way to carry out
these issues.
SILVA, Josefa Isaurindo.- R. Cristiano Viana, 753/43 054 I I -00 I - Sao Paulo-SP - Brazil
Tu.C.2623
STD SURVEY AMONG FEMALE INMATES IN THE CITY OF SANTOS, BRAZIL
Tellini, Regina M.C*, Carvalho, E.L.*, Gomes, E.*, Ebner, FV.*, Castro, M.T.F.*, Mello, L.B.*,
Arreaza. L.A.*, Sosres, M.C.*,Vieira, E.M.*, Fernandes, M.E.L.*. *SHS-Santos - **Family Health
International/AIDSCAP-Brazil
Objectives: To determine the HIV and STDs prevalence among female inmates and factors associated with seropositivity in the city of Santos.
Methods: A total of 140 female inmates were recruited from the regional prison and invited to participate in this survey Up to now a total of 57 women were interviewed using
standard questionnaire after signed consent.The interviews collected demographic information reasons for imprisonment and medical history including: STD, pregnancy, use of injecting drugs detailed sexual practices, knowledge on STD/AIDS. Blood samples were tested
for HIV 1, using specific Elisa and Western Blot; syphilis (VDRL/FTA-ABS); hepatitis (Hbsag),
Chlamydia (Elisa and Immunofluorescence), vaginal discharge was tested for gonorrhea (culture) and candidiasis (bacterioscopy and culture). All participants received pre and post test
counseling.
Results: Out of 57, 15 women (26%) tested positive for HIV I, 8 (14%) were positive for
syphilis, 3 (5.2%) were HbSag positive, I (1.75%) was positive for Chlamydia, I (1.75%) was
positive for HlPV and none of the subjects were positive for gonorrhea. Out of 57: 54.5%
were arrested due to drug dealing; 65% reported drug use and 28% reported injecting
drug use. 70% of subjects were single and 77% reported a steady partner. A total of 10%
reported use of condoms always; 21I.2% sometimes and 66% reported no use of condoms.
Conclusion: HIV and syphilis prevalence is high in this population. Surprisingly the prevalence of Chlamydia and gonorrhea is very low.The use of injecting drugs is high among
femnale inmates. Blood transmission of HIV1 seems to be relevant. Educational intervention
are urgently needed to protect this women and their sexual partners from further spread
of HIV
Elton Lopes Carvalho -SHS - Pga. Rui Barbosa, 23 - 4~ and. Santos - SP - Brazil Telephone:
55 3 233 3634
Tu.C.2624
PREVALENCE OF HIV INFECTIONS AMONG SEX WORKERS IN CAMEROON
Tamoufe 1U.*, Roctdy R.E.**, Ryan K.A.**, Zekeng L*. * Nonoxynol-9 Project Cameroon; **
Fhi/Usa
Objectives: To determine the prevelence of HIV among Sex Workers in Cameroon.
Methodology: Sex Workers (SW) in Douala and Yaounde were recruited and screened
between February and December 1995.To be eligible, women were required to: be
between the ages of 18 and 45, not be pregnant, live in eitherYaounde or Douala, have at
least 4 different sex partners per month, undergo pretest counselling, sign a consent form,
have an HIV test and be willing to learn the result.
Results: About 209 I SW were screened. 35 I (1I6.8%) of them were positive for HIV infection. 95% were positive for HIV- I, 0.2% were positive for HIV-2, and 4% were positive for
HIV I group 0.We found a prevalence of 17.7% in Yaounde and 15.2% in Douala. Overall,
50% of the women screened were between the ages of 18 and 24 with a mean age of
25.5 years. 55% had a middle school education, 55% had between I and 3 children. 97% of
then could read, 98% were not married, 92% had used a condom and all had heard of a
condom. 46% reported using a condom during their last sexual intercourse. 28% reported
hav:rng occupations in addition to sex work.This study shows that the important risk factors
for l-IV infection among SWs in Cameroon include higher age (greater than 20), low level
education (primary or less), length of time in Yaounde or Douala (less than I year), number
of children (4 or more), soliciting clients in the home, making less than I 2,000 CFA per
week, aid lsarvrsg no ether occupation.
Conclusion: This study does not confirm results from a previous seroprevalence study conducted in Yaounde (25%) and Douala (45%) among SW in 1992.The last research team
went into r small number of areas where known SW lived and conducted business. In our
study women f-om all parts ofYaounde and Douala were eligible.This prevalence may
thereirre reflect a wider representative prevalence among SW in Yaounde and Douala.
Tamoufe Ubald, NACP Cameroon. PO. Box 155 Yaounde Tel/Fax 22-67-19
Tu.C.2625
COMPARISON OF BASELINE CHARACTERISTICS OF INCARCERATED AND
NON-INCARCERATED HIV POSITIVE PATIENTS,TREATED AT THE CLINICAL
IMMUNIOLOGY CLINIC IN KINGSTON, ONTARIO, CANADA
Aissln,rss Ford, P. Zee, B., Ford, S.
Objective: To determine if there is a significant difference in several baseline characteristics
between snci eerated and non-incarcerated patients with HIV infection, treated at the
CIlfC iin finstcos Ontario.
Design: tV poive patients treated at the CIOC were studied retrospectively using chart
reviews. Incr eeated patients were compared to non-incarcerated patients with regards to

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Period of diagnosis
1982-1989
1990-1992
1993-1995

Rio de Janeiro City
185 (82.2%)
198 (69.5%)
202 (11.6%)

Metropolita
29 (2.9%)
62 (21.7%)
200 (41. i.,)

I, in cities
II (./%)
2:- (l8.8%)
84- (17.3%)

Conclusion:There has been a sharp increase in AIDS cases on t si frf-om inner
cities and metropolitan areas in relation to the City of Rio.This i-tsi o ct to ihigher vulnerability of that group to HIV infection.These results can be suse r,ra. n >rrationale for
determining priorities on behaviour changes programs.
K. Sanches, R. Jornalista Henrique Cordeiro, 310/1008 - BI-II Bari,i.i s iP.J. Brasil -
CEP 22631-450Telephone: [phone] Fax: [phone] e
Tu.C.2622
STD/AIDS PREVENTION AMONG FEMALE PROSTITUTES IN SAO PAULO STATE.
Silva, losefa, L*, Nakata,A.K*, Fiugueiredo, C.R.*, Andrade, L.F.** -
Reference and Training Center- STD/AIDS ** STD/AIDS Progra.
***Piracema Organization **** APTA. Sao Paulo- Brazil