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

Track C: Epidemiology and Public Health
perinatal transmission 10.5%. Compared to non-Aboriginals, Aboriginal AIDS cases are
younger (30% vs 19% diagnosed at <30 years of age) and are more likely to be IDU (6.5%
vs 2.4% for men, 37% vs 12% for women).When compared with American AIDS data on
Indian/Alaska Natives, Canadian data show a lower proportion of IDU in both men (6% vs
13%) and women (37% vs 49%). Seroprevalence studies among high risk Aboriginals in
Canada indicate prevalence rates up to 8%, a rate similar to high-risk non Aboriginals.
Conclusions: In Canada, the HIV epidemic in Aboriginal people is still poorly understood.
Few studies have been done specifically in Aboriginal populations or in mixed populations
where Aboriginals can be identified. A significant proportion of AIDS cases are reported
without ethnic status. Evidence suggests that Aboriginals are infected earlier than nonAboriginals and that IDU is the most important mode of transmission among Aboriginal
women. Better data on HIV/AIDS epidemiology in Aboriginals in Canada are needed to
guide future prevention strategies.
Mai Nguyen, Research Analyst, Postal Locator 0202A,Tunneys Pasture, Ottawa, Ontario, KIA
0L2 Canada,Telephone: [phone] Fax: [phone]
Tu.C.263 I
BORDER-CROSSING SOCIAL WORK ACTIVITIES ON THE GERMAN-CZECH
BORDERS
ledlicka Jaroslav *,Trmal J. *, HubAckov4V. *,Vytlacil J. *, Leopold B. **, Steffan E.**,
Heckmann W **, Kraus M.. * working group on border issues, Czech Republic, ** SPI,
Berlin, F. R. Germany
Issue: "Opening doors" for prostitution in the Central and Eastern Europe has followed
shortly after deep societal changes in this region in 1989.
Project: Border-crossing social work project in the border area between Saxony (Federal
Republic of Germany, F.R.G.) and North//estern Bohemia (Czech Republic) has been
launched in 1993.The project is sponsored by various international, German and Czech
authorities and coordinated by the Social Pedagogical Institute in Berlin.Three bilingual border-crossing social teams are currently operating in this area, addressing female commercial
sex workers (FCSWs), clients, pimps, persons using narcotics and surrounding community
One of the teams is using mobile ambulance unit offering free of charge gynaecolocical and
STDs/HIV examinations. All teams perform counselling, distribute condoms, lubricants and
various preventive materials (brochures, leaflets, project newsletter etc.), provide sterile
inlecting equipment, if necessary, and offer various social services.
Results/Lessons Learned: Thousands of women offering sexual services in this area have
been addressed so far with the aim to improve their knowledge and skills in individual protection against STDs/HIV and to induce appropriate behavioural changes. Personal dependance on pimps and "overpay" by Western clients are the major reasons for continuing
unsafe sex practices among FCSWs originating from different countries of Central/Eastern
Europe (mainly Czech Republic, Slovakia, Romania, Bulgaria and different countries of the
former Soviet Union).
Jaroslav JEDLICKA, M.D., National Institute of Public Health, Srobarova 48, 100 42 Prague
10, CZECH REP
Tu.C.2632
HIV TESTING, PREVALENCE,AND RISK BEHAVIORS AMONG PRISONERS
INCARCERATED IN SOUTH-EASTERN FRANCE
Rotily M..-2,Vernay-Vaisse C.3, Messiah A. 2. I South-Eastern France Regional Center for
Disease Control, Marseille, France; 2 Inserm U 379, Marseille, France; 3
Direction of Social and Health Affairs, General Council, Marseille France.
Objective:To describe HIV testing, prevalence, and risk behaviors among prisoners incarcerated in south-eastern France.
Method:This was a consecutive convenience sample of 3727 prisoners who visited the
Center for Free and Anonymous HIV Screening (CIDAG) in the Marseille prison system
between January 1994 and May 1995. HIV screening is proposed to all inmates entering the
prison system. Data was collected via face-to-face standardized interview with a physician.
Results: HIV testing and prevalence: In this sample, 43% of prisoners accepted CIDAG
HIV-testing (na 1589), and 4% were already aware of their HIV seropositivity (n156).Thus,
the known HIV seroprevalence rate was 12.7% (222/1745). Of the 222 seropositive prisoners, 70% (n= 156) knew their HIV+ serostatus before entry; 18% (n-40) knew their HIV+
serostatus and tested again; 1I2% (n=26) did not know their HIV+ serostatus before testing.
On the whole, 19% of subjects reported injecting drugs during the last twelve months.The
HIV seroprevalence rate among IDU prisoners who tested was 42. 1% (19 1/454).
HIV risk behaviors: 40% of subjects reported multiple sexual partners during the last
twelve months. Among prisoners reporting multiple partners, 42% never used a condom.
Among prisoners reporting IDU, 22% reported sharing their syringe, and 34% sharing their
spoon during the previous year. Approximately one third of all inmates who attended the
CIDAG had been incarcerated previously.
Conclusion:This study shows a high prevalence of HIV infection aisorig south-eastern
French inmates, as well as a high prevalence of risky sexual and drug use behaviors.These
results necessitate not only continued availability of HIV testing to prisoners, hut also the
implementation of education and risk reduction programs. Continuous data collection in
prisons is not only feasible, but represents an efficient way to survey HIV prevalence and
risk behaviors among fringe populations, especially injection drug users.
Antoine Messiah, INSERM Unit6 379, Inistitut Paoli Calmettes, Boulevaid Sainte Marguerite.
13009 Mlarseille - France T(dl(phone: [phone] / Fax: [phone]
Tu.C.2633
HIV/HCV RISK OF TRANSMISSION IN CHILDREN LIVING IN A BOARDING
SCHOOL WITH CO-INFECTED HAEMOPHILIACS
A.M. Berthier I-_,B. Coatmelec I, A. Ruffault 2,. Fonlupt I, M. Pommoreuil 2, I Centre de
Traitement de I'H6mophilie Rey-Leroux La Bouexi6re 2 CHR Rennes 35 France
A previous study conducted in children living in a boarding school with inultilcanisfused
haemophiliacs, demonstrated the absence of horizontal HIV transmission but in contrast

HBV contamination in 20% (Lancet 13 Sept. 1986).These data and contradictory reports
from the litterature led us to evaluate, in addition, the risk of HCV contamination, in children living in this institution,(in close contact) with HIV/HCV co-infected haemophiliacs (as
compared to prevalence for other viruses).

Tu.C.263 I - Tu.C.2636
Patients: 22 haernoph. and 114 never transfused (NT) children (x - 12y. Average lenght of
stay at the school: 37 months)
Results: Absence of HIV transmission in the 62 NT children tested. HCV Ab. detected in
21/22 haemophiliacs whereas all NT children remain negative. HBV markers only in
haemoph. (in 8/22; 14 vaccinated). HAV Ab. in 10/22 haemoph. (14 vaccinated) and only in
2/44 NT children. Finally very high prevalence for PV B19 Ab. in haemoph. (95% vs 39% in
controls).

NT(I st gen. HCV Ab. test) n- 62 HIV tICV HBV
( AT Children 0% 0%
(3d gen. HCV Ab. test) n=-52
0%z 0%o

tiBC Ab HAV PV BI9
0% 4.5% 39%
27% 45% 95%

Hacmophdiacs n22

40% 95% 369

Conclusion: These results confirm the absence of HIV seroconversion and show HCV
seronegativity in these children living in close contact with infected haermophiliacs.Thus
these data provide good arguments for a very low HIV/H-CV transmissibility Moreover the
high prevalence for PV B19 in haemophliacs,points out the residual risk for non-enveloped
viruses in blood products.
A. Berthier, Centre Regional dei-Traitement de I'Hemophilie Rey-Leroux 35340 L a
Bouexiere France.Tel: [phone], Fax: [phone]
Tu.C.2634
HOTELS - BARS AND STD/AIDS AT KM.36 (REPUBLIC OF GUINEA)
SanoMohamed*, Diane I*, Conde S.*, Camara D*, Dr Kouyate M*, Dr Lamarque Jp. *
Sidalerte Guinee, *-* Eec Delegation
I) Introduction: The crossroad called "Kilomtre 36" is a "chneck point" for all traffic entering
and leaving the capital city of Conakry, Guinea. All trucks entering are stopped for the night
after 7 PM: consequently, there is a large number of potential clients for female commercial
sex workers (CSW).This location has countless places for meetings and chance encounters:
outdoor restaurants, bars of all sorts, rooms for rent, hotels, huts for rent, etc.
2) Objectives:-3o promote peer education among the CSWs to promote safe sex practices
as well as to offer diagnostic and treatments for STDs.
3) Methods: a) To identify all the possible meeting sites; b) to do a KAP (Knowledge,
Aptitudes, Practices) study among the owners/managers of those meeting sites and among
the CSsAis so as to find appropriate AIDS prevention messages; c) to train opinion leaders
in IEC regarding HIV/AIDS & STDs prevention, to establish a system of care nmanagement
for the CSWs.
4) Preliminary results: From a representative sample of CSWs, 78 participated from ten
sites (I 8 meeting sites were identified), the following problems were frequently identified:
- economic constraints (lack of social support, poverty..) - necessity of care management for
STDs - inferior status of women, - client's or CSW's refuisal or reluctance to accept condoms (lack of pleasure, fear to lose clients..) - absence of IEC campaigns tailored to the
needs of CSWs. A central selling point for condoms (in large quantities) was installed in the
offices of SIDALERTE at KM 36, with a financial grant from the EEC delegation, to service
the local bars, hotels and meeting sites.
5) Conclusion: Peer education seems best for this priority target group. After an evaluation,
we expect to spread this action to other sites in the city of Conakry as well as inland.
Serological studies would be useful to evaluate prevalence rates and the effect of the
actions.
M. Mohamed Sano, SIDALERTE Guinea, BP 25 39, Conakry Rep. of Guinea.Tel/fax
224443040
Tu.C.2635
FOURYEARS' EXPERIENCES OF THE AIDS OUTREACH PROGRAM FOR
SEXWORKERS IN BUDAPEST
Bolvary K,Viczi M. National Institute for Health Promotion, Budapest, Hungary
Objective: The enlightement of the marginal layers of prostitutes in the capital, with regard
to illnesses spread through sex, with particular emphasis on the transmission of HIV, the
dangers and health hazards following their style of life, and the possibilities and methods of
prevention.
Methods: I. Only these street workers can reach the endangered persons fioin the aspects
of AIDS, who belonged to this layer and are appropriately prepared.The future street workers have been looked for and found in shelters for the homeless, juvenile institutes and family core centres.
2. So far we ran six courses of education, each of a duration of six weeks. In 1992, altogether nine and in 1995 twenty-one of our street workeis were active after being instructed in
AIDS prevention in our Institute.
3. In order to evaluate the work of the street workers we applied the worksheet used by
the Cardift stieet workers.
Results: The estimated numbers of those occasions when streetworkers meet with the target group was as follows: 5,290 in 1992, 7,493 in 1993 and 13,646 in 1994. In two-thirds of
the meetings, the street workers handed out condoms. Rates of respondens who use condoms were 23.7 % in 1992, 35 6 in 1993, 37.2 C in 1994 (data from 1995 under evaluation). Distribution of the use of condom show significant differences by age.
Conclusions: The monitoring of the work in the 1992-1995 years indicated that the outreach activity of the street workers not only reached the marginal prostitute layerK. Bolvary 82. Andrassy ut, 1062 Budapest, Hungary-Telephone (36-1)-1I 12-2694 Fax: (36-I)13 1-6 26
Tu.C.2636
SOCIO ECONOMIC STATUS OF TRUCKERS, IN WEST BENGAL INDIA.
Islam Amirul, Misra K,Verma K, Dey A, Rao A. (Bhoruka Public Welfare Trust)
Objective: To understand the socio economic characteristics of truck drivers and helpers.
Methodology: Data was collected from 500 truck drivers and helpers fronn offices of clearing agents dhabas, parking area and clinic at iUiuberia checkpost in West Bengal. Sonne
group discussions were also conducted to elicit more information besides focuis group discussions.

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