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

Track C: Epidemiology and Public Health
Results: From the total number of 2,780 subject tested, none of them were positive for
HIV antibodies while I18 (0.65%) were confirmed positive for Syphilis.
Conclusion: The practice of risk behavior indicates that future preventionI r qlcires greater
engagement of health services.
Major Alberto I Gabriel, MD DTM & H, AFP Med Ctc\/. Luna Road. Qureor ily Phils.
Tu.C.2683
ADULT/CHILD SEXUAL EXPERIENCES REPORTED BY TERTIARY LEVEL STUDENTS
IN ZAMBIA.
Haworth A*, Mataka Elizabeth N**, Muzizi L*, Poulter C**. *Urivervty f Zarbia; **Family
Health Trust, Lusaka
Object: To determine the nature and extent of childhood sexual experiences and particularly contacts between adults and children in the context of preetion i ansmission of
HIV.
Method: Questionnaires for anonymous completion and focus group discussions.
Data: Of the 969 students completing the questionnaire (628 nmen and 341 women), 20%
reported that they were invited or forced to "play" sex as a child - 25.6% of the men and
17.2% of the women.Thirty percent of those who first learnt about sex before age 14
reported acquiring this information practically Incidents were classified into four categories:;
same age children's experiment (I 8.3%), willing participation adult/child (2 I.5%), complaint
of adult/child activity by force/abuse/rape (8%); 28.6% gave insufficient information. Only 2
unequivocal cases of same-sex activity were reported; 5.6% of men and 4.9% women
reported ever having engaged in same-sex activity in the total samplc. Boys tended to be
induced into sexual behaviour by considerably older cousions, aunts, neighbours and house
servants.Two males reported having been accosted and forced to engage in sex by groups
of much older girls who dragged them into a field.
Conclusion: The occurrence of sexual assaults on boys by older women has not been previously reported in Zambia and needs further study Older men have been reported to
seek school-girls as "safe" sexual partners; the implications of adult/child sexual contacts in
the light of a high prevalence of HIV infection are discussed.
Mrs. E.N. Matalka, Family Health Trust Private Bag E243, Lusaka, Zamnbia Telephione 260- I
222589 Fax [phone]
Tu.C.2684
HIV AND SYPHILIS INFECTIONS IN FEMALE PROSTITUTES BETWEEN 1988 AND
1995 IN KINSHASA, ZAIRE.
Nzila, Nzilambi, Malele B, Kivuvu M,Tuliza M, Edidi B. Projet SIDA. BP 8502 Kinshasa I, Zaire.
Objective:To monitor trends of HIV and syphilis infections in female proslitutes in Kinshasa,
Zaire.
Methods:In 1988. 1226 prostitutes enrolled in a cross-sectional survey were tested for HIV
(EIA Vironostiki -i Wellcozyme) and for syphilis (RPR + TPHA).The saie study was
repeated in 1994 and in i1995 with 998 and 60 1 new prostitutes. respectively
Results:
1988 1994 1995

Tu.C.2683 - Tu.C.2688
Tu.C.2686
CIRCUMSTANCES IN MALES AND HIV TRANSMISSION
Kullkarni Ulhas*, Saple Dattatray**
Colorectal surgeon, Bombay; **G.T Hospital, Bombay
Aim: To assess the usefulness of circumcision in males as a method of reducing HIV transmission.
Method: Over last six years, I 839 male patients suspected of having HIV infection, referred
to our tenters for detection or confirmation were examined.Their HIV status was confirmed by Elisa.They were also examined for STDOs dermatological and systemic manifestations and whether circumcised or non -circumcised.
Results: Of I 839 patients, 224 were circumcised and I 6 I 5 were non-circumcised. Of I 6 I 5
of non-cicurncised cases, 1934 were HIV positive; 81.36%, compared to of 224 circunmcised,
96 were HIV positive 42.8%. History of multiple exposure was positive in 96% of the cases.
Majority of the patients were low socio economic group, staying away from families for variable length of time. 20 to 40 years was the main age group.
Conclusion: Incidence of HIV positive is almost 50% or less in circumcised than in non-circumncised. In high risk groups, circumcision should be considered as a method of reducing
risk of HIV infection in addition to other methods.
Dr Kulkarni Ulihas, 576B, Jam-e-Jamshed Road, Matunga (East), Bombay-400 019, India.Tel.:
9 I 22 -4 14-0726; Fax. [phone]
Tu.C.2687
HIV INFECTION AND ASSOCIATED RISK FACTORS AMONG FOREIGNERS IN
ITALY: DATA FROM STD CLINICS
SluhgoitBarata*, Giuliani M*, Camisa D, Innocenti M, Nunzi E, Priano L, Geraci S, Capitanio
B, Afli-onti M, Arico M, Menegatti M, D'Antuono A. *Istituto Superiore di Sanita - Rome; the
Migration Medicine Study Group, Italy
Objectives: To determine the proportion of HIV--positive persons among foreigners with
STDs, and to analyze risk factors associated with HIV infection.
Methods: A total of 3,005 foreigners with an acute STD were tested for HIV antibodies in
five Italian STD clinics, between January 199 I and June 1995. Standardized STD case definitions were used by all the STD clinics.The distribution by area of origin was: 1,643 from
Af ica, 708 fiom other European countries, 404 from Central-South America, 197 from
Asia, and 39 from North America.
Results: 1he overall HIV prevalence was 5.0%, though it widely varied by continent of origin: 15.4% amnong North Americans, 13.6% among Central-South Americans, 4.4% among
Europeans, 3.3% among Africans, and 1.0% among Asians.The annual proportion of HIVpositive persons decreased among all nationalities except for Central-South Americans who
showed an increase from 8.6% in 1994 to 17.9% in 1995.
HIV-positivity was not associated with gender or age. Risk factors positively associated with
HIV infection were: presence of ulcerative STDs (OR 2.8), having had more than three
partners in the last six months (OR = 3.4), previous STDs (OR = 3.1), homosexuality (OR
= 9.2), and previous or current use of intravenous drugs (OR = 13.5). An analysis by continent of origin and exposure category showed the highest HIV positivity rate among Irooo
sexuals originating fr-om Central-South America (43.8% seropositive individuals).
Conclusions: Although most foreign STD patients in Italy come from Afica or from other
European countries, these persons seem less likely to be HIV+ compared to American
patients.The high prevalence among homosexuals coming ftiomn Central South America, a
phenomenon which may not be limited to Italy stresses the need to offer an HIV testing to
persons coming f-om these areas, together with thorough pre- and post-test counseling.
especially when an acute STD has been diagnosed.
Barbara Suligoi, Istituto Superiore di Sanit,Viale Regina Elena 299, 00161 Roma, Italy
tel:(39) (6) 4990 2337; fax (39) (6) 4456 74 I; e-mail: SULIGOI @ ISS.IT
Tu.C.2688
HIV- I INFECTION AND CEFETAMET-PIVOXIL USE AMONG ANTENATAL CLINIC
ATTENDERS IN NAIROBI, KENYA.
Gichangi,Peter B*, Ndinya-Achola J*, Haller L**, Bwayo J*, Ombete J*, Plumrnmer F*,
Nagelkerke N*,Temmerman M.**"*. *University of Nairobi, Kenya, **Roche Aft-ica Foundation, Cote D'ivoire, ***University of Ghent, Belgium.
Objectives: I.To determine the HIV-I and syphilis seroprevalence rates postnatally 2.To
determine endocervical N. gonorrhoea isolation postnatally 3.To determnine incidence of
upper genital tract infection(UGTI). 4.To deterrmine the usefulness of cefetamet-pivoxil
administration antenatally to improve the pregrnancy outcome.
Methods: A total of 320 patients who had a previous history of bad obstetrical
outcome(BOH) we recruited in an intervention study 160 were randomized into cefetamet-pivoxil intervention, dose of 2grams stat and I 60 received placebo between 28 and
32 weeks gestation. Patients were followed for pregnancy outcome, HIV and syphilis serology and gonordhoea isolation.
Results: 257 patients mainly flom low socio-economic status delivered and 210 were seen
postnatally HIV I seroprevalence was 18. I%, syphilis was 9.5% and gonorrhoea isolation
rate was 9.3%. HIV- I infection was significantly associated with: BOH defined as premature,
stillbirth, or low birth weight deliveries (OR 2.69, 95% CI I.20-6.02, p=0.0I 3), and gonorrhoea isolation (OR 3.25, 95% CI I.05-9.9 I,p0.039). Antenatal administration of cefetamet-pivoxil significantly reduces gonorrhoea isolation (OR 0.32, 95% CI 0.09-0.98,
p=0.048); BOH (OR 0.5, 95% CI 0.27-0.94,p0.03 I) and UGTI (OR 0.45, 95% CI 0.22 -0.94, p0.030). Logistic regression analysis showed cefetamet-pivoxil to be reducing BOH
b reducing gonorrhoea infection.These results show a high prevalence of HIV-I and
uyphilis infection.They also suggest that cefetamet-pivoxil is useful in reducing gonorrhoea
infection snd improving pregnancy outcome.
Conclusions: HIV- I infection is significantly associated with BOH and gonorhoea infection
which is a risk factor for BOH. Use of cefetamet-pivoxil among antenatal women with a
high prevalene of gonorrhoea is useful in reducing gonorrhoea infection and therefore
BOH Control teasures to reduce the raising rates of HIV and other STDS are needed.

r)t: Peter B. Gichangi, Medical Microbiology University Of Nairobi PO. Box 19676, Nairobi,
Telephone No. 254-0 I 61-3027 I

Numler
I -IV (+) %
Active syphilis %
Latent syphilis %
Condom use reguilarly %
Reported transfusions

1226
35.0
16.0
28.6
12
12.5

998
34.8
3.2
11.0
64.8
7.4

601
30.3
3.1
12.1
660
7.0

O\
0
)
U
c
0
v)
C
a0
N
c:
0
U
no
c
a)
c
x.

Conclusions: Decreased syphilis infection, probably due to increased condom use and penicillin trealment (many times self-prescribed), may have contributed to the stabilization of
HIV infection in prostitutes in Zaire.
fDr Nzila N. C/o Mc Jan Vielfont; Institute ofTropical Medicine; B-2000 Antwerp I; Belgium
Tel: [phone]I Fax: [phone]
Tu.C.2685
SECRETORY LEUKOCYTE PROTEASE INHIBITOR (SLPI) IN CERVICOVAGINAL
SECRETIONS FROM HIV-NEGATIVE AND HIV- POSITIVE WOMEN
Belec Laurent Tevi-Benissan Carol, Matta Mathieu, All Si Mohamed. Laboratoire de
Virologie, h6pital Broussais, Paris, France.
Background. In saliva, leukocyte protease inhibitor (SLPI) has antiretroviral power and may
contribute to the important antiviral activity of saliva associated with the infrequent oral
transmission of HIV- I [McNeely et al., J Clin Invest 1995;96:456-64]. 5 PI could also contribute to decrease the infectivity of other body fluids, such as the cevicivaginal secretions.
Objectives. To evaluate the cervicovaginal concentrations of SLPI in normal and pathological
situations.
Methods. Cervicovaginal secretions (CVS) firot i5 iealthy HIV negative women without
genital symptoms, 27 HIV I-infected, non AIDS w osen, and 26 HIV -negative wonmen with
vaginosis were evaluated for SLPI by ELISA (R & D Systems, Minneapolis, USA). SPI was
also measured in the saliva from the healthy HIV-negative women.
Results. SLPI was generally detected at significant levels in all tested body fluids: () The cervicovaginal concentrations [mean~standard error] were significantly higher in healthy HIVnegative women [8760~+850 ng/ml] than in HIV-infected women [5760~1 II 160 ng/ml]
(p<0.03) and than in women with vaginosis [2430~535 ng/ml] (p<-0.001 ); cervicovaginal
concentrations of SLPI were also significantly higher in HIV-infected women than in women
with vaginosis (p<O.04); (ii) In healthy HIV-negative women, SLPI levels in sahliva [mean:
1650 ng/ml] were 5-10 fold less elevated than those in paired cervicovaginaii secretions.
Conclusions. (i) Cervicovaginal SLPI could contribute to decreae the tnfectivity of cervicovaginal secretions in HIV-infected women, and the susceptibility to H-/ in till -negative
women; (ii) Women with vaginosis could be at increased risk for IflV transmission (infectivity as well as susceptibility), in part because of decreased levels of c:ervickovaginal SLPI.
Dr Belec Laurent Laboratoire de \/irologie H6pital Broussais 96 ruse idot 7567 t Paris,
Cedex 14 France Fax: [phone]

382