Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

1118 Abstracts 60641-60646

12th World AIDS Conference

care plans, 4% were "self pay" (uninsured), 2% had ADAP and a hospitalization
plan, 2% had commercial indemnity plans, 1% had medicare and a commercial
plan. 56% of these patients had insurance problems requiring social work advocacy in 1997. 18% needed clinic charity to pay for medications during lapses in
coverage or inadequate coverage.
Lessons Learned: Recertifications for public plans, cost saving limitations
imposed by managed care, stricter qualifications for disability eligibility, the high
cost of indemnity plans and exclusions for "pre-existing" conditions create an
atmosphere of continuing stress for patients and wastes significant amounts of
time and energy of social workers. Patients and clinic staff would benefit from a
universal single payer system.
60641 HIV/AIDS/STD Epi Fact Sheets: a new tool for
surveillance in Latin America and the Caribbean (LAC)
Paloma Cuchi12, B. Schwartlinder3, K. Stanecki4, F. Zacarias5, L. Loures3. 1525
Twenty Third St NW Washington, DC 20037; 2UN Programme on HIV/AIDS
UNAIDS Washington, DC 20037; 4 US Bureau of the Census, Washington DC;
5Pan American Health Organization, Washington, DC, USA; 3UN Programme on
HIV/AIDS UNAIDS, Geneva, Switzerland
Objectives: To establish a systematic global method of collection, analysis and
dissemination of relevant HIV/AIDS/STD data, and to strengthen surveillance of
HIV/AIDS/STD in LAC.
Methods: Data were collected from 44 reporting countries and territories in the
Americas, using a standardized reporting form (Epi Fact Sheet) and secondary
sources. Active direct data collection was utilized when necessary. Information
was provided and validated by the countries. In addition to the collection and
analysis of reported AIDS cases, the Epi Fact Sheets included other key elements
such as social, behavioral and demographic information that influence the trends
of the HIV/AIDS/STD epidemic. The Epi Fact Sheets also integrate data on HIV
prevalence and other critical elements for the interpretation of the epidemic, such
as 1997 HIV estimates, STD estimates, and a subregional analysis, are part of
the new tool.
Results: Subregional Epi Fact Sheets (7) and Country Epi Fact Sheet (44)
have been developed and disseminated for global and country use. The elements
collected in the Epi Fact Sheets allow adequate interpretation and comparability
of HIV/AIDS data over time, within a country and across countries. Furthermore,
they provide information for national and global analysis of the trends and status
of the epidemic for better strategic planning.
Conclusions: The LAC Epi Fact Sheets are part of a global strategy and will
provide broader insights into the behavior of the epidemic in LAC and in the world.
606421 Epidemiology of HIV prevalence in the workplace
Alan Smith. Dpt. Virology, Univesity of Natal, Private Bag 7, Congella 4013,
South Africa
Objectives: (1) An anonymous unlinked study to determine the prevalence of
HIV in several industries for the purpose of projecting the economic impact of
the AIDS epidemic (2) To correlate the prevalence figures from females in this
study with seroprevalence figures from antenatal surveys. (3) To determine the
HIV prevalence in working male compared to STD clinic attenders and hospital
patients.
Methods: Saliva was used in preference to blood for ease of collection and
to assure workers of the anomity of the sample collection. The demographics
of the population sampled was examined in order to obtain an unbiased truly
respresentative sample.
Results: shown in graphical representation.
Conclusion: The methods used are applicable to large scale prevalence studies in schools and factories. The study illustrates the HIV prevalence in a sample
workforce. The data can be used to study the economic impact of the epidemic
and to measure the effects of intervention measures.
60643 | Setting up STD clinics specific for youths and
adolescents in developing countries
Eunice Nmari1, F.S. Mhalu1, D.S.M. Mwakagile2, J. James1, M. Lyaruu1,
G. Biberfeld3, E. Sandstrom4. Dar Es Salaam City Commission, MUCHS PDO.
Box 65001 Dar Es Salaam; 2Muhimbili Medical Centre, Dar Es Salaam,
Tanzania; 3lnfectious of Diseases Control, Stockholm; 4South Hospital and
Karolinska Institute, Stockholm, Sweden
Issue: Youths and adolescents are the most vulnerable age groups for acquisition
of STDs/HIV infection and yet most of those with symptomatic STDs fear to attend
STD clinics meant for all age groups including adults.
Project: Given the very high prevalence of symptomatic STDs among youths
and adolescents below 25 years of age in Dar es Salaam, it was decided to
establish a specialised youth reproductive health clinic beginning 8/9/1997 in the
premises of the Dar es Salaam Commission's general open STD clinic. The clinic

has been operating from 15.00 to 18.00 hours on week days and from 9.00 hours
to 12.00 noon on Saturdays while the general STD clinic runs from 8.00 hours
to 15.00 hours during week days only; thus ensuring privacy and relaxed and
congenial atmosphere for the youths. During afternoons and on Saturdays many
youths and adolescents are free from school or work. The youth clinic is being
run by one clinical officer, one nursing officer, one social worker (counsellor) and
one medical officer incharge.

Results: Between September 8th 1998 and December 5, 1997 out of 970 new
patients 802 males (82.7%) and 168 (17.3%) females who visited the clinic; 473
(48.8%) youths attended the youth clinic including 323 (68.1%) males and 151
(31.9%) females. Proportionately more female youths attended the youth clinic
compared with adult females who attended the general STD clinic. All of the
youths expressed satisfaction with the services offered to them by the clinic.
Lessons learned: Providing STD services for youths and adolescents separate from services for adults is attractive especially to female youths and could
provide a significant role in the reduction of STDs in youths in communities where
such services can be afforded.
606441 Sustaining responsiveness of (target audience) the
hard-to-reach grassroot community at the motor parks in
Nigeria to AIDS education: An 8-year experience
Pearl Nwashili, B. Nwabulo, J. Olabisi, O. Ogunbunfunmi, J. Onyebuenyi. Stop
AIDS Organisation, 95 Suit ESA&BTBS Box 5052 M.M. Airporti Kejalagos,
Nigeria
Background: Providing only HIV/AIDS issues in educational program is an overflogged and boring exercise to target groups over time. There is need to sustain
interest/responsiveness.
Methods: Through participatory involvement of target audience in planning
of project activities and Focus Group Studies (FGDs), the needs including local
endemic health problems of the community were highlighted. These issues were
thus addressed in the course of health education and community-based management services while opinion leaders such as the union officials and women
leaders were nominated and trained as Peer Educators. The Peer Educators
form Advisory Committees who assist in running the program using various approaches. Issues emanating from United Nations Conference in Cairo and Beijing
such as reproductive health and rights, female genital mutilation and other health
problems as they relate to AIDS are integrated into the program.
Result: Enthusiasm run high as topical issues included in the training module
generate interest. Peer Educators along with the rest of the target audience are
thus motivated and empowered to put new knowledge into action, and even help
in creating new initiatives.
Conclusion: The tendency to overlook the response of the target population to
AIDS/STDs education becomes very rampant even when surveys show some significant changes within the community. Modification of approaches which involves
integrating other relevant issues into the program has proved very successful
keeping both target audience and health educators on their toes.
60645 1 Education of students at the Cameroonian University on
the prevention of STDS/AIDS: 4 years of experience and
lessons learned
Wafo Ida Mefoualo. University of Douala, BP155, Yaounde, Cameroon
Context: Students' population was estimated in 1993 to be 45 000 yongs 30%
femele and 70% males, all bachelors with a high rate of sexual activities. In
other words available heath statistics classity STDS on the Ist range of infactions
needing consultations in our universities.
Objective: Reduce the propapation of STDS/AIDS in this target population by
reduring risky behaviours, prachices.
Methods: Training of peer Educators, production and distribution of IEC material sales of condoms, bearing the responsibility of students with STD; creation of
STD/AIDS Information and documentation centres.
Results: (04 years) 278 students peer educators trained
- 3621 educative dialogues on AIDS held.
- 55788 students sensitized
- High frequency of social medical centers
- Very low STD cases, daring consultations in the University dispensaries in
Cameroon.
The necessity of associating students in all activities was raised, forsce the
motivation of peer educators and their org. in club associations, for their better
mobilisation in the control of AIDS and a perrinisation of activities.
60646 | Influence of HHV-8 infection on the course of HIV disease
Peter Low1, F. Neipel2, A. Rascu1, M. Raab2, J.R. Kalden3, B. Fleckenstein2
T. Harrer1. 'Department of Medicine III D-91054 Erlangen; 2lnstitute of Clinical
Virology D-91054 Erlangen; 3 Institute of Clinical Rheumatology, Medicine III
D-91054 Erlangen, Germany
Objectives: To analyze the seroprevalence of human herpes virus 8 (HHV-8) in
various risk groups of HIV-infected patients and to study potential influences of
HHV-8 infection on the course of HIV-infection.
Methods: Using a newly developed Western Blot against the glycoprotein K8.1,
sera of 167 HIV infected patients (125 male, 42 female), collected in Germany
between 1995 and 1997, were tested for prevalence of antibodies against HHV-8.

Risk factors for HIV infection were homosexual contacts (n = 92), heterosexual
contacts (n = 50), IV drug abuse (n = 20) and exposure to contaminated blood
products (n = 5).
Results: Antibodies against HHV-8 could be detected in 35 patients (21%,
25 males, 6 females). 25 of them were homosexual men, 4 heterosexual men
and 6 heterosexual women. In 6 patients Kaposi sarcoma could be diagnosed.
All drug users and all individuals infected by blood products were negative for