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

1166 Abstracts 60903-60908

12th World AIDS Conference

(iv) Three cases of teenage pregnancies who work VDRL positive were diagnosed (blood testing normally not done, because syndromic management is
followed).
Conclusion: These results might be showing just "The tip of the ice-berg".
High prevalence of STD's makes street children highly suceptible group to HIV
infection. There is an urgent need for more clinics and intervention programmes
for them.
[60903 Study on sexuality, STD/AIDS and drug use in female HIV
infected prisoners of Rio de Janeiro, Brazil
Helio R.A. Nattos, E.J. Biondi, L.P. Veiga, J.L. Fialho, S.A. Castro, Jr.,
P.G. Bauer, D.A. Freitas. Superintenddncia de Saude, Desipe-Sejint, Rua
Senador Dantas 15 90 Andar, 20031-201 Centro, Rio de Janeiro, Brasil
Objectives: To know the behavior of female seropositive inmates with regard to
sexuality, STDs and drugs.
Methods: A specific questionnaire was administered by health care professionals to HIV positive inmates of three female prison units and a penal hospital.
Female inmates were interviewed face-to-face individually, about risk behavior.
Anonymous questionnaires were used to improve fidelity of the answers.
Results: The studied cases represent 95% (19/20) of all known seropositive
women inmates. The results revealed that 80% knew of their seropositive status
in prison. 67% thought that they acquired the infection by sex with their stable
partner, 13% by occasional partners, 7% by shared iv drug use and 13% by
blood transfusion. Sexuality: 73% declared to be heterosexual, 27% bisexual and
all mentioned not engaging in intimate visit, prefering to stay sexually abstinent.
67% had a history of STDs, mainly sifilis (64%). 67% never used condoms during sex. Drug use: all interviewed women consumed some kind of illegal drug.
Cocaine was inhaled by all. 17% injected the drug, 7% shared syringes. 67%
were imprisoned due to crimes related to purchase of illegal drugs, 56% for drug
dealing.
Conclusions: Necessary interventions on these women should focus on their
refusal to engage in sexual activity due to the HIV transmission by their partners,
improve their consom use and reduce cocaine consumption, especially the unsafe
one.
S60904 European Network Male Prostitution (ENMP)
Katrin Schiffer. Javastraat 52 III 1094 HJ Amsterdam, The Netherlands
Issue: To develop a network of organizations in the Member States of the European Union and East Europe that work in the field of HIV/STD-prevention for
male sex-workers.
Project: The network, which is financed for two years by the European Commission exists in the first year of organizations from Germany, Belgium, Denmark,
United Kingdom, Austria, Rumania and the Netherlands. In the second year the
network will invite organizations from other countries.
The concrete aims of the ENMP-project are:
* To develop a European Resource book with information about the different
organizations and their aims and services for the target group, as well an analysis of the social, juridical and medical situation in these countries regarding
male-prostitution and homosexuality.
* To develop a Travel Guide with reference addresses for male sex-workers.
* To facilitate the repatriation of migrant male sex-workers to the country of
origin.
* To exchange experience and knowledge concerning strategies and methods
of HIV/STD-prevention and to stimulate mutual support through bilateral visits.
Results: The ENMP-project is financed till September '99. The first meeting
of the network took place in September '97. The participants worked very intensively at the development of the Resource book and the Travel Guide. Besides,
the developments in the different countries were discussed. The exchange of
experience and knowledge will stimulate HIV/STD-prevention activities in each
country. At the end of 1999 the network will be able to present the final results of
this project.
Conclusions: The increasing number of migrant male sex-workers (most of
them come from East Europe), who travel around in Europe makes it more
and more necessary for the different organizations to exchange experience with
other countries. Different HIV/STD-prevention strategies and methods have to be
developed. The exchange on international level can stimulate new activities.
|60905 Condom intervention as a behavioural preventive
strategy for HIV/AIDS transmission between men and
women
Lugonvu Alice Kiwanuka1, P. Gitta2, J. Nabalonzi3. 1RO. Box 22167 Kampala;
2Mulago Hospital P.O. Box 7051; 3Joint Clinical Research Centre Box 10005,
Uganda
Issue: Uganda many couples living together as steady partners do not use con
doms. One would rather practice preventive behaviour with a non stable partner,
whom they consider risky. In sero discordant couples there is a significant risk of
HIV transmission to the HIV negative partner.
Project: Given the fact that some couples were found HIV sero discordant;
an intervention to asses the use of male condoms was embarked upon. Five
sero-discordant couples were enrolled in the study 1997 January - 1997 December. Among these couples, two of the men were HIV sero negative, while

their partners were HIV sero positive. Three of the men were HIV sero positive
while their women were HIV sero negative. These couples received HIV/AIDS
counselling first, especially on preventive behaviour and had to consent before
joining the study. The index partner had to be confirmed sero positive then the
non index partner would be tested. If found HIV negative, they would be enrolled
as a couple. There was sex education accompanied by male condom distribution,
and counselling on preventive behaviour. After a follow up period of one year, the
sero status remained unchanged for all partners.
Results: Male condom intervention was well received as a preventive strategy
by the three couples where the men were HIV sero positive; since the women
were submissive. The two couples where the male were HIV sero negative
stopped having sex. One of the couples separated bedrooms while another had
occassional fights which died off with repeated counselling. There was male
dominance
Lessons learned: Women stand a higher risk of HIV transmission from their
infected partners due to the cultural and social economic enequities that deprive
them of the power to control their sex lives. Women need to be empowered
to be more self reliant especially economically, and to be educated on their
human rights. Women need a preventive strategy for which they can have control
themselves.
60906J Assessment of services for the treatment and prevention
of sexually transmitted diseases among Nigerian
adolescents
Valentine O. Otoide, F.E. Okonofua. Women's Health & Action Research Center,
4 Alofoje Street, Benin City, EDO State, Nigeria
Sexually transmitted diseases increase the risk of acquiring HIV/AIDS infection.
One approach to prevention of HIV/AIDS infection has been the effective treatment and prevention of STDs. In Nigeria, STD services are provided by both
the formal and informal health services. To date however, the quality and nature
of these services has not been properly evaluated. This study was designed
to investigate the quality of services for the treatment and prevention of STDs
among adolescents in Benin City (Nigeria). In depth confidential interviews were
conducted with private doctors, public doctors, traditional healers, pharmacists,
patent medicine dealers, nurses and laboratory technologists who were identified
by key informants as being the primary providers of STD treatment in the City.
Their facilities were also visited by a team comprising an obstetrician and gynaecologist and a pharmacist to assess the quality they provide for STD treatment
and prevention. The result showed inadequate knowledge of the appropriate
treatment and prevention methods on the part of informal sector providers (traditional healers, patent medicine healers and pharmacists). By contrast, the forma
sector providers (private and public doctors, laboratory technologists and nurses),
although they had appropriate knowledge, lacked management guidelines and
were poorly oriented to the problem of STDs among adolescents. In both the
formal and informal sectors, there was evidence of inadequate counselling of adolescents, poor attitude to promotion of condom use in adolescents and inadequate
use of referral opportunities.
We conclude that comprehensive public health measures are needed to address these issues. These include the provision of reproductive health education
for adolescents, the training and re-training of health providers in the formal and
informal sectors and the integration of services for the prevention and treatment
of STDs in adolescents.
S60907 Chemoprophylaxis for TB in HIV/AIDS, Mumbai
Swati Desai1.2, D.G. Saple3, J.K. Maniar3. 1302, Navin Asha, 126-D, Phalke
Road, Dadar, Mumai-400 014; 2AIDS Clinic, G.T. Hospital, Mumbai; 3Hon. Prof.,
STD & AIDS Dept. G.T. Hospital, Mumbai, India
Aim: To study the effect of chemoprophylaxis for Tb in seropositive patients on
the basis of Mantoux reactions.
Methods: Asymptomatic seropositive patients attending the AIDS clinic at G.T.
Hosptital, Mumbai were investigated in detail for active foci of Tb. 58 Patients
who showed a negative Mantoux reaction were advised chemoprophylaxis for
6 months with 2 drugs (INH & RMP) while 42 patients who showed a positive
Mantoux reaction were not advised any treatment. Both groups were followed-up
for 2 years.
Observation: Of those who were on chemoprophylaxis 7.3% developed Tb.
While of those who were not advised chemoprophylaxis 68.4% develop Tb. 92.7%
of those who were on chemoprophylaxis remain protected from Tb for 2 years.
Chemoprophylaxis for Tb is protective. 2. All patients irrespective of Mantoux
reaction should be given chemoprophylaxis.
60908 The association of epidemiologic risk factors and HIV-1
subtype in recent military seroconverters
Brodine Stephanie1, Richard A. Shaffer2, M.J. Starkey2, J.L. Gilcrest2,
F.E. McCutchen3, S.A. Tasker2, T.C. Vancott3, J.R. Mascola4. 1751 Rosecrans

San Diego California; Naval Health Research Center San Diego CA; 2Henry M.
Jackson Foundation, Rockville MD; 3 Walter Reed Army Institute of Research
Rockville MD, USA
An ongoing prospective study has been initiated to describe the distribution of
HIV-1 subtypes and associated risk factors in recent military seroconverters.
Participants are US military personnel with a first HIV seropositive within the past