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

144 Abstracts 13290-13295

12th World AIDS Conference

39 (32%) had a positive syphilis serology. Among the HIV seronegatives (n =
734), 260 (35.4%) were HBV positive and 121 (16.5%) had syphilis.
Conclusion: A high prevalence of STDs was diagnosed in both in HIV seropositiveand seronegative individuals. Follow-up of the latter will help clarify the
relationship between STDs and incident HIV infection.
(Grant Support FHI 01-35173-15)
13290 Epidemiological co-relates of HIV infected sexually
transmitted disease (STD) clinic attendees at New Delhi
A.S. Rathore', K. Ray2. 1553-A, Sector-3, R.K. Puram, New Delhi-110 022;
2STD Centre Safdarjang Hospital, New Delhi, India
Objectives: To determine
(a) The HIV seroprevalence in STD clinic attendees.
(b) The time trend of HIV infection and its interaction with STDs.
(c) The epidemiological characteristics of this high risk group.
Methods: The patients attending the Regional STD Teaching, Training and
Research Centre, New Delhi, were subjected to clinical and laboratory diagnosis
of HIV and STDs. All confirmed HIV infected cases from 1990 to 1997 were
included in the study.
Results: A total of 19840 clinic attendees were screened for HIV, 96 were
found to be seropositive, none of them had signs/symptoms of ARC/AIDS. The
prevalence was 4.8 per thousand. The incidence of HIV seroconversion amongst
confirmed STD patients has risen from 3 per thousand in 1990 to 43.6 in 1997.
54 per cent of STDs, were ulcerative. Over the time the incidence of HIV infection
in females rose 10 times. Most affected age group was 21-30 years. Transport
workers (41.7%) and unskilled migratory labour (32.3%) constituted majority of
HIV positives. All the females and 97.4 per cent males were heterosexual. Two
men reported having sex with men. About 95 per cent males and 21 per cent
females were promiscuous.
An increasing trend of HIV sero-conversion was observed. Syphilis was the
commonest STD. The incidence in Indian women has been increasing rapidly
due to high promiscuity and gender superiority in males. The mobile people like
long distance lorry staff and migratory labour are affected more due to ignorance.
Homosexuality is under-rated in our culture.
132911 HIV prevalence among male patients attending sexually
transmitted disease clinics in Kuwait, 1996-97
Rashed Al Owaish', S. Anwar', P. Sharma2, S.F. Shah'. 'Department of
Community Health PO Box 12227 Al Shamieh 71653; 2University of Kuwait,
Kuwait, State of Kuwait
Objectives: To determine the prevalence of HIV infection among male patients
with sexually transmitted diseases (STDs) in Kuwait with emphasis on the source
of infection.
Methods: A cross-sectional survey was conducted among the STD patients
who visited the Family Planning Clinic and Special Primary Health Care Center.
The patient data was recorded by the attending physician on a specially designed
questionnaire including sociodemographic characteristics (e.g. age, marital status, nationality, and socio economic status [SES]), type of STD, type of sexual
partners and source of infection.
Results: A total of 2591 subjects were screened during June 1996 to October
1997, which represented 35% of total STD patients attending Family planning
Center and all patients from Special Primary Health Care Center. Among the
screened, 76% were non-Kuwaitis. Most of the subjects belonged to the age
group 207-49 years (98%), were single (42.4%) and had primary/junior education or were illiterate (67.5%). Also 76% of the participants belonged to low SES
group. Among screened, the most common STD's were non-specific urethritis
(41.3%) and gonorrhea (40.5%), followed by chancroid (5.5%). As regards type
of sexual partner in Kuwait, 41.3% reported female prostitute and 18.4% reported
girlfriend.
Conclusion: There was not a single HIV positive case among those screened.
This finding is contrary to the studies conducted elsewhere. For residency purposes the HIV screening is mandatory in Kuwait making it easier to identify
the virus carriers among expatriates. Prostitution being illegal in Kuwait, such
practices are largely hidden, as prostitution does not exist as professional group
indicating that there is no indigenous circulation of the virus. Nevertheless, close
monitoring and surveillance is necessary to prevent the high risk groups from
contracting the virus through sexual transmission.
S13292 HIV/AIDS in India - Need for a national STD surveillance
system
S.N. Mishra', N.C. Bhargava', S.K. Satpathy2, J.V.R. Prasada Rao2. 'National
AIDS Control Organisation, Ministry of Health & F.W., Government of India, 5th
fl., Room No. 536/A, Nirman Bhavan, New Delhi-11001; 2Ministry of Health, New
Delhi;, India

Issue: A National STD Surveillance System needs to be developed and integrated
in the HIV/AIDS Control Programme.
Project: - All HIV/AIDS cases as reported to the National AIDS Control Programme under the Ministry of Health & Family Welfare upto December, 1997 were
collected from the monthly surveillance reports from all over the country. Modes
of transmission and the presence of various sexually transmitted diseases in the

AIDS cases were analysed. In addition, sentinel surveillance data from selected
STD clinics were also included for analysis.
Results: A total number of 71,400 HIV infections have been reported which
included 5145 AIDS cases. Out of the total AIDS cases, 3813 (74.1%) were
through heterosexual mode of transmission and 30 (0.6%) were through homosexual contact. Various other STDs were seen in 1773 (34.4%) AIDS cases which
included 1548 (87.3%) males and 225 (12.7%) females. A significant difference
was observed between male and female AIDS cases with 38.12% males having
other STDs as compared to 20.7% of females. Genital ulcer disease was seen
in 686 (38.6%), recurrent urethral/vaginal discharge in 322 (18%) and genital
warts were seen in 86 (4.8%) cases. Inguinal swelling was seen in 32 (1.8%)
cases. Sentinel surveillance data from selected STD clinics show HIV prevalence
ranging from 5% to 38% among STD clinic attendees.
Lessons Learned: Large number of AIDS cases suffers from various other
STDs. There is urgent need to develop a national STD surveillance system for
control of the epidemic in India.
S13293 HPV DNA in cervical secretion in women in relation to
HIV infection and CD4+ cell count in peripheral blood
Walentyna Mazurkiewicz', E. Firlag-Burkacka2, A. Piasek2,
E. Wiecko-Jankowska', M. Karnyska-Trypens', A. Horban2. 102-008 Warsaw
Koszykowa 82A, Institute of Veneorology, Warsaw School of Medicine; 2AIDS
Diagnosis and Therapy Center, Warsaw, Poland
1. Prevalence of HPV DNA in cervical secretion of 114 women was studied by
the Digene Hybrid Capture System HPV DNA Assy.96 of patients were HIV+: 82
intravenous drug users/IVDU/, 13 infected by sexual route and 1 by blood transfusion. 18 IVDU were HIV-. The presence of HPV DNA with high risk of malignant
transformation /types 16, 18, 31, 33, 35, 45, 51, 52, 56/ was demonstrated in
cervical secretions in 36,6% of HIV positive IVDU, in 33.3% of HIV- IVDU and
23% of women sexually infected with HIV. HPV DNA of low risk for malignant
transformation /types 6, 11, 42, 43, 44/ was found in 22% of HIV- IVDU and
38.5% of infected during sexual intercourse. Its presence was not demonstrated
in the cervical secretions of HIV- IVDU.
2. In the peripheral blood of 39 HIV+ women the mean CD4+ cell count was
calculated. The highest values were found in women without cervical HPV infection /577.2/, values 18% lower were found in women infected with HPV of low
malignant transformation risk /474/, while in women infected with HPV of high
malignant transformation risk this value was reduced by 32.7% /389/.
Conclusions: The highest percentage of HPV infections with high risk for
malignant transformation was found in cervical secretions of IVDU HIV+ as well
as in non - HIV - infected IVDU. The lowest mean peripheral blood CD4+ cell
count was noted in women with DNA of oncogenic HPV types with high risk for
malignant transformation.
S13294 A comparison of survival between HIV-1 and HIV-2 in the
Gambia, West Africa
Maarten Schim Van Der Loeff', S. Jaffar2, A. Akum', K. Ariyoshi1, S. Sabally',
T. Corrah', H. Whittle'. 1 MRC Laboratories PO. Box 276, Banjul, The Gambia;
2London School of Hygien & Tropical Medic., London, UK
Introduction: The natural history of HIV-2 is not well known. Transmission rates
are lower than for HIV-1, and the mortality ratio compared to HIV-negative people
is much less increased than in HIV-1. In 1993 we conducted a survival analysis
in a hospital-based cohort of HIV-1 and HIV-2 infected subjects, showing a longer
survival for HIV-2; now we are repeating this analysis on a much larger data set.
Methods: Since 1988, patients seen at the Medical Research Council clinic in
Fajara, The Gambia, who tested positive for HIV have been followed up. Indications for an HIV test included: tuberculosis, blood donation, sexually transmitted
diseases, commercial sex work, clinical HIV disease. Patients were invited to
attend clinic 3-monthly and defaulters were visited at home. Lymphocyte subset
analysis was performed at the start and every 6 months afterwards.
Results: Preliminary data indicate that up till 1 Oct 1996, 1387 patients above
14 yaers had been enrolled: 507 HIV-1, 473 HIV-2, and 73 dually infected; for 334
further serology assays are analysed. CD4% at enrolment was available for 1108
subjects. The proportion of HIV-1 infected subjects recruited annually increased
from 9.5% (1988) to 55.2% (1996). By 1 Jan 1997, 230 of the HIV-1 subjects had
died, 208 of HIV-2, and 43 duals.
Conclusion: Kaplan Meier survival analysis and proportional hazards regression analysis are underway and will be presented.
13295 A population-based study of specific sexual practice risk
factors for acquisition of human herpesvirus 8 infection
Jeffrey N. Martin, D.H. Osmond, D.E. Ganem, K.A. Page-Shafer, D. Macrae,
D.H. Kedes. UCSF Center for AIDS Prevention Studies 74 New Montgomery,
San Fran., CA, USA

Background: Infection with human herpesvirus 8 (HHV-8), a likely causal agent
of Kaposi's sarcoma (KS), has been shown to be more prevalent in sexually
active populations and is directly correlated with number of male intercourse
partners. Prevention of transmission, however, requires knowledge of specific
routes of sexual transmission; little to date is known about the risk of specific
sexual practices for HHV-8 infection.