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

12th World AIDS Conference

Abstracts 13391-13395 165

Year Pregnancy Sexual harassment
1994-95 11 22
1995-96 16 12
1996-97 00 02
The students have effectively been involved the fight and programme. The
campaigns meetings take place every wednesday afternoon and saturday morning. Eventually they have produced a final document which set the subjects of
sexual educal teaching in the gramework of MCE (Moral and Civic Education)
Lessons Learned: This programme showed to be efficient when applied with
the participation of the targeted population-the students-and the effective support
to the NGDS which struggle to reduce the rate of AIDS contamination in Africa.
Dearing in mind that the school context is the most precarious and exposed zone
to contact HIV/AIDS.
13391 Postperative complications following 191 gynecological
and obstetrical surgical interventions in HIV-infected
women
Olaf Dathe', R. Lutz-Friedrich2, T. Grubert2, A. Knobbe2, R. Kastner2,
B.H. Belohradski3, L. Gurtler4. 1Fraunhoferstr. 15, D80469 Mdnchen; 21.
Universitats-Frauenklinik, 80337 Munchen; 3Universitaats-Kinderklinik;
Munchen; 4Max- Von-Pettenkofer-Institut, 80336 Munchen, Germany
Objective: In 1995 A. Semprini showed that HIV-infected mothers are at an increased risk of post-operative complications when delivered by caesarian section
especially with severe immunosupression.
Methods: 141 female patients of the Ludwig-Maximilians-University-Hospital
(1. Frauenklinik) in different stages of HIV-disease [HIV+] underwent 191 obstetrical and gynecological surgical procedures between 1984 and 1997. Matched
pairs of non-HIV-infected [HIV-] women with equal operations were set up retrospectively. Complications were defined as major (severe infection with antibiotical
treatment, revision surgery, blood transfusion, intraoperative lesion, DIC) and
minor (wound healing impairment, fever >38"C, endometritis, mild anemia).
Results: The rate of complications [RC] was significantly higher (p < 0.0001)
in HIV+ patients with 18.3% (n = 35 cases; major 25/minor 10) vs. control with
4.2% (n = 8; major 3/minor 5). Highest RC occurred in laparotomy (70%; control
20%) followed by caesarian section (42.9%; control 7.1%) and induced abortion
(13.0%; control 2.2%). In HIV+ patients severe infection was the most frequent
complication observed in 42%, followed by secondary surgery in 18%, healing
impairment 12%, fever 8% and lesion & transfusion 6% each. Stage CDC I (at the
time of operation) had 14.2% RC, CDC II 30.2%, CDC III 15.4% (only 13 cases).
We found an increased RC in patients with low preoperative immunological status,
expressed in CD4-counts and CD4/CD8-ratio. Since 1995 viral load was tested
in 44 cases at time of operation and showed no difference in mean and median
number of RNA copies (Roche) in patients with and without complications. In the
subgroup with preoperative antibiotical treatment the RC was 27.5% (38.9% in
primary caesarian section only!).
Conclusion: Following major gynecological and obstetrical operations more
complications were observed. Also poor immunological status led to more complications. Therefore, in patients with these conditions the indication for surgery
should be well defined. Furthermore, we recommend in these cases a prophylactic
treatment with broad spectrum antibiotics.
13392 The epidemiological background for new prevention
strategies among youths and young adults
Paul Senge, J.N. Nday Ongeje. PO Box 11857 Dar Es Salaam; National AIDS
Control Programme Dar Es Salaam, Tanzania
Background: HIV prevalence is highest among the young adults (20-24, 25-29
and 30-34 year olds). This suggests considerable rates of HIV transmission at
earlier ages. The method of reporting was established in 1990 giving information
on various persons and demographic characteristics on AIDS patients.
Method: Each region in the country is issued with a pad containing sets of
forms on which all cases of AIDS are reported. All filled forms are returned and
submitted to the Epidemiology unit of the National AIDS Control Programme,
compiled and prepared for data entry and analysis.
Results: The first 3 AIDS cases were reported in Tanzania in 1983. By the
end of 1991 there were 34,208 AIDS cases reported and by December 1996 the
reported cases reached 88,667. However, these numbers are underestimated
by 4 to 6 times due to a number of problems. The prevalence of HIV infection
among women attending ante-natal clinics range between 5.5% and 23.1% in
1996. The overall cumulative AIDS case rate over 1030 per 100,000 are seen in
the age group 30-34 years among men and over 778 for 100,000 among female
in the same age group. During 1996, 3.6% of all reported AIDS cases were due
to vertical transmission.
Discussion: On this background, the Medium Term Plan III in its objectives
included: - to promote awareness on the part of the communities, to disseminate

knowledge, to redress the economic, social gender and other inequalities, to
provide appropriate treatment and to support research programmes.
Conclusion: The high infectivity among teenagers and other youths seriously
threaten Tanzania's future generation Women are manifestly at a greater risk of
HIV infection especially a girl, being susceptible to infection at an earlier age than
her peer. It is very important to develop targeted interventions for various groups,
empowering women both socially and economically.

13393 AIDS related knowledge among Brazilian youth:
Misconceptions or unveiled conceptions?
Simone Monteiro1 2, E.M. Santos2. 1AV Brasil 4365, 2Fundagao Oswaldo Cruz,
Rio de Janeiro, RJ, Brazil
Objectives: Recent National studies have shown that the level of knowledge on
HIV transmission, prevention and control is moderate to high among Brazilian
adolescents despite of regional differences. For instance 87.6% out of 2,464 females 15 to 19 years old (national sample of 12,612 women 15-49 years old) and
86.3% out of 575 males 15 to 19 years old (national sample 2,949, 15-40 years)
answered correctly several questions on these issues. However ethnographic
studies in Brazil have identified that this knowledge is mostly technical, normative
and does not consider the ways by which this information is apprehended.
Methodology: Results from a National survey based on a sub stratified sample
of 12,612 females and 2,949 males were analyzed through ethnographic data
obtained through in depth interviews with 22 youth (11 males and 11 females) 13
to 19 years old from a Rio de Janeiro slum. The qualitative data depict nuances
on the knowledge described by the survey since it was able to highlight how the
adolescents incorporated the information on AIDS.
Results: Despite of being convergent, that is, in both studies most of the
answers on HIV transmission and prevention are correct, it was suggested by the
ethnographic research that the youth are not able to differentiated very important
aspects of these issue. For example, they could neither explain the different
effect of contraceptive pills and condoms, nor evaluate the risk between vaginal and anal sex. These findings are crucial to plan effective AIDS prevention
programs.
S13394 Detection of HIV-1 infection in individuals treated in an
emergency service of a University Hospital, Ribeirao
Preto, Sao Paulo, Brazil
Roberto Martinez1, Alcyone Artioli Machado2, J.M.P. Pyntia3, M.L.C. Zucolotto4,
G.H. Bueno4. 1Av Bandeirantes 3900-FAC Med Riberao Preto - Sao Paulo;
2Universidade de Sao Paulo, Ribeirao Preto SP; 3Secretaria Municipal da
Saude, Ribeirao Preto SP; 4Hospital das Clinicas Rib Preto, Ribeirao Preto SP
Brasil
Introduction and Objectives: The detection of Human Immunodeficiency Virus
(HIV-1) infection in asymptomatic subjects is essential for the adoption of preventive measures and the evaluation of their efficacy in the control of the epidemic.
So-called "sentinel" programs have been set up in some Brazilian cities for this
purpose. Ribeirao Preto is the fourth town in Brazil in number of AIDS cases.
Cases and Methods: The study was conducted from 9/95 to 3/97 on patients
seen at the Emergency Unit of the University Hospital due to multiple traumatic
injuries and submitted to laboratory tests. An additional 5 ml of blood was collected from each patient and placed in a separate tube identified only by patient
sex and age (the cases remained anonymous). Serum samples were studied
for the presence of anti-HIV antibodies using a third generation ELISA HIV 1
kit (Abbott), and the positivity of reactive samples was confirmed by the gelatin
particle agglutination test (Serodia-IIV, Fujirebio brand).
Results: Samples were obtained from 468 patients aged 12 to 84 years. Twenty
of the 410 men (4.8%) were HIV positive, distributed over the 20-29 year (6.3%),
30-39 year (8.8%) and 40-49 year (4.0%) age ranges. Among the 58 women, 3
(5.2%) were seropositive, all of them aged 20-29 years.
Conclusions: The rate of HIV-1 infection among individuals with multiple
traumatic injuries was significant. There seems to be an equivalent number of
seropositive males and females, probably reflecting the penetration of HIV-1
among women in the community.
Project financed by "Programa Nacional de DST/AIDS" (Health Ministry of
Brazil).
113395 Secondary school students' knowledge and practices
towards sexuality in a urban and rural area of togo (lome
and kpele-adeta)
Yawo D. Atakouma, E. AG Bobli-Apetsianyi, K. Bassabi, K. Tatagan-Agbi,
A.R.D. Agbere, A. Gbadoe, J.K. Assimadi. Detemennt de Pediatrie Chu-Tokoin
BP 8649-Lome, Togo
Objectives: A prospective study was conducted in 2 areas of TOGO in order to
evaluate among secondary school knowledge and practices towards sexuality at
these two differents places (urban an rural).
Design: Prospective study.
Methods: The population in this study consisted of male and female secondary
school students 13 to 24 years old from which 342 (66.8%) in Lome against 170
(33.2%) in Kp ele-Adeta, 320 males against 192 females (Sex-ratio = 1.6). This
study toak place from December 16 1991 to January 8 1992.
Results: This study led to following findings:
- Secondary school students in Lome had more knowledge in sexuality than
those in Adeta (76.4% in Lome against 23.6% in Adeta; p < 0.001). The main

sources of informations of sex education are school in 51.1%, friends 25.2% and
media in 19.9% with no significant difference considering the area.
- 67.6% of them reported having had sexual intercourse already with 73.1%
in boys against 58.3% in girls; p < 0.001. Yore students in Adeta 85.9% Versus
58.5 in Lome with significant difference; p < 0.001.
- 92.5% of the secondary school student have not used any modern contraceptive method during their first sexual intercourse and only 22.4% of them are