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

12th World AIDS Conference

Abstracts 14114-14117 205

indicated that they carried condoms with them were asked to show them. Urine
samples for crack/cocaine and opiates were conducted with Abuscreen Ontrak
assays.
Results: Concordance for opiates was 84.68% between self reported and opiate assay measures. Rates for crack/cocaine self-reported use and urine assay
was 64.10%. Lower concordance was observed for condom use practices; thirty
six percent of the street sex workers who reported always using condoms had a
condom with them at the moment of the interview.
Conclusion: Findings reveal differences in concordance rates for type of drugs
and condom practices. Results suggest that opiate drug users are more likely to
report the use of this drug than crack/cocaine users. Results have implications
for the study of HIV risk behaviors, particular attention needs to be focused on
the validation of self-reported measures of condom use.
14114 The validation of statements by injecting drug users
(IDUs) based on the analysis of blood traces on their
used syringes
Cristina Menoyo, D. Zulaika, E. Lamikiz, A. Urcelai, I. Zubia. Plan Del Sida,
Avda. Navarra 4. 20013, San Sebastian, Spain
Issues: To study the correlation existing between the statements made by Injecting Drug Users (IDUs) and the analytical observation of their used syringes, with
regard to needle and syringe non sharing and HIV serology.
Project: A survey was carried out on 137 IDUs participating in different Needle Exchange Programmes (NEPs) throughout the Basque Country. The used
syringe they handed over in exchange for a new one was kept to study the "DNA
fingerprint" and the presence of HIV.
Results: The DNA fingerprint carried on 123 syringes belonging to different
injectors who stated that they had not shared them with others IDUs, confirmed
that this was so 121 (98%) of the cases. The HIV analysis applied to the 137
syringes and 63 (46%) had HIV antibodies. The consistency was 89% for the
cases who voluntarily declared themselves to be HIV-positive and 76% for the
cases who declared themselves to be HIV-negative. For the unknown cases, 6
(31.6%) syringes were HIV-positive.
Lessons Learned: This study supports the validity and reliability of the surveys, based on statements made by the IDU's themselves, on their behaviour. The
prevalence of HIV infection in the IDU's population must be based on detection
of antibodies againts HIV.
14115 Nigerian youth's treatment seeking behavior for STD:
Targets for intervention
Friday Okonofua1, P. Coplan2, M. Temin3, E. Renne4, K. Heggenhougen5,
J. Kaufman6. 1Women Health & Action Research Centre, No. 4, Alofoje Street,
Off Uwasota Str PO Box 10231, Benin City Nigeria, Africa; 2Merck Research
Laboratories, West Point, PA; 4Princeton University, Princeton, NJ; 5Harvard
School of Public Health, Boston, MA, USA; 3 World Health Organization, Geneva,
Switzerland; 6Ford Foundation, Beijing, China
Objectives: To identify choices made by Nigerian youth to treat symptoms of
sexually transmitted diseases (STDs) and identify targets for improving treatment
of STDs. These findings are intended to guide an intervention to reduce the
prevalence of STDs and incidence of HIV among Nigerian youth.
Methods: 510 randomly selected secondary school students in Benin City,
Nigeria were interviewed (March to April 1997) using a structured survey instrument based on qualitative research. The average age was 18 years (14-29
range).
Results: Of the 65% of respondents who reported sexual intercourse experience, 40% of girls and 29% of boys reported having ever had a STD. Sources
of treatment for STDs among youth who had had STDs were reported to be:
"chemists" (over the counter drug stores) (22%), no treatment (19%), private
physician (16%), public hospital or clinic (8%), self treatment (8%), friends or relatives (5%), traditional healers (3%), and pharmacists (3%). Men were more likely
than women to use chemists (31% vs. 17%, p < 0.033) and traditional healers
(7% vs. 1%, p = 0.028). The cost of treatment was higher at physicians/public
clinics than at chemists or traditional practitioners (US $4.69 compared to US
$3.01 and US $3.07 respectively). Reported cure rates were 69% at a chemist
or drug store, 77% by a medical doctor, and 82% after treatment by traditional
practitioners. Reasons for not using public clinics for STD treatment were cost
(58%), privacy (46%), guilty feeling at clinics (42%), long wait time (14%), and
poor medicinal effectiveness (8%).
Conclusions: Reported STDs were common, yet few youth reported seeking
treatment at private physicians even fewer at public clinics. Over the counter drug
stores were the most common source of treatment, mainly because of the lower
costs. Many youth, especially women, reported no treatment for STDs. Initial
treatment by traditional healers was infrequent. Interventions aimed at educating
youth on the importance of seeking STD treatment from physicians and facilitating
access to well-trained physicians are proposed.

I14116 Knowledge, attitudes and practices (KAP) about
HIV/AIDS and sexuality among high school students in
Tibilisi, Georgia
Carlos Del Rio1, R. Saluja1, R. Gvetadze2, T. Tsertsvadze2. lEmory University
School of Medicine 69 Butler St S.E. Atlanta, GA 30303-3033; 2Georgian AIDS
& Clinical Immunology Ct. Tbilisi, Georgia, USA
Background: Georgia, a newly independent state formed after the breakdown of
the former Soviet Union, has 50 persons reported with AIDS through Dec/97 but
it is thought that up to 700 are HIV infected. Although these numbers are small
when compared to other countries, Georgia is considered at high risk for HIV
infection because there is an increase in sexually transmitted infections (STI's),
intravenous drug use and commercial sex trade. Our study seeks to assess
knowledge, attitudes, beliefs and practices (KAP) about sexuality, HIV/AIDS and
STI's among high school students in Tibilisi, Georgia.
Methods: A descriptive cross-sectional survey was conducted in 10 randomly
selected high schools; 464 students between the ages 15-18 participated. A
standardized self-administered questionnaire, based on one used for a similar
study in St. Petersburg, Russia [AIDS 9 (suppl 1):S53-60; 1995] was applied after
informed consent. To decrease "socially desirable" responses men and women
completed the questionnaire separately. Statistical analysis was performed using
Epi-lnfo 6.0.
Results: Of 464 students -250 (53.9%) women and 214 (49.1%) men- 278
(60.8%) had engaged in sexual activity by the age of 16 but only 85 (30.6%)
reported ever using a condom during intercourse. Most students (71.4%) considered condoms protective against HIV but only 12% believed they were necessary
when partners love each other and 76% of respondents stated that condoms
can be reused after washing. The primary source of information about sexuality
were friends (75.7%) and movies. Most (72%) believed that AIDS is a disease
exclusively of homosexuals, prostitutes and drug users, 74% stated that people
with HIV should be isolated and 52% declared that they don't want to study with
an HIV-infected person for fear of contagion.
Conclusions: Students in Tibilisi, Georgia are engaging in unsafe sexual activity without adequate knowledge which puts them at risk for HIV and STI's. In
addition, misconceptions about HIV/AIDS as well as homophobic and discriminatory attitudes that may further fuel an HIV epidemic. There is a need to implement
sex education programs that address specifically issues of gender and human
rights as a HIV prevention strategy.
S14117 Antibody to Herpes simplex virus type 2 as a marker of
sexual risk behaviour in rural Tanzania
David Mabey1, Angela Obasi12, F. Mosha3, M. Quigley1, K. Munguti4,
J. Changalucha3, D. Brown2, R. Hayes1. 'London Sch. of Hygiene Tropical
Medicine Keppel Street London WCIE 7HT, 2Central Public Health Laboratory
England; 3NIMR, Mwanza; 5AMREF, Mwanza, Tanzania
Objectives: To estimate the seroprevalence of Herpes simplex virus type 2
(HSV-2) infection n a rural Tanzanian population. To examine the association between HSV-2 infection and socio-demographic and behavioural risk factors, and
thus to evaluate the use of HSV-2 serology as a marker of sexual risk behaviour.
Methods: A sero-survey was conducted in twelve rural communities in Mwanza
Region, Tanzania. The survey was nested within a community-randomized trial
of the impact of improved STD treatment services. An age-stratified random
sample of adults aged 15-54 years who participated in the baseline survey of
the trial was selected, with over-sampling of young persons aged under 25 years.
Sera from 259 women and 231 men were tested for HSV-2 antibodies using a
novel type-specific ELISA. Socio-demographic variables, syphilis serology, and
reported sexual behaviour were examined for statistical association with HSV-2
infection.
Results: HSV-2 seroprevalence rose steeply with age to a plateau of 78% at
age >30 years in women, and 64% at age >35 years in men. Prevalence was
high in young women (27% at age 15-19). Behavioural data were available on
180 women and 176 men. HSV-2 positive women and men aged <25 years were
significantly more likely to report increased numbers of lifetime sex partners. After
adjusting for age and residence, HSV-2 prevalence was higher in women who
were married (OR = 2.4), had a co-wife (OR = 4.9), were TPHA positive (OR =
5.2), or had more lifetime partners, and lower in those who travelled (OR = 0.4);
while prevalence was higher in men who were married (OR = 5.0), had lived
elsewhere in the past 5 years (OR = 4.0), had more lifetime partners, had used
condoms (OR = 3.0), were TPHA positive (OR = 6.6), or were uncircumcised (OR
= 2.6). In both sexes, HSV-2 infection was significantly associated with recent
history of genital ulcer.
Conclusions: There was a high prevalence of HSV-2 infection in this population. It is possible that HSV-2 is a significant cause of genital ulceration and that
its role in HIV transmission has been underestimated. The association of HSV-2
serology with reported numbers of sexual partners supports its use as a biological
marker of sexual risk behaviour in this population.

114118 Active surveillance of sexual behaviour amongst
homosexual men in London - Results over 2 years
Anthony Nardone, J.P. Dodds, D.E. Mercey, A.M. Johnson. Sexually Transmitted
Disease, University College London Medical School, UK
Background: The objective of this study was to establish a surveillance pro