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

386 Abstracts 23222-23227

12th World AIDS Conference

factors on demographics and injection behaviours with HIV seroconversion was
assessed using univariate and multivariate Cox proportional hazards regression.
Results: Between 1992 and 1997, 1024 seronegative subjects were enrolled
in the cohort. Most subjects recruited were men (80%) and 81% spoke French
as their first language. The mean age was 33.8 years (range 16-62), and the
mean period of drug injecting was 10 years (~ 8.7); 59% reported cocaine as
their drug of choice, 25.2% heroin and 15.8% other drugs. The mean follow-up
time was 22.8 months and 89 IDUs seroconverted for a global incidence rate of
4.7 per 100 person-years (95%CI: 3.8-5.8). Injection behaviours independently
associated with HIV seroconversion were: booting (last 6 months): HR: 2.40
(95%CI: 1.5-3.8); gender (men as reference = 1.0): HR: 0.25 (95%CI: 0.1-0.6);
borrowing syringes from 1 HIV+ person: HR: 1.27 (95%CI: 05.-3.1); borrowing
syringes from > 1 HIV+ person: HR: 2.85 (95%CI: 1.6-5.0); borrowing syringes
(last 4 weeks): HR: 1.96 (95%CI: 1.2-3.1); injecting with regular partner (last
6 months): HR: 0.51 (95%CI: 0.3-0.8); injecting with a group of friends (last 6
months): HR: 1.61 (95%CI: 1.0-2.5); ever shared syringes in prison: HR: 1.82
(95%CI: 1.0-3.4).
Conclusion: Recent high risk injection behaviours are important predictors
of HIV seroconversion. Understanding how personal relations and networking
influence injection behaviours is crucial to target prevention interventions.
23222 1 Recovery of HIV from syringes
Beth Masters, M. Abrishanir, H. Farzadegan. Johns Hopkins University, 615 N
Wolfe St, (6614) Baltimore, MD, USA
Objective: To determine if viable HIV virus can be recovered (cultured) after
varying dry times, from pre-exposed syringes containing a known quantity of HIV.
Methods: Nine insulin syringes were inoculated with 10,000 TCID50 of MN
laboratory strain of HIV. Each syringe had a designated dry time of either 0, 1,
2, 4, 8 and 24 hrs, 1 week, 2 week and 1 month. Syringes were preloaded with
sterile PBS, to mimic the presence of drug. Approximately 0.5 cc of viral stock
was drawn up into the syringe and a 'booting' procedure was applied for 30 sec.,
after which all contents of syringe were pushed out. Syringes were stored at
room temperature for each designated dry time. Virus was recovered by drawing
up 2 cc of culture medium containing one million non-infected peripheral blood
mononuclear cells. After 2 minutes contents were pushed out, cultured for 21 days
using microculture techniques, and tested for growth by p24 antigen production.
Results: Syringes with dry times up to 24 hours were culture positive, except
for the 8 hr dry time. All syringes with dry times longer than 24 hours were culture
negative.
Conclusion: Based upon the experimental design utilized in this study, laboratory strain of HIV was recovered from syringes with varying dry times up to 24
hours.
232231 Drug treatment and HIV risk reduction among injectors in
Seattle, USA
Hanne Thiede1, J.P. McGough', H. Hagan1, G. Hansen2, J. Fields1,
S.G. Hopkins1. 1Seattle-King County Dept. of Public Health, 106 Prefontaine
Place South, Seattle, WA; 2Dept. of Health and Environment, Topeka, KS, USA
Background: We assessed changes in drug-use risk behaviors and bloodborne
infections among injection drug users entering methadone treatment in Seattle,
USA 1994-97.
Methods: We conducted a longitudinal cohort study of 784 drug injectors entering methadone treatment. A standardized questionnaire and testing for HIV,
hepatitis B (HBV) and C (HCV) were administered at baseline and at 12 months
follow-up.
Results: The follow-up rate was 81%. At follow-up 59% were in drug treatment,
91% reported injecting sometime during follow-up and 63% in the past month.
The estimated number of injections, however, declined 60% with daily injections
decreasing from 76% to 26%. Compared to those who left treatment, injectors
who remained in treatment were significantly more likely to reduce the number of
injections. Injection decreases translated into a 64% reduction in needle sharing
and a 67% decrease in backloading. Incidence of HIV, HBV, and HCV was 0,
7.0/100 person years at risk (PYAR), and 9.0/100 PYAR, respectively, among the
766, 239, and 84 susceptibles.
Conclusions: Even though injection frequency and opportunities for drug-use
equipment sharing declined dramatically, transmission of hepatitis B and C underscores the importance of both retaining injectors in treatment and providing
effective interventions in this setting to further reduce or eliminate unsafe injection
practices.
1 23224 Behaviours change's among Basque Country injecting
drug users (IDUs): 1992-1996
Cristina Menoyo, D. Zulaika, A. Urcelai, E. Lamikiz, I. Zubia. Plan Del Sida,
Avda. Navarra, 4. 20013, San Sebastian, Spain

Issues: To determine the temporal trend of the prevalence of the major risk
behaviour for HIV infection and the prevalence of this infection among IDUs
attending in Needle and Syringe Exchange Programmes (NEPs) in the Basque
Country during the period 1992-1996.
Project: Structured interviews of 100, 114 and 127 IDUs attending the NEPs
were carried out in the years 1992, 1994 and 1996, respectively. Socio-demographic data, variables related to the injecting drug use, sexual behaviour, and

the variable HIV infection prevalence were considered. For the statistical analysis
the chi-square for trends was used.
Results: The prevalence of syringe sharing (giving and/or receiving), referring
to the previous six months, fell from 53% in 1992 to 43.9% in 1994 and to 32.3%
in 1996 (X2 for trend = 9.997, p = 0.00157). The sexual risk behaviour prevalence
(not always using a condom), among sexually active injectors and referring to the
previous year, fell from 82.6% in 1992 to 73.1% in 1994 and to 61.1% in 1996 (X2
for trend = 10.445, p = 0.00123). The prevalence of HIV infection did not show
statistical significance in its trend (X2 = 5.081, p = 0.02419).
Lessons Learned: The IDU's of the Basque Country attending NEPs have
modified their behaviour. However, the IDU's still show a high prevalence of risk
behavior and a high prevalence of HIV. NEPs are necessary, but is also necessary
to carry out specific preventative measures for subgroups of IDU's.
23225 HIV-antibody testing policy and HIV-infection spreading
in IDU in Russian Federation
Iriwag Savtchenko, N.N. Ladnaya, M.S. Bochkova, V.V. Pokrovski,
E.V. Buravtsova. b. 2, 15, 8-ya Ulitsa Sokolinoi Gori, Russia AIDS Centre,
105275 Moscow, Russia
Objectives: To study the changes in HIV-antibody testing and revealing HIV-positive IDU in Russian Federation before and after the adoption of the new Federal
Law on AIDS in 08.1995.
Methods: Monthly reports on HIV-antibody testing and reports on newly identified HIV-positive persons, main risk factors of HIV-transmission in 1994-1997
were analysed in Russia AIDS Centre.
Results: Before 08. 1995 15 population groups were compulsory and mandatory tested in Russian Federation with more than 19 mln tests per year. IDU
might have avoid testing and the epidemy could have developed undergroundly.
According the New Federal Law compulsory testing was prohibited, only 2 groups
were left for mandatory testing: donors and medical personnel, working with
HIV-infected material and patients, other Russian citizens could be tested only
voluntary with counselling. Actually, there are neither changes in the number of
population groups nor in the number of persons tested in 1994-1997. HIV-positive
IDU were mainly revealed in narcological sites - 1663; in prisons - 703; as patients
with symptoms, resembling HIV-infection - 407; by contact tracing/partner notification - 226; as blood donors - 15; military men - 13, etc. Totally 3258 HIV-positive
IDU were registered in Russia: 1994 - 2, 1995 - 5, 1996 - 1018, 1997 - 2233.
Conclusion: A rapid increase in the number of HIV-positive IDU in Russian
Federation is not due to the changes in HIV-antibody testing policy, but is a result
of entering HIV the IDU population and its rapid spreading in 1996-1997.
23226 1HIV infection among younger drug injectors in Chicago,
1997-1998
Lorna E. Thorpe, Wayne Wiebel, L.J. Oullet. Epi/Bio (MC922), University of
Illinois at Chicago, 2121 W Taylor, Chicago, IL 60612, USA
Background: This study examines the HIV-related risk behaviors and the prevalence of HIV, hepatitis B hepatitis C, gonorrhea, and chlamydia among younger
injecting drug users (IDU) in Chicago.
Methods: Drug injectors 18-30 years old are being street-recruited for a
prospective study from racially and ethnically diverse community settings across
Chicago and neighboring suburbs. Recruiting is being done by indigenous outreach workers, and through respondent-driven chain referral and advertising in
print media. All respondents are interviewed with respect to drug - and sex-risk
behaviors, and each is screened for HIV, hepatitis B (HBV), hepatitis C (HCV),
gonorrhea, and chlamydia.
Results: To date, 135 study participants have been recruited, their mean age
is 25 years, 47% are women, and 30% are African-American, 25% Latino/a, and
42% White. The mean age of injection initiation is 21 years, and respondents
report having injected for an average of 4 years. Heroin is the primary injected
drug for over 90% of study participants. The main reasons cited for initiating
needle use were curiosity about injection and dissatisfaction with intranasally
administered heroin. Receptive needle sharing in the six months prior to baseline
was reported by 45% of respondents. HIV prevalence among participants is 9%
and women were more likely than men to be HIV seropositive (OR = 4.8, p =
0.036). The prevalence of chlamydia is 8% and gonorrhea is 4%, with no gender
differences. Of the 16 HBV and HCV serologies analyzed to date, 30% tested
positive for HBV and 30% for HCV.
Younger drug injectors are engaging in high rates of drug-related HIV risk
practices. The proportion of women among younger IDUs may be greater than
among older IDUs, and younger women may be at greater risk for HIV infection.
HIV prevention programs for drug injectors need to target younger users.
S23227 A typology of injection drug users: Identification of HIV
risk-behavior patterns and implications for behavioral
interventions

Neema Doshi. 1011 Gadd Rd. #318, Hixson, TN 37343-5117; The University of
Akron, Akron, OH, USA
Objectives: To develop a HIV risk-behavioral typology of street-recruited injection
drug users (IDUs) using information about their drug use, needle use, and sexual
behaviors; profile the socio-demographic characteristics of the derived types,;
and relate the typology to type-specific intervention needs.