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

12th World AIDS Conference

Abstracts 23337-23341 409

Methods: The Italian Study on Occupational Risk of HIV, HCV, and other
bloodborne infections in health care workers is a propspective multicentric study,
started in 1986.
Results: Globally, data on more than 20,000 occupational exposure have
been collected; in more than 3000 occupational exposure the source patient was
HIVinfected. HIV seroconversion rates are: 0.19% (95%CI 0.04-0.54) following
percutaneous injuries [0.16% by hollow-bore needle (0.55% by blood-filled needle and 0% by non blood-filled)], 0.25% (95%CI 0.01-1.40) after mucocutaneous
contamination and 0% (95%CI 0-0.77) after non-intact skin contamination.
Conclusions: Occupational exposusure continue to represent a relevant problem in health care setting. To reduce the exposures, continuous educational
programs aimed at improving compliance to standard and universal precautions
and better safety devices are needed.
23337 Surveillance of HIV-1 accidental contamination among
health care workers in Ribeirao Preto, Sao Paulo, Brazil
Alcyone Artioli Machado1, G. Castro2, R. Abuch2, J.F.C. Figueiredo3,
R. Martinez3. 1Av Bandeirantes 3900 FAC Med Ribeirao, Preto - Sao Paulo;
2Hospital das Clinicas - Rib Preto, Ribeirao Preto SP; 3Universidade de Sao
Paulo, Ribeirao Preto SP Brasil
Introduction: In Brazil, few places carry out the surveillance for blood exposure
accidents. Potential risk for health care workers (HCW), in the University Hospital
of Ribeirao Preto, Sao Paulo, Brazil, are followed up in a special ambulatory.
Objectives: This study was carried out to investigate the risk for occupational
contamination by HIV-1 for the main causes of injury in the HCW in the Ribeirao
Preto city, and to develop preventive measures.
Subjects and Methods: 143 cases of occupational exposures in the HCW between March 1997 to January 1998 were studied. We analised: age, sex, activity,
years of employment, type of injury, material which was exposed, anatomic area,
source patient serologic status, drugs used and acceptance. The serologic test to
detect HIV-1 antibodies was the ELISA method made with third-generation EIA
KIT/Abbott. The HCW were observed 6 weeks, 3 months, 6 months and 1 year
after injury.
Results: Most of the injuried HCW were female (64.34%). The median age
was 33 years. Nursing auxiliaries (32.16%) and physicians (30.06%) were more
frequently injuried. The years of employement were from 1 to 5 years (32.16 %).
Percutaneous exposure (59.44%) with needle was the most frequent injury. The
fingers were the body areas most affected. The serologic status for HIV-1 from the
source patients was frequently unknown, what implicated in more frequent use of
the combined prophylatical therapy. The medication was well accept, but not all
HCW completed the 4 weeks course recommended. Untill now, no seroconvertion
occurred.
Conclusions: 1-No soconvertion occurred in a year observation after injury.
2-New team members, specially nurses and physicians, were at higher risk for accidents. 3-Needle percutaneous exposition was the most frequent injury.4-Devices
to increase safety against needle percutaneous injury are urgently needed. 5-HCW
need to be informed/educated about risks for occupationel exposure.
23338 The African street barber: Is he/she a risk in HIV
transmission
Vitalis Goodwell Chipfakacha. Department of Health Bag X2068 and Develop.
Social Welfare of Mmabatho 2735, South Africa
Issue: According to the World Health Organisation the African region belongs Epidemiological Pattern II of HIV transmission: - heterosexual transmission, blood
products and unsterile instruments. The African barber who services a lot of
people in all communities utilises sharp instruments, which if not sterilised may
facilitate HIV transmission.
Project: The African barber services many communities for social occasions
such as rituals and for cosmetic purposes. The street barber in particular is found
in most African cities housed in makeshift premises. A study was done to find the
knowledge, attitudes, practices and beliefs of barbers in 3 countries of Southern
Africa. 250 barbers answered a semi-structured questionnaire and were also
observed by the researcher. This was to see whether they practised what they
preached.
Results: The barbers have a high knowledge of HIV: its mode of transmission and how to prevent its transmission. However very few sterilise instruments
immediately after use or before servicing the next client.
Lessons learned: Change of behaviour does not usually correlate with the
amount of knowledge people have. The cottage industry has been also ignored by
most programmes that deal with HIV/AIDS at the work place as the questionnaire
showed.
23339 Monitoring knowledge and behavior of travellers and
temporary employed workers in high AIDS risk countries
Sanja Matovic-Miljanovic, G. LonCarevic, R. Popovic, J. Petrovic. Institute of

Public Health of Serbia, Belgrade; Olge Alkalaj 6/32, 11000 Beograd, Yugoslavia
Objectives: The aim of this paper is to monitor the existing knowledge and
behavior on AIDS of travelers and workers on temporary work in high AIDS risk
countries in order to complete the existing education material and to establish
and applicate program of organized education.
Design: Prospective study

Method: The research is done in Institute of Public Health of Serbia through
1997. on targeted population of 198 workers on temporary work in high AIDS risk
countries. As an instrument for this research, specially constructed questionnaire
is used.
Results: The research results shows that tested workers are aware that sexual
intercourse is one way of HIV transmission, but 23.4% never use condom. 26.6%
of tested workers state that HIV can be transmitted with a kiss, mosquito, flea,
or mouse bite. High percentage (92.5%) agrees that condom use is effective in
prevention of HIV infection. However, 7.5% also state that both pill and spiral too
prevent HIV infection. Those 7.5% also state that they never use a condom. Also,
unsatisfactory result is that about 30% of tested workers believe that HIV infected
person differs in its look from healthy person. Of these people. 25% never use
condom.
Conclusion: Basic knowledge on AIDS protection is present among workers.
However, there are still a significant percentage of workers whose knowledge
is not adequate, together with those whose behavior is not appropriate to their
knowledge. The result shows critical points in worker's knowledge, on which basis
the program of organized education, targeted on this group, is formed.
23340 An infection control program to decrease the risk of
occupational transmission of HIV
Aldo Vivar1, J.B. Gilman2, M. Sandoval2. I Carlos Gonzales 2S1 VR3 Maranga
Lima 32; 2A.B. Prisma Lima, Peru
Issues: Occupational HIV transmission is a potential risk for health care providers.
In developing countries such as Peru, there is a limited knowledge of preventive measures and a shortage of supplies for barrier protection. This situation
increases the discrimination of HIV-infected patients.
Project: The goal of the project was to decrease the risk of occupational transmission of HIV and other blood-borne pathogens in a large urban hospital of Lima,
Peru. The intervention consisted of: 1. Training of health care workers (HCW) 2.
Replication of the training workshops for hospital employees; 3. Development of
a hospital communication campaign; and, 4. Advocacy to hospital authorities for
the implementation of an Infection Control Committee.
Results: Between mid-1996 to late 1997, 90 HCW (physicians, nurses, housekeepers, midwives) were trained in three workshops: a. Universal precautions
and hospital regulations; b. Safe invasive procedures and c. Safe Hospital Environment. These HCW conducted replica training events of this information for
an additional 400 HCW. A communication campaign for all hospital employees
consisting of pamphlets, posters, banners and warning signs are ready to be delivered, especially in hospital high risk areas. The newly created Infection Control
Committee is working actively in the Policy & Procedure Manual. A protocol for
the Post Exposure Prophylactics to HIV is already in use. Qualitative data suggest
that trained HCW are less prone discriminate against HIV infected patients.
Lessons Learned: The training and sensibilization of Health Care Workers to
the adoption of Universal Precautions combined with clear and effective Hospital
regulations can virtually eliminate the risk of occupational transmission of HIV
and achieve the additional benefit of lessening the discrimination of HIV patients
in a hospital setting.
23341 Knowledge, attitudes and sexual practices of taxi drivers
and truck drivers/helpers
Cesar Dumayag1, Fortunata L. Baco1, Ma. Imelda Santos2. 1Occupatinal Safety
and Health Center, North Avenue Cor. Science Rd. Diliman, Quezon City, Metro
Manila; 2Bereau of Working Conditions, Department of Labir and Employment
Manila, Philippines
Background: A cross sectional survey of 200 taxi drivers & 100 truck
drivers/helpers was conducted to assess their knowledge, attitudes and practices
relative to STDs/HIV/AIDS and recommended appropriate intervention programs
to the transport industry.
Method: A structured questionnaire for drivers/helpers, focus group discussion
or key informant interviews from management were conducted.
Results: Numerous misconceptions about mode of transmission exist among
the respondents. Although, most of them will pity a person with HIV an equal
proportion (40%) will discriminate against them. Practices like alcohol drinking,
watching pornographic films, familiarity or overfriendly with sex workers who are
their passengers and usage of prohibited drugs, make them a vulnerable group.
A little more than a half of the respondents (54%) admitted having multiple sex
partners Both types of respondents (20%) confessed of doing so last year or
less than a year ago. During this occassion, only 24% (taxi drivers) and 15%
of truck drivers/helpers used condom. Majority of them suggested that the best
way to protect oneself from the STD or HIV is to avoid sexual relationships with
commercial sex workers. Moreover, they expressed the need for government to
do intensive information campaign and seminars/lectures to educate this sector
on the disease.
Conclusion: Recommendation for intervention is through access to accurate
information and intensive, continuing education for the drivers.