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

12th World AIDS Conference

Abstracts 23376-23380 417

ing specific groups who carry these traits (youth, drug and alcohol users, etc.).
The social context approach, still in the process of formulation, examines such
dyad, group and collective-level factors as sexual interaction, relationship quality,
social stigma, and collective meanings as related to risk-taking. The resultant
interventions are population-based and political, focusing on social change. Both
approaches will be compared during the course of the presentation with regard to
issues of decision-making, the role of the individual, and lifestyle factors, drawing
on international experience. Emphasis will be placed on the concrete implications
of each approach for prevention programs.
Conclusions: The dominant risk-factor approach needs to be expanded to include elements being proposed by research concerning the context in which risk
takes place. A false dichotomy of individual versus population-based approaches
needs to be avoided. Rather, practitioners and researchers need to focus on
developing a new ecopsychosocial model which incorporates elements of each.
Features of a new integrative model will be proposed within the presentation.
S23376 1STD/AIDS perceptions, condom use and partner choices
among male clients attending a public STD clinic in
Guatemala City
Blanca E. Samayoa-Herrera', B. Marin2, S. Hassig3, N. Hearst2, E. Arathoon4,
A. Desalazar4. 17036 Walmsley Av. New Orleans L.A. 70125; 2University of
California, San Francisco; 3University of Tulane, New Orleans LA, USA; 4Asoc.
Guatemalteca Control Prev. Sida AGPCS, Guatemala, Guatemala, City
Background: Almost no information about AIDS/STD and condom use exists
among Latin American heterosexual males. In some Latin American countries,
heterosexual transmission is the leading cause of HIV infection. Among the
women infected in Guatemala, the only risk known was a steady male partner.
Objective: To describe information about STD/AIDS perceptions, condom use
and partner relationships among male STD clients in Guatemala City.
Method: A survey combining quantitative and qualitative items was conducted
among 75 males clients attending a public STD clinic in Guatemala City. Information regarding their STD/AIDS perceptions, condom use, and partner relationships
was obtained.
Results: Preliminary data frown 44 questionnaires show the following: Male
clients believed that their STD transmission had Occurred through sexual intercourse with a partner (31.8%) and by having sex with CSW (18.2%). Among the
respondents, 70% stated they had used condoms at least once. However of those
ever users, 64.5% did not use condoms during sex in the last 30 days. The most
common reasons for not using condoms were: decreased pleasure, knowing the
partner, and they "felt healthy". The condoms used were often obtained from
pharmacies rather than public clinics. Clients reported having a steady partner
(59.1%), casual partner (29.5%) or both types (11.4%). The perceived risk of STD
transmission from steady vs. casual partners was 3.6% and 76.5%, respectively.
Conclusion: In order to protect male STD clients and the general population,
prevention programs that promote sexual education and the practice of protected
intercourse among this population are urged.
23377 Birthplace and AIDS incidence in Australia, 1992-1996
Ann McDonald', Y. Li2, J.M. Kaldor3. 1NCHECCR 37 Victoria Street,
Darlinghurst; 2Albion Street Centre, Sydney, NSW; 3NCHECR Sydney NSW,
Australia
Objective: To describe the relationship between AIDS incidence and country of
birth in Australia.
Methods: Information on AIDS incidence was obtained through national AIDS
surveillance. Information sought at AIDS notification included sex, date and country of birth, year of arrival in Australia for cases born overseas, date of AIDS
diagnosis and HIV exposure category. AIDS incidence per capita resident population was calculated by country of birth and duration of residence in Australia.
Results: Of 3,812 (97%) people diagnosed with AIDS in Australia in 1992-1996
for whom country of birth was reported, 906 (24%) were born overseas; almost
half (429, 47%) were born in Europe. Most cases born in Australia (85%), Europe
(73-86%), North (90%) or Central/South America (79%) reported a history of
male homosexual contact. While age standardised AIDS incidence in the Australian born population (4.6, CI 4.3-5.0) was significantly higher than that in the
overseas born population (3.6, Cl 3.0-4.2), it was highest in North American born
population (12.3, CI 5.6-19.1). Of overseas born cases, 25% were diagnosed
with AIDS within 2 years of arrival; 59% were diagnosed more than 10 years
after arrival. Within 12 months of arrival, the risk of AIDS relative to the Australian
born population was highest in populations born in South/Central America (5.5,
p - 0.0005) or North America Relative risk declined with increasing duration of
stay in Australia in the South/Central American born population (p < 0.0005) but
remained high (4.0) in the North American born population.
Conclusion: While almost a quarter of Australian AIDS cases were born overseas, duration of stay in Australia prior to AIDS diagnosis suggests that HIV
infection was probably acquired in Australia in the majority of these cases.

23378 | The association of active hepatitis B and C (HBV and
HCV) infection with HIV transmission from HIV positive
male blood donors to their regular female partners
Vinai Suriyanon', P. Tanan', K. Rungruengthanakit', A. Tansuhaj', S. Sennan',
T. Nagachinta2, K. Nelson3. 'Research Institute for Health Sciences Chiang Mai
University Box 80 CMU, Thailand; 2Conrad, Atlanta; 3Johns Hopkins University
Baltimore, MD, USA
Objective: To evaluate the association of active infection with HBV & HCV with
HIV transmission from HIV infected male blood donors to their regular female
partners, i.e. their wives.
Methods: The prevalence of HIV antibodies were evaluated (repeat ELISA and
Western blot) in the regular female partners of HIV positive male blood donors at
Chiang Mai University Hospital in Northern Thailand; the men had acquired their
infection from a commercial sex worker. Women with risk factors for HIV other
than sexual contact with the HIV infected index male were excluded. Serologic
tests for HBV & HCV markers were done on both HIV positive blood donors
and their regular female partners; male index cases were tested for hepatitis B
surface antigen (HBsAg) and HCV antibodies by 2nd generation ELISA (Abbott).
Women were tested for HBsAg and antibodies to HBsAg, HCV & HIV. Serological
data on the couples were evaluated by odds ratios, 95% Cl and multiple logistic
regression.
Results: 278 couples were studied; 139 (50%) of the female partners were HIV
positive. HBsAg positive blood donors were more likely to have transmitted HIV to
their wives (O.R. = 2.21, 95% CI = 1.00 - 4.93). Hepatitis B markers in the female
were not associated with HIV seropositivity. There was no association between
HCV in the male index case and HIV transmission. In multivariate analysis the
association of HIV seropositivity in the female with hepatitis B antigen in the male
index was significant after controlling for history of STD and CD4 count (Adjusted
O.R. = 2.53, 95% CI = 1.16-5.51).
Conclusion: HIV-1 prevalence among regular female partners of HIV positive
male blood donors in Northern Thailand was high (about 50%). The association
of HBsAg in the HIV infected male index case and transmission of HIV to his wife
could be due either to higher HIV viral load in men with an active HBV infection
or to immunosuppression from HIV increasing the HBsAg carrier rate.
23379 Prevalence of HIV, hepatitis B and C and syphilis
infection in a different risk behaviour groups in Latvia
Andris Ferdats, Iveta Divberna, I. Upmace, S. Eglite, V.I. Kalnina, A. Duks,
T. Kolupajeva. 7 Klijanu Str., Epidemiologist of AIDS Prevention Centre, Riga,
Latvia
Objective: To determine the prevalence of HIV, hepatitis B (HB) and hepatitis C
(HC) and syphilis in four different risk behaviour groups: men who have sex with
men (MSM), female street sex workers (FSSW), injecting drug users (IDUs) and
prisoners (P) - female (F) and male (M).
Methods: Anonymous surveys in selected risk behaviour population groups
have conducted in April-June and October-December, 1997. Blood samples were
taken for detection of HIV 1/2 (ELISA, WB), HB (anti-HBs, anti-HBc, HBsAg,), HC
(anti-HCV) and syphilis (RPR and TPHA) infection indicators. Blood donors (BD)
were considered as control group.
Results:
Groups Anti-HIV 1 RPR TPHA Anti-HBs Anti-HBc HBsAg Anti-HCV

MSM (n = 206) 5 17
(2.4%) (8.3%)
FSSW (n =198) 0 36
(18.2%)
IDUs (n =156) 3 4
(1.9%) (2.6%)
P (n = 389) 0 15
(3.8%)
F (n = 207) 0 14
(6.8%)
M (n = 182) 0 1
(0.5%)
BD (n = 476) 0

26
(12.6%)
61
(30.8%)
17
(10.9%)
46
(11.8%)
35
(16.9%)
11
(6.4%)
4 (0.8%)

27
(13.1%)
23
(11.6%)

105
(67.3%)
155
(39.8%)
81
(39.1%)
74
(40.6%)

14
(6.8%)
23
(11.6%)
6
(3.8%)
5
(1.3%)
2
(0.9%)
3
(1.6%)
3 (0.6%)

8
(3.9%)
42
(21.0%)
133
(85.2%)
119
(30.6%)
56
(27.0%)
63
(34.6%)
6(1.3%)

Conclusion: Data suggest that MSM and IDUs are most vulnerable groups to
acquisition of HIV. However risk behaviour patterns for sexual transmission as
well as for transmission of HIV through blood are present in different population
groups. High HC prevalence may indicate transmission by intravenous drug use.
Most extensive spread of HIV may be expected among the population at higher
risk in Latvia.
23380 STD assessment and sexual contact networking in a
cohort of pregnant women attending prenatal clinics in
the Philippines
Reynaldo Imperial1, L.I. Hernandez2. Coll. of Arts & Sci., Soc. Sci. Dept. 3/F
Univ of the Phil. Mla, Padre Faura St. Manila; 2Univ of the Phils. Manila & CEMS
HAD, Manila, Philippines
Issues: Patterns of sexual contact between female sex workers and married men
in the Philippines revealed that the STD infection could spread to the general
population through subsequent sexual intercourse of these men with their monogamous wives. Researches in the Philippines had targeted populations perceived