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

452 Abstracts 23548-23552

12th World AIDS Conference

Variable 1990 1991 1992 1993 1994 1995 1996 1997
Number 1,826 3,286 4,335 4,301 4,380 5,439 5,153 253
HIV% 0.43 0.60 0.16 0.25 0.3 0.3 1.0 1.1
C.I. 95% 0.20- 0.38- 0.07- 0.13- 0.19- 0.16- 0.04- 0.30 -0.83 0.92 0.31 0.44 0.55 0.44 0.24 3.19
Partial information to March 15, 1997
Conclusions: These results reinforce that these groups once considerate with
high risk factor for transmission the HIV, nowadays the prevalence is low comparison with other groups. The 1-% prevalence found in 1996 compared with the
0.43 in 1990 shows a slow increase.

1235481

Establishment-based STD/HIV-IEC Intervention to
identified fun houses and illegally operating
entertainment establishments in depressed areas of
Tondo community

Nenita Ortega1, Arnold Dendiego2, N.M.C. Sescon Jose2. 1066 Remedios
Street, Malate, Metro Manila, Philippines
Issue: Since the crackdown of all operating male and female entertainment establishments in 1992 by the City of Manila, most of the sex workers have migrated
to different areas like Pasay and Quezon City and in nearby provinces. Few have
shifted into freelance sex work while others continued in the establishment that
are illegally operating in the depressed areas with in the City of Manila particularly
in District I of Tondo, Manila. Because of the condition and proximity in the heart
of the city, there is seldom monitoring of activity which is being conducted by the
Manila police authorities providing them protection.
The increase in the number of female sex workers in the unregistered entertainment establishments in the area has brought about various concerns regarding
the health status of the sex workers, especially in the area of HIV/AIDS and
reproductive health.
This area is requiring intensive, target specific health education intervention
program and activities.
Methodology: Community based outreach activities has been considered as
one of the main strategy. Through this activity, target groups and individuals
were tapped by the outreach IEC activities establishment-based. It also identify
immediate needs of the target that require immediate action in the field of health
education intervention program.
Result: It was observed that through IEC activities and medical services being
provided by the project, the knowledge of the project partners has been upgraded. There is an increase in the number of project partners who availed the
STD medical services as well as demand for condom supplies.
Access and penetration into existing unregistered entertainment establishments
has proved to be difficult, because they do not want to be identified as illegal sex
industry operator and traders.
123549 | Behavioural aspects of HIV infection amongst the sex
workers of Agra
Mohammad Aijaz Khan. ICPO ICMR Mamc Campus Bahadur Shah, Zafar Marg
New Delhi, India
Objective: To study the psycho-social and Behavioural aspects of HIV seropositivity amongst the sex workers.
Methods: The present study is based upon 10 months of experience of health
survey of behaviour amongst the sex workers in the red light area of Agra. It
was carried out on 90 sex workers in the age group between 15 and 40 years
(26.89 + 6.0). They hailed from various states of India and majority of them were
uneducated. The information was recorded on a specially prepared proforma.
Health care education and counselling on prevention of STD and HIV infection
was carried out during the interview.
Results: In the beginning of he study very few workers (6%) were aware
of AIDS disease. Though some of them (10%) were aware on the usefulness
of condoms but practically none of them were using the same. However, after
providing the health care education and intervention counselling by the author
(MAK) to the sex workers 27.7% of the sex workers ensured that all their clients
used condoms regularly. STD were detected in 16.6% through case histories and
clinical examination. Serum VDRL is done for STD patients. Seven (7.7%) sex
workers were found positive for either HIV1 or HIV2.
Conclusions: Presently, the prevalence of both HIV1 and HIV2 infection
amongst the female sex workers in Agra indicates that there is a need for an
intensive health care education programmes to affect behaviour change and STD
control amongst the high risk groups.
23550 Men who have sex with men and also inject drugs
(MSM-IDU): A profile of the group at highest risk for HIV
transmission in Denver
Sheana Bull, P. Piper, C. Rietmeijer. Denver Public Health 605 Bannock St.
Denver CO, USA
Objectives: Men who have sex with men and also inject drugs (MSM-IDU) are
currently the group at highest risk for acquiring and transmitting HIV in Colorado;
it is also estimated that HIV prevalence rates among MSMIDU are higher than
would be expected on the basis of the additive effects of being MSM or injecting

drugs. We conducted a survey among MSM-IDU in Denver to better understand
risk behaviors and develop interventions in this population.
Design: Community-based survey in a purposive sample of MSM-IDU in Denver.
Methods: Survey data on sexual and drug risk behaviors were collected with
MSM-IDU; eligible participants have had sex with men and injected drugs within
the past six months.
Results: Of 85 men surveyed to date, 44% report HIV infection. Consistent
condom use (defined as using condoms all the time) varied by type of partner and
sexual activity from 5/45 (11%) for receptive anal sex with main male partners to
16/50 (32%) for receptive anal sex with non-main male partners. Injectable drugs
of choice included cocaine (reported by 88%) and methamphetamine (reported
by 55%), while heroin was injected by only 18% of the sample. Needle sharing
was reported by 35% of the sample, and among those who shared, 38% used
bleach consistently to clean their syringes. Sex while high on drugs was reported
as frequent by 46% of the sample and was associated with less condom use with
female partners. Risk behaviors differed little by HIV status. Among HIV-infected
men, 98% felt it was important to avoid infecting others, but none reported consistent condom use for all types of sexual encounters. Also, 33% of the HIV-infected
men shared needles and of these, and only 7% report consistent bleach use. Sex
while high on drugs was reported as frequent for 31% of this group.
Conclusions: These data show that MSM-IDU are engaging in multiple risk
behaviors that may have a synergistic effect on HIV transmission. There do not
appear to be consistent differences in preventive behaviors between men with or
without HIV infection, which, in combination with a 44% HIV prevalence, suggests
a greatly increased risk for HIV transmission in this group of men and their
partners. Targeted intervention strategies for this group are urgently needed.
23551 ]Correlates of HIV infection among incarcerated women in
Vit6ria, Brazil
Angelica Miranda1, M.C. Viana2, P.R.M. Vargas2. 1Rua Luiza Grinalda, 207 Villa
Velha-Espirito Santo; 2 Universidade Federal do Espirito Santo Vitoria, Brazil
Objectives: To identify the patterns of HIV-related risk behavior among female
prisoners in the Espirito Santo State Prison in Vit6ria, Brazil.
Design: Cross-sectional study.
Methods: The study was conducted from March to September 1997. All
participants were systematically interviewed through a questionnaire exploring
demographic information and patterns of risk behavior, constructed for the purposes of this study. A blood sample to determine HIV and HCV serostatus was
collected.
Results: One-hundred-twenty-one women were assessed out of 122 invited to
participate (response rate of 99%). Twelve women (10%) were HIV seropositive.
Regular condom use was not frequent (21.5%). Regular anal and oral sex were
reported by 18% and 80%, respectively. Homosexual and bisexual activity was
reported by 4% and 11% of the sample. 54.5% reported previous or current
drug use and 11% had experienced IV use. Previous alcohol abuse and tobacco
smoking were reported by 49% and 70%; 16% received blood transfusions, 24%
had at least one body tattoo and 19% were HCV infected. Condom use and sexual
activity were not associated with seropositivity. All of the other factors reported
were correlated with HIV infection: previous or current drug use (OR 10.8; 95%
CI 1.4, 86.6), IVDU (OR 14.6; 95% CI 3.7, 57.1), alcohol abuse (OR 6.1; 95%
CI 1.3; 29.3), tobacco smoking (Fisher's Exact Test p = 0.017), blood transfusion
(OR 4.8; 95% CI 1.4, 17.4), body tattoo (OR 5.5; 95% CI 1.6, 19.1) and HCV (OR
12.5; 95% CI 3.3, 46.8)
Conclusion: Such findings point out to the urgent need for education and
prevention activities during imprisonment, as most of these women are sexually
active and pose a high risk for heterosexual and vertical HIV transmission. Since
high rates of drug abuse in prisoners are associated with HIV seropositivity,
imprisonment provides a special opportunity for the implementation of treatment
programs and preventive measures targeting drug abuse.
23552 Low HIV seroprevalence in spite of high risk behaviour in
nine Swedish prisons
Kerstin KilI1, R. Thorstensson2. 1Runslingan 39, 18772 Taby; Beroendecetrum
Nord Stockholm; 2Shittskyddsinstitutet Stockholm, Sweden
Background: The high prevalence of injecting drug users (IDUs) in many prisons
make them a risky environment for HIV. Within the European Network on HIV and
Hepatitis Prevention in Prison, funded by the European commission, a common
study of HIV and hepatitis prevalence and risk behaviour was performed in eight
country members of the EU in 1997/98. The Swedish study was done in October
1998.
Method: All short term, regional prisons within 170 kilometers from Stockholm,
one female and eight male prisons, were investigated in Sweden. The method
was a voluntary, anonymous, linked questionnaire and saliva antibody testing.
Murex ICE HIV-1.0.2 was used for HIV screening and confirmation was done with
western blot HIV-1 (version 2.2), Diagnostic Biotechnology.

Results: Of 386 inmates 305 (79%) participated, 34 women and 271 men.
After logical checks 302 individuals remained to be analysed. 65% were injecting
drug users (IDUs). Five (all of them IDUs) were HIV seropositive (3%). Four were
aware of their infection. All female and 95% of the male IDUs were previously
tested for HIV antibodies. Of the male IDUs 30% had shared needles last injection
before going to prison, 70% had injected in prison, 56% had shared needles last
injection in prison and 6% had taken their first injection in prison.