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

460 Abstracts 23592-24101

12th World AIDS Conference

HIV infection among commercial sex workers in Santos city.
Project: This is a prospective studu and was performed with 707 sex workers
who realized HIV and siphilis and answer a questionaire about: work; sexual
practices with clients and partners; drug user; knowledge aboouut STD/AIDS;
health matters; preservative use. The participants were submitted to a full gynaecological examination and received counselling. The analysis was executed
in three different steps; descritive analysis of total sample; followed by univaried
contingent chart analysis, related to each variable about study and HIV result.
Result: 700 participants were analysed; a prevalence of 8.3% (n = 58) to HIV
and 14% to Siphilis (VDRL) and preliminary resullts show a high association
between drug user as crack being a highly associated factor; besides it was
observed that 22% of the soropositives are iliterate; the average media among
positives is of 32% inidicating how long they have been iin this profession and
consequently risk exposed can be determiners to combination risk.
Learned lessons: The actual research, shows us the elevate vulnerability of
the sex workers to contamination, especially among the ones who are addicted
to any sort of drug. The crack prevention is a challenge. The prevention program
is the utmost inside the developing countries, where matters such as education
and surviving highly over the spread of the epidemy.
S23592 STDs, HIV/AIDS and illegal drug consumption in prison
system of Rio de Janeiro, Brazil
Jorge Luis Fialho1, Helio R.A. Mattos2, E.J. Biondi2, L.P. Veiga2, P.G. Bauer2,
C.A. Moraes de Sa2, S.M. Santos2, I.T. Biavati2. 1Rua Senador Dantas 15 90
Andar 20031-201 Cantro Rio de Janeiro; 2Superintendencia de
Saude-Desipe-Sejint Rio de Janeiro RJ, Brasil
Issue: The Knowledge of the prevalence of infectious diseases and drug use in
a closed system with their probable interrelationship, may allow the development
of more appropriate prevention and assistance measures for inmates and their
family members.
Project: To determine prevalence of STDs, HIV/AIDS, Hepatite B and C, use
of illegal drugs and risk behaviors among 13.000 inmates of the prison system of
Rio de Janeiro, Brazil, composed of 22 interrelated units. A detailed questionnaire
was administered by health care professionals of 2.600 inmates at the prison
units of Rio de Janeiro. Those prisoners with risk behavior were offered voluntary
testing for STDs, HIV, HBV, HCV, pre and post counselling. 250 HIV seropositive
inmates were considered as control group.
Results: The questionnaires administered to a sample of 500 inmates revealed
consume of marihuana in 89 (18%), cocaine 77 (15%), both drugs 113 (23%),
crack 6 (1%). No case of heroine consumption was found 212 (42%) have never
used any illegal drug. Serum blood tests were reactive for HIV, syphilis, hepatite
B, C in 160 (32%) 19 (5%) from control group were interviewed: 13 (67%) had
history of STDs mainly syphilis (64%), all consumed illegal drugs.
Lessons learned: There is a high level of illegal drug consumption among
prisoners in Rio de Janeiro. Seroprevalence of infectious diseases and HIV
were high. It is important to develop specific prevention programmes and peer
educators for prisoners and family members to decline those high prevalences.
23593 1Trends in human immunodeficiency virus (HIV) infection
in sexually active Ghanaian women
Julius A. Addo Mingle (Prof)1, A. Asamoah-Adu2, V. Bekoe2. 1Dept. of
Microbiology, Ghana Medical School, PO. Box 4236; 2Public Health Ref. Lab.
Min. of Health, Accra, Ghana
Heterosexual transmission is the major mode of spread of HIV in most African
countries including Ghana. Prevalence rates in commercial sex workers (CSW)
and pregnant women who can be more appropriately defined as sexually active
can provide useful information on the extent of current as well as projected
epidemics of the virus in Ghana.
The dynamics of HIV spread in these two groups were analysed and the results
are presented.
Subjects & Methods: CSW and pregnant women attending STD and antenatal
clinics respectively were included in sero-epidemiologic and sentinel studies. The
clinics were sited in rural/semi-urban and urban areas in the Southern sector
of Ghana. Serum samples were tested for HIV Abs using ELISA and another
screening test. Samples that were repeatedly positive by both methods were
confirmed using INNOLIA which is a line immunoassay.
Results: 2027 pregnant women and 518 CSW were enrolled in the studies. In
the semi-rural areas the prevelence rate ranged between 2.7% to 10.3% depending on locations in 1989/90 and 2.2% to 12.8% in 1996. The urban site registered
only 2.2% in 1996.
For the CSW, the study was carried out only in the urban areas and the rates
were 2.4% in 1985 and 72.5% in 1997. There was an increase of dual reactivity
signalling an increase in high risk sexual behaviour.
Conclusion: HIV infection is increasing in these groups which has very serious
social and other implications. From our experience there was a continuous mass
movement of sexually active females in some localities studied. There is there
fore the need to evaluate the use of pregnant women and CSW as convenient
indicators of epidemics of HIV infection in this context.

23594 1 STD/AIDS counselling - A prevention strategy to sex
workers
Renata Guimaraes1, Luciana Rodrigues Villarinho2, I. Rodrigues Villarinho2.
SPraca Rui Barbosa No. 23, 4" Aundar Brasil-Santos-Sao Paulo; 2ASPPE,
Santos SP, Brasil
Issues: How to manage the development of counselling technic to a specific
population at their working or living places.
Project: Through an educational intervention project in STD/AIDS to sex workers in Santos, which has been sistematically developed since august/1993; the
counselling technic has been required and used to meet population demand
during these years practice has shown that only STD/AIDS information and
orientation through face to face contacts are not enough to supply population
needs.
Results: From 3810 sex workers inscribed since the beginning of the project,
600 are monthly reached, where each one of them receives one monthly counselling, considering that the number or monthly contacts with the population is
twice as much the number of the reached ones.
Learned Lessons: Counselling is a technic that may be used to any type of
population, reaching a great number of people. It can be done by individuals or
groups, in any acting place and by any health area pro as long as trained to do
so.
23595 1Epidemiology of HIV infection among indigent patients
Lumbila Musongela, B.K. Bila Kapita. Hopital General de Kinshasa BP 169
Kinshasa I, Rep. Dem. Du Congo
Objective: To describe epidemiological aspects of AIDS among indigents hospitalised in departmentent of internal medicine of the General Hospital.
Design: Retrospective.
Methods: Collection of demographic, sociological, medical history and clinical
data of all indigent patients admitted for hospitalisation during one year period
from July 1, 96 to June 30, 97. HIV infection diagnosis was obtained by double
ELISA test. Criteria for inclusion in the study were duration of hospitalisation at
least 5 days and ELISA test performed for outcome.
Results: 179 patients among 248 were selected for the study, 54% of women
and 46% of men. The mean age was 31 years (range 21-41) for women and
37 (range 26-48) for men. 113 patients (62.6%) were HIV positives. Chronic
diarrhoea, tuberculosis and pneumonia constitute 65% of the clinical manifestation of HIV-infection among these patients. The mortality rate of 30% among this
category of patients reflect the difficulty of management.
Conclusion: Hospitalised indigent patients have a very high prevalence of
AIDS. This may reflect the high prevalence of infection in this group population in
the city of Kinshasa. The 01 found although manageables contribute to the high
mortality due to the socio - economical precariousness and the lack of compliance
to treatment.
1 23596 Male sex work in Mexico City
Ana Luisa Liguori1, Peter Aggleton3, Juan Jacobo Hernandez2. 'John D. and
Catherine T. MacArthur Foundation, Niho Jesus 92-1, Mexico, D.F; 2Collective
Sol, Mexico D.F, Mexico; 3The Thomas Coram Research Unit, Inst. of
Education, Univ of London, London, UK
Objectives: In Mexico City, there are different types of male sex workers. This
study focueses on three of them: two that pick up their clients on the street
-transvestites and men dresses in masculine gear- and masseurs, that perform
their services in public bathhouses. Male sex work is analyzed in the context of
the AIDS epidemic and some prevention recommendations are formulated.
Methology: This study uses qualitative ethnographic and the basic technique
is in depth interviews with sex workers and with key informants.
Results: Very little research has been done on male sex workers and few
specific prevention programs have been designed for them. Although the groups
that were studied are all from a very low socioeconomic strata, their working
conditions, the personal security risks they take, and their prevention practices
vary widely.
Discussion: Neither the Mexican Health authorities nor the NGO community
have produced specific HIV prevention program for male sex workers and although some of the latter have tried to reach out to this population, their work
has been limited and insufficient. Male sex work is a high risk activity. The
lack of specific programs is a health threat first of all to thee male sex workers
themselves; secondly, to a wider population, since many of their clients are men
that besidespaying to have sex with women; and also because many male sex
workers also have female sex partners.
S24101 Integrating ethnography and virology in the study of viral
transmission in injection drug use

Michael C. Clatts', J.L. Sotheran1, R. Heimer2, K. Anderson3, L. Hoffer3,
T.M. Gallo1, P.A. Luciano1. 1NDRI, 2 World Trade Center 16 th Floor New York,
New York 10048; 2Yale University, New Haven, CT; 3 University of Colorado,
Denver, CO, USA
Issues: Drug injectors are at risk for several viral pathogens, including HIV-1,
HBV, and HCV. Factors influencing risk include the infectivity of the viruses,
background prevalence, and length of time the virus remains viable. Little is