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

12th World AIDS Conference

Abstracts 33203-33208 633

S33203 Peculiarities of AIDS/STDs prevention work by NGO in
prison settings in St. Petersburg region
Yakov Kucherov. HPFI, PO. Box 16 Saint-Petersburg, 195197, Russia
Objectives: To outline the most effective ways of AIDS/STDs prevention work
in prison communities as the most difficult to reach contingents vulnerable to
AIDS/STDs and communicable diseases' epidemics.
Methods: Establishing good personal relations with the Prison authorities and
medical staff of the Central Department of Interior, their support to find foreign
partners and twins through participation in two WHO's projects MCAP AIDS and
Health in Prisons. Material and financial support to promote healthy environment
in prisons for inmates and prison staff could established long-tern contract relations and access to inmates and administration of some prison settings and
formerly secret information concerning the number of inmates and the staff in the
Region as well as the situation with health promotion, nutrition and medication for
prisoners.
Results: For the first time in Russia's history a Contract of Collaboration
between NGO -The International Charity Foundation for Health Promotion in
Prisons (HPFI) - and the Prison Authorities was signed last year that allowed to
plan the work on prevention of AIDS/STDs and other communicable diseases on
a long-term basis and attract the internationally recognized experts from WHO,
UNAIDS and the International Council of Prison Medical Services for inspections
and counseling. The intermediate role of the Foundation was recognized internationally by its inclusion into a list of the permanent members of the WHO's
Project "Health in Prisons" to present (equally with the Prison authorities of Saint
Petersburg) the interests of the prison communities of Russia on the whole.
Conclusions: To work successfully on AIDS/STDs prevention with such a
difficult to reach and cooperate with Department as the Prison Service on stable
and long-term basis an NGO should establish fruitful international relations with
Western counterparts (both the NGOs and Prison Medical Services) first, find
its own sources of earning money inside Russia to promote the supplies of humanitarian support to inmates in food, clothes and recreation and medical staff in
medication, last achievements of medical science and methods of treatment.
33204 Ensuring blood safety in Latin American and the
Caribbean (LAC): A cost-effective strategy
Paloma Cuchi1, M. Weissenbacher2, G. Schmunis3, R. Mazin-Reynoso3,
F. Zacarias3. 1UN Programme on HIV/AIDS UNAIDS, 525 Twenty Third St NW
Washington DC 20037; 3Pan American Health Organization Washington DC,
USA; 2UN Programme on HIV/AIDS UNAIDS Montevideo, Uruguay
Objectives: To collect and produce information to affect policies to improve blood
safety in Latin America and the Caribbean.
Methods: One questionnaire per country was completed by a national expert in
the area of hemotherapy. Information was collected on screening, type of donors,
prevalence of infectious agents, legislation, and barriers to safe blood from the
national institution (governmental or NGO) in charge of blood services within the
country. As follow up, external evaluations of the country blood bank network
have been conducted in five countries in LAC.
Results: For the initial survey, a total of 23 questionnaires (out of 32) sent
were received. Substantial improvement of blood safety strategies for blood-borne
infectious diseases had been triggered in most cases by the HIV/AIDS epidemic.
However, although HIV screening of blood ranged from 88-100%, screening of
other infectious diseases could be as low as 1% (e.g. hepatitis C). Major barriers
to achieve and sustain a safe blood supply were identified as lack of funding and
infrastructure. Follow up external evaluations in 1996-1997 indicated that many
of these factors are still in place. Economic analyses comparing cost per blood
unit ($15-110USD) versus the costs of care for any of the blood-borne diseases
($300-15,000) and the estimated cases averted make a compelling argument for
ensuring the safety of the blood safety.
Conclusions: Improvement of blood safety is a reachable and cost effective
strategy in which even the resource-limited countries should invest.
S33205 Blood safety in India through judicial and NGO activism
P.R. Gattani, I.S. Gilada, G.V. Bhimani. Indian Health Orgn. Jodhpur, Jalore
Gate, Jodhpur, India
Issues: In India 5% of an estimated 7 million HIV infections, have occurred
through contaminated blood. Half of the annual collection and supply of 2.2 million blood units, come from blood sellers, while on the other hand 40 to 50% blood
is used as single bttle transfusion for correction of nutritional anaemia. While the
Government had often shown its commitment towards blood safety, the easiest
to be achieved as compared to sexual safety thro' behavioural modification has
taken 12 years to reach good results that too is attributed to Judicial and NGO
activism supported by media.
Methods: Demand/supply of blood and its safety levels were studied by evaluating blood banks, and hospitals in Bombay. After study of 200 blood sellers in
1989, we filed a Public Interest Litigation (PIL) for blood safety in Bombay High

Court. The demographic markers, behaviour pattern, frequency of selling and
venue, STD status were in support of case. Defaulters were exposed thro' media
and judiciary. Penal actions were initiated against few. Three kinds of PILs were
filed: for Blood Safety, rehabilitation of blood sellers and for penal action against
defaulters.
Results: None of the 1018 blood banks had HIV screening prior to 1989. After
first PIL in 1989, HIV screening program was initiated in 4 metro cities in 1990

and expanded to cover 250 banks in the country meeting 50% supply by 1996.
Unhappy with the pace, the Supreme Court of India ordered for universal blood
safety and ban on blood sellers by July 31, 97; which was extended to Dec. 31, 97
at the Government request. Phase-wise up-gradation of blood banks, promotion
of judicious blood uses and voluntary blood donations and ban on professional
blood donation are some landmark achievements, though other goals have not
been achieved.
Lessons Learned: Though predominant mode of HIV transmission in India is
unsafe sex, quality of blood and Blood Banks also reflect on the epidemiology of
AIDS. From the Bombay High Court order in 1989 to the Supreme Court ruling in
1997, the judicial and NGO activism with media support is responsible for bringing
in Blood Safety.
33206 Sero-prevalence of HIV-1 and other blood borne diseases
among blood donors at Queen Elizabeth Hospital, Malawi
Augustine K. A. Barnaba. Malawi National HIV Ref Lab., Qech, PO. Box 30142,
Chichiri, Blantyre 3, Malawi
Objectives: 1. To monitor the trend of HIV, HBsAg, and Syphilis among blood
donors. 2. To find out which group of blood donors between family and non-paid
voluntary blood donors have high HIV/STD sero-prevalence.
Design: Prospective audit study.
Methods: Blood donor data from 1992-1995 was retrieved and analysed on
Epi Info 6, stratified by Age, Sex, Source of donation, Occupation, and HIV,
HBsAg, and Syphilis serodiagnosis.
Results:

Year
1992
1993
1994
1995

HIV+
23.7%
22.3%
20.3%
19.9%

HBsAg+
10.5%
7.8%
8.4%
10.4%

VDRL+
4.5%
3.5%
3.3%
4.8%

A total of 16,154 blood units were collected and analysed, 21.7% (3,506/16,154)
were diagnised HIV reactive, 9.2% (1,492/16,154) were diagnosed HBsAg positive, and 3.9% (631/16,154) were diagnosed VDRL reactive. We also found that
25.3% (2,483/9796) family donors were HIV reactive, and 16.1% (1,024/6,358)
non-paid voluntary blood donors were HIV reactive.
Conclusion: There is a downward trend in number of infected blood donations. p > 0.0005. This could be attributable to improvements in selection criteria
of blood donors. Family blood donors have highest HIV, and VDRL seroprevalence while non-paid voluntary blood donors have lowest HIV seroprevalence
especially students below the age of 20 but this agegroup have highest HBsAg
seroprevalence.
33207 Sickle cell anaemia and the risk of HIV infection in Lagos,
Nigeria
Ibironke Akinsete', Alani S. Akanmu2, R.O. Olatunji3, O.S. Njoku4. 1Dept. of
Haemotology and Bid. Transf. Luth PMB 12003, Lagos; 2Dept. of Haemotolyg,
Luth, Lagos; 3Dept. of Haemotolgy, GH, Lagos; 4Army Base Hospital, Yaba,
Lagos, Nigeria
Background: Transfusion of blood and blood products is in important and frequent modality of teatment for either veno occlussive or anaemic crises in patients
with sickle cell disease. We determine the relative risk of a patient with SCD seroconverting to HIV infection by comparing seroprevalence of HIV antibodies in
transfused and non-transfused patients with haemoglobin genotype SS in Lagos.
Method: One hundred and sixty (160) sickle cell anaemia patients who had
received at least one point of blood in the last one year were recruited. Another
eighty patients (age-matched) with confirmed Hb SS but who has never had blood
transfusion served as the control group. The were all screened for HIV antibodies.
Positive specimen were confirmed by Western blot.
Results: 6/160 (3.75%) of transfused patients were HIV seropositive. Age
range was 5-9 years. None of the eighty in the control group was positive.
Conclusion: HIV transmission through blood transfusion is very high in Nigeria. It is important that the issue of global blood safety initiative be emphasised
particularly in developing countries.
133208 India marches towards safer blood transfusion!
Jayabaskar Thiyagarajan', R. Ramanathan Ravinathan2, R. Amudhamozhi
Ravinathan3, A. Aswathaman Karthikeyan, K. Shibi Chakravarthi,
P.T. Thiyagarajan Ravinder, T. Thiyagarajan Mohankumar4. 'Kilpauk Medical
College, 74-A, Barathiar Street, Manali, Madras; 2Chengalpattu Medical College,
Chengalpattu; 3Centre for AIDS Prevention Education and Research (CAPES),
Madras; 4Madras Medical College, Madras, India
Background: Now in INDIA the blood donation by professional donors is banned.
Voluntary blood donation is encouraged. The present scenario of the transfusion
Medicine is evaluated.
Methods: In a blood bank attached to a Medical College the results of screening of blood is compared as on 1991-92 (Mar-Apr) and 1996-97. Donors were
screened for syphilis (VDRL), HBV (HBsAg-RPHA), HIV (ELISA & WBlot) and
malaria (MP). Receipients were tested for HIV after 6 months of transfusion. The
Dept. handles 5000 units every year.