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

872 Abstracts 43124-43128

12th World AIDS Conference

have not tested before, suggesting that home collection is being used by persons
at risk who may not access other testing opportunities. Studies are continuing
to determine the utility and potential public health impact of this new method for
consumer-controlled HIV testing.
43124 HIV counseling and testing of contacts to HIV-infected
clients by notification assistance program field staff
Helene Cross, Sindy Paul, Leg Ganges, M.S. Shumsky, I.V. Vega, M.P. Pierce,
D.H.M. Morgan, B.W. Wolf. New Jersey Dept of Hlth & Senior SVS, PO Box 363
Trenton NJ 08625 0363, USA
Issue: Although HIV counseling and testing has been widely available at numerous health care settings in the State since 1987, many cases are diagnosed
only after they become symptomatic. New developments in treatment and testing
technologies have combined to make it both necessary and possible to test the
highest risk clients early.
Project: In May of 1997 the New Jersey Department of Health and Senior
Services began using the OraSure oral test kit to screen for HIV. For the first
time, field workers who routinely locate and counsel individuals named as sex
or needle sharing partners by people testing HIV positive, were able to offer
on-the-spot HIV testing. All field workers were trained by the NJDHSS to deliver
standard HIV counseling and testing, and to administer the OraSure test kit.
Results: During the first 6 months of the program, 239 contacts were counseled. 92 had never tested, 48 had previously tested positive, 83 had previously
tested negative, 2 had tested indeterminate, and 14 had tested previously with
unknown results. 130 contacts tested with a seropositivity rate of 15.4%. Of the
20 positives, 70% had never been tested and 25% had tested previously with
unknown results.
Lessons Learned: Given the high seropositivity in this population, the known
exposure to HIV, and the number of clients tested who had not previously been
tested, this has proven to be an effective method to access the highest risk
population.
43125 Taking it to the streets: HIV testing, treatment information
and outreach in a Los Angeles neighborhood coffee
house
Michael Weinstein, C. Farthing, C. Portillo, T. Ford, J. Mendelson, M. Mallory,
G. Kenslea. AIDS Healthcare Foundation, 6255 Sunset Blvd., 16th Fir., Los
Angeles CA, United States 90028
Issue: Young, gay population vulnerable to HIV/AIDS through proximity to epicenter of gay culture and community in Los Angeles require innovative and
appropriate preventive outreach, access to HIV testing and treatment awareness.
Project: Given the risk-taking nature of youth and a complacency fostered
about possible HIV infection due to widespread and optimistic media reports of
successful combined drug therapies for HIV, an alternative prevention, testing and
treatment strategy for at-risk youth and others was developed. AIDS Healthcare
Foundation's Treatment Equals Life Division with the WEHO Lounge, the United
States' first coffee house/HIV testing and information center, was established
to bring outreach, testing and treatment information directly to the community.
Located between two of the busiest gay discotheques in Los Angeles, WEHO
Lounge includes in its staffing volunteer peer educators, clinical oversight by
AIDS Healthcare Foundation's medical director, a Treatment Equals Life program
manager and collaboration with government-sponsored HIV testing professionals. Strategies include free, confidential oral HIV testing available two evenings
per week at WEHO Lounge, weekly HIV "Cocktail Hour" community forums,
one-to-one counseling sessions by peer educators; HIV drug adherence support
groups; an HIV/AIDS resource library and youth resource library; & HIV treatment
education accompanied by the distribution of condoms.
Results: Treatment Equals Life's WEHO Lounge opened in the spring of 1997.
Testing began on July 29, 1997; by the end of the year, 360 people had been
tested. Since June 6, 1997, more than 12,000 condoms have been handed out
(free) at WEHO. To date, this concept for bringing HIV testing and information
directly to the streets where people congregate has proven to be highly successful.
Lessons Learned: Treatment Equal's Life's WEHO Lounge demonstrates that
Testing and Outreach efforts placed directly in the community in a non-traditional
Community Site are potentially successful if they are specifically addressed and/or
adapted to meet the specific needs, habits, patterns and understanding of the
targeted at-risk populations.
43126 Are Russian HIV-antibody surveillance data true?
Eugenia B. Buravtsova1, A.T. Gouliusov2, M.S. Vorobiova3, G.A. Lomonova3,
V.V. Pokrovski1. 1'B2, 15, 8Va Ulitsa Sokolinoy Gory, Moscow 105275, Russia
AIDS Center; 2Russia Ministry of Heath; 3Tarasevith Institute of Standartization,
Moscow, Russia

Objectives: To determine the quality of HIV-antibody tests produced in Russia in
order to compare with national surveillance date which indicated that only 1535
persons from 19593490 tested for HIV-antibodies were found positive in 1996.
Methods: 15 HIV 1 and HIV 1/2 antibody test-kits produced by 13 Russian
factories were tested with the special Russian national panel of HIV-antibody
positive and negative sera and BBI Anti-HIV-1 low titre Panel (PRB106) and AntiHIV-1 Seroconvertional Panel (PRB931). One samples of test -kits were taken

from factories and another one from local diagnostic laboratories where kits had
been distributed previously.
Results: Sensitivity and specificity of 3 kits were 100% and these kits recognized all low titre positive sera from BBI panels. 8 kits had 100% specificityy and
99.4-99.9% sensitivity and did not recognize 1 or 2 low titre sera. Only 4 kits
had sensitivity from 83.4 to 99.2% and specificity from 71.6 to 99% and 2-4 sera
from BBI panels were not recognized as positive. The quality of kits taken from
local laboratories was lower than the quality of kits taken from factories probably
as a result of a distant transportation. Using of the 4 kits with poor results were
prohibited in Russia and only 3 kits with the better results were permited for blood
testing as a result of the present study.
Conclusion: The quality of HIVantibody test-kits which were produced in Russia and which had been used for testing of the Russian population was satisfactory
for the purpose of the surveillance for HIV-infection. However the prohibition of
low sensitive kits will improve data for 1997.
43127 Trends in HIV testing among US adults, 1993 to 1996
Deborah Holtzman, S.D. Bland, D.V. McQueen. Centers for Disease Control and
Prev. 4770 Buford Hwy NE MS-K30, Atlanta GA, USA
Objectives: HIV testing data and changes in rates over time are useful in tracking
the epidemic and assessing the effectiveness of testing as a prevention strategy.
The purpose of this study was to examine the prevalence of voluntary HIV testing
among the general US adult population and to determine if testing rates have
changed from 1993 to 1996. These rates were further examined to see if they
varied by perceived HIV risk.
Methods: Data are from the 1993-1996 Behavioral Risk Factor Surveillance
System (BRFSS). The BRFSS is a state-specific population-based, random telephone survey that collects information monthly from US adults, >18 years of age.
AIDS-related questions were asked only of adults <65 years. Using weighted
data and aggregating across states, annual prevalence estimates and 95% confidence intervals were calculated for voluntary HIV testing for 1993 to 1996. Annual
rates of HIV testing and changes in rates by categories of perceived HIV risk
(high, medium, low, none) were then calculated and compared to see if patterns
emerged by risk over time. The range of respondents who provided usable data
over the four-year period was 82,021 to 97,385.
Results: In each year, a majority reported their risk of HIV as low or none
(range = 89.9%-92.6%) compared to medium or high (range = 7.5%-10.2%).
From 1993 to 1996, a significant increase was found in the percentage who
reported being voluntarily tested for HIV (13.8%; 95% Cl = 13.4-14.2 in 1993 and
23.2%; 95% CI = 22.9-23.7 in 1996). This represents almost 35 million adults
aged 18-64 years who were tested in 1996 to see if they were infected with HIV.
Except for changes from 1994 to 1995 among those at medium or high risk for
HIV, increases were found each year within each of the four risk categories. From
1993 to 1996, however, the percent increase in voluntary testing among those at
no risk (78%) was substantially greater than that among those at high risk (36%)
for HIV.
Conclusion: The results show that voluntary HIV testing among US adults has
increased from 1993 to 1996. However, a greater rate of increase in testing over
time was observed for those at low or no risk compared to those at medium or
high risk for HIV infection. Trends in HIV testing, particularly by risk status, should
be continuously monitored, as these data show a critical need to step up efforts
to promote testing for individuals at increased risk for HIV infection and prevent
the further spread of infection in the United States.
143128 Sharing HIV test results with the partner
Michael T. Kelly1, S. Weinreich1, I. Kayawe1, G. Phiri1, S. Chama1,
R. Baggaley2. 1c/o Kara Counselling and Training Trust, PO. Box 37559,
Lusaka, Zambia; 2WHO, Geneva, Switzerland
Objectives: 1. To determine if attenders of Voluntary HIV Counselling and Testing
(VCT) share their test results with their partner. 2. To determine clients' knowledge
of their partner's HIV serostatus
Methods: A random sample of 377 attenders of VCT in Lusaka, Zambia, were
interviewed using in-depth interview techniques at 3 times: time 1 (one week after
having received their test results), time 2 (1-6 months after), time 3 (7-12 months
after)
Results: 68% of the study sample were male and 32% female. 14% of the
male and 26% of the female tested seropositive. The majority of clients attended
VCT as individuals, few clients attended as a couple. Six months after receiving
their test reults the majority said that they had disclosed their status to at least one
person. More seronegative than seropositive people had done so. Often people
preferred to share their test results with friends and relatives rather than with their
partner. However over time most of the people were able share test results with
their partner. Common reason for not having disclosed a seropositive result to
the partner was fear of rejection. Some seropositive people said that they did not
want to trouble their partner. People with seronegative results often feared that
they would be rejected because they had gone for an HIV test. Clients who shared

test results with their partner often said that they did so because they wanted
their partner to be HIV tested themselves. Many said that they felt comfortable
sharing because they were being supported by their partner. The majority said
that their partner was not HIV tested. Most people would have liked their partners
to be tested. However often the partner did not want to discuss HIV testing. Many
felt unable to discuss HIV testing because of fear of negative consequences, as
being rejected.