Program Supplement [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

SLBPED90401
5 years of reproductive assistance with ivfet in HIV discordant
couples
Ravizza, Marina, Foina, Sara, Seveso, Anna, Magiarotti,
Lavinia, lerardi, Maria Grazia, Serafini, Paola, Pariani,
Sara, Ragusa, Guglielmo, Pardi, Giorgio (Italy)
Background: Sexual transmission remains by far the
predominant mode of hiv infection. Since 1990 we have been
assisting hiv discordant couples (men hiv positive and women
hiv negative) with sperm washing to reduce risk of hiv
transmission by intrauterine insemination (aih) and in vitro
fertilisation (ivfet). Aim of this study is to determine in vitro
fertilisation outcomes in 165 couples.
Methods: 165 couples underwent ivfet from 1997 to February
2001. Inclusion criteria consisted in AIH failure, female age
over 35 years, tubal factor, male factor; all women were HIV
negative. Ovarian stimulation was performed with standard
protocols used for sterile patients. Semen was prepared with
Percoll gradient washing and swim-up technique and tested,
before oocytes insemination, using pcr Nasba technique.
Women were tested for hiv 6 and 12 months after ivfet and the
offspring at birth and at twelve months life.
Results: Pregnancy rate was 24.9% (64 pregnancy/ 257
embryotransfers): 37deliveries, 52 livebirths, 7 ongoing
pregnancies, 16 miscarriages, 2 ectopic pregnacies, 2 voluntary
interruptions for foetal malformations. No seronconversions in
women or offspring. Indications to ivfet: AIH failure 32%, male
factor 26%, tubal factor 25 %, female age 13 %,ovarian factor
4%. 3 of the 282 treated semen resulted positive to pcr.
Conclusions: Ivfet is a safe mean of conceiving for HIV
discordant couples. Abnormal semen is frequent in
seropositive men: this is a critical information when selecting
the most suitable technique for conceiving. Sperm washing
and PCR test are today the only available methods to minimize
the infection risk in these couples.
Corresponding author: Ravizza, Marina, via a. di Rudini 8,
20142, Milano, San Paolo Hospital, Italy,
Tel: [phone], Fax: [phone],
Email: [email protected]
[LBPED90411
The effectiveness of Harm Reduction by community based
care in Arkha minority group of northern Thailand
Saksoonq, Pornpimon (Thailand)
Background: Drug (opium, heroin) used situation among
people from the Arkha hiltribe minority group is very high. The
strategy of harm reduction by community base care should be
the effectiveness strategy to control HIV/AIDS, risk behavior,
reduce drugs demand and crime and increse quality of life in
drug user group.
Method: Harm reduction by drug replacement therapy in term
of long term methadone treatment for 4 years at Saen-suk
Arkha village that have 104 household involve all 79 drugusers
(35 injecting drug users, 22 smoking heroin, 22 smoking
opium). And provide methadone daily dose by volunteer at
community center and strengthen on counselling, awareness
risk behavior, and try to removing drug users from their
lifestyles in the criminal world and attracting them to socially
acceptable by leader village and village commitee.
Result: Still on methadone program 43 cases (average doses
of methadone is 15 mg) remain abstinence 17 cases, in jail 1
case, and dead io cases (HIV+). And work out of village 4

cases.The effectiveness are non new case of drug user, non
new case of HIV+ among drug users group, non injecting drug
user, so the strategy can reduce drug use and criminality and
improve quality of life of drug users (they can work in field,
take care of themselves and their kid and their family).
Conclusion: The result support the effectiveness of harm
reduction strategy by community base care is sustainable
method and suitable to control drug user group in Arkha
hiltribe minority of northern Thailand.
Corresponding author: Saksoong, Pornpimon, Pharmacy
Section, Maechan Hospital, Maechan District, Chiangrai,
Thailand, Tel: [phone], Fax: [phone],
Email: [email protected]
[LBPED90421
Removing barriers to knowing HIV status: A comparison of
testers and non-testers in Sub-Saharan Africa
Mutevedzi, Tino a', Routh, Jane/P2, Khumalo-Sakutukwa,
Gertrude', Fritz, Katherine', Morin, Steve 2
('Zimbabwe; 2United States)
Background: Voluntary HIV Counseling and Testing (VCT) is an
effective method of promoting behavior change and reducing
stigma in sub-Saharan Africa. However, utilization of VCT is still
low in African communities with a high prevalence of HIV. As
part of a demonstration study of mobile VCT (MVCT) in
Epworth, Zimbabwe, a peri-urban community near Harare, we
examined facilitators and barriers to MVCT.
Methods: The MVCT team provided free, anonymous VCT using
rapid HIV testing, and distributed educational materials and
condoms in the community. Data on barriers to VCT were
collected from a random sub-sample of MVCT clients (testers,
n=148) and from a convenience sample of people declining
MVCT (non-testers, n=6o).
Results: Among those with no prior HIV test, MVCT testers
cited logistical barriers such as limited VCT center hours of
operation (53% vs. 16%, p <.ol) and center location(53% vs.
21%, p<.o5) as the primary reason for no prior HIV test
compared to non-testers. Anxiety over being recognized was
surprisingly low in both groups (4% testers vs. lo% nontesters). While also low, worry about being labeled HIV
positive when using MVCT was higher in non-testers (8% vs.
1%, p<.ol), as was the worry that a spouse/partner would
discover use of MVCT (8% vs. 1%, p <.ol). Testers had
significantly more knowledge about HIV/AIDS than non-testers
(p<.ol), although only 43% of those tested had perfect
knowledge scores vs. 23% of non-testers. Although number of
partners and soliciting sex were not associated with MVCT use,
lack of condom use with regular partners (69% vs. 53%, p<.o5)
and casual partners (25% vs. 12%, p <.05) influenced testing
behavior, as did recent STD symptoms (15% vs. 3%, p <.o01).
Demographic characteristics of age, gender, income and
marital status did not differ significantly between testers and
non-testers.
Conclusion: Barriers to HIV testing in Sub-Saharan Africa are
often logistical and can be removed through community
outreach programs such as mobile VCT.
Corresponding author: Mutevedzi, Tinofa, UZ-UCSF Research
Programme, 15 Phillips Avenue, Belgravia, Harare, Zimbabwe,
Tel: [phone], Email: [email protected]

Program Supplement