Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

106 Abstracts WePeC6091-WePeC6095

XIV International AIDS Conference

Presenting author: Francisco Bastos, Av Brasil, 4365, Biblioteca de Manguinhos # 209, 21045-900, Rio de Janeiro, Brazil, Tel.: [phone], Fax: +55
21 22702668, E-mail: [email protected]
WePeC6091] Women and aids in Brazil - epidemiological update
A.J.L. Costa1, L.L.V. Vermelho2. 1NESC - UFRJ, Rio de Janeiro, RJ, Brazil;
2Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Background: Sexual transmission pattern has changed in Brazil during 90's.
While the number of female aids cases increased the impact of perinatal infection
attained the general population and specially an unprepared national and local
health sector.
Objective: To describe the general profile and trends of the aids female cases in
Brazil.
Methodology: All the 56584 female cases aids cases reported during 1983-2001
(June) period were taken into account. Descriptive analysis was carried out on the
basis of the age, schooling, transmission category, partnership profile and national and regional epidemiological features, by period of time.
Results: The data point out that the total number of new female cases increases evey year. Meanwhile male new cases figures remain stable (around
16.000/year). The median age at diagnosis was 32 years (period 1996-2001),
higher than previous periods. Most of these women had received only elementary
education, even lower than the general female brazilian population. Sexual transmission prevailed and syringe-sharing, nothwithstanding the meaningful number
of cases, seems to lose its strenght, considering women or their partnership. Regional features were investigated and although the Southeast leadership in total
aids cases remains, all the other regions show higher proportions of new cases
and the heterosexual sexual transmission stands out.
Conclusion: In Brazil the number of female new cases is not stable, which is
probably the aids male cases trend. To worsen the situation their diagnosis seem
to be delayed and they show lower impact in mortality than men, since specific
therapy became available.
Government and society efforts targeting more vulnerable women is urgent,
through prevention, education for safer sexual activities and responsable paternity, as well as better social support.
Presenting author: Antonio Jos6 Costa, NESC - UFRJ, Av. Brigadeiro
Trompowski s/n, HU/50 andar, Ilha do Funddo, Cidade Universitaria - CEP
21941-590, Rio de Janeiro, RJ, Brazil, Tel.: +xx5521- 25626235, Fax: +xx5521
-22700097, E-mail: [email protected]
WePeC6092 Usefullness of env HMA for subtyping Cuban
strains
N. Martinez, M. Blanco, H.M. Diaz, A.L. Lubian, A. Medina, D. Romay. L/S/DA,
LISIDA, Carretera de Jamaica y Autopista Nacional, San Jose de /as Lajas, La
Habana, Cuba
Background: Heteroduplex Mobility Assay (HMA) is a rapid and cost-effective
method for subtyping HIV-1 strains compared to sequencing. As viral sequences
continue to diverge and new geographic regions are sampled the failure of
primers has been reported for the application of this technique to the env gene.
Methods: A total of 63 HIV-1 positive samples from Havana were analysed by
env HMA, using for nested PCR primers ED5-ED12, for the first round, and for
the second E57-E58 or ED31-ED33 whenever necessary
Results: Only 39 samples amplified with E57-E58; using ED31-ED33 amplified
almost all the remaining samples. In the V3-V5 region subtyping was possible
in 27 samples, the rest could be subtyped using the C2-C3 region. Only 10% of
the samples that were not amplified by E57-E58 could be subtyped in the C2 -C3 region. Subtypes A, B and C were detected, as have been reported, besides
subtype G and a considerable number of strains without a definite subtype in the
C2-C3 region could be given for the extense HIV-1 variability in the env gene, influenciated by the age of the Cuban epidemic, its origin and social and behavioral
factors in the populations studied.
Conclusions: In spite of the limitations reported for the env HMA, the technique
allowed assigned a subtype to more than a half of the samples studied and the
detection of a subtype (G) that has not been reported in Cuba by HMA.
Presenting author: Nadia Martinez, LISIDA, Carretera de Jamaica y Autopista
Nacional, San Jose de las Lajas, La Habana, Cuba, Tel.: [phone], Fax: +53
7574009, E-mail: [email protected]
WePeC6093 HIV surveillance in the State of Sao Paulo - Brazil
C.S.B. Dominques, N.M.L. Rodrigues, M.V. Tancredi, E.M.S. Brito,
A.O. Kalichman, N.J.S. Santos. STD/AIDS Training and Referra/ Center/SES-SP
Rua George Schmidt, 165, Apto. 82, Lapa, So Pauo, So Paulo, CEP:
05074-010, Brazil

Background: Due to the growth of the AIDS epidemic in the State of Sao Paulo,
the STD/AIDS State Program Disease Surveillance implemented an Information
System of HIV seropositive asymptomatics (SIHIV) in 1994, to analyze trends and
orient program action in regard to assistance and prevention, as only AIDS case
are reported in Brazil.
Methods: Implementation of an Information System in health services in the
State of Sao Paulo, reported through the Internet.

Results: From 1994 to July/01 7,693 cases were reported, 66% (n=5,074) of
which male, and 34% (n=2,619) female. The most important category of transmission was heterosexual with 3,704 cases (48%), followed by men who have
sex with men (MSM), 1,724 cases (22.4%), injecting drug users (IDU), 990 cases
(12.9%), vertical, 261 cases (3.4%), MSM+IDU, 129 cases (1.7%), blood transfusion, 44 cases (0.6%) and unknown, 841 cases (11%). The most affected age
groups were 20-29 year-olds with 3,192 cases (41.5%) and 30-39 year-olds with
2,665 cases (34.6%). Adolescents (13-19 year-olds) represented 4.7% (n=361).
As to schooling, 3,460 cases (45%) did not finish elementary school and, only 304
cases (3.95%) went to college. The illiterate represented 2.2% (n=171). Among
IDUs, low schooling prevails in both genders, 62% (n=610) with incomplete elementary school. Among MSM 25% (n=276) reported multiple sexual partners
and 11% (n=124) had HIV/AIDS sexual partners. Among the heterosexuals, 25%
(n=722) had HIV/AID
S sexual partners, 73.5% (n=531) of which were women. Pregnant women comprised 1.9% (n=145) of reported cases. One pregnant woman was a 13 year-old,
whose category of transmission was vertical transmission.
Conclusions: Knowing HIV seropositives is very important, because it allows analyzing the trend of the epidemic, reviewing the program's health care, prevention
and education targets, in addition to promoting financial analyses.
Presenting author: Carmen Domingues, Rua George Schmidt, 165, Apto. 82,
Lapa, Sdo Paulo, Sdo Paulo, CEP: 05074-010, Brazil, Tel.: [phone], Fax:
[phone], E-mail: carmenbru @ uol.com.br
WePeC694 Surveillance of syphilis, hepatitis B and Human
Inmunodeficiency virus among pregnant women
in antenatal care in Honduras
M. Sierra1, C. Paredes2, J. Soto3, J. Fernandez4, R. Hernandez2, R. Pinel2,
B. Branson5. 1 Universidad Nacional, Unidad de Investigacion Cientifica,
Facultad de Ciencias Medicas, Contiguo Hospital Escuela, Universidad
Nacional, Honduras; 2Secretaria de Salud, Tegucigalpa, M.D.C., Honduras;
3 PASCA, Tegucigalpa, M.D.C., Honduras; 4SIDACOM Project, Tegucigalpa,
M.D.C., Honduras; 5 HIV/CDC, Atlanta, United States
Background: As part of the strategies to map the HIV epidemic developed by
the Surveillance and Research Unit of the National AIDS/STI/TB programme, a
cross-sectional study was conducted in 1998-1999 that included pregnant women
in antenatal care (PWAC) attending public clinics in urban an rural areas, and social security clinics of two cities. The main objective of the study was to determine
the prevalence of syphilis, hepatitis B and HIV among PWAC in Honduras.
Methods: Once a written informed consent was obtained all participants were
asked to fill a short questionnaire and to provide a blood sample for regular testing fo syphilis. All serological samples were initially screened with RPR an titer,
and all positive samples were confirmed with MHA-Tp. A random subsample of
specimens were anonimous and unlinked tested for hepatitis B and HIV described
as follows. For hepatitis B: initial screening for Total core Ab IgG and all positive
samples were tested for Total core Ab IgM and HBs. For HIV: initial screening with
ELISA (3rd generation) and if positive a second test in the same blood sample.
Results: a total of 3,248 PWAC were included. The seroprevalence for active
syphilis (RPR with titer greater or equal to 1:8) was 0.5% (95% Cl: 0.3-0.8); for
hepatitis B (total core Ab IgG) was 6.0% (95% Cl: 5.2-6.9); and for HIV was 1.4%
(95% Cl: 1.0-1.8). HIV prevalence in PWAC was heterogeneous. HIV's prevalence
was higher in PWAC attending public urban clinics of San Pedro Sula (2.9%, 95%
Cl: 1.8-4.4) and Puerto Cortes (3.6%, 95% Cl: 1.7-6.7).
Conclusions: One of the still useful tool for HIV surveillance in general population is the implementation of sentinel sites among PWAC. HIV is a generalized
epidemic in Valle de Sula, in the north of Honduras.
Presenting author: Manuel Sierra, Unidad de Investigacion Cientifica, Facultad de Ciencias Medicas, Contiguo Hospital Escuela, Universidad Nacional, Honduras, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeC6095 A comparison of HIV-related data generated by a
HIV sentinel surveillance project and a Voluntary
Counseling and Testing (VCT) program, Botswana,
2001.
T.H. Roels1, M.G. Alwano1, V. Mwasalla1, R. Molosiwa1, K. Masupu2,
T.A. Kenyon1. 1 The BOTUSA Project/CDC, The BOTUSA Project/CDC, PO Box
90, Gaborone, Botswana; 2National AIDS Coordinating Agency, Gaborone,
Botswana
Background: Few countries do regular general population surveys to monitor the
HIV epidemic. Sentinel surveillance among pregnant women is the most common used alternative. We compared HIV prevalence and demographic factors
of surveillance participants (pregnant women) with female VCT clients to assess
whether VCT data could supplement sentinel surveillance data.
Methods: Between April 2000 and November 2001, seven VCT centers in dif
ferent health districts, tested clients (17,858 visits including 13,567 initial visits).
From July to September 2001 Botswana conducted its sentinel surveillance in all
22 health districts. HIV prevalence and demographic factors were compared in the
7 districts where both programs occurred. For VCT clients, only the information of
female first attendees was used.
Results: Mean age and single status of the 2566 pregnant women (25.3 years,
79%) and 7175 female VCT clients (27.7 years, 81%) were similar. Overall, HIV+