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

112 Abstracts WePeC6118-WePeC6122

XIV International AIDS Conference

SWePeC6 18 HIV surveillance system in Lazio region, Italy:
update to the end of 2000
D. Porta', A. De Luca2, A. Carboni2, F. Forastiere3, C.A. Perucci'. 'Department
of Epidemiology, Rome, Italy; 2Agency for Public health, Rome, Italy;
3Department of Epidemioloy Rome, Italy
Background: After the changes in the natural history of HIV infection due to the
introduction of new combination therapies (HART), HIV surveillance systems are
much more important to describe HIV epidemic. We describe the trend of new
diagnoses of HIV and the changing patterns of HIV transmission in Lazio, Italy.
Methods: A mandatory HIV Surveillance System (HSS) has been active in Lazio
since 1985. Each individual HIV-positive test is anonymously reported to the Regional Epidemiological Department, by public and private laboratories and blood
banks. The "new diagnoses" of HIV infections are identified through a recordlinkage procedure based on sex, date and place of birth. We report an update of
the data from HSS up to the end of 2000.
Results: As of December 31 2000, 44815 notifications of HIV-positive tests were
reported to the HSS, corresponding to 17853 new diagnoses of HIV infection.
The incidence rose until 1992, reaching two peaks in 1987 and 1989 (1729 and
1772 new diagnoses). From 1992 it steadily decreased to the end of 2000 (463).
Data show an increasing number of new diagnoses among women and higher
mean age at diagnosis. Data also show an increasing proportion of both men
and women reporting heterosexual contacts as risk factor and a corresponding
decrease in the proportion of injection drug users. Sexual exposure represent the
main modality of transmission for women and men, since 1992 and 1995 respectively. The decrease in mortality due to HAART led to an increase of prevalence
of people living with HIV infection.
Conclusions: Data from the HSS suggest a consistent decrease of new diagnoses of HIV, attributable in part to a decrease in the sensibility of the system.
The infection is spreading more and more in the "general" population, exposed
through sexual transmission, even though the introduction of more effective therapies could give rise to a recrudescence of the infection in high risk groups such
as men who have sex with men.
Presenting author: Daniela Porta, Department of Epidemiology ASL RME, Via
S. Costanza, 53, 00198 Rome, Italy, Tel.: [phone], Fax: [phone],
E-mail: aidsl @asplazio.it
WePeC6119 Three years of experience on HIV control in
St. Petersburg (1998-2001) among IDU's
T. Smolskaial, V. Tretiakoval, D. Ostrovsky2, S. Suvorova2, S. Ogurtcova2. 1St.
Petersburg Pasteur Institute, St. Petersburg, Russian Federation; 2NGO
Vozvrashcheine, St. Petersburg, Russian Federation
Background: To study HIV prevalence among IDUs by using sentinel surveillance techniques in St.Petersburg methods.
Methods: The sentinel group included intravenous drug users participated in the
IDU's Help Bus of outreach programme including syringe exchange. The project
involved unlinked anonymous testing of residual blood for HIV antibodies at two
sentinel sites. Each of the sites collected 120-150 syringes within 3-4 days. Blood
samples were obtained from syringes returned by drug users.
Results: The average HIV prevalence among IDU's at two sites totalled 12% in
1999, 19.3% in 2000, 35.7% in 2001. At the third stage (April 2001), residual
blood from syringes was serologically tested for viral hepatitis, syphilis and tuberculosis markers. No TB agent summary antibodies have been identified in any of
the cases. At the same time nearly every drug user (92%) had hepatitis C antibodies, every third person (33%) had hepatitis B markers (anti-HBcor summary),
6% of the all IDU's had antibodies for Tr.pallidum. On the whole, only 10 residual
blood samples (3.9%) out of 252 taken from IDU's at the third stage had no HIV,
hepatitis B and C, syphilis or tuberculosis markers.
Conclusions: The sentinel surveillance data were confirmed by a subsequent
rapid epidemic growth in St.Petersburg in 2000-2001, the incidence rate being
3-4 times higher for IDUs "in the street" than for drug injection on treatment.
Presenting author: Tatiana Smolskala, 14, Mira Street, Saint Petersburg Pasteur
Institute, 197101, Saint Petersburg, Russian Federation, Tel.: [phone],
Fax: [phone], E-mail: [email protected]
WePeC6120 HIV infection among persons of foreign origin
voluntarily tested in Spain. A comparison with
national subjects
P. Sobrino', J. Del Amo2, J. Castilla 3. 'Centro Nacional de Epidemiologia
(ISCIII), c/Sinesio Delgado 6, 28029 Madrid, Spain; 2Secretaria del/Plan
Nacional sobre Sida, Madrid, Spain; 3 Centro Nacional de Epidemiologia (ISCIII)
y Secretaria del/Plan Nacional sobre Sida, Madrid, Spain
Background: Until the year 2000, only 2.5% of the AIDS cases diagnosed in
Spain had were persons of foreign origin, but there is not information on cur
rent HIV infections. We describe exposure categories and HIV prevalence among
subjects voluntarily tested in Spain by country of origin.
Methods: HIV prevalence and exposure categories were compared between national and non-Spanish subjects voluntarily tested in 18 sexually transmitted disease/HIV testing clinics from 16 Spanish cities in 2000.
Results: Of 8861 testers, 2810 (31.7%) came from foreign countries; 73.1% from
Latin America, 9.1% from Western Europe, 6.2% from Central/Eastern Europe,

4.4% from Northern Africa, and 4.2% from sub-Sahara Africa. Among women
from Latin America, 78% were sex workers compared to 5.5% Spanish women.
HIV infection was diagnosed in 170 persons, 34.7% from foreign countries. HIV
prevalence for Spanish men (2.3%) and women (1.0%) was significantly different
to those from Latin America (11.3% and 0.3%, respectively), Sub-Saharan Africa
(9.1% and 7.5%, respectively) and women from the North of Africa (11.8%). Compared to Spaniards, analyses of persons of the same exposure category showed
higher HIV prevalence in men who had sex with men from Latin America (odds
ratio: 4.1; 95% CI: 2.4-6.9), heterosexual men from sub-Sahara Africa (OR: 19.3;
95% CI: 6.4-58.0) and Latin America (OR: 9.4; 95% CI: 3.4-25.9), heterosexual
women from sub-Sahara Africa (OR: 16.9; 95% CI: 3.5-82.4) and from Northern
Africa (OR: 15.3; 95% Cl: 3.2-73.2).
Conclusions: An important proportion of HIV testers from these clinics came
from foreign countries, mainly from Latin America. Some groups show high prevalences of HIV infection. Specific prevention and testing programmes adapted to
the needs of migrants in Spain should be developed.
Presenting author: Paz Sobrino, c/ Sinesio Delgado 6, 28029 Madrid, Spain,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeC6121 HIV seroprevalence among men who have sex
with men voluntarily tested in Spain, 1992-2000
J. Perez de la Paz', A. Barrasa', J. Del Romero2, J. Castilla 3. 'Centro
Nacional/ de Epidemiologia, Centro Nacional de Epidemiologia, ci Sinesio
Delgado, 6, 28029, Madrid, Spain; 2Centro Sanitario Sandoval, Servicio
Regional de Salud, Madrid, Spain; 3Centro Nacional/ de Epidemiologia,
Secretaria del Plan Nacional sobre Sida, Madrid, Spain
Objective: To analyse recent changes in HIV seroprevalence among men who
have sex with men (MSM) voluntarily tested in Spain.
Methods: We studied 9383 MSM who voluntarily had a test done in 10 sexually transmitted disease and HIV clinics in 9 Spanish towns between 1992 and
2000. Only patients who attended each clinic for the first time were included. We
analysed HIV prevalence according to year of diagnosis and year of birth.
Results: Between 1992 and 2000 a mean number of 1042 MSM was analysed
each year (range 962-1179). Mean age was 29.7 years, without any significant
change over time. From the 1992-1994 period to the 1998-2000 period, the proportion of injecting drug users (IDU) decreased from 2.4% to 0.9%, and the number of those who declared they exercised prostitution increased from 1.4% to
4.0%, whereas the number of those who declared they also had sex with women
remained around 4.5%. HIV prevalence diminished from 20.3% in 1992 to 10.1%
in 1996, and since then remained without significant change. Between 1992-1994
and 1998-2000 periods, HIV prevalence decreased significantly in all age groups,
but nevertheless did not lessen among IDU MSM (36.6% versus 38.5%), nor
among those who practise prostitution (25.0% versus 20.5%). In the multivariate
logistic regression analysis we observed a significant decrease in HIV prevalence
between 1992-1994 and 1995-1997 (OR=0.78; CI 95% 0.66-0.90), but this was
not the case between this last period and the 1998-2000 period (OR=0.90, Cl
95% 0.76-1.08). When adjusting by other variables (including age and year of diagnosis), we observed a significant decrease in HIV prevalence among MSM of
successive birth cohorts.
Conclusion: Although new generations of MSM are less affected by HIV, it is necessary to intensify prevention so as to reactivate the decrease in HIV prevalence
among MSM.
Presenting author: Julio Perez de la Paz, Centro Nacional de Epidemiologia, c/
Sinesio Delgado, 6, 28029, Madrid, Spain, Tel.: [phone], Fax: [phone]
7816, E-mail: [email protected]
WePeC6122 HIV infection in Slovakia - results of pilot study in
gypsy population
D. Stanekoval, S. Wimmeroval, M. Habekoval, V. Mayer', E. Ginter',
M. Kudlaekova', P Truska2. IlCPM, Limbova, 14, 833 00, Bratislava, Slovakia;
2SZU, Bratislava, Slovakia
Objectives: From 1986 to April 2001 135 HIV-positive cases were registered in
Slovakia, from them 93 were Slovaks and 42 foreigners. Just one HIV-positive
case was found in the group of gypsies. Bad economical and social situation as
well as low level of education and high level of unemployment makes this group
of people volnurable to HIV infection
Aim of the study: To determine the prevalence of HIV infection and to describe
risk behaviour of gypsy population in Slovakia.
Patients and methods: Participants were recruited in the town Zlate Klasy in
May 2001. Testing of HIV antibodies was provided voluntarily by the diagnostic kit
Vironostika Ag/Ab, Organon Teknika. and an anonymous questionnaire regarding
sexual behaviour was completed.
Results: In the group of 116 gypsies tested for the presence of HIV-antibodies no
one was found HIV-positive. 56 persons (26 males and 34 females) were involved

in the study of risk behaviour. Mean age of participants was 36.33 years. Level of
participants education was following: 77.8% grammar schools, 22.9% secondary
schools, 1.85% secondary schools with a leaving examination. Mean age of the
first sexual intercourse was 16.94 years. 76.78% of responders had steady partners, 58.2% were maried. One responder stated homosexual orientation. Mean
number of sexual partners of men and women was 2.98 and 1.12, respectively.
Most of responders proclaimed fidelity without testing as a mode of protection.