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

116 Abstracts WePeC6135-WePeC6139

XIV International AIDS Conference

cepts of sexuality were strongly linked to STD and HIV-related prevention practices.
Presenting author: Emilia Alduvin, Proyecto PASCA, Colonia Palermo Calle 1
No. 1838, Tegucigalpa, MDC, Honduras, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeC6135 J Ethnographic assessment in Honduran female sex
workers - The Central American multicenter study
of HIV/STD and behavior
E. Alduvin', R.J. Soto2, A.E. Ghee3, M.A. Alvarenga4, C.A. Nuhez5,
K.K. Holmes3. 1National Autonomous University of Honduras, Master of Public
Health Program, Proyecto PASCA, Colonia Palermo, Calle 1 No. 1838,
Tegucigalpa, Honduras; 2PASCA / The Futures Group International,
Tegucigalpa, Honduras; 3Center for AIDS & STD, University of Washington,
Seattle, WA, United States; 4 Ministry of Health, National AIDS Program,
Tegucigalpa, Honduras; 5PASCA / The Futures Group International, Guatemala
City Guatemala
Background: An understanding of the sexuality of vulnerable groups like female
sex workers (FSW) is seen as complementary to quantitative epidemiological
surveillance. Study objectives were to identify: FSW male partner recruitment
and their relationship to prevention methods including condom use; and beliefs
related to STD care seeking behavior.
Methods: Between July and September, 2,001, a total of 30 in-depth semistructured interviews were conducted among FSW, police, pimps, and managers
of sexual establishments in Tegucigalpa and San Pedro Sula. All study participants gave verbal informed consent prior to interview.
Results: Reported client recruitment strategies varied depending on whether
commercial sex is their only income activity or not; when sex work was primary
source of income negotiation of the service cost, type of sex and condom use
were adversely affected. FSW reported inconsistent condom use especially with
stable partners and in some cases when clients paid more. FSW felt that STD
services met their needs, except for some complaints about intermittent medication supplies. The health card system was vulnerable to various forms of corruption that undermine its effectiveness as STD control mechanism. Most women
reported migrating within Honduras reflecting rural to urban migration patterns
rooted in a need to solve economic needs.
Conclusions: There are several dimensions of social vulnerability that are linked
to FSW's susceptibility to STD/HIV infection: knowledge levels, lack of job opportunities, lack of gender equity status, violence and clandestine nature of their
situation. Sanitary and legal regulations for sexual work do not appear to benefit
the health or safety of either FSW or their clients. It is important that health services go beyond a passive surveillance role, developing services that address the
social vulnerability of this group rather than solely their perceived HIV/STD risk.
Presenting author: Emilia Alduvin, Proyecto PASCA, Colonia Palermo, Calle 1
No. 1838, Tegucigalpa, Honduras, Tel.: [phone], Fax: [phone], Email: [email protected]
WePeC61361 Characteristics of HIV-infected homeless
individuals who do not receive HAART
E.D. Riley, S. Perry, D.R. Bangsberg, D. Guzman, R.A. Clark, E. Charlebois,
A.R. Moss. University of California, sfgh - 1001 potrero ave., bldg.90, 5th floor,
ucsf box 1347, san francisco, ca 94110, United States
Background: We compared characteristics of HIV-infected homeless and
marginally housed (HMH) individuals who did and did not receive HAART among
those eligible.
Methods: Between 1996 and 2001, HIV-specific questions regarding sociodemographics, housing, health care, and medication were asked among a populationbased cohort of HIV-infected HMH individuals living in San Francisco (the REACH
study). Interviews and blood draws occurred every three months. Current analyses are limited to individuals who were eligible for HAART, defined as those whose
lowest CD4 count was <500 before July 2000 or <350 during or after July 2000.
Descriptive statistics and inferences were based on ever receiving HAART.
Results: Among 269 individuals eligible, 70% had ever received HAART. This
population was comprised of individuals who were African American (40%),
Latino(a) (16%), had not completed high school (33%), were current drug users
(53%), and 40 years old on average. Half (52%) of respondents reported living
on the street or in a shelter for more than one year. After controlling for lowest
CD4 count in a logistic regression model, characteristics associated with ever
receiving HAART were living on the streets or in a shelter for more than one
year (OR=0.46) and identifying a regular health care provider (OR=2.37). Characteristics not associated with ever receiving HAART included ethnicity, sex, age,
education, health insurance, drug use (ever or current), and time period of study
entry.
Conclusions: These data suggest that the majority of eligible HMH living in San

Francisco have accessed HAART. Among individuals transitioning in and out of
homelessness, those who have experienced more than one year of street or shelter living are less likely to receive HAART The remaining 30% of HAART-naive
HMH will likely be the most challenging to reach. New outreach methods may
need to be developed to target long-term street and shelter-based individuals.
Presenting author: e riley, sfgh - 1001 potrero ave., bldg.90, 5th floor, ucsf box

1347, san francisco, ca 94110, United States, Tel.: [phone], Fax: +1
[phone], E-mail: [email protected]
WePeC6137I Repeated surveys as a tool for HIV surveillance
among IDUs: the circus project
M.J.W. Laar van de, R.J. Beuker. RIVM Dept Inf Dis Epi, RIVM-CIE, POB 1,
3720 BA, Bilthoven, The Netherlands
Background: - IDUs are a major risk group for infection with HIV. Injecting and
sexual risk behaviour may lead to further spread of HIV among IDUs and to the
general population. In the Netherlands, repeated surveys among IDUs were conducted to determine the prevalence of HIV-infection and the level of risk behaviour
in order to assess the potential for HIV transmission.
Methods: - A national, ongoing, two-yearly repeated, cross-sectional study was
started in 1991 among IDUs. Participants were recruited through methadone
care, daytime care projects, street prostitution projects and 'on the street'. A short
questionnaire on demographics and risk behaviour and a saliva sample were collected for HIV antibody testing. In 1991-2000, 15 surveys were carried out in 9
cities in the Netherlands.
Results: - In total, 4119 saliva samples were collected. HIV prevalence varied
between cities from 1% to 26%. In cities with multiple surveys, HIV prevalence
was constant in all but one city (Heerlen); in this city an increase was found from
11% in 1994 to 22% in 1999. Injecting risk behaviour through borrowing of needles or syringes was reported by 11% - 42% of participants. In one city with low
degree of urbanisation, injecting risk behaviour decreased considerably over time
(42% - 39% - 16%). Sexual risk behaviour through unprotected sexual contacts
was highly prevalent among steady partners (79% - 96%) and casual partners
(39%- 62%).
Conclusions: - Except for Amsterdam and Heerlen, HIV prevalence rates were
low to moderate in the Netherlands. HIV prevalence was stable over time in all but
one city. Injecting and sexual risk behaviour was frequently reported in all cities.
Prevention programmes should not only address injection risk behaviour but also
the promotion of safe sex. Repeated surveys provided quickly an insight into the
nature of the HIV epidemic in the hard-to-reach IDU population.
Presenting author: Marita Laar van de, RIVM-CIE, POB 1, 3720 BA, Bilthoven,
The Netherlands, Tel.: [phone], Fax: [phone], E-mail: mjw.van.
[email protected]
WePeC61 38 Knowledge of HIV serostatus is associated with
risk behaviour among IUDs
M.J.W. Laar van de, E.L.M. Op de Coul, R.J. Beuker. RIVM- dept Inf Dis Epi,
RIVM-CIE, POB 1, 3720 BA, Bilthoven, The Netherlands
Background: - In many countries, voluntary HIV counselling and testing (VCT)
is used as a major form of HIV prevention among injecting drug users (IDUs).
However, in the literature, the impact of VCT on risk behaviour is controversial.
In this study, the association between self-reported HIV serostatus, actual HIV
status and risk behaviour is examined.
Methods: - Data were collected in a national, ongoing, two-yearly repeated,
cross-sectional study among IDUs that was conducted between 1991-2000. Participants were recruited through methadone care, daytime care projects, street
prostitution projects and 'on the street'. A short questionnaire on demographics,
previous HIV testing and risk behaviour, and a saliva sample were collected for
HIV antibody testing. In the period 1991-2000, 15 surveys were carried out in 9
cities or areas in the Netherlands.
Results: - Of the IDUs, 59% (n=1089) reported to be previously tested on HIV.
Previous and current test results corresponded in 97%. Comparing to IDUs who
reported to be HIV negative, IDUs who reported to be HIV positive less often lent
their used syringes or needles to other IDUs. They also used condoms more often
in sexual contacts with steady and casual partners in the last 6 months. There is
no difference in risk behaviour between IDUs with a former negative HIV test and
IDUs with unknown serostatus.
Conclusion: - These data suggest that knowledge of HIV serostatus reduces the
level of injection and sexual risk behaviour. The encouragement of VCT among
IDUs can result in a reduction of HIV transmission in this population.
Presenting author: Marita Laar van de, RIVM-CIE, POB 1, 3720 BA, Bilthoven,
The Netherlands, Tel.: [phone], Fax: [phone], E-mail: mjw.van.
[email protected]
WePeC6139 Intake prevalence and intraprison incidence of
HIV, Hepatitis B (HBV), and Hepatitis C (HCV)
among sentenced inmates in Rhode Island, USA
G.E. Macalino1, J.D. Rich2, S. Sanford-Colby', C.M. Salas2, D. Vlahov3.
'Brown University Medical School 169 Angell St., Box GS-210, Providence, RI,
02912, United States; 2Miriam Hospital Brown University Providence, RI, United

States; 3New York Academy of Medicine, New York, NY, United States
Background: Prisons represent an important setting to study HIV, HBV and HCV.
We sought to determine the intake prevalence and incidence potentially due to intraprison risk behavior in the Department of Corrections.
Methods: Discarded intake blood on 5053 individuals (87.5% male; 59.0% white,
24.9% black, 14.8% Hispanic, 1.3% other) sentenced between 1998 and 1999